A Qualitative Study of Collegiate Student-Athlete Experiences of Recovery After Concussion.

Objective: Social and cultural dynamics surrounding expectations of athletes may influence recovery after sport-related concussion. Qualitative investigations narrowly focus on reporting, or specific age groups or sports. We explore how collegiate student-athletes experience concussion recovery; manage diagnosis, symptoms, and return-to-academics and return-to-play decision-making.

Setting: Collegiate athletics at a large, private Division 1 University in Philadelphia, PA.

Participants: Twenty-two varsity student-athletes who sustained a diagnosed sport-related concussion within 1 year from start of data collection (October 1, 2022) and progressed through the return-to-play protocol, inclusive of recently graduated alumni.

Design: Qualitative interview study.

Main measures: We conducted semi-structured interviews between October 2022 and May 2023 about how experience with concussion(s) shaped their perception of risk, reporting, recovery, and that of stakeholders (teammates, coaches, athletic trainers, family members). We analyzed interview data using the framework analysis method and created a post-injury-recovery-return model to summarize participant experiences in the context of these key moments over time.

Results: Twenty-two student-athletes (women, 59.1%; White, 77.3%; 27.3% Sophomore year) representing 15 sports teams participated. The majority of respondents experienced at least 1 concussion prior to their varsity athletics concussion. Respondents reflected on 4 key moments in their experience recovering from a concussion: (1) immediately post-diagnosis, (2) during recovery, (3) decision-making about sport and academic return, and (4) return to sports and academics. We identified the importance of managing expectations, previous concussions, and emotions on recovery and return-to-academics and sport decision-making. We also found experiences were shaped by the social environment and key actors.

Conclusions: Our findings indicate that experiences after concussion are influenced by factors including expectations for recovery, managing symptoms, and navigating decision-making, and by relationships and the social environment. Findings have implications for the way concussion is managed, and the design and application of new treatment and management guidelines for concussion. Future targeted work should investigate ways to explore and measure these factors.