CFL players are keeping quiet about their concussions, study finds

A survey of Canadian Football League players from the 2015 season has found that almost one-quarter of them believed they suffered at least one concussion that year. Yet an overwhelming majority of them didn’t raise the issue with the team, many out of fear of losing playing time.

More and more, professional and youth sports are being scrutinized for their health impacts on players, especially when it comes to head injuries and concussions. For pro sports leagues like the NFL, the NHL and the CFL, critics are calling for substantial rule changes and precautionary measures while others are seeing the revelations about damaged and suicidal retired athletes as signalling a moment of reckoning for leagues which have for too long hidden (or turned a blind eye towards) the endemic problem of concussions.

And while the pro leagues continue to stick-handle around the issue, the research keeps piling up.

Just last month, a study from McMaster University in Hamilton found that the brains of ex-CFLers had significant damage to the cerebral cortex, with a full 95 per cent of players examined showing decreased activity in the part of the brain involved with decision-making.

The issue is a complicated one, as ingrained in the cultures of sports like football and hockey is an ethos whereby playing through the pain is considered a virtue. And while it’s known that athletes don’t always voluntarily tell their coaches and trainers when they’ve experienced head injuries, the reasons for keeping quiet aren’t as well documented.

In some instances, the athlete him- or herself may not realize that they’ve suffered a concussion, while in others, a team’s medical staff and trained “spotters” charged with looking out for signs of head injury may not see anything that warrants attention. That’s a major problem, say researchers at the McGill Sport Medicine Clinic in Montreal, whose new research explores the rationales behind CFL athletes’ decisions to keep quiet about concussions.

“There is no loss of consciousness and no obvious external signs in the vast majority of sport-related concussions,” say the authors. “Any obvious signs exhibited by an athlete may be very transient and not observed by medical personnel … [Thus], physicians, therapists, and trainers are often dependent on athletes coming forward to volunteer their symptoms to make the diagnosis of a concussion.”

During the 2016 CFL preseason, the researchers sent out questionnaires to all nine teams, asking for players to anonymously respond with their comments on concussions that may have occurred during the previous 2015 season. Of the 454 players who completed the survey, 106 (23.4 per cent) said they thought they’d suffered a concussion during the previous season, with 87 of those 106 (82.1 per cent) saying that they did not seek medical attention for the problem.

When asked why not, the most common response (49 out of 106) was that they didn’t feel that the injury was serious and that they could keep playing with little danger to themselves. The other two most common explanations were that the player didn’t want to be removed from the game (42 out of 106) or that they didn’t want to risk missing future games (41 out of 106).

The survey showed that while players seemed to be well-educated on the nature of concussion and about treatment guidelines, the numbers indicate that such knowledge “did not translate into safe and appropriate behaviour at the time of injury,” say the study’s authors.

“Future concussion research may wish to study ways to ensure that knowledge transfer to athletes results in decisions that can improve player health and safety at the time of injury,” the authors write.

The study was published in the Clinical Journal of Sport Medicine.