CFL players admit hiding concussion symptoms, new McGill study finds

In 2016 survey, 82% say they didn’t report their condition to coach or trainers

Concussion awareness in sport has come a long way from the days when players accepted having their “bell rung” as part of the game.

Yet a study by a team of researchers from the McGill University Health Centre suggests heightened awareness has not led to a change in attitudes as far as players removing themselves from the field of play. The survey was conducted in the summer of 2016, with players reporting on their experiences from the 2015 season.

Of the 454 players who responded to the survey, roughly one quarter (23.4 per cent) reported suffering at least one concussion in practice or a game and 82 per cent of them hid the concussion by failing to report it to a coach or member of the training staff. Just six per cent of players who said they would seek medical treatment after a game actually did.

The study did have some limitations. The players were reporting from memory months after the fact, and many were relying on self-diagnosis of head trauma they experienced but did not share with team officials.

Dr. Scott Delaney, an assistant professor and researcher at McGill and the team physician for the CFL’s Montreal Alouettes, led the study, which was published in this month’s Clinical Journal of Sports Medicine.

The results are not all that surprising given the competitive nature of athletes and their willingness to play through injury, but Delaney is concerned that old school habits about head trauma persist.

“What can be difficult to rationalize is that this type of behaviour is occurring at a time when athletes have never been better educated about concussions,” Delaney said in a release. “This is not a problem isolated to CFL players, as we have seen identical behaviour in male and female university athletes.

“What we have to figure out now is how we get athletes to change their behaviour when routine concussion education may not be enough.”

Wide receiver Ernest Jackson, who caught the winning touchdown for the Ottawa Redblacks in overtime of the 2016 Grey Cup game, believes reluctance to report concussions is slowly changing, helped along by independent concussion spotters.

“Oh, there’s definitely a lot more awareness,” said Jackson, who played for the Alouettes in 2017. “We have a guy watching from the press box now, and if they think there’s a player who needs to be pulled from the game, he has no choice.”

Jackson, speaking to Postmedia News at a Concussion Legacy Foundation conference in Ottawa last fall, admitted players never want to come out of a game, and sometimes have reason to argue their case.

“It happened to a guy on our team,” Jackson said. “He caught a ball and fell on his head. He was OK, but he just sat there, didn’t want to jump up too fast, and the spotter pulled him and made him go through the protocol.

“He was fine and came back later in the game, but they checked him out.”

Ironically, Jackson has never had a head injury in football, but suffered a serious concussion while riding a bike at age 15. Jackson’s cousin was sitting on the handlebars and the pair were sent flying when they hit a stretch of gravel road. Jackson was so disoriented he couldn’t identify his own belongings at his cousin’s house.

For the McGill study, Delaney and his team sent out 100 questionnaires to each of the nine head trainers and therapists in the CFL to distribute to players at the 2016 training camps. In 2015, 662 players participated in at least one game.

Of the 454 voluntary respondents, 106 believed they had suffered a concussion during the previous season, and 87 of that 106 said they did not seek medical attention.

The most common reason for not reporting a head injury (from 49 of the 106) was that the player did not believe the concussion was serious, and thought he could continue to play without causing harm. Forty-two players said they did not want to be removed from a particular game and 41 were concerned about missing future games if they admitted to a concussion.

Delaney’s conclusion is that awareness of concussion symptoms and protocol do not necessarily translate to “safe and appropriate behaviour at the time of the injury.”

The researchers wondered aloud if players would consider more seriously taking a step back from the field of play to get assessed if the word concussion was replaced with the term brain injury.