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Theater injuriesStudents in rotation at the SHAPe Clinic, part of the School of Health Sciences and Wellness, practiced extraction drills in the lighting grid of The Forum Theater in 2015. Photographer Matthew Forsythe, BBA '12.

OHIO research calls attention to concussions in theater personnel

There’s no tackling or helmet-to-helmet hits in theater, but actors and stagehands are just as susceptible to head injuries as those on the field.

Assistant Professor of Athletic Training Jeff Russell and Brooke Kapple, BSAT ’16, noticed a growing trend in head injuries while working in the Science and Health in Artistic Performance Clinic (SHAPe Clinic). Students working in theater, including set builders, soundboard technicians, actors and stagehands, frequently visited the clinic complaining of concussion symptoms. The people working behind-the-scenes of a production have to move quickly through dark, crowded spaces with a lot of moving props, which creates additional hazards.

“If you turn on SportsCenter, concussion is always a hot topic,” Kapple said. “Young kids aren’t playing football because their parents are scared that they’ll get a concussion, but theater might be a dangerous activity, as well.”

The pair wanted to determine how prevalent concussions are among theater personnel and their knowledge and attitudes regarding concussion and concussion risks. They conducted concussion research on theater personnel last March, and were shocked and concerned with the results.

Backstage Bumps Stay Behind the Curtain

After surveying more than 200 members of university theater departments and professional theater companies, they found that 72 percent of participants indicated they hit their head, experienced concussion symptoms but did not report the incident. Twenty-eight percent of participants who were seen by a health care provider and diagnosed with a concussion were not given any activity restrictions.

“The number of people who are reporting that they’ve hit their head is troubling, and the fact that they’re not telling anybody is almost worse,” said Russell, who is also the director of the SHAPe Clinic. “The fact that they don’t seem to have access to quality health care is also troubling.”

The results of the study indicated theater personnel could distinguish concussion symptoms pretty well. Nearly three-quarters of participants said they had an unreported concussion. That finding indicated to Russell and Kapple that theater personnel understand concussions, but do not know how to manage them.

“Concussion management is a skill that we can bring to theater,” Russell said. “That’s what we do at OHIO, and that’s why we should promote this for other theater companies.”

Injured? Take Five

Russell and Kapple were also alarmed by the 28 percent of participants who received medical attention after a head injury, but were not given any activity restrictions. Kapple, who is currently studying the effects of concussions on metabolism and energy balance in high school and college athletes at The University of Virginia, said the results of the study revealed a need for doctors and physicians to treat theater as an at-risk activity.

She said when a sports athlete is diagnosed with a concussion, physicians have a set procedure for how to manage their injury and its symptoms before the athlete is allowed to return to practice. However, when someone in theater gets a concussion, even if it’s properly identified, it’s likely that the doctor won’t give them an activity restriction plan because theater is not seen as something that could further their injury.

Multiple national studies show that if a concussion is properly handled there are no long-term consequences. However, if the person sustains another concussion during an at-risk activity before the original injury heals, that could result in permanent injuries, disabilities or death.

Russell said the findings from the study made it clear that the average doctor or physician doesn’t understand the demands of theater or have the specialized training to properly manage concussions.

“If you’re going to a health care provider and they’re not going to restrict you from activity in any way, then that’s not helpful,” Russell said. “That’s not the proper way to deal with concussions and it’s going to make it more likely that you’re going to have another one and it’s going to take even longer to heal.”

Spotlighting Theater Safety

With funding from OHIO’s Provost Undergraduate Research Fund, Russell and Kapple attended the Performing Arts Medicine Association National Sympsoim in July to present their findings to health care and performing artist professionals. Kapple gave a 20-minute oral presentation about their pilot study, and they were excited to receive positive feedback from audience members. Many asked questions about how their research could act as a springboard for future studies to help further knowledge and management of concussions in theater personnel.

“It was our job to get some statistics out there and show a need, and I think people got that,” Kapple said. “I hope that because of it people start to research more about the topic to help the theater population.”

Russell and Kapple hope their presentation will lead to a task force of performing arts professionals who will focus on researching concussions in the arts to counteract problems identified in the research. They also plan to publish their study in a performing arts or athletic training journal.

But more than anything, Russell and Kapple want to use their research findings to help theater personnel. Russell said the data reinforced the protocols the OHIO Theater Division has in place to manage head injuries, but it will help them look into other ways to educate theater participants about the seriousness of concussions.

“I want them to participate, but I want them to participate safely and not with any pain,” Russell said.