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Kids and Concussion

posted by SK Brain Injury    |   December 19, 2011 12:00

He may be the Mayor of Brantford but he's also a hockey dad and like a lot of other parents these days Chris Friel is disturbed by what he sees happening on the ice.

"The fun is being taken out of the game," Friel said. "There are kids who are getting hit and injured -some really badly -concussions are spiralling right out of control.

"These are the kinds of injuries that can really affect kids in the future."

He and others are so concerned they have formed a Dangerous Play in Sports task force to bring everyone involved with sports -governing bodies, referees, coaches, players and parents -together to help make playing both fun and safe. The task force is starting with hockey and includes representatives from local hockey associations.

"We want to put fun back into the game," Friel said. "There's a lot of the 'get'em, hitem, kill'em' out there right now and we want to get rid of that kind of attitude, take it out of the game.

"There's nothing wrong with a good clean hit but there is something wrong when the game becomes all about hitting."

Although the task force intends to look at all contact sports, it's starting with hockey because it's the sport that gets most of the attention when it comes to concussions. A lot of that attention is the result of hockey star Sidney Crosby being forced to stay on the sidelines for more than 10 months after suffering a concussion in January.

With Crosby unable to play, the NHL was missing its best player and his injury created widespread awareness of the devastating impact concussions can have on an individual. That awareness has become so pronounced parents, players, coaches and officials are taking steps to improve safety and cut

down on hits that could lead to concussions.

Just prior to the start of the season Hockey Canada approved a new head contact rule that reflects a zero tolerance approach to hits to the head, neck and face. Under the new rule, a minor penalty is to be assessed to a player who accidentally hits another player in the head, face or neck.

When the hit to the head is judged to be intentional, the offending player is to be assessed a double minor penalty or a major penalty and a game misconduct.

Locally, the Brantford Minor Hockey Association has implemented a concussion management program that includes baseline testing for representative teams this season. The goal of the program, which is operated in co-operation with the Clinical Medicine Research Group Ltd., is to ensure players who suffer concussions don't return to the ice too soon.

In addition to education and information about concussions, the program includes neuro-cognitive testing, proper medical management and research.

The program is in its first year and covers 12 teams from pee wee to midget and is being very well received by coaches, players and parents, said Todd Francis, the director of risk management for the Brantford Minor Hockey Association.

So far, about 12 players have been part of the program after suffering concussions.

Making sure kids who have concussions take enough time off to heal and don't return to the ice too soon is a big part of the program. But so is education and awareness for everyone involved including parents, trainers and coaches, Francis said.

"One of the things you have to remember is that minor hockey, like all of these sports, is driven by volunteers and one of the things we've done is provide them with pocketbook-sized card to help them recognize the signs of a concussion," Francis said. "We don't expect them or want them to be able to diagnose a concussion, that's not their job.

"But we want them to be able to recognize the symptoms so that a kid who gets hit hard and might have a problem doesn't go back on the ice until he or she is checked out. We want to give them the best information possible so they can make good, informed decisions."

The card includes the signs and symptoms of a concussion as well as a way of testing memory function and a player's balance.

Under the program, players who have suffered a concussion are examined by specialists who help determine the severity of the injury and develop a treatment plan.

The program is also an opportunity to collect data and keep track of players.

Association officials plan to review the program at the end of the season and are looking to expand it to all travel teams with the idea of encompassing all teams under the association's banner including house league.

He couldn't say for sure how many other associations across the province have a similar program. However, a lot of associations either have or are looking at introducing something similar because everyone involved in hockey is taking concussions far more seriously these days.

He believes its only a matter of time before such programs and policies become mandatory for all minor sports associations.

Francis is a Brantford Alexander's Alumni who played for the team when they were an Ontario Hockey League Junior A team in the early 1980s. He was drafted 35th in the second round of the NHL entry draft in 1983 by the Montreal Canadiens and played for several teams including the Brantford Smoke of the Colonial Hockey League in the mid-1990s. His playing career included the Oshawa Generals, the Flint Generals, Saginaw Generals and the Jacksonville Bullets as well as the Brantford Smoke when they were part of the Colonial Hockey League.

In addition to being the director of risk management for the Brantford Minor Hockey Association, Francis is part of the Dangerous Play task force.

The task force has the potential to do a lot for hockey and other sports but its important for people to understand what the task force is trying to accomplish, he said.

"There had been some discussion leading up to this and I think there was some apprehension amongst some groups as to what the task force was going to do," Francis said. "I think it's important people realize that we're not trying to change the rules of the game, that's the job of the governing bodies.

"What we want to do is bring everyone together to see what we can do to make playing sports a better experience for everyone involved especially the kids."

By way of example, the task force might be able to help improve communication between all of the groups involved in minor hockey especially between the coaches and hockey referees.

"One of the issues we need to address is the recruitment and retention of referees," Francis said. "Retention is a huge problem because some people start out refereeing but soon give it up because they get tired of the abuse and lack of respect."

In hockey, and he suspects a lot of other sports, a lot of people involved in a game get too caught up in specific calls that were made or missed by an official. Instead of having huge arguments about specific incidents, the idea of the task force is to look at the big picture and see what can be done to improve the game locally.

"Ultimately, we're all responsible for the product that gets put on the ice and we all want it to be the best product possible," Francis said.

And yes, he acknowledged, some of the work of the task force is to help market the community which already bills itself as the Tournament Capital of Ontario.

"We want people to come into our community, play in tournaments and when they go home we want them to leave with the feeling that they've had a good experience," Francis said.

Brad Cotton is a hockey dad, the trainer for his 12-year-old Michael's competitive team and a member of the Dangerous Play Task Force.

"We want our kids to be competitive but we also want them to be safe," Cotton said. "I think we have to remember that these kids have to have a life outside of hockey.

"The vast majority of them will have to be able to function in school or in a workplace outside of hockey. Even those who do make it to the NHL have to be able to function once their career is over."

To do that they need to be able to use their brains and society is just now starting to understand the damage caused by concussions, he said.

"These kids represent our future but what kind of a future will we have if they are brain damaged as a result of too many concussions," he said. "I worry about my son when he's on the ice, that's why I became a trainer.

"I want to do what I can to help keep him safe."

Carol DeMatteo was pleased to hear about the steps being taken by city and Brantford Minor Hockey Association officials with respect to keeping kids safe.

She is an associate professor at the School of Rehabilitation Science at McMaster University and runs the acquired brain injury follow-up clinic at McMaster Children's Hospital.

More sports leagues and associations need to follow the example set by Brantford just as parents and coaches need to pay closer attention when a child is hit in the head.

"People really need to pay attention when a child hits his or her head," DeMatteo said. "They need to take it seriously and not let their child go back to doing what he or she was doing because they're going to get another injury.

"I think it's also important to understand that we're learning more about the brain and we're learning more about how long it takes to recover."

People who have multiple brain injuries risk permanent damage, she said.

DeMatteo prefers to use the term 'brain injury' instead of concussion because that's what a concussion is, a brain injury. When people use 'concussion' to describe the injury it has a way of minimizing it and that has to change, she said.

Brain injuries can have a huge impact on a young person's life, she said.

"They're devastated because they're not able to go to school, they start feeling bad about themselves and their self-esteems suffers," she said. "We're starting to get a much better picture of how much these so-called 'little' concussions can affect their lives."

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