“Why Professional Football Players Chose Not to Reveal Their Concussion Symptoms during a Practice or Game”

"What can be difficult to rationalize is that this type of behaviour is occurring at a time when athletes have never been better educated about concussions."
"This is not a problem isolated to CFL (Canadian Football League) players, as we have seen identical behaviour in male and female university athletes."
"What we have to figure out now is how we get athletes to change their behaviour when routine concussion education may not be enough."
Dr. Scott Delaney, assistant professor, researcher, McGill University

"Oh, there's definitely a lot more awareness. We have a guy watching from the press box now, and if they think there's a player who needs to be pulled from the game, he has no choice."
"It happened to a guy on our team. He caught a ball and fell on his head. He was OK, but he just sat there, didn't want to jump up too fast, and the spotter pulled him and made him go through the protocol."
"He was fine and came back later in the game, but they checked him out."
Ernest Jackson, wide receiver, Ottawa Redblacks, Montreal Alouettes

Ottawa Redblacks wide receiver Ernest Jackson (9) catches a touchdown pass during overtime CFL Grey Cup action Sunday, November 27, 2016 in Toronto. Nathan Denette / THE CANADIAN PRESS

A study conducted by a team of researchers from the McGill University Health Centre seems to conclude that though those involved in professional sport are now aware of the dangers inherent in concussions, particularly in sports where repeat concussions were always accepted as part of the game, now equating with long-term, extremely dangerous health effects, the players themselves tend to minimize the dangers they face, reluctant to take precautionary measures after a concussion to ensure they heal well before continuing to play.

The study resulted from a 2016 survey where players voluntarily reported on their experiences from the 2015 season. Published in January 2018's Clinical Journey of Sports Medicine, roughly one quarter (23.4 percent) of the 454 players responding to the survey reported having suffered at least one concussion during practise or a game, while 82 percent of that one quarter kept silent about the concussion rather than reporting it to a coach or training staff member. Moreover a mere 6 percent of players who had claimed they intended to seek medical treatment post-game, did.

Dr. Delaney, team physician for the CFL's Montreal Alouettes, led the study whose results present as no big surprise in recognition of the competitive nature of the athletic community and their traditional reaction to injuries, seeing them as an impediment to continue playing the entire game, and thus minimizing injury to themselves, keeping it from those who might insist they sit out the rest of the game and seek medical help. It is largely the players themselves for whom head trauma is a matter to be kept to themselves.

Now, however, that the sport industry itself has recognized the reluctance of players to reveal their injuries, independent concussion spotters have been deployed to identify those instances where players appear to have suffered serious injury, so they could intervene and remove them from the game. Dr. Delaney distributed 100 questionnaires to each of the nine head trainers and therapists in the CFL to distribute to players at the 2016 training camps. In total 662 players had taken part in at least one game.

And of that 662 number, there were 454 voluntary respondents, casting their minds back over the 2015 season of play to recall incidents of injury and how they had reacted to them. Of the respondents, 106 felt reason to believe that had suffered a concussion, while 87 of that number admitted they hadn't sought out medical attention; the most common reason cited (from 49 of the 106) being they failed to identify the concussion as serious, feeling that no further harm would result when they continued to play after sustaining the injury.

Other reasons fell into place when 42 players revealed they hadn't wanted to be removed from a specific game, and 41 claimed to have been concerned with the prospect of missing future games should they admit to having suffered a concussion. Dr. Delaney concluded that awareness of concussion symptoms and the follow-up medical protocol often fails to translate to "safe and appropriate behaviour at the time of the injury".

He speculated, along with the other researchers in discussion whether the perception among players of the seriousness of the issue might be brought home more effectively, causing players to react differently should the word 'concussion' be replaced with the term 'brain injury'. Brain injury necessarily conjures up deep-seated fears of possible lethal end-results, while the word concussion seems far less urgent, given the fact that so many children, let alone adults, at some time in their lives do suffer a concussion.