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 Researchers interviewed 64 high school athletic trainers from 26
states and the District of Columbia about challenges they
encountered when trying to follow state policies designed to educate
coaches and parents about concussions, remove athletes from sports
during concussion recovery and ease athletes back into sports
participation safely.
"Not giving the brain enough time to heal after a concussion can be
dangerous," said senior study author Jingzhen Yang of Nationwide
Children's Hospital in Columbus, Ohio.
"A repeat concussion that occurs before the brain heals fully from
the first concussion can slow recovery and increase the individual's
risk for short- and long-term health problems," Yang said by email.
"If a child or teen is believed to have a concussion, they need to
be removed from play immediately, and . . . only return to play or
practice after obtaining permission from a healthcare professional."
Concussion education materials given by schools to athletes, coaches
and parents were often loaded with jargon, lacking in active
learning approaches and only available in English, the study found.
One challenge in removing students with suspected concussions from
sports is that athletes may be unwilling to be sidelined or may mask
symptoms to avoid it, the study found. Coaches and parents can also
resist taking athletes out of competition, and many athletic
trainers also noted a culture that encourages students to "tough it
out" instead of leaving games.
Finding the right time to return injured athletes to practices and
competitions can be tricky because many students don't have access
to concussion specialists, who are in the best position to determine
readiness, the study found. Students may lack insurance or live far
from specialists or face other barriers to care. When they do
receive care, they may not always be forthcoming with coaches about
the need to remain on the sidelines when they want to get back to
playing.
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One limitation of the study is that researchers only looked at
schools with the resources to hire athletic trainers and with
written concussion policies. Barriers to implementing state
concussion laws might differ at schools without athletic trainers or
written policies in place, the study team notes in the Journal of
Adolescent Health.
"Laws are passed with good intent but organizations like schools
that are mandated to implement these laws are often not resourced to
do so," said Dr. Monica Vavilala, director of the Harborview Injury
Prevention and Research Center at the University of Washington, in
Seattle.
"So, schools have to prioritize care needs and not all schools have
athletic trainers or school nurses," Vavilala, who wasn't involved
in the study, said by email. "Therefore, the students with the most
serious and life-threatening conditions get more attention."
The study results underscore how crucial it is for parents of
student athletes to be proactive in concussion prevention, detection
and treatment, said Avinash Chandran, a brain injury researcher at
the University of North Carolina at Chapel Hill who wasn't involved
in the study.
Parents should talk about concussions with their children, coaches
and especially with doctors, Chandran said by email.
"Conversations with their children about concussions will help
emphasize the seriousness of concussions in youth sports, encourage
the reporting of symptoms (as they are felt and for as long as they
are felt) and subsequently minimize the risk of recurrent
concussions as well as of long-term adverse outcomes following
concussions," Chandran added.
SOURCE: https://bit.ly/2RE6qqV Journal of Adolescent Health, online
November 19, 2019.
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