Concussions during theater? Yes, that’s right. They’re a huge problem that happen, for the most part, “off the grid.” In other words, they are not publicized, nor are they cared for properly most of the time.
As an athletic trainer, my education and licensing includes evaluating and caring for those who suffer concussions. Back in 2002, I chose to change my career direction and apply my skills to performing artists instead of traditional athletes. They have an enormous need for proper, specialized healthcare for concussions and every other injury they encounter. Today I lead a performing arts medicine program at Ohio University that I designed to meet the healthcare needs of the university’s performing arts students. But, I want to focus on theater here.
FREQUENCY OF CONCUSSIONS DURING THEATER
While the sports world places heavy attention on concussion, virtually no consideration is given to this serious brain injury in performing arts. This is especially true of concussions during theater activities. Initial research from my lab suggests that technical theater and production work account for 8 out of 10 theater-related blows to the head. While theater personnel generally understand concussion symptoms and the serious nature of concussions, nearly three-quarters of those who experienced a blow to the head and concussion-related symptoms did not report their injury to anyone in authority, including healthcare practitioners.
For those who did visit a healthcare professional and receive a diagnosis of concussion, more than 25% of them were released back to their theater activity with no restrictions nor with any guidance for a progressive return to activity known to be essential in managing concussions. This is appalling! And dangerous!
HOW ATHLETIC TRAINERS CAN HELP THE PROBLEM
Athletic trainers are healthcare professionals with specialized education in diagnosis and management of concussion. They can provide theater personnel with appropriate advice regarding prevention, evaluation, and treatment of this injury. That’s why in our performing arts medicine program at Ohio University, we equip athletic trainers with skills to care for performing artists. Hopefully more and more universities, as well as professional arts organizations, will employ athletic trainers or other healthcare providers with a background in performing arts medicine. Artists are special people with special talents. They need special care to match.
MORE ABOUT THE RESEARCH ON CONCUSSIONS DURING THEATER
For a fuller picture of the initial research that I did with one of my honors athletic training students, here is the abstract (summary of a research project) that we presented at the 2016 annual symposium of the Performing Arts Medicine Association in New York City. I’m pleased to say that this is just the beginning of our work with theater injuries.
Title of Presentation: Concussion Knowledge of Theater Personnel
Authors: Brooke Daniell, ATC and Jeffrey A. Russell, PhD, AT, FIADMS
Background: Concussion is a neurometabolic brain injury that is well publicized in sports. Performing artists are at risk for concussion, but do not always have access to specialized healthcare to manage this injury. Many on-stage and backstage activities, obstacles, and hazards place actors and production workers at risk of concussion.
Purposes: to determine the knowledge and attitudes of theater personnel regarding concussion and concussion risks, and whether they have previously experienced concussion.
Methods: An online survey was sent to members of university theater departments and professional theater companies. Respondents were asked to identify concussion symptoms from a list of correct and incorrect symptoms and to share their attitudes regarding concussion by completing sentences about sustaining and reporting this injury. Participants then selected mechanisms of sustaining a concussion from a list of correct and incorrect choices. Finally, respondents indicating they had suffered one or more concussions during theater activity answered questions regarding mechanism of injury, symptoms experienced, whether they reported the injury, and, if so, to whom.
Results: Theater personnel have a general understanding of concussion mechanisms and symptoms and perceive the injury as serious and worthy of medical attention. Sixty-seven percent of true concussion symptoms were identified by participants, and only 21% of false concussion symptoms were incorrectly identified. However, 72% of participants indicated they hit their head, experienced concussion symptoms, yet did not report the incident. Eighty-two percent of participants who hit their head in the theater were participating in an activity related to scene construction or technical elements. Twenty-eight percent of the participants who were seen by a healthcare provider and diagnosed with a concussion were not given any activity restrictions.
Conclusions and Practical Relevance: Theater personnel work in environments that present risk for concussion. Safety in performing arts environments cannot be accomplished unless risks are identified and personnel are properly educated. This study provides insight into the extent to which theater personnel understand concussion and its risks, as well as the nature of healthcare delivered to concussed theater personnel. Concussions are prevalent in theater; however, better care for this injury is needed.