A Look at the issues facing students post-concussion
Shepherd HA, Kolstad AT, Caron JG, Reed N, Yeates KO, Schneider KJ, Black AM, Emery CA. Unravelling the web: Experiences of adolescents returning to school following a concussion. Neuropsychol Rehabil. 2023 Jul 26:1-20. doi: 10.1080/09602011.2023.2236776. Epub ahead of print. PMID: 37496176. Béatrice St-Cyr-Leroux, University of Montreal. When is the right time to start playing again after a concussion? SEPT 21, 2023.
20% of adolescents will sustain a concussion in their sports lifetime, according this article’s estimates. Post-concussion an individual may have symptoms that interfere with more than the ability to return to sports. The student may have issues that go beyond the physical. These would include (1) concussion symptoms affected adolescents’ schoolwork; (2) access to academic accommodations eased adolescents’ return to school; (3) having supportive and understanding friends, family, and teachers facilitated adolescents’ return to school; (4) communication amongst school stakeholders was desired, but often lacking; and (5) feeling anxious, frustrated, and sad with the return to school process. So returning play and returning to school is not always the same for the student. The post concussion management plan needs to consider more than just is the student physically ready. Whether a student is mentally ready is also a question. This study explores the implications of that question.
Methods:
This study conducted one-on-one semi-structured interviews to explore the perspectives of 20 adolescents (ages 14-18) returning to school after a concussion. Interviews were coded inductively and analyzed using reflexive thematic analysis.
In other words, this study attempted to look beyond The standard practice for athletes recovering from a concussion is to follow the "return-to-sport strategy," a six-stage program supervised by a health professional that outlines which are allowed, based on the athlete's symptoms and their severity. Once the stages have been completed, the athlete is considered ready to return to the field.
However, this strategy focuses almost exclusively on the physical side of a concussion and pays little attention to other considerations, whether behavioral, psychological of social. In this evaluation, Many mentioned nervousness about other people's expectations and, loss of motivation, fear of collisions (and therefore avoidance of certain situations on the field), loss of confidence, and identity issues (when the sport is part of the athlete's self-awareness).
What Dr. Caron and his group found was that a student may unconsciously change their behavior on the field due to the recent concussion. This may mean avoiding certain on field situations or playing more passively than before.
Additional Thoughts:
A student who returns to play even after the health provider clears them may act or participate in sport in a way that indicates they are not fully ready. Additionally, school administrators and teachers should anticipate a lag in their academic performance. The level of change is based no the individual but it should be expected to some degree.
So a student is not completely ready even when their body may indicate they are a go for game play. Does this mean they should be prevented from return to play? No, what it does mean is that we should look at more than their physical responses as clues to how much additional support the athletic trainer and team doctor need to provide moving forward.