“My head hurts”: A look at how concussions are treated in university sports

Most athletes from the rugby and football programs were anonymously interviewed for this article.  The names John, Martin, Jayden and Dr. Sarton are pseudonyms.

“I got knee’d in the back of the head during a game,” said John, a varsity athlete in his second year. “My friend told me to go see a trainer because I seemed out of it.”

“I got tackled during practice, [hit my head], and was out for two weeks. I couldn’t really do school work,” said Martin, another athlete in his third year.

Primarily an academic school, UW has invested millions of dollars into its sports programs and gyms over the past several years. Student-athletes who have been training their entire lives fantasize about receiving athletic scholarships to attend such a prestigious university. But what are the hidden costs that aren’t mentioned in the acceptance letter?

A concussion is a brain injury suffered when a blow, usually to the neck or head, rattles the brain inside the skull. One of the most common injuries in contact sports can harm individuals by altering their ability to feel, concentrate on important tasks, and use their motor skills. Common symptoms include vomiting, headache, sensitivity to light and noise, irritability, and difficulty sleeping. It’s not always initially visible, and many athletes still think they can play after it happens. Brain injuries are also associated with dangerous or violent behaviour later in life, in addition to a shortened lifespan. 

I spoke with Dr. Sarton, a neurologist who conducts research at UW. In their studies, they’ve found that “there’s other work out there that suggests people in a sports context who have a concussion seem to be at greater risk of a subsequent injury, whether that’s another concussion or a musculoskeletal injury.” 

Moreover, student-athletes who are unable to play or study due to a concussion “will get clearance to return to their sport or classes or everyday activities, somewhere around 14 days, [on average],” which can be a significant amount of time in a 12-week semester. They added that there aren’t objective ways to test for a concussion, and most methods involve the affected person self-reporting their injuries.

Every athlete I spoke with mentioned how difficult it was to attend class or fulfill academic obligations while they were concussed. Prospective UW students and their families might ask themselves what protocols are in place to protect them if they have to miss school due to an injury. The results, according to current students, are a mixed bag. 

John began playing his sport around the age of five, following in the footsteps of his father and grandfather, who played professionally. He was invited to UW after impressing his team’s coach throughout several training camps for his youth team. After a game against the Western Mustangs, the third game of his OUA career, he took a knee to the back of his head after getting tackled. He didn’t regret making the play that hurt him, however.

“Big hits are important; they change the flow of the game. They get the bench riled up, and you’re more likely to keep your spot on the team if you make big plays,” he said. 

Jayden, a key player on his team who has never been diagnosed with a concussion, echoed the sentiment, saying, “Our coaches say there’s a difference between hurt and injured. If [a player is] hurt, you dust yourself off and get back up. If you’re injured, that’s when you get off the field.” He says he’s thought he had a concussion before, but continued playing when symptoms subsided. 

Caelan Fernando, an athlete in his fourth year who was concussed around the same time, agreed, saying, “If you put your body on the line, you’re more likely to win.” 

The game against Western was John’s third concussion in life, something which was known to the university, and he reported feeling isolated during his recovery.

“[UW] didn’t really follow up with me or anything like that. I had to report it myself, check in with them myself, like they didn’t reach out. It was hard to do things like check my email and schedule an appointment. I couldn’t look at screens too much and I had to [be very proactive in receiving treatment],” he says. “I went back for either the next game or the game after that, [a week later]. Most of the tests were self-reported.” 

He was injured the week of one of his first midterms, and he reported difficulty studying and concentrating. He says his grades for the midterms he wrote after being concussed were worse than those he achieved by the end of the semester. 

Nevertheless, all interviewed players agreed that UW offered proper accommodations for the time they missed in class. They received a verification of illness form (VIF), which allotted them extra time for their missed exams and assignments, although they still had to reach out and inform professors themselves. 

The danger with self-reporting lies in the different ways people experience discomfort. If two athletes both have a concussion, one might go to a doctor for their symptoms, while another might take Tylenol and rest in bed without telling anyone. 

John reported feeling concerned about telling his coach he would be out. Martin and Caelan said they knew their team would understand. All three said that they knew some of their teammates didn’t speak to trainers when they thought they were hurt for fear of being sidelined. They also agreed that they felt the university could’ve taken a more active role in their recovery.

Becoming a university athlete is a challenging task to accomplish, and missing an opportunity to impress scouts or help win an important game can be disempowering, especially for athletes like John, for whom sports have played a significant role in their personal lives. He’s from a well-off family that can send him to university. But what about the athletes who can’t afford post-secondary education without their scholarships?

An objective test is a preeminent goal for most research surrounding concussions, says Dr Sarton. There has been great progress in finding one. At the women’s rugby world cup this year, flashing mouthguards that light up when a player receives a hit big enough to cause a concussion. In OUA football, there are concussion spotters who pull players out when they may be hurt. But not every obstacle can be overcome in the lab. 

“[The issue] is around the education of, if [an athlete] thinks they’ve had a concussion, [they shouldn’t] just shrug it off, go get medical help… once that’s done [UW has] more options to help deal with that,” Dr Sarton said.

Athletes agree that UW does make an effort to educate them on the symptoms and signs of a concussion. Every athlete I spoke to mentioned going through training and tests at the beginning of their season to recognize when they or a teammate may be concussed. These are online tests that give a certificate that must be uploaded to the athletics portal to be eligible to play, such as the Concussion Awareness Training Tool. Brian Bourque, UW’s associate director of Athletics and Recreation, has stated that some athletes provide data to Headfirst, a UW startup that uses saliva samples to detect whether a person is concussed. He added that return to play is a five-step process where an athlete is supposed to be carefully monitored and given increasingly physically demanding challenges to see how they perform and if they’re fit to return.

But problems still exist. 

No athlete entering a contact sport is under the illusion that they’ll never get hurt, but personal and institutional responsibility are different. Athletes are responsible for greater accountability amongst each other. Dr. Sarton says one of the greatest challenges in their research around the long-term effects of multiple concussions is that senior citizens “grew up in a generation where concussions generally wouldn’t have been reported,” rendering it difficult to know whether adverse health effects stem from brain injury or other factors. Coaches should also avoid pressuring players to soldier on when it’s clear something bad may have happened.

Regarding educating athletes, perhaps in addition to the existing training to identify when someone’s concussed, there should be some information about how to foster a culture of acceptance so that athletes aren’t ashamed or afraid to step off when they need to.

UW’s responsibility is not to police adults on how they speak to each other or train, but rather to provide the necessary care for injured students. Brain injuries are fundamentally different than body injuries, and have different symptoms and prognoses. Many people can still run and jump after a concussion, as opposed to if they had a broken leg, for instance. This creates the idea that it’s something that can be ignored because it doesn’t immediately affect you.

If there were a greater deal of care to reach out to concussed players and slowly provide them with the tools to recover on their own, it would help with destigmatization and create a safer environment for all.