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Lorenzo Luna

ENGL 1302-231

Dr. Sharity Nelson

9 February 2024

Concussions in Athletes: An Annotated Bibliography

Beilder, Erica, et al. “Going Beyond the State Law: Investigation of High School Sports-Related

Concussion Protocols.” The Journal of Athletic Training, vol. 57, no. 1, 2022, pp. 32-43.

EBSCO doi: 10.4085/1062-6050-0505.20.

Beilder, et al. starts off by going into depths of why and how concussions suffered at the

high school level have long term detrimental effects on the youth. Beilder, et al. identifies

sports related concussion as (SRC) from this point forward bringing up that technology

that helps in regards diagnosis in recovery and detectability has advanced. The

advancement of said technology is leading to more diagnosis in the high school level and

led to a law being created in 2009. The law started in Washington, but since then had a

multitude of states following and eventually leading the whole United States to having

laws related to (SRC) in some way or another. Beilder, et al. includes a graph to showcase

the differences between public and private schools in regards to the amount of

concussions suffered and how many are covered by sports insurance (36). There is a

notable difference between public and private schools as private schools tend to enroll

less kids compared to public schools and are privately funded as opposed to the opposite.

I believe this can help further my research as a multitude of athletes that suffer

concussions later on in life come from a majority of public schools as there are more kids

enrolled there.
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Bretzin, C. Abigail, et al. “Clinical Recovery Timelines After Sport-Related Concussion in

Men’s and Women’s Collegiate Sports.” Journal of Athletic Training, vol. 57, no. 7,

pp. 678-687. EBSCO. doi: 10.4085/601-20

Bretzin, et al. makes the arguments that there are timelines in regards to SRC that

differ based on gender. This article in particular really focuses on collegiate athletes

as opposed to the professional or high school levels. The median amount of time for man

is 8 days as opposed to a woman which is 9 days (678). However, within this window

a student athlete can return faster to their academics as opposed to athletics to not further

injury to the athlete. Participation can restart towards the 12th day without contact, but if

symptoms still appear, then they are still sidelined until their clear protocol. Having a

sense of a timeline furthers my knowledge upon SRC as I can better grasp the severity

of the injury as well as understanding the situation is equal and fluidity is needed.

Bunt, C. Stephen, et al. “Resilience and recovery from sports related concussions in adolescents

and young adults.” Journal of Clinical and Experimental Neuropsychology”, vol. 43, no.

7, 2021, pp. 1-13. EBSCO, https://doi.org/10.1080/13803395.2021.1990214

Bunt, et al. points out that society is getting more involved with sports starting at a

younger age. The ages ranging from 15-24 have increased by up to 25.9% a younger

age. The ages ranging from 15-24 have increased by up to 25.9% since 2003 (1). With the

influx in kids participating also leads to more SRC in the youth with can pose detrimental

effects in the future. This could not only affect their future in regards to being a

professional athlete, but in general just their well being in regards to their normal

everyday civilian life. A graph is included in that showcases patients histories of illnesses

and past disorders which show a direct reflection when they suffered a SRC (4).
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This benefits my research as it only further proves that the youth is suffering from SRC in

the modern day as technology is increasing and the participation in sports tends to grow.

Ellington, J. Chase, et al. “Alteration in Baroreflex Sensitivity and Blood Pressure Variability

Following Sport-Related Concussion.” Life, vol. 12, no.1,400, 2022, pp. 1-6. EBSCO

https://doi.org/10.3390/life12091400

Ellington opens up this article by stating blood cycles can be directly associated with

concussions after the fact (6). The test has people sitting 5 days after suffering their

injury doing breathing exercises while their vitals and blood pressure is analyzed

closely. This all correlates to the brain where blood is pumped to and from and

this is crucial evidence as the whole purpose of concussions is that the brain is

directly affected and it can stunt you in the long run. Brain trauma can be

directly impacted by the blood flow and how little or too much oxygen is being

received. With these tests doctors can better prevent a second incident from

happening again (5). This adds an untraditional test or variable to my study as I would

not associate this simple “test” or metric to be anything more than just a small exercise.

Gray, Haleigh, et al. “Quality-of-Life Outcomes in Individuals with a History of Sport-Related

Concussion and ACLReconstruction: A Pilot Study.” Journal of Sports Behavior, vol. 46,

no. 3, pp. 30-38. EBSCO. https://journalofsportbehavior.org/index.php/JSB/issue/view/18

Gray, et al. opens up this article by stating that concussions as well as ACL tears are

Becoming more and more popular due just the evolution of sports and ability to diagnose

these health concerns. This can lead individuals who partake in sports more vulnerable to

other lingering problems and probable future health risks (30). This is similar to a chain

type reaction and it’s not so black and white. Gray includes a chart of all demographics
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to further find the root of the problem and it in summary means that there is an underling

“string” that follows you throughout your life that can determine the severity of future

injuries if you were to re-injury yourself in any way. This was always a small assumption

of mine that it was similar to a “domino effect”, but to actually get confirmation upon my

theory leaves me at ease.

Hardesty, Kelly, et al. “Treatment of non sports related concussions in adolescents following an

irritability algorithmic approach: a case series.” Physiotherapy Theory and Practice, vol.

38, no. 10, 2022, pp. 1570-1578. EBSCO.

https://doi.org/10.1080/09593985.2020.1855683

Hardesty, et al. states that cost for post concussion treatments is rising due to the increase

of concussions a year (1570). Treatment has also doubled for individuals under the age of

19 which correlates with the already rising risk of individuals obtaining a concussion in

contact sports. There were a multitude of tests done on individuals that had obtained

concussions from sports compared to those who received them in other ways in this case

a motorcycle accident (1571). It was proven the sports related cases are more at risk of a

re-injury due to the need of them returning to their respective sport. When they re-enter

their sport they seriously pose a health risk if they weren’t cleared properly by a medical

official. Compare this to the motorcycle accident, it’s not as likely to happen again as

opposed to an athlete who returns to the sole thing that caused them an injury in the first

place. This further aids my research due to knowing concussions are more likely to recur

when you eventually go back to the cause of the accident as opposed to being a freak of

nature accident.

Henke, D. Ryan, et al. “Does Early Low-Intensity Aerobic Exercise Hasten Recovery in
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Adolescents With Sport-Related Concussion?” Journal of Sports Rehabilitation, vol. 29,

no. 9, 2020, pp. 248-252. EBSCO https://doi.org/10.1123/jsr.2019-0070

Henke, et al. argues that aerobic activity can play a part in recovery in regards to SRC.

The two subjects tested on were athletes and non-athletes and they were given the same

variables and circumstances were consistent throughout (248). Contrary to popular belief

the “4 week” recovery period in which you shouldn’t be attempting physical activity is

false as this aerobic exercise can actually prove beneficial. Improve blood flow and

increase of oxygen to the brain proved beneficial to the athletes in particular as their body

has been through more turmoil compared to the average person. Henke, et al concludes

aerobic activity should be encouraged in small increments as there can always be “too

much of a good thing (249). In regards to recovery I did always wonder what could be

done besides “resting”, so being able to backpocket this knowledge is truly beneficial

for my research on sports concussions going forward.

Musko, Patryk, and Andreas K. Demetriades. “Are Sex Differences in Collegiate and High

School Sports-Related Concussion Reflected in the Guidelines? A Scoping Review.”,

Brain Sciences, vol. 13, no. 1310, 2023, pp. 1-18. EBSCO,

https://doi.org/10.3390/brainsci13091310

Musko and Demetriades delve into the topics of gender differences and how it relates to

concussion suffered in sports. In this article, sports related concussion is also referred to

as (SRC) as the previous (1). Musko and Demtriades argue that with the increasing

involvement of women in sports, they are also more susceptible to SRC as opposed to

their male counterparts (1). Most of the trauma is induced from soccer related injuries

and they suffer a multitude of side effects including loss of sleep, headaches, migraines,
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and the ability to recover from SRC. A table is included with various sports and how

there is a difference in the amount of SRC’s that women suffer from as opposed to men

(4). Sports like football, rugby, hockey, and male dominated fields have a very small

number of women suffering from SRC due to a small number of women participating in

said sports. Sports shared more widely by both genders such as soccer, softball, and

swimming have women exceeding the average number of SRC (4). This greatly helps my

research as I believe that when people associate concussions in athletes I believe they

always greatly overlook women’s involvement in the sports world due to the bigger view

that is placed on solely men’s sports.

Tsur, Atzmon, and Avi Ohry. “Sports-related concussions and strangulation.” Health, Sports and

and Rehabilitation Medicine, vol. 24, no. 1, 2023, pp. 27-31. EBSCO,

https://doi.org/10.26659/pm3.2023.24.1.27

Tsur and Ohry open up the article by defining what a concussion and strangulation is

(27). As we are familiar with what the term concussion or SRC by now, Tsur and Ohry

also mention strangulation. Strangulation is not so common in sports like football, soccer,

baseball, etc, but is common in sports such as judo and wrestling. It involved cutaway of

oxygen to the brain in hopes of making your opponent pass out. Kids and adolescents are

more at risk for severe head damage to their head being undeveloped which further

proves all the other studies' claim (28). Tsur and Ohry also state concussion recovery

period should be two weeks before an athlete can return to action while kids should wait

up to four weeks (29). Post-traumatic syndrome may arise after recovering from a

concussion as a side effect after obtaining a SRC. This enhances my knowledge on the

topic as I now have a recovery timeline and get further confirmation about the effects of
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concussions on the youth.

Walker, Daniel, et al. “Developing a simple risk metric for the effect of sports-related concussion

and physical pain on mental health.” Plos One, vol. 18, no. 10, 2023, pp. 1-12. EBSCO

https://doi.org/10.1371/journal.pone.0292751

Walker, et al. goes into explanation by saying that besides the physical impact you feel

from SRC, there is also the mental aspect associated with it. In today’s day and age of

mental health awareness, this should not be overlooked as mental health is just as

important as being physically healthy. A survey was created called the “Center for

Epidemiological Studies Depression Scale” which surveyed 144 participants who

suffered from SRC in the past (1). An overwhelming majority came back with

depression-like symptoms. In addition to this women experience higher levels of

depression compared to men despite competing in less contact sports (2). Walker, et al.

going into depth that the creation of the survey was in order to help society with their

decisions to participate in sports and to also consider the mental side effects that might

also appear with time. Without a doubt my research can benefit from this article because I

feel like society just views these athletes as just machines and forget that first and

foremost they are people too.