More than one-quarter of college athletes responding to a survey said they had felt pressured by coaches, teammates, fans, or parents to keep playing following a head injury. Nearly half continued competing while experiencing symptoms of a possible concussion.
The findings, from a report published on Friday in the journal Social Science & Medicine, suggest that coaches and teammates exerted the most pressure, and that athletes who had been diagnosed with a concussion during the previous season were more likely to have felt pressure to underreport the injury than were those who had not suffered a concussion.
The study, “Concussion Under-Reporting and Pressure From Coaches, Teammates, Fans, and Parents,” was conducted in 2014 and included responses from 328 NCAA athletes in seven men’s and women’s sports, including soccer, lacrosse, basketball, and field hockey.
Athletes in football and ice hockey were not part of the study, which involved colleges outside of the five largest NCAA conferences and comprised responses from roughly equal numbers of men and women.
Only a small fraction of coaches were found to be “part of the problem,” at least in the sports included in the survey. Coaches often exert pressure by controlling playing time and shaping team norms about concussion safety as much as through “overt pressure,” the report said.
Fewer than 10 percent of the responding athletes said they had had a concussion diagnosed within the previous athletic season.
The study joins a growing body of research on how concussions among college athletes are treated. In a study published in The American Journal of Sports Medicine last year, nearly a quarter of respondents said their institutions did not have a formal process for educating athletes about head injuries. A 2013 Chronicle survey found that almost half of athletics trainers surveyed had felt pressure from coaches to return concussed athletes to action before they were medically ready.
The researchers in the new study were Emily Kroshus and Christine M. Baugh, of Harvard University; Bernice Garnett, of the University of Vermont; Matt Hawrilenko, of Clark University; and Jerel P. Calzo, of Harvard Medical School.
