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Getchya Head Outta

the Game
Rohit Vepa

Mrs. Elizabeth Chung

Independent Research G/T

13 March 2016
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Like many other high school athletes, Chris Coyne would do anything for his team even

if it meant putting his body on the line. After a brutal helmet-to-helmet collision in football

practice, Coyne knew that he had sustained a fifth concussion. He reasoned that, since he was the

senior captain of the team and there was only a week left in the season, he should just keep his

injury to himself. He avoided the coaches and trainers in order to make sure they didnt notice

his condition and prevent him from playing. I put pressure on myself to do well and not to let

my teammates down, said Coyne. He didnt realize the risks he was taking until he suffered a

sixth concussion in his freshman year of college. His symptoms were so severe that he had to

rely on a note taker in school as well as take medication for his wandering attention. It wasnt

until two years after his sixth concussion that he felt symptom free.

A concussion, or traumatic brain injury (TBI), is a serious danger. Of the 1.4 million

Americans who seek medical treatment for traumatic brain injuries each year, 50,000 die and

more than 80,000 of have long-lasting symptoms that affect their daily lives. ("Exploring Why

Traumatic Brain Injuries Go Undiagnosed, n.d.). A TBI occurs when an impact to the head

causes the brain to bounce around inside the skull. To recover the brain needs special

accommodations such as rest and food, but if the TBI is not reported these accommodations

cannot be made. High school athletes are especially at risk of not reporting their concussions

because they may be trying out a new sport or pursuing a college scholarship often while

disregarding the safety risks. These unreported concussions pose a major threat to student

athletes due to the absence of physical symptoms that make diagnosis of concussions difficult,

the lack of knowledge regarding the consequences unreported concussions impose, the influence

of the culture of sports on decision making, and the scarcity of data on concussions in youth.
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Due to the fact that symptoms are often noticeable only to the person who has sustained a

concussion, head injuries easily go undiagnosed and untreated. Concussions, also called the

invisible disease, may have no physical symptoms, which makes it hard for another individual,

like a coach or trainer, to identify the concussion. According to the Institute of Medicine,

diagnosis is based primarily on the symptoms reported by the individual rather than on

objective diagnostic markers (Institute of Medicine & National Research Council, 2013). If a

student athlete chooses not to report the TBI, they are choosing to continue their day-to-day

activities without receiving treatment. In addition, there are a vast variety of physical, cognitive,

and emotional symptoms that an athlete may experience, such as memory loss, headaches,

dizziness, nausea, mood changes, and balance problems. The fact that each individual

experiences different combinations of symptoms, or none at all, makes it even more difficult for

another person to identify the concussion.

In order to recover from a TBI, rest is essential. The athlete should avoid phones, lights,

computers, and socializing for no less than 48 hours. A healthy, balanced diet and lots of fluids

are needed to provide the brain with much needed fuel. High school athletes in particular need

accommodations when it comes to school. Teachers should lessen homework and cut out

unnecessary assignments to decrease the amount of energy the brain exerts on schoolwork. In

most cases, an observed concussion that occurs on the field is resolved in about 4 to 6 weeks

(Decombe 2015). The recovery is longer for unreported concussions because the athlete will not

receive proper treatment. Without treatment, the stresses of everyday life will continue to affect

the concussed brain, leading to a prolonged recovery. In addition, the individual will not only

have trouble in sports, but also in school, and in relationships. When a TBI goes unreported, it

not only causes symptoms to worsen, but may also lead to serious medical conditions.
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When a student athlete chooses to not report a head injury, he or she is at risk of suffering

serious health implications like Second Impact Syndrome (SIS). This condition occurs when

someone has a second blow to the head before the symptoms of the first impact have subsided.

As a results, the brain loses its ability to auto regulate intracranial and cerebral perfusion

pressure (Second Impact Syndrome, 2015), or in other words, the brain starts to swell

uncontrollably. Young athletes who chose not to report concussions are particularly susceptible

to SIS. An athlete can suffer from SIS after receiving a mild concussion, which is the hardest to

identify as well as the most common type of head injury. This makes it even more necessary for

athletes to report their symptoms, because by continuing to play, they are putting themselves at

risk of sustaining a second head injury. In addition, the fact that most cases of SIS occur in

young athletes demonstrates how the attitude and lack of knowledge leads high school athletes to

be more prone to suffering from this syndrome. SIS is not the only condition an athlete risks

suffering from by not reporting a head injury. Multiple head injuries can also lead to dementia,

paralysis, epilepsy, or death (Cantu, 1998). Although there have been many attempts to prevent

these conditions by educating athletes, many still choose to ignore them.

As the dangers of concussions were brought to light, there have been many campaigns to

raise awareness and educate young athletes about the risks of concussions. Although statistics

show that more high school athletes are educated, there still seems to be something that stops

these athletes from reporting their injuries. The cause for this is the culture of sports, which

influences an athletes actions on the field. This culture of resistance urges an athlete to shrug

off the invisible injuries and return immediately to the field ("Don't Tell Coach': Playing

Through Concussions" 2013). High school athletes in particular may have an attitude of

invincibility that leads them to believe that none of the health risks may affect them. They may
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also not want to report an injury because of the fear that their coaches and teammates would

think of them as weak. In a study of 119 high school athletes, 92% knew the risks of returning to

the field immediately after a head injury and 75% knew the symptoms of these types of injuries.

On the other hand, only 54% said they would report their symptoms and 53% said they would

continue to play (Anderson 2013). These statistic show that it is not enough to just educate

athletes. The social norms must be changed to encourage being open about injuries rather than

fighting through them.

When it comes to concussions in young athletes specifically, there is a scarcity of data

concerning how often they occur. There has been a rise in the number of reported head injuries,

but this can be attributed to the increased awareness and better recognition of symptoms. The

Institute of Medicine and National Research Council has recommended that more data be

collected regarding concussions in young athletes because it is very important to prevent these

injuries in adolescents, as their brains are still growing. The Center for Disease Control and

Prevention has also started a Heads Up campaign directed towards student athletes, parents,

and coaches. Some of the methods they have used include leaflets, seminars for coaches, and

public service announcements from professional athletes. The overall message is that playing

with a concussion is not worth the risks, and that it is better to miss one game than the whole

season (Center for Disease Control and Prevent, n.d.).

There is still no solid data to show the effect of these campaigns on young athletes. In an

attempt to generate more data, I surveyed 78 high school students who participated in sports

programs. I asked them to describe, on a scale from one to five, how a certain scenario would

affect their decision-making when it comes to reporting injuries, with a higher number

representing them being more likely to report the injury. By analyzing the results I was able to
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determine the best ways to change the attitudes of young athletes. I found that most participants

thought that by being warned by a professional athlete they admired about the dangers of

reporting concussions, they would be more influenced to report a concussion of their own. On

the other hand, I learned that trainers or coaches using the scare tactic to dissuade the player from

hiding an injury were not as effective.

When Chris Coyne made his decision to keep playing with a concussion, it probably

hadnt crossed his mind that his dreams to play football professionally would be ruined. Many

athletes chose the same path as Coyne, myself included. After suffering a kick to the head in a

soccer game, I chose not to tell the trainer because I thought that by playing through the injury

my team would have the best chance to win. Looking back, I realize that this was a big mistake

and I risked the entire season to play in one game. My coach assumed I was all right because he

did not see any physical symptoms. Having been 15 at the time, I thought that the things that

Chris Coyne suffered from could never happen to me. Other high school athletes are prone to not

report their own concussions because many share the same mentality as me. In order to prevent

this we must raise awareness about the dangers of unreported concussions. The biggest obstacle

is the culture of sports. The attitude that reporting an injury is a sign of weakness must be

changed. Societal change is needed in regards to sports, especially for high school students as

concussions can seriously damage their developing brains. Although head injuries are an

unavoidable part of sports, not reporting a TBI is unnecessary risk that can lead to further,

preventable injuries.
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Bibliography

Cantu, R. C. (1998). Second-Impact Syndrome. Clinics in Sports Medicine, 17(1).

http://www.sciencedirect.com/science/article/pii/S0278591905700594

Center for Disease Control and Prevention. (n.d.). Concussion-A must read of young

athletes [Leaflet; PDF]. Retrieved from http://www.coachesontario.ca/wp-

content/uploads/Concussion_A-Must_Read_for_Young_Athletes-a.pdf

"'Don't Tell Coach': Playing Through Concussions." Well Dont Tell Coach Playing Through

Concussions Comments. The New York Times, 05 Nov. 2013. Web. 27 Sept. 2015.

"Exploring Why Traumatic Brain Injuries Go Undiagnosed." Exploring Why Traumatic Brain

Injuries Go Undiagnosed. N.p., n.d. Web. 22 Sept. 2015.

Institute of Medicine, & National Research Council. (2013, October). Sports-Related

Concussions in Youth. Retrieved from

http://iom.nationalacademies.org/~/media/Files/Report%20Files/2013/Concussions/concu

ssions-RB.pdf

Ms. Decombe.(2015) Concussions in the Classroom [PowerPoint slides].

"Second Impact Syndrome." BrainandSpinalCord.org. N.p., n.d. Web. 27 Sept. 2015.