Young athletes: Psychological recovery from concussions may take more time

A young Hockey team prepares for practice.(AP Photo/Stephen Whyno) New research out of Universite de Montreal shows that even though the physical symptoms of a concussion have resolved, psychological recovery can take longer.

A young athlete who has physically recovered from a concussion is not necessarily ready to return to the game immediately, warns a new study published by a Université de Montréal researcher.

The young person may need more time to recover psychologically and regain their confidence, and a hasty return to the game could have serious consequences for them, says Professor Jeffrey Caron, from the School of Kinesiology and Physical Activity Sciences at the Montreal institution.

"I imagine many athletes feel very comfortable returning to sport quickly once they have medical clearance," said Caron, a former major junior and university field hockey player himself.

"But from my point of view, it's not everyone and we should be asking more questions. Are they really, really ready to put themselves in situations where there's contact and collisions?"

The researcher and his colleagues interviewed not only concussed athletes, but also coaches, athletic therapists, physical therapists, nurse practitioners and sports physicians who work regularly with these athletes.

This enabled them to identify behavioral, psychological and social factors that should also be taken into account before considering a return to the game. Some study participants mentioned the scrutiny of others and social pressure, loss of motivation, playing more timidly to avoid further collisions, loss of confidence in one's skills and the important role sport plays in the identity of many athletes.

Let's take the example of a situation where the player disputes possession of the ball or puck with an opponent," Caron suggested. In that situation, the player may be more passive (than usual), and that shows us that he wasn't ready to get back into the game."

The young athlete, he added, remembers exactly how they played "before" their concussion, and it could therefore be concluded that their new, slightly more timid game is a conscious decision they're making to protect themselves.

The media regularly reports, for example, on cases of chronic traumatic encephalopathy in former athletes, and the youth may begin to fear hard contact and collisions after a concussion for fear of one day suffering from it, Caron explained.

Their new, more timid way of playing may give coaches the impression they're not the player they used to be, that they can no longer be trusted, and that they may no longer have a place on the team, he points out.

If we're talking about top-level sport, it's performance that counts," he said. Then if something is detrimental to your performance, unfortunately, you're not going to have the same position on the team."

The important thing, he says, is to foster an environment in which the youth feels entirely comfortable expressing themself and openly confiding any hesitations they may feel about returning to the game.

Simply giving the athlete a few extra days to recover, without pressure or judgment, after his physical symptoms have ceased, can help them regain their confidence and even prevent him from being sidelined prematurely.

Just because a young person is healed (physically) doesn't mean they're ready to get back into the game," concludes Caron. It's one thing to be symptom-free; it's quite another to feel ready to return to sport."

The findings of this study were published by the Clinical Journal of Sports Medicine.

 This report was first published in French by The Canadian Press on Sept. 20, 2023.