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Non-reporting of sport-related concussion symptoms: a cross-sectional study of community rugby league players in the UK
  1. Daniel Isaac Tadmor1,2,
  2. Lucy Chesson1,
  3. Kevin Till1,2,
  4. Gemma Phillips1,3,4,5,
  5. Laura Fairbank4,
  6. James Brown1,6,7,
  7. Matt Cross1,8,
  8. Andrew J Gardner1,9,
  9. Rich D Johnston1,10,11,
  10. Cameron Owen1,4,
  11. Sharief Hendricks1,7,
  12. Keith A Stokes12,13,
  13. Ben Jones1,4,7,8,10
  1. 1 Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
  2. 2 Leeds Rhinos Rugby League Club, Leeds, UK
  3. 3 Hull Kingston Rovers, Hull, UK
  4. 4 England Performance Unit, Rugby Football League, Manchester, UK
  5. 5 Uno-X Mobility Professional Cycling, Oslo, Norway
  6. 6 Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University, Stellenbosch, South Africa
  7. 7 Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  8. 8 Premiership Rugby, London, UK
  9. 9 Faculty of Medicine and Health, Sydney School of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, Camperdown, New South Wales, Australia
  10. 10 School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
  11. 11 Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Brisbane, Queensland, Australia
  12. 12 Centre for Health, and Injury & Illness Prevention in Sport, University of Bath, Bath, UK
  13. 13 Rugby Football Union, Twickenham, UK
  1. Correspondence to Dr Daniel Isaac Tadmor, Leeds Beckett University Carnegie School of Sport, Leeds, UK; d.i.tadmor{at}leedsbeckett.ac.uk

Abstract

Recognising and removing players with suspected sport-related concussions is crucial for community sports.

Objectives Quantify rates and factors associated with non-reporting of concussion symptoms in community rugby league.

Methods Overall, 484 community rugby league players aged ≥18 years and 965 parents of rugby league players aged <18 years completed an online survey, regarding concussion history, knowledge, prevalence and reasons for non-reporting of concussion, long-term implications and perceptions of concussion.

Results Thirty-five percent of players aged ≥18 years and 22% of parents of players aged <18 years reported at least one concussion in the last two seasons. Forty-three percent of players aged ≥18 years and 5% of parents of players aged<18 years surveyed stated they did not report concussion-related symptoms sustained during 2020 and 2021 seasons. The two most common reasons for non-reporting of concussion symptoms were ‘didn’t want to be ruled out of a match’ and ‘didn’t want to let down the team’. Players aged ≥18 years who received external coaching pressures around concussion were more likely to not report concussion symptoms. Over 40% of parents and players were concerned about the potential long-term implications. Ten percent of players aged ≥18 years and 7% of parents of players aged <18 years would encourage their family members/children to not play rugby league.

Conclusions Non-reporting rates of suspected concussion symptoms in adult community players were twice as high as in professional rugby league, with similar reasons (wanting to play and not letting the team down). Engaging coaches to prioritise brain health and providing broader and appropriate education on concussion should be focused on, given the concerns reported by community players and parents.

  • Traumatic Brain Injury
  • Concussion
  • Community Research
  • Recreation / Sports
  • Injury Diagnosis

Data availability statement

Data are available upon reasonable request.

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Data are available upon reasonable request.

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Footnotes

  • X @danieltadmor, @mattjcrossie, @23benjones

  • Contributors DT: Investigation, Methodology, Writing Original Draft, LC: Writing – Review & Editing, KT: Writing – Review & Editing,Supervision,GP: Conceptualization, Investigation, Data Curation, Writing – Review & Editing, Laura Fairbank: Writing – Review & Editing, Project Administration, J B: Writing – Review & Editing, MC: Writing – Review & Editing, AJG: Writing – Review & Editing, SH: Writing – Review & Editing, RDJ: Writing – Review & Editing, CO: Writing – Review & Editing, Formal Analysis, KS: Writing – Review & Editing, BJ: Conceptualization, Methodology, Investigation, Data Curation, Writing – Review & Editing, Project Administration. DT, BJ and KT accept full responsibility for the work and conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Daniel Tadmor’s PhD is part-funded by Leeds Rhinos rugby club and works as a medical doctor for multiple sports teams. Kevin Till is employed by Leeds Rhinos in a consultancy capacity. Gemma Phillips is employed in a consultancy capacity by the Rugby Football League and Hull Kingston Rovers. Laura Fairbank is employed by the Rugby Football League. James Brown has received research funding from World Rugby. Matt Cross is employed by Premiership Rugby and has recieved funding for travel from World Rugby. He has previously been employed by the Rugby Football Union. Andrew J Gardner has a clinical practice in neuropsychology involving individuals who have sustained sport-related concussion (SRC) (including current and former athletes). He has been a contracted concussion consultant to Rugby Australia. He has received travel funding or been reimbursed by professional sporting bodies, and commercial organisations for discussing or presenting SRC research at meetings, scientific conferences, workshops and symposiums. Previous grant funding includes the NSW Sporting Injuries Committee, the Brain Foundation (Australia), an Australian–American Fulbright Commission Postdoctoral Award, a Hunter New England Local Health District, Research, Innovation and Partnerships Health Research & Translation Centre and Clinical Research Fellowship Scheme, and the Hunter Medical Research Institute (HMRI), supported by Jennie Thomas, and the HMRI, supported by Anne Greaves. He has current philanthropic support from the Nick Tooth Foundation. He acknowledges unrestricted philanthropic support from the National Rugby League (NRL), Cameron Owen’s research fellowship is part-funded by the Rugby Football League, and he has consulted for World Rugby. Keith Stokes is employed by the Rugby Football Union. Ben Jones is employed in a consultancy capacity by Premiership Rugby and the Rugby Football League.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.