Using Your Head

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If you are an athlete or follow sports, you have surely heard the discussions regarding the severity and frequency of concussions in contact sports. The evidence is there and the protocol is now in place, but what does not receive enough attention is the reality that, no matter the recovery protocol, there is no way to force an athlete to report a concussion if he or she doesn’t want to.

It has been well documented that concussions and post concussive syndrome are responsible for several symptoms including difficulty forming thoughts, impaired judgement, depression, memory loss, and even substance addiction and abuse.

This begs the question, is an athlete with a concussion in a good enough state of mind to make important decisions regarding his or her health?

I conducted interviews with two athletes, who will remain anonymous, to get a clearer perspective on the mindset of athletes struggling with post concussive syndrome.

The first interview was with an NCAA division III men’s ice hockey player. For the sake of privacy, we’ll refer to him as Jack. Jack has sustained thirteen concussions playing competitive hockey, but at the time of his most recent one he had only reported seven to doctors. Jack had to go through physical therapy over this past summer because his post concussive syndrome had gotten to a point that he had started to experience chronic migraines (four to six a week), confusion or difficulty focusing, memory loss, and even serious thoughts of suicide.

Jack explained that the mental illness had left him with no sense of self-worth and to this day has him suffering from self-doubt and a lack of confidence.

These symptoms are not to be taken lightly, so then why did Jack insist on ignoring his symptoms or lie to his trainers to convince them that he was ready when he really wasn’t? When asked about this he simply stated that he didn’t tell people because he figured that maybe the severity wasn’t that bad, and it may not come back to bite him. He also put off admitting the severity of his symptoms out of fear about what he may be diagnosed with. Ultimately, he loves the sport he plays, and he didn’t want to be told that he might not be able to anymore.

Simply put, most athletes don’t like to be sidelined. Most athletes will tell you that when they are injured they want to be back to playing as soon as possible. This is easy to understand, but the gravity of Jack’s situation makes his decisions more difficult to comprehend. I asked him if he could do it over again, would he change anything? He told me that if he could have it all back he would tell his trainers that he had an issue instead of just hiding it. He said he would want to take proper time to recover.

“If I would have taken care of my head earlier on, I wouldn’t have to deal with the problems that come with post concussive syndrome.”

Jack’s sentiment leads to the conclusion that he wasn’t in a healthy enough state of mind due to the concussions to be able to make decisions about whether he should be back on the ice. In a relatively healthy state of mind, it is obvious to him that he shouldn’t have been playing; however, when he was struggling with his symptoms his decision making was flawed and the choice was not so simple.

Jack said that the hardest part of everything was not the concussions but the post concussive syndrome. He knew what it was like to have concussions but not the post concussive syndrome symptoms. “I never thought it would hit me, but I got home and got depressed and scared because I didn’t know if it would be permanent.”

My second interview was with a club hockey player in Arizona, who I will call Brendan. His story is like Jack’s in that he had around eight reported concussions but had sustained at least sixteen. He said that his reasons for hiding his concussions is because when you say that you have one you must sit out for a couple months, so he hid it to stay in the lineup. Brendan told me that he has suffered from headaches every day for the past three to four years, his ability to remember things is almost completely gone, and he has been hospitalized multiple times due to collapses because his brain occasionally “shuts down.”

I asked Brendan if he felt like he was in a healthy enough state of mind to make decisions on whether he should have been playing and he said no and explained that he was depressed because of the post concussive syndrome and he thought that playing would help his depression.

“It’s hard to be in that position. It’s easy to look at another guy and say that he shouldn’t be playing, but it’s different when it happens to you,” he said.

Brendan would change his decisions if he could, saying that after his fourth or fifth concussion he should have quit, but he loves the game so much that he would rather die than not play anymore.

Brendan told me that he would like to see education for athletes about the real effects of post concussive syndrome. He talked about his own head and said that he would always try to hide his own struggles with humor, but it all builds until you reach a point where you break, both physically and emotionally.

When it is all said and done, there is no way to force an athlete to report their symptoms. Many athletes don’t know the serious risks of post concussive syndrome until it is already too late. The best opportunity to keep athletes healthy both physically and mentally is to inform them about the possibilities of lasting effects from concussions. In the end, the decision is theirs but they should be provided with every detail about concussions.

Brendan concluded: “The headaches are so common that they aren’t the real issue anymore. What started happening after a few of them was that the post concussive syndrome was worse because you’re conscious enough to know that something is not right, but you can’t help it. You lose control of your emotions and begin to cry all the time. The depression hits you hard because of the post concussive syndrome but it gets worse because you want to play so badly, and you start to question yourself and question if it was ever really worth it.”

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