'Culture of resistance' prevents young athletes from reporting concussions, following treatment plans

There is little evidence that the current design of sports helmets has reduced the incidence of concussions among youth athletes, the Institute of Medicine and National Research Council says in a report. It also said more work is needed to analyze and understand the health impact of such injuries.

The report found there remained a “culture of resistance” among young athletes in reporting concussive injuries and in following recommended treatment plans despite a strong medical consensus about the harmful effects concussion can have on the brain over time.

“The findings of our report justify the concerns about sports concussions in young people,” said Dr. Robert Graham, director of the national program office for Aligning Forces for Quality at George Washington University and chair of the research committee that authored the report. “However, there are numerous areas in which we need more and better data. Until we have that information, we urge parents, schools, athletic departments and the public to examine carefully what we do know, as with any decision regarding risk, so they can make more informed decisions about young athletes playing sports.”

Incidents of concussion were more common among high school athletes compared with college players. Rates of concussion were found to be highest among those playing football, ice hockey, men and women's soccer and lacrosse, wrestling and women's basketball. Concussions were more frequently reported during actual competitions than during practices. The report also found higher concussion rates among female athletes than male athletes, and also among youth players with a history of prior concussions.

Typical recovery time for athletes who have suffered concussive injuries has been about two weeks. But symptoms have been known to last weeks, months, or even years after the injury in about 10% to 20% of cases.

According to the report, not enough information existed to set a universal standard for recovery times, suggesting such determination be made on a case-by-case basis.

The researchers recommended establishing a national surveillance system to gather more accurate data on the prevalence of concussive injuries in youth sports. It also recommended tracking the long-term effects of concussions to better evaluate how rules and practices can be changed to reduce risk.

Public awareness of and concern about concussions suffered by athletes has greatly increased in recent years because of high-profile reports of chronic traumatic encephalopathy among professional and college football and hockey players. A recent PBS Frontline documentary called “League of Denial” reported that National Football League officials publicly downplayed the problem for years despite knowing about its seriousness.

Follow Steven Ross Johnson on Twitter: @MHSjohnson