Concussion Response Plans Are Lacking at Some NCAA Universities, Study Finds

A Harvard/Boston University paper finds small but dangerous lapses in concussion reporting in a survey of 2880 coaches, clinicians, and school administrators.

The scientific evidence and anecdotes are mounting: Football poses dangerous consequences for a player's brain. In the short term, a hard enough hit can kill, as we've tragically seen this fall in high school football. In the long term, professional players have been facing chronic neurological diseases, as researchers have discovered in autopsies of deceased players' brains.

Yet concussive injuries at the college level aren't consistently reported. Earlier this month, researchers at Harvard and Boston University released a disturbing statistic: For every concussion diagnosed, players experienced 21 smaller hits that weren't reported. While those hits didn't necessarily result in concussions, failure to report each one—and to do the assessment that would normally follow—means that some percentage of players could be on the field with an undiagnosed concussion.

That same Harvard/BU team released a follow-up study Tuesday in The American Journal of Sports Medicine on what happens when concussions are actually reported. And while the research team finds that a vast majority (92 percent) of the coaches, clinicians, and administrators representing 85 percent of NCAA schools said they employed a concussion management plan as mandated by the NCAA, the holes in compliance are unsettling:

Collectively, the institutions without a concussion management plan are responsible for the well-being of thousands of collegiate athletes each year.... Thirty respondents at 27 schools reported their school did not have a concussion management plan, 175 respondents from 140 schools were unsure whether their school had a concussion management plan, and 135 schools had conflicting responses about whether the school had a concussion management plan.

Even if the schools did indeed have concussion plans in place, the fact that coaches, clinicians, and administrators were unaware of them means that these NCAA schools need to do a better job of making them known. "For stakeholders to follow an institution's concussion management plan—or to have confidence that other stakeholders are following the plan—they must first know that it exists," the study's authors write.

The study also concludes:

• "A minority of respondents believed that coaches or athletes could also make final [return to play] decisions." Those decisions should be made by clinicians, according to the NCAA guidelines.
• "Adherence to the NCAA's athlete concussion education mandate was reported at 70.8 percent of schools."
• "It is concerning that even minimal levels of information provision are not reported at all institutions."