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Concussion prevention more important than ever: experts

by Aryn Strickland

WELLINGTON CTY. - September is synonymous with back to school, but it is also the start of another season for many minor league sports.

While families with young athletes will be rushing to buy new equipment, concussion training is another item that should be added to the list, according to health care professionals, and starting this year, the Ontario government.

Over the last five years, concussion baseline testing has been a main safety measure for many minor league teams in Wellington County.

The teams work with businesses such as Eramosa Physiotherapy and Impact Physiotherapy and Performance to test the neurological and physical functions of players at the beginning of the season before a concussion occurs.

“It becomes important when we are doing a concussion assessment if a baseline test has already been done … to compare the objective values before and after there has been an injury,” said Rachel Martin, physiotherapist at Eramosa Physiotherapy.

According to both practices, baseline testing became popular within the international medical community between 2011 and 2013.

Both practices then began providing the tests and offering educational training about how to handle a suspected concussion.

Baseline testing

Baseline concussion tests assess an athlete’s average level of function.

According to Ronda Schnurr-Smith, owner of Impact Physio, there are two standardized versions of baseline tests that can be performed by kinesiologists and physiotherapists.

Baseline testing is a combination of a computerized neurocognitive test called ImPACT that measures memory, attention span and information processing speed, as well as a physical assessment.

“We do a balance test; we take a look at their vision so that would include tracking a pen, looking from one finger to another to see how quickly their eyes are moving and if they get any symptoms with that,” Martins said.

Change in approach

As awareness about the neurological health risks surrounding concussions has improved, popular high-impact sports leagues in the area like hockey and lacrosse either encouraged baseline testing or made it mandatory for young players at the beginning of the season.

In cases where it was mandatory, the cost of the baseline test was included in registration fees.

The Centre Wellington Minor Hockey Association was one league that made the test mandatory.

“In previous seasons if you didn’t have the baseline concussion testing done, you couldn’t play in Centre Wellington,” said Mark Ewing, head trainer of CW Minor Hockey Association.

However, that is no longer the case for the league this year.

That is because conflicting research has come out in the last year.

“There is an organization called Parachute Canada that studies concussions in athletes and their recommendation is not to go ahead with baseline testing in younger athletes playing in minor sports,” Ewing said.

The organization, he adds, suggests that, “In younger athletes the only ones that are able to clear the athlete back to play are family physicians.”

According to Schnurr-Smith, recent research suggests the age of the athlete makes all the difference.

“The research that has come out in the past year is showing that a child’s brain develops so rapidly that their baseline testing is almost not accurate already part way through the year,” she said.

“In kids 10 and up the baseline test is going to be more relevant for a full season.”

Despite the research, many leagues still encourage parents to get their children tested.

CW Minor Hockey’s sister organization, the Grand River Mustangs, still believe getting the baseline testing done is a good choice for parents to make.

“Every year we encourage parents to get baseline testing done and we provide the names of providers in the area,” said Mustangs president Mindy Ferguson.

While some research suggests baseline testing is not as accurate in younger players, Ferguson says it is a starting point, and can give peace of mind to parents.

“I think it’s important; I’ve had two daughters that have had concussions in their time playing hockey,” she said.

Non-high impact sports

Another sports team that encourages parents to do baseline testing is cheerleading. This is just one example of a non high-impact sport that has experienced increased awareness about concussions.

Three years ago, Bears Cheerleading started baseline testing and concussion training.

“It came into the cheer world that the risks of potential concussions needed to be managed,” said Cyndi Guthrie, coach and co-founder of Bears Cheerleading.  

“Down in the [U.S.] there were some fairly serious accidents that pushed the issue that year.”

Recently, the Ontario provincial government has taken stock of the serious health risk concussions pose to all young athletes, not just those who play high-impact sports.

In March, the government passed Rowan’s Law, a concussion safety legislation.

New provincial policy

The new law is named after Rowan Stringer, a 17-year-old rugby player from the Ottawa area who died as a result of sustaining multiple concussions.

The new legislation requires all sports teams in the province, both in and outside of school, to review concussion awareness resources and provide them to parents.

It also requires teams to establish a code of conduct to help prevent concussions and create protocols to ensure athletes are immediately removed from a sport after sustaining a concussion and don’t play for a required time before returning.

According to the website, “Ontario is the first jurisdiction in Canada to pass concussion safety legislation, setting a precedent for sport legislation across the country.”

Already teams in Wellington County are adhering to the new law.

“Hockey is in a pretty good place in terms of complying with Rowan’s Law already,” Ewing said.

“We have always had a return-to-play policy and this year all teams have distributed a preseason concussion information form.”

Other preventative measures

While the new policy shifts the focus from baseline testing to concussion training, practices like Eramosa Physio and Impact Physio will continue to be pivotal in providing information and education to teams about concussions.

“There are parents and coaches that continue to struggle with identifying and managing concussions,” Eramosa Physio founder Jackie Sinkeldam stated in an email to the Advertiser.  

“We need to keep a consistent evidenced-based, medically-backed education platform in the community.”

At the same time, many other preventative measures are also in development.

Schnurr-Smith says examples that have caught her attention include the stop badges on jerseys to deter players from hitting from behind, as well as NHL research on constructing helmets based on a player’s position.


September 14, 2018


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