Academic journal article Journal of Sport Behavior

Social Influences on Return to Play Following Concussion in Female Competitive Youth Ice Hockey Players

Academic journal article Journal of Sport Behavior

Social Influences on Return to Play Following Concussion in Female Competitive Youth Ice Hockey Players

Article excerpt

Ice hockey is among the most popular youth sports in North America, behind only soccer and swimming (Government Canada, 2013). Recent data suggest there were approximately 351,890 youth hockey participants in the United States (USA Hockey, 2014), and more than 600,000 youth registered for hockey in Canada (Ontario Hockey Federation, 2013). Participation in hockey has increased world wide with many of the new participants coming from countries in Europe (IIHF, 2014). Among European countries, Russia, Sweden and Finland have lead the way among youth hockey registrants (IIHF, 2014). Youth hockey players are subject to a wide range of injuries; however, there is literature to support that concussions are not only the most common specific injury type, but also that concussion rates appear to be rising among youth hockey participants (Emery, 2006; Emery & Meeuwisse, 2006; Proctor & Cantu, 2000). These recent findings have prompted a greater discussion around the safety of players in youth hockey and led to rule changes in both Canada and the United States. For example, in response to the elevation in sport-related confirmed concussions, the Ontario Minor Hockey Association (OMHA Official Playing Rules, 2013) has changed Rule 6.2--Body Checking, twice in the past two years, more recently removing body contact at the Peewee age group (ages 11-12) in order to promote greater player safety. This rule change has since been implemented nation-wide across Canada.

The prevalence of concussions in youth sport has generated discussion around the Return to Play (RTP) guidelines for athletes who have suffered a concussion (e.g., Creighton, Shrier, Shultz, Meeuwisse, & Matheson, 2010; Davis & Purcell, 2013; Echemendia, 2006). Following the diagnosis of a concussion, athletes may begin the RTP process. This process is fluid and can be influenced by a variety of factors. Creighton and colleagues have provided a decision-based RTP model that outlines three key factors and numerous sub-factors. The three main factors outlined are; (1) Medical factors (e.g., demographics, symptoms, and medical history), (2) Sport risk modifiers (type of sport, position played, and competitive level), and (3) Decision modifiers (timing, pressure from the athlete, and external pressure). Decision modifiers are identified by Creighton and colleagues as additional factors that may change the athlete's decision to RTP. The factor that is the focus of this study is decision modifiers, and more specifically, external pressure otherwise described as social influence of others. Creighton and colleagues consider external pressure to be "pressure from people other than the athlete, and the clinician" (p. 383). This pressure may come from family members, teammates, coaches or others, and could influence the athlete's decision when contemplating returning to sport. Based on this definition, the pressure may be considered a form of social influence.

Social influence is commonly described as how one individual impacts, directly or indirectly, the thoughts, feelings, or behaviours of another (Turner, 1991). There is literature that highlights the importance of supportive roles from important others during the recovery process from both orthopedic injury (Bianco & Eklund, 2001) as well as concussive injuries (Caron, Bloom, Johnston, & Sabiston, 2013). Bianco and Eklund (2001) identified that elite level skiers found family and important others (e.g., spouses, loved ones, or close friends) to play a predominantly supportive role when recovering from a variety of injuries. More specific to concussion, Caron and colleagues (2013) found that former NHL hockey players were subject to a number of social influences including family members, coaches, and medical professionals. The athletes identified varying types of influence, including positive influences from family members, and at times negative influences from medical professionals or coaches. …

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