by Ella Malone, Concussion Recovery Advocate

(Read Part 1 and Ella’s Success Story)

We know that when a player returns to the field after a head hit like I did, the risk of brain damage increases and effects of the concussion become exacerbated. Injured players must be pulled off the field immediately, even if a concussion is only suspected. However this is not always the case. For all the wrong reasons, we see players of all ages return to the field hit after hit after hit.

So if returning to the game can be more devastating to recovery, why do players do it? After a genuine passion for playing the game, there are two answers to that question:  pressure to “be a team player” and a culture that rewards those who “tough it out”. Before I even dive into this, players, know this:

“Sometimes walking away has nothing to do with weakness, and everything to do with strength”- Toby Mac.

It’s okay to take a knee! There is courage in doing so.

A true team cares about its members

Many players with head injuries stay on the field so they don’t feel like a let down to their team, their coach, or loved ones watching from the stands. For those of you that view walking off the field as weak, you’re just plain wrong; those willing to admit and own up to their situation are courageous. Teammates, the best thing you can do as a member of a team is support each other, especially in decision making. Do your part as a teammate and don’t put pressure others to play after a head injury. While you may feel like encouraging someone to keep playing is the same as cheering them on, you’re really asking them to ignore what could be a life-threatening injury. Instead, tell a concussed player it’s okay to walk off and rest. Make sure they know that it’s in their best interest to stop before things become worse. Communication is key!

COVD’s ‘Return to Learn’ infographic on getting back to school safely after concussion

The dangers of “toughing it out” not only apply on the field but in a school or work setting, as well. If the brain is rushed back to mental strain before it has had a chance to restore its normal activity, it can prolong recovery time. It’s important that the brain gets adequate rest before return to any mental or psychical activity. That’s why there are protocols in place that you must pass or be cleared for before returning to school, work, or other activities. The protocols exist for a reason–to ensure your protection and health, both mental and physical. (Not all protocols are created equal–read our post about the National Women’s Soccer League’s questionable return-to-play guidelines.)

Please don’t tell players to “tough it out”

Now that we’ve addressed the misguided fear of letting down your team, here comes the infamous “tough it out” card. We all have probably heard it or used it ourselves (even in circumstances outside of sports), but have you ever once to stopped and thought of the damage that attitude can, and probably will, cause? If someone continues to play while injured, the risk of new injury and more damage to the previously injured area increases.

When another player kicked me in the head during a soccer game, I played the final ten minutes of the second half and then went on to double overtime. Fortunately, I wasn’t handed the “tough it out” card by my parents, I did not want to tough it out myself, and I wasn’t pressured by my teammates. But none of this mattered because my coach did not see me get kicked and refused to let me sit out the end of the game, despite my tell-tale signs of concussion. Former soccer coaches and parents on the sidelines kept telling my coach “You need to pull her out!”… but nothing happened. Only when that double overtime ended was there finally concern that I may need medical help. That was in September 2014 and, while I’ve made huge improvements thanks to vision therapy and other treatments,  I continue to live with post-concussive syndrome. Almost three and a half years later, I still have symptoms on a daily basis. I can’t help but think that those extra minutes in the game may be part of the reason my symptoms stick around.

Coaches and parents, players know their own bodies and limits best. If a player seems “with it” enough after a head hit to tell you something feels not quite right, you need to listen. Please, don’t ignore the signs.

Players, please don’t “tough it out”! If you are hurt, take a knee. If you don’t, you will only make things harder on yourself. The longer you play with a brain injury, the more you increase your chances of other injury and increased damage. Just minutes on the field while your brain swells up inside your head could prolong your recovery by months or even years. Do yourself a favor by getting the rest your brain needs.

Parents, I ask and advise that if your child takes a fall or hit that might be a concussion, please have them pulled from the sport for screening. Communicate with your child before any game and let them know that it’s okay if they are pulled out. Make sure they know you care more about their health and well-being than a game. That can be hard for an athlete to understand because, to them, it’s more than just a game. I myself understand that. For passionate athletes, what looks like “just a game” to others is really a way of life; your teammates and coach become your family.

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Join us at the 48th Annual Meeting April 10-14, 2018, for these courses that bring together concussion, sports, and vision, plus so many more!


As a closing remark, I strongly advise players to take a knee. Go down if you are hurt, don’t tough it out. Teammates, parents, and coaches–help injured players stay safe by assuring them it’s okay to leave the field. Make the right call: sit it out, don’t tough it out!

Have you or a loved one suffered a concussion, or any blow to the head, either on the field or off it? Don’t just shake it off–Locate a Doctor near you who can help and learn more from COVD!