Sport-Related Concussion

According to the CDC (2019), a concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the brain to move rapidly back and forth. There are many dangers associated with concussion including severe brain injury and even in more extreme cases, death. Coakley (2017) discussed the complexity of the “tough athlete” and the societal pressure to push through injury. This “walk-it-off” mentality may be detrimental to the developing youth athlete.

Athletes are taught at a young age to push through, to fight against, injury. Sometimes in high intensity sport environments, because of adrenaline, it may be hard to fully understand symptoms of the body and brain. Tua Tagovailoa, quarterback for the Miami Dolphins, had two head and neck injuries in week 3 (against the Bills) and week 4 (against the Bengals). Tua was cleared to remain in the game in week 3 and played against the Bengals a few days later. He had then suffered a similar blow by hitting his head on the turf of the field. Tua was carted off the field on a stretcher then later that night was discharged from the hospital to fly home to Miami with his teammates (Stefel, 2022). Tua was cleared by several layers of medical professionals during the game against the Bills raising questions about the effectiveness of sport-related concussion diagnosis through self-report, the societal need to show toughness in the face of a potentially deadly injury, and the competence of management to not take the athlete out and send for more testing.

Seguin and Culver (2022) discussed the complex factors that impact an athlete’s experience with concussion and potential targets for applied sport psychology and rehabilitation interventions. The athlete has many experiences associated with sport-related concussions (SRCs) including social isolation and grief, feelings of dehumanization, changes in role in the team environment, loss of identity, and scarceness of social support.

The researchers discussed Bronfenbreener’s ecological systems theory emphasizing the Microsystem, Mesosystem, Exosystem, Macrosystem, and Chronosystem of SRCs. The Microsystem consists of the athletic identity and what happens inside the athlete, psychologically, when suffering from a SRC. Issues of identity are relevant especially when athletes rely on their feelings of gratification and social inclusion (relatedness) through their sport and sport alone. The more areas of related community an athlete may have the more “pluralized” they may be in their identity.

The Mesosystem are the interrelationships between the microsystem like the coach-athlete relationships or other relationships surrounding the athlete. The encouragement of the management team to push an athlete to continue play may be part of this Mesosystem relevant to the way it makes the athlete feel. Other areas of the Mesosystem highlighted in Seguin and Culver (2022) are ways in which athletes may fear coaches’ distrust of the reports of the athlete. This fear may inhibit the athlete from telling the truth about their symptoms. Discussing symptoms of any injury may feel vulnerable for athletes. Creating an environment that is open and trusting is important for not only coaching staff, but also doctors and other health professionals that are inclusive of the team setting.

The Exosystem are the sport related policies, regulations, and laws in the settings of the sport. Concussion protocols are important to implement and continuously update with current health literature. The Macorsystem are the cultures or subcultures overarching the micro, meso, and exo-systems. The Macrosystem consists of the sport nature to be tough and fight through pain. There are times where this is true. Obviously in lifting weights finding through the burn may increase muscle growth. However, in detrimental times of traumatic brain injury this may be dangerous and expose athletes to greater risk. The Chronosystem is representative of time’s impact on the relationships within all systems including transitions later in life. The Chronosystem is relevant especially in seasonal determinants of the athlete’s action. In other words, athletes that are in the championship may have a greater difficulty self-reporting any pain and discomfort or mental instability associated with SRCs.

Mental toughness and overcoming adversity do not mean the athlete needs to put their life at risk. Coaches need continuous training and information on how to help support these athletes that may be struggling with SRC. Changing the culture starts with awareness. Athletes need a place where they can feel safe and trust that what they say will be heard. More strategies for athletes to have a place to discuss their struggles are apparent in Sport and Performance Psychology. The psychology of injury, the detriment to the athletic identity, and then the process of becoming mentally ready to return to sport are all intricate parts of the athlete’s mind that go unnoticed in the medical field. The need for CMPCs is clear in the process for injury recovery. Athletes need someone on their side that will react without judgement, that have no stake in anything other than the athlete’s well-being, and that can listen and help them grow as an individual, an athlete, and a human being, this is where we come in.

References

Centers for Disease Control and Prevention. (February 12, 2019). What is a concussion?

Retrieved October 24, 2022, from

https://www.cdc.gov/headsup/basics/concussion_whatis.html

Coakley, J. (2017). Sports in society: Issues and controversies (12th ed.). McGraw-Hill Education.

Seguin, C. M. & Culver, D. M. (2022). The lived experience of sport-related concussion: A collaborative inquiry in elite sport. Journal of Applied Sport Psychology, 34(5), 916- 937.

Stiefel, K. (October 24, 2022). Tua Taglovailoa Has Odd Answer Concussion-Related Question. NESN. Retrieved from google.com/amp/s/nesn.com/2022/10/tua-tagovailoa- has-odd-answer-to-concussion-related-question/amp/