Former NHLer leads discussion on head trauma in sport

It is a debilitating head injury whose effects extend well beyond the world of sport. The complexity of a concussion is undeniable and has left sport communities grappling to find the best approach to cope with this widespread yet often misclassified and ill-understood injury.  On Feb. 19, the University of Guelph and Guelph sport communities offered the Guelph Concussion Panel to facilitate a community-wide discussion based on the experiences of a series of panellists, led by former NHLer and politician Ken Dryden.

The evening featured three panels composed of concussed youth athletes, medical professionals and members of elite and recreational athletic programs who shared their experiences.

In response to the increasing prevalence of concussions and the many approaches to reconcile player safety with competitive sport, the answer came in the simple thought of appreciating the injury for what it is. Often, advice and assessment are catered to the elements of play beyond the athlete. Young, recreational players may be more readily recommended to rest while professional and elite athletes will have advice confounded with their obligation to perform.

“We must remember to treat the patient not the player. It is too easy to place distinctions on an individual, when we should be seeing a patient as a patient,” urged Dryden.

Unlike many other sports injuries, concussions are unique for their somewhat subjective air. While recovery from most injuries can be assessed and monitored based on the progression of physical changes and the advice of sport scientists, the assessment of concussions is not so clear. A single succinct and step-wise recovery pathway is less likely due in large to the reliance on intuition and the qualitative (not quantitative) nature of diagnoses.

In this way, as highlighted in the youth panel, concussion management is much more susceptible to influence by pressure and stigma from the community. Unlike other sports injuries, there are no physical signs to prevent the athlete from returning to play. A cast does not need to be removed nor are you clutching crutches that indicate that return to play is not an option.

While these traditional signs of injury remain discrete, medical professionals advocate instead for the reliance on the familiarizing themselves with their patient. It is a warranted approach given that all six athletes of the youth panel discussed an intangible woe and feeling “like they were just not themselves.” Many discussed feelings of depression, feeling isolated from the sport they had been so immersed in, as well as the difficulties they faced in school and work environments. As the treating trainer, physician or physiotherapist, the ability to recognize these differences provides the ability to detect the lingering effects of a concussion that preliminary routine tests may not capture.

Of course, while identifying strategies to treat and minimize the impact of a concussion, prevention at the level of the playing field could alleviate the complications of concussions and the strain they place upon the athletic community.

The consensus was clear that education is key. Teaching players the fundamental skills to maintain a competitive edge without compromising safety is essential as is community awareness and the ability of involved individuals to recognize the signs of a concussion.

Amidst the confusion and concern shown towards the issue of concussions, the symposium captured the spirit of sport in its ability to draw individuals together to achieve a common goal.

Dryden was optimistic for the future and believes the work on concussion awareness, treatment and prevention is only beginning to take shape.

“The game is always changing. What we’re seeing is only the end of the beginning.”

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