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In Reporting Concussions, a ‘Culture of Resistance,’ New Study Finds

If you’re not convinced that concussions are a major health crisis, you should check out a report released on Wednesday by the National Academies’ Institute of Medicine and National Research Council.

The 309-page report—“Sports-Related Concussions in Youth: Improving the Science, Changing the Culture”—summarizes much of the current research on head trauma in college and youth sports, including a sharp increase in concussion rates despite a pattern of athletes’ underreporting the injury.

“Young athletes in the U.S. face a ‘culture of resistance’ to reporting when they might have a concussion and to complying with treatment plans, which could endanger their well-being,” the National Academies said in a news release.

Among the most disturbing findings was that the rate of brain injuries reported among high-school athletes was nearly twice that of college players. The report does not elaborate on the disparity, but one medical expert said that developing brains are more vulnerable to harm and take longer to recover from head trauma.

The report has a handful of takeaways for colleges:

  • In 10 percent to 20 percent of cases, concussion symptoms persist for weeks, months, or even years, suggesting that colleges must do a more thorough job of evaluating athletes before allowing them to return to competition.
  • Athletes, coaches, and parents often fail to recognize the “seriousness of the threat to the health of an athlete suffering a concussion,” says the report, which calls on the NCAA and others to improve their efforts to communicate that potential threat.
  • The report sees little evidence that current sports-helmet designs reduce the risk of concussions, and notes concerns about manufacturers’ touting the safety of equipment that was not scientifically proved.

The report looks at concussion rates in a variety of sports, focusing on athletes ages 5 to 21. It says that the rates of reported concussions are often higher among high-school athletes than college athletes—particularly in high-contact sports such as football—and that concussions typically happen more often during competition than at practice.

According to the report, a study using data from 15 NCAA sports found that, from the 1988-89 to the 2003-4 academic years, the overall reported concussion rate doubled, from 1.7 to 3.4 per 10,000 athletic exposures.

The report suggests that the NCAA, in conjunction with the National Federation of State High School Associations, should undertake a “rigorous scientific evaluation” of the effectiveness of age-appropriate techniques, rules, and playing and practice standards in reducing sports-related concussions.

The Institute of Medicine and the National Research Council also urge the NCAA, the National Athletic Trainers’ Association, and others to help develop and evaluate the effectiveness of large-scale efforts to increase knowledge about concussions, and to work to change the attitudes and behaviors surrounding head trauma among college athletes, coaches, and health professionals.

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