In the arenas of both amateur and professional sports, particularly high contact sports such as American football and hockey, athletes are significantly at risk of receiving a variety of severe injuries which can lead to physiological complications that persist for decades or entire lifetimes. One such injury that is especially prevalent yet routinely underrepresented among athletes in high contact sports is the concussion, which has the potential to cause a myriad of psychological and cognitive complications that can range from depression to dementia. Concussions among athletes such as hockey and football players are especially prevalent at both the college and professional level, and the psychological consequences of such seemingly short term injuries has recently become the primary focus of medical studies, psychological analyses and ethical debates surrounding the overall health and well-being of the athletes and regarding the development of preventative measures to limit brain injuries, as well as effective psychological and clinical treatment methods to help athletes cope with such debilitating injuries. This analysis will focus on both the psychological and cognitive dynamics of concussions to highlight the risks posed to athletes who play high contact sports such as football and hockey in an effort to encourage the development of preventative measures and effective treatment for sports related concussions.
Concussive injuries present a myriad of psychological complications for the athletes who experience them and the emotional and psychological aspects associated with sports related concussions often arise from the athlete’s response to the injury itself as well as the recovery period following the injury. Athletes report suffering from concussions have reported experiencing isolation from their professional communities, pain, anxiety and general disruption of daily life due to the consequences of such injuries. (Bloom, Horton, McCroy, Johnston, 2004). In addition to these symptoms, athletes suffering from concussive injuries have also reported experiencing a wide range of symptoms of psychological distress due to the social stigma associated with being injured, and common emotional responses reported by athletes include anger, denial, depression, distress, bargaining, shock, and guilt.(Bloom, Horton, McCroy, Johnston, 2004) The psychological symptoms such as emotional distress factors associated with concussive injuries are capable of negatively affecting the recovery process of injured athletes and causing further health related complications. In a medical a study consisting of a survey conducted among 43 medical practitioners to determine the side effects of psychological distress experienced by injured athletes, it was discovered that athletes primarily suffered from substance abuse, exercise addiction, weight control problems and family adjustment issues which were associated with both depression and anxiety.(Bloom, Horton, McCroy, Johnston, 2004)
Another factor to take into account when considering the psychological effects of concussive injuries on the mental state of injured athletes is the anxiety caused by the social stigma and professional pressure exerted on the athlete by relentless media coverage, the public audience, and members of their professional communities, such as teammates and coaches. Concussions are considered to be a form of “invisible” injuries, meaning there are no physically indicative signs through which members of the athletic community, mass media and public audience are able to assess the severity of the concussive injury, which can result in increased amounts of anxiety experienced by the athlete due to the pressure he or she experiences to return to play. (Bloom, Horton, McCroy, Johnston, 2004) This is further complicated by the general lack of understanding among coaches, teammates and the general public for the necessity of long term rehabilitation regarding concussive injuries. While it is widely regarded as necessary that physical injuries require periods of weeks or months of rehabilitation to recover from, it is generally not considered acceptable to spend prolonged periods of time recovering from a concussive injury. This can lead to a myriad of psychological issues associated with post concussive symptoms, such as anxiety, maladaptive coping mechanisms and the “nocebo effect”, which is a series of adverse psychological effects created or maintained by negative expectations perceived by the athlete. (Hahn, 1997).
In addition to the myriad of psychological complications experienced by athletes suffering from concussions, there are also a wide range of cognitive issues associated with concussive injuries which can range from acute symptoms to long term neurological damage. Immediately following a sports related concussion, neurocognitive testing results often reflect a decline in certain cognitive areas over a span of time, and in some instances, normal range cognitive inefficiencies are seen as results of ongoing concussion symptoms or slowed post-concussive healing.(Coppell )In regards to short term cognitive complications, concussions are capable of causing temporary loss of brain function which can lead to symptoms such as confusion, amnesia and the disruption of regular sleep patterns, and according to neuropsychologist Dr. Maryse Lassonde, damage to the brain persists even after the short term symptoms of the concussion have dissipated.(Nordqvist, 2013)
In addition to the short term cognitive complications associated with sports related concussions, athletes also run the risk of developing long term cognitive impairment and brain injuries. According to research presented at an annual meeting of the American Association for the Advancement of Science in 2013, damage to the brain caused by concussions can last for decades following the initial injury. (Nordqvist, 2013) In addition, an analysis conducted by Dr. Lassonde on members of the Montreal hockey team who had suffered severe head injuries, in an effort to determine the long term effects of such injuries, revealed irregular brain wave activity that persisted for years following the initial injury and the partial breakdown of motor pathways in the brain, which is attributed to significant attention issues. (Nordqvist, 2013) Evidence also suggest that the lingering effects of concussions are significantly more severe in the cognitive functionality of older athletes who have suffered such injuries earlier in their careers. In a study comparing the cognitive capabilities of healthy athletes with those of athletes of the same age who had suffered concussions thirty years prior, results indicated that athletes who had suffered head trauma exhibited symptoms similar to early Parkinson’s disease, as well as deficiencies in attention and memory. Additionally, further tests demonstrated that older athletes who suffered head injuries earlier in their careers typically experienced a thinning of the cortex in the same region associated with Alzheimer’s disease. (Nordqvist, 2013)
It is apparent that athletes who participate in high contact sports, such as hockey and football, are significantly at risk of incurring a sports related concussion at some point during their athletic careers, and these concussive injuries can be accompanied by a range of psychological and cognitive complications which can further complicate the lives of the athletes and persist for years following the initial injury. Therefore, preventative measures must be adopted by administrating members of the athletic community to mediate the risk posed by such injuries, such as a mandatory minimum recovery period for athletes suffering from concussions which is aligned with medical research regarding the persistence of post-concussive symptoms. Allowing athletes the time to fully recover from the symptoms of concussions may aid in the prevention of long term cognitive impairment and neurological damage witnessed in athletes who have suffered multiple brain injuries over an extended period of time. In addition, developing effective social networks, such as support groups, to aid injured athletes in the psychological and emotional coping process may prove beneficial in promoting a more successful healing process and the long term mental health of these athletes.
Bloom, G., Horton, A., McCroy, P., & Johnston, K. (2004, January 1). Sport psychology and concussion: New impacts to explore. Retrieved November 5, 2014, from http://bjsm.bmj.com/content/38/5/519.full
Coppel, D. (n.d.). Psychological Aspects of Sports Concussion. Retrieved November 5, 2014, from http://www.ncaa.org/health-and-safety/medical-conditions/psychological-aspects-sports-concussion
Hahn, R. (1997) The Nocebo Phenomenon: Concept, Evidence and Implications for Public Health. Preventive Medicine, 26, 607-611.
Nordqvist, J. (2013, February 18). Concussions Cause Long-Term Effects Lasting Decades. Retrieved November 5, 2014, from http://www.medicalnewstoday.com/articles/256518.php