Sports are a major source of concussions in teens, and experts agree that players should not return to sports while still experiencing concussion symptoms, the researchers write in the Clinical Journal of Sports Medicine.
"Teenage hockey players often do not report their concussion," said lead author Dr. Michael Cusimano, a neurosurgeon at St. Michael's Hospital in Toronto.
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Coaches and parents need to have serious discussions about this topic with their young athletes to make sure they know the importance and need for rest and recovery.
- Stefan Duma
He and his colleagues conducted one-on-one interviews with 38 youth hockey players and 23 other people who might have an influence on the way the young players behave, such as parents and coaches.
Counter hero culture
Many players and coaches did not recognize the symptoms of concussion and some players were unsure if they had gotten a concussion in the past.
In addition, about half of parents, coaches, and trainers allowed players to return to the ice immediately after a head injury without seeking medical attention.
There was also a "hero" culture, with teammates, parents, and coaches encouraging players to be "tough." In this culture, players who were injured too often might be viewed as "wimps," the authors say.
Both players and coaches also experienced pressure from parents, who may view hockey not just for fun, but as a potential profession for their child.
Players were also motivated not to report symptoms because they did not want to miss games, and this was particularly true for larger players. Many interviewees believed that larger players were at lower risk for injury and could safely return to play more quickly.
Stefan Duma, a professor at Virginia Tech in Blacksburg, Virginia who studies sport-related head injuries, noted by email that underreporting is an issue in all sports. He said risks run high without proper rest after an injury.
"Our findings strongly support the need for … mandatory education of players, parents, and coaches to improve awareness and recognition of concussion," Cusimano advised.