Why do pediatric athletes continue to play after concussion?


As sport-related concussion incidence has increased in the pediatric population, the risks of continuing to play while injured have become apparent. These risks include subsequent injury, prolonged recovery, and Second Impact Syndrome. The purpose of this study was to determine why pediatric athletes continue to play following a concussion.


Prospectively collected data of subjects enrolled in the North Texas Concussion Network Registry (ConTex) between December 2015 and April 2018 was reviewed. Subjects were included in this analysis if they were diagnosed with a sport-related concussion, less than 19 years old at time of injury, reported they continued to play, and provided a reason for continuing play.


Two hundred fifty-eight subjects met inclusion criteria. Mean age was 13.9 years (range: 7–18 years) and 130 (50.4%) subjects were female. One hundred forty-two (55%) subjects reported they continued to play following their concussion. Of those subjects who continued to play, 45 (31.7%) reported they “felt okay at the time” 41 (28.9%) reported they wanted to “play through the injury or tough it out” 36 (25.4%) reported they “did not realize it was a concussion” 17 (11.9%) reported they “felt pressured to play from their coach or teammates” and 3 (2.1%) reported they “were allowed to continue to play by an athletic trainer.” No significant differences were noted in age, gender, or sport of the pediatric athletes amongst the reasons for continuing to play.


More than half of pediatric athletes continued to play following their concussion. Pediatric athletes most frequently continued to play because they were not experiencing symptoms at the time of the injury, wanted to play through it, and did not think their injury was a concussion. Future educational programs should take these reasons into consideration to prevent pediatric athletes from continuing to play following a concussion.

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