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Study raises questions over coaches’ awareness of concussion protocols in youth football

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A new study has raised questions over an apparent lack of awareness of concussion protocols among coaches in Scottish youth football.

Led by the University of Stirling, the research involving interviews with 10 coaches, found the majority had no knowledge of Scotland’s “If in doubt, sit them out’ initiative—the only sport-related concussion campaign in the world that has the backing of all sports and national government.

Of those interviewed in October 2018, only one had heard of “If in doubt, sit them out,” which was launched earlier that year to encourage coaches, parents, players and others to recognize when a concussive injury may have been sustained.

Researchers believe the lack of meaningful understanding demonstrated by this group of coaches based at a mix of girls’ football clubs in central Scotland, may point to a wider unfamiliarity with the policy among those who play a key role in recognizing head injuries in players.

“If in doubt, sit them out’ saw Scotland recognized as a world leader in recognizing the significance of sport-related concussion in young players. Bringing all sports together in response, the policy urges coaches to adopt a sense of caution and remove someone from play to get medical attention in a bid to protect them from short- and long-term harm.

With the UK Parliament’s Digital, Culture, Media and Sport Committee currently undertaking an inquiry into the long-term effects of concussion in sport, and what can be done to prevent it, there is a sustained focus within the world of sport on the prevention of long and short-term brain injuries.

Alongside low levels of awareness of Scotland’s national campaign to protect the head in sport, any knowledge of concussion of those involved in the research had come from the media or social media, rather than specific training or guidance delivered through their sport.

Dr. David McArdle, Head of the University of Stirling Law School, said: “This small study has shown us that awareness of “If in doubt, sit them out’ was far more limited than we had anticipated. With no meaningful knowledge of the initiative, coaches who are faced with a child who had received a blow to the head are not using the guidance to inform their decisions about what to do next.

“The policy was a fantastic, positive step forward in the discussion around concussion, putting Scotland at the forefront of progress around the issue, but it may be that more needs to be done to ensure coaches implementing the practice on the ground are aware of it so it can be as effective as possible.”

While much research has focused on the long-term impact of sports-related brain injuries, this study sought to gage coaches’ awareness of more immediate, short-term damage including ‘second impact syndrome’ – when the brain swells rapidly shortly after a person suffers a second concussion before symptoms from an earlier concussion have subsided.

Dr. McArdle explained: “The problem is that if even a ‘minor’ sports-related concussion is followed by another head-knock before it is resolved, the second impact can prove very serious. We want people, particularly youngsters, to stay active so ensuring coaches have an understanding of concussion guidance allows everyone to take part in sport in as safe an environment as possible.

“As we look towards organized physical activity in a post-COVID world, there may be more potential opportunities to engage people in a range of public health and safety messages including a renewed focus on concussion.”

The research, funded by the Royal Society of Edinburgh, was a small project involving coaches of under 14 girls’ football teams. Awareness across girls’ and boys’ football and a variety of sports, geographical locations and backgrounds involving a larger number of participants and coaches is still to be investigated.

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