Tackling the Concussion Topic: Athletic Training Student Examines Concussion Injury Prevention and Diagnosis

Growing up as an athlete, Hannah Clayton was no newcomer to the world of sports injuries. Throughout her high school soccer and basketball career, what stuck with Hannah was the assistance of her athletic trainers. When it came time for her to choose a career path, the choice was clear.

“I always knew I wanted to be around athletes and in a competitive environment,” Hannah says. “I had my own fair share of injuries in high school, and that’s how I was introduced to athletic training.” 

Soon after beginning her clinical rotations at Greensboro College as an athletic trainer, Hannah says she fell in love with the role. Due in large part to the relationships she forged with her athlete patients, Hannah was eventually compelled to pursue further study on a topic that has garnered much controversy in both the medical and sports world today: concussions. 

THE GAME PLAN 

When Hannah took a multidisciplinary psychology and sociology class entitled Death and Dying, she had no idea the class would lead to her honors thesis. She chose to write the required literature review for the class on catastrophic brain injuries in football players—a topic connected to athletic training and her clinical rotations with Division III football players at Greensboro College. Soon Hannah realized this topic could provide her with more material than one literature review could handle. 

“I had a lot of questions about all the concussion research that’s been coming out recently, so I took that route with my thesis,” she says. “In my athletic training education we hadn’t really talked a lot about concussions, but at the same time I was working with football, so I saw in the field how concussions were being evaluated and treated.” 

Hannah dove more deeply into her observations of what goes into a concussion evaluation, and she noted there didn’t seem to be one streamlined approach to diagnosis. This gap in concussion diagnosis and reporting revealed yet another layer to Hannah’s research topic—how football culture influences the self-reporting of concussion symptoms.

“It kind of turned into how athletes perceive concussions, because a lot of [concussions] go unreported and undiagnosed. Concussion symptoms are subjective, which means you can’t really observe them from an outsider’s point of view,” she explained. “The concussion evaluation depends on the athlete being honest and coming to [the athletic trainer] about their symptoms. If your athletes don’t feel comfortable or don’t want to report their symptoms, then there’s no way you can do an evaluation.” 

THE FIELD STUDY

So Hannah took her research to the field—the football field. Along with her extensive secondary research, Hannah constructed a questionnaire that she sent to various athletic trainers, concussion specialists, and football coaches. Hannah ended up receiving responses from 18 athletic trainers, eight coaches, and three concussion specialists. Although she hoped to gain more responses, she admits timing was a major obstacle to overcome in the course of her project. 

“It took a while to get the questionnaire together. I sent it out in the fall, which is football season—the busiest season,” she laughs.

However, the data Hannah received back from her study participants still yielded telling results. She asked questions on concussion diagnosis and treatment to each audience segment—even receiving players’ perspectives from coaches who were former players. While some of the responses to her questionnaire and even several interviews aligned with her hypothesis, she was surprised by some of the findings. 

“Going into the project I thought that a lot of athletes would be hesitant to report their symptoms, and a lot of the athletic trainers I interviewed talked about that,” Hannah says. “But some of them really said their athletes are more hypersensitive to impacts and are really concerned about concussions.” 

Hannah attributed this kind of hyperawareness and fear associated with head injuries to the shift of media portrayals of concussions. CTE and concussion research also factor into the growing public opinion of the dangers of head injuries. Hannah knows though, that media portrayals can only express so much of the importance of concussion research.

“From the athletic trainer’s perspective, it’s really important to stay up to date on the research and know the facts so that you can educate your athletes and build those relationships so they’ll come and talk to you.”

THE END GOAL 

Hannah eventually compiled a manual from her research for entry-level athletic trainers to use when assessing concussion symptoms and further treatments, particularly for those unfamiliar with football injuries. This manual is partially fueled by what she found through the process of her honors thesis: the value of staying informed on current athletic training research. 

“Learning to be a critical consumer of the research that’s coming out and being able to think and process through it and form your own opinions on things,” Hannah says is one of the major takeaways from her project.

“I really like to learn more and build myself up in knowing facts so that in my clinical practice I can implement those things and be able to explain the how’s and the why’s to my athletes of what we’re doing and why we’re doing it.” 

At the Alpha Chi conference, Hannah had former and current football players approach her to ask about her work—even before the presentation of her findings. Many of the players, disappointed by their own athletic trainers’ disengagement and lack of energy on concussion research, voiced their appreciation for Hannah’s work. 

Hannah learned from these conversations how easy it is for athletic trainers to burn out and voices her own dedication to fighting against the compassion fatigue that can challenge medical professionals.

“It’s understanding my own personal boundaries because it is important to build those relationships, but at the same time, you need to take care of yourself so you don’t get burned out,” Hannah says.

Even still, Hannah is quick to call relationship building “the best part of athletic training.” She says that it’s the healthy dedication to open communication and trust-building that serves entry-level athletic trainers especially well. 

Hannah graduated in May of 2019 from Greensboro College with her bachelor’s degree in athletic training and is now a certified athletic trainer. She will attend the University of Kentucky to receive her master’s degree in athletic training and is considering eventually pursuing her doctoral degree. But Hannah doesn’t plan to let her concussion research live only in the classroom—eventually she intends to use her research to create educational materials for coaches and athletes so that concussions can be better prevented and treated daily.

“I think the biggest thing for me is the education as far as promoting injury prevention and really building those relationships with your athletes,” Hannah says. “That’s the most important thing in concussion prevention and evaluation.”