Abstract
Field hockey has an increased risk for sports-related concussion injuries due to intrinsic and extrinsic factors associated with the rules and equipment of the game, despite hockey being classified as a non-contact sport. Symptoms of concussion are diverse and may have a delayed presentation, contributing to a high number of sports-related concussions that are overlooked and undetected. Undiagnosed concussion injuries may result in adverse health complications and impact long-term neurological conditions. Multiple concussion injuries and sub-concussive impacts may have a cumulative effect or threshold dose effect, contributing to neurodegenerative diseases. Concussion injury protocols are imperative to improve the detection, management, and outcomes of sports-related concussion injuries. However, hockey concussion injury protocols are insufficient compared to those for sports such as rugby.
This study was a partially mixed sequential dominant status design (QUANT – qual), divided into two phases. In phase one, a modified RoCKAS-ST questionnaire was conducted with hockey players, coaches, umpires, and technical officials (n = 119). In phase two, a focus group discussion with umpires (n = 3) and interviews with coaches (n = 3) were conducted.
Of the 101 hockey players 18,8% were diagnosed with a sports-related concussion between March 2018 and March 2022. Of this population, 35.6% reported having had a concussion before March 2018. Injuries to the shoulder, neck, head, and face were reported as the result of the following: 98 stick-related injuries; 102 ball-related injuries; and 187 collision-related injuries. However, only 20 of these reported injuries resulted in a concussion, indicating that possibly many concussion injuries were overlooked, undetected, or not reported at the time of injury. Of those players diagnosed with a concussion, 40% continued to play following the injury, either because it was an important game or the severity of the injury was not detected. During the focus group discussion and interviews coaches and umpires recognised that potential concussion incidents required educational intervention to improve on-field diagnosis and management.
Of the total number of reported hockey-related injuries (n = 387), only 20 (5,2%) were identified as concussion. These results indicate that many injury incidents occurred to the head, face, mouth, neck, and shoulders of the athletes but the actual number of concussions diagnosed following these injuries
iv
were minimal (18.8%). The reported number of injury incidents suggests that many concussions could have been undetected and left untreated. This small percentage could indicate a gap in the knowledge regarding concussion injury detection and poor on-field management. It is imperative that concussion protocols are developed to support player welfare.