April 29, 2025
Student athletes with ADHD more susceptible to concussion: U-M researcher discusses
Study shows high school athletes with ADHD who experience a concussion also experience prolonged recovery
When athletes who have attention-deficit/hyperactivity disorder get concussions, their ADHD disorder may prolong recovery, researchers think.
A recent study in the Journal of Athletic Training has examined this theory. It found that high school athletes with ADHD who experience a concussion also experienced prolonged recovery in returning to learn and returning to sport. The researchers also found that women and younger athletes experienced a longer recovery.
Steven Broglio is a professor of kinesiology, neurology, and physical medicine and rehabilitation at the University of Michigan, and director of the U-M Concussion Center. He joined a roundtable discussion hosted by the National Athletic Trainers' Association to discuss the research.
Can you give a brief context of the study and your discussion for us?
The study evaluated the length of recovery among concussed high school student-athletes, finding that those with ADHD had a slightly longer timeline. These studies are important as we think about concussion as a biopsychosocial injury, with risk and recovery influenced by the injury biology, the psychology of the athlete (e.g., ADHD) and the social structure around the athlete (e.g., team/family support).
What were the primary study findings?
Between 4% and 8% of young athletes have ADHD. Athletes with ADHD often present with multiple risk factors for prolonged concussion recovery, which makes it difficult to isolate the effect of ADHD. Athletes with ADHD are more susceptible to multiple concussions, exhibit more severe acute symptoms, and typically have at least one coexisting condition. While the effect of ADHD has been debated extensively, there's no clear clinical consensus on how to optimize patient recovery.
This study analyzed the recovery outcomes of student athletes from 60 high schools between 2010 and 2018, tracking the recovery of 553 males and 382 females. It found that ADHD was a significant predictor of prolonged recovery to both return to learn and return to sport. Athletes with ADHD were about 1.16 times longer to return to learn and 1.17 longer to return to sport.
The study also found that female athletes and younger athletes were also more likely to have a longer recovery. Women took about 1.13 times longer to return to learn and 1.07 times longer to return to sport. Younger athletes experienced longer recovery, but each year they gained in age decreased recovery days by 0.98.
Why are student athletes with ADHD more susceptible to concussions, and why would they have more acute symptoms?
It is believed that those with ADHD are less likely to pay full attention to their environment and other players while participating in sport. In those instances, they may not appropriately brace for or avoid a head impact that results in a concussion.
What should athletic trainers or health care providers understand from this study?
Athletic trainers are typically the front line health care providers for active individuals. As each concussion is unique and specific to the athlete, athletic trainers are best equipped to provide an individualized approach to concussion management that is unique to the athlete.
In light of the study findings, health care providers need to recognize ADHD as a risk factor for prolonged concussion recovery. Given the significance of sex-based and age-related differences, individualized approaches to concussion management should be prioritized to optimize recovery outcomes.
Roundtable discussion: ADHD & Concussion Recovery: New Research, Best Practices & Beyond
