Why Coaches, Athletic Trainers and Doctors Must Avoid Terminology That Downplays the Seriousness of a Concussion

How we describe and label injuries can affect how young athletes perceive their severity.

Injuries are a part of sports; there is no doubt about it. Strains, sprains, concussions, chronic overuse injuries, acute traumatic injuries, etc. are all a part of sport. The sporting environment demands athletes to be tough and play through aches and pains. This is news to no one.

But as we begin to better grasp the effect of communication and terminology between healthcare professionals, coaches, athletes and parents, we have to realize that what we say can affect perception, outcomes and health. For example, if a football player goes down after a blunt force impact to the tip of the shoulder, many coaches or old-school athletic trainers may shrug off that injury as a "stinger" or "shoulder pointer."

If I were to express that to one of my athletes, their fears of a serious injury would likely decrease and they would be more likely to try and continue playing, regardless of their signs and symptoms. If I were to tell them they suffered from a possible brachial plexus injury where the biggest grouping of nerves in trunk are located that supply innervation to most function of the upper extremity and that continuing to play could have a negative effect on their long-term function, well their mindset may be a bit different.


You can see how different explanation of the same situation can either downplay the severity or accurately describe it. This may not be as big a deal with an ankle injury for example, but if we are dealing with concussive blows or repeated sub-concussive blows, it can greatly affect the healthcare of an athlete. Knowledge and research of traumatic brain injuries has greatly improved over decades of intense scrutiny and we are only now really even scratching the surface of the long-term effects of these injuries.

"Sport-related concussion is a traumatic brain injury induced by biomechanical forces. Concussion may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an ''impulsive'' force transmitted to the head. These typically result in the rapid onset of short-lived impairment of neurologic function that resolves spontaneously." This is a nice operational definition that is commonly used to define what a concussion is.

We have come a long way from coaches and even sports medicine professionals having athletes "push through the pain" or "stop being soft," and that isn't to say that it doesn't still happen, because it unfortunately does. But the sooner we get away from making light of or downplaying the severity of concussion, the better we will be able to manage these traumatic brain injuries. My tagline to athletes and coaches has been the Friday night game isn't worth the risk of a lifetime of complications. I hope this statement holds some weight with them, because although now my main priority is the health and safety of student-athletes, I used to be an athlete as well and can tangibly remember how important those sporting events seemed to be at that present moment.

Just like my example with the brachial plexus injury, communication and terminology can play a big role in how brain injuries are viewed, and it's our job as healthcare professionals to not take that responsibility lightly. I have seen it first-hand, when I send an athlete and their parents to a physician for a traumatic brain injury evaluation after I have completed an evaluation myself, the physician's words can go a long way. "Mild traumatic brain injury" or "slight concussion" or "bell-ringer" are a few that come to mind when talking about poor terminology. When we hear these words that downplay the severity of something very serious, we can begin to become numb to just how dangerous these injuries can actually be.

I urge professionals, coaches, athletes and parents who are around athletics to think about how you are talking about things and the impact it can have on others, especially young student-athletes. We are here to provide safe and productive environments for young people to reach their full potential while keeping their best interests at heart, and it all starts with our words. Let's do better.