Photo: Rich Vintage/iStockphoto
Sherri Sanders breathes a sigh of relief every time one of her three kids comes off the ice. “There’s so many goons out there that have your number, especially if they’re 14-year-olds,” Sanders says.
That said, the mother of three from St. Thomas, Ont., wouldn’t think of banning her sons Alex, 14, and Duncan, 12, and daughter Cameryn, 10, from playing competitive hockey: “They love it.” Still, she worries about them getting a concussion and what it could mean to their long-term health. “They’re not going to go to the NHL. They need their brains to think,” Sanders says.
Yet, it’s the increase and severity of concussions in pro sports in recent years — highlighted by Sidney Crosby’s long absence from the NHL — that have raised awareness and concerns for parents. So how do you weigh the risks and benefits to make the right choice for your kids?
Know the facts
Over the course of a year of play, the chance of a 10-year-old suffering a concussion in a contact sport is about 10 percent. “The statistics show a significant escalation of head injuries beginning probably in the 10- and 11-year-olds, and then going straight up to age 20,” says Charles Tator, a neurosurgeon and founder of ThinkFirst Canada, a national non-profit group dedicated to the prevention of brain and spinal cord injuries.
Trouble is that concussions can be difficult to diagnose in the first place. Concussions rarely show up on conventional neuro-imaging tests and are easy to miss — particularly if another injury occurs at the same time, says Robin Green, Canada Research Chair in Traumatic Brain Injury at Toronto Rehab. “If someone gets a blow, but they hurt their leg, people may not be attuned to the possibility of a concussion,” Green says. “The same thing happens in emergencies. When someone gets into a car accident and sustains a spinal cord injury, often the brain injury gets missed.”
Compounding the problem is the culture of contact sports where players are loath to leave the game and toughness is still considered to be a key element in success. As a result, “concussions are vastly under-reported,” says Tator. The worst-case scenario for those who suffer multiple concussions is a form of dementia called chronic traumatic encephalopathy (CTE).
In February 2011, researchers at Boston University discovered former NHL tough guy Bob Probert had CTE, believed to be linked to the head trauma he received in the game. Shortly after Probert died of a heart attack in 2010, his family donated his brain to the Sports Legacy Institute to help advance the study of sports-related head injuries. “It’s certainly not every athlete who develops this dementia,” Green says. “We don’t know how many concussions it takes, and we don’t know what the other risk factors are.
Weigh the benefits
Neither Tator nor Green thinks kids should be kept away from contact sports.
“I think parents should encourage their kids to play. There’s so many benefits from getting out there and playing,” says Tator, pointing to a decrease in the risk of childhood obesity. There are also social benefits, particularly from team sports. Daniela Pippo’s 11-year-old daughter, Ripley, and her 10-year-old son, Corbyn, both played tackle football for the first time in 2010 and are registered to play again this fall. Pippo, of Alymer, Ont., says she understands the risks, but she “can’t let her children live in a bubble” and “we can’t put the onus on the sports for injuries. Corbyn received a concussion on a roller coaster. Ripley broke her elbow, which required surgery, going down a slide at a park.”
Ripley’s coach, Scott Foster, says, “I always warn parents, ‘It is violent. There are injuries.’” That’s the reason he emphasized safety from the very first email to parents and the first practice, even refusing to let Ripley and two others in contact drills until they went back to the league’s equipment depot for better-fitting helmets.
Pippo says football has been an outstanding experience for both kids. “Football’s great for fitness, obviously, and for agility and strength. I think it’s great for confidence,” she says. “Corbyn was being bullied at school until he started football. He would warn them, ‘If you continue to bully me, I’m going to tackle you.’”
Limit the risks
Concussion research, education and awareness have increased in recent years, but there’s still much to learn. It’s still difficult to accurately assess when the brain has fully healed.
Sherri Sanders has tried to counteract that by having her boys take a baseline cognitive function test before they started hockey in 2010. Her daughter will take hers this year. If they do get a concussion, they can retake the test to measure their results against the original. “It’s like insurance. You have it, but you don’t ever want to use it. That’s what it is to me,” says Sanders.
As for protecting children while they’re playing contact sports, awareness as well as proper equipment and techniques are key. Tator says the roles of coaches and parents are crucial. Coaches need to eschew violence. Parents can help by “making sure that the culture of the game is conducive to safety,” Tator says.
Tammy Dufour’s 13-year-old son, Hunter, suffered a concussion playing hockey when he was 12. The Amherstburg, Ont., teen was elbowed in the head, fell and then hit the back of his head on the ice. At first, Dufour didn’t realize it was her son lying on the ice, but as soon as she did, she knew something was wrong. “He’s not one to stay down,” she says.
Fortunately, after Hunter was escorted off the ice, his coaches did not let him return to the game. Dufour took her son to the hospital where he was diagnosed with a mild concussion. He was told not to have any physical activity for seven to 10 days. Dufour’s family doctor recommended Hunter take two weeks off from any physical activity to give his brain proper time to heal.
Concussion Education Project
That’s good advice, says Tator, but mental rest is also key. “It’s not just desisting from vigorous activity, but also from vigorous mental activity. So it means no homework, no video games, no TV — just mental rest.”
This fall, Tator’s ThinkFirst group is advocating for their Pre-season Sports Team Concussion Education Project. The goal is for every organized sport in Canada with a high incidence of concussion to have a mandatory 45-minute concussion information session involving all players, parents and coaches “so everybody would be on the same page,” Tator says. “We would like parents to make sure the team that their kid is playing for has had one of those sessions. If they haven’t, they should go to the coach and insist that this be done.”
It’s just another tool to reduce the risk of concussion and allow parents like Sherri Sanders to breathe easier.
What is a concussion? A concussion is a brain injury that changes how you think and remember things. You don’t need to lose consciousness to have had a concussion.
Causes: Any blow to the head, face or neck or to the body that causes a sudden jarring of the head.
Thinking problems: • may not know time, date, place or details of situation • general confusion • cannot remember things that happened before and after the injury • knocked out
• feels dazed
• feels “dinged” or stunned
• sees stars, flashing lights
• ringing in the ears
• loss of vision
• double or blurry vision
• stomach ache or pain, nausea
• poor coordination
• blank stare/glassy-eyed
• slurred speech
• slow to answer questions or follow directions
• easily distracted
• poor concentration
• strange or inappropriate emotions (laughing, crying, getting mad easily)
• not performing as well
Treatment: Stop activity right away if a concussion is suspected. The child should not be left alone and should be seen by a doctor as soon as possible on the day of the injury. If he has lost consciousness, call an ambulance to take him to a hospital immediately. Do not move the child until the paramedics arrive.
Recovery: Physical and mental rest are key to recovery. The symptoms often last for approximately seven to 10 days but, in some cases, healing may take many weeks or months. Previous concussions may increase the time needed to heal.
– modified from Sport-Related Concussion: Guidelines for Parents at thinkfirst.ca, where you’ll also find the new video Smart Hockey, featuring stars, such as Patrice Bergeron, Caroline Ouellette and John Tavares.
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