Game-Changer: The Risks of Concussion

When it comes to concussions, be an agent of change.

The score is 3-2 in the final minutes of the third period, and if they can hang on, Samantha’s team will make the playoffs. Then it happens. You watch as a player comes speeding down the ice, her head turned as she plows into a head-on collision with your daughter. You sit still, barely breathing. She seems fine, the coach says. But later, Samantha complains that her head hurts and she’s dizzy. Does she have a concussion? What should you do?

This scenario is all too common—and becoming more so, according to Dr. Michael Cusimano, a St. Michael’s neurosurgeon and professor of Neurosurgery, Education and Public Health at the University of Toronto.

Despite all the debates and safety programs, the rate of concussions has not decreased in the past few years. “If you look at hospital data, the numbers are actually going up,” Dr. Cusimano says. “But that doesn’t mean we’re not making progress. We’re dealing with more concussions partly because more people are seeking medical attention, and more doctors are diagnosing it.” That’s partly because of new policies like Ontario’s Rowan’s Law, which mandates concussion education and medical evaluation before patients return to learning and active play.

Dr. Cusimano is a pioneer in advanced neurosurgery procedures—including the use of endoscopic and 3D techniques to treat brain tumours. He’s also a longtime advocate for public education about traumatic brain injuries like concussion. His research has led to rule changes in the NHL, the National Football League and soccer’s World Cup. And he was recently given the U of T’s President’s Impact Award for his work in all those areas, as well as the Carolyn Tuohy Impact on Public Policy Award.

“The awards are recognition of the fact that people now understand that concussions are not good for your brain, and that we should be making changes in our society that help keep our brains healthy,” he says.

While advances in medical technology can lead to improved outcomes for brain injury patients in the future, Dr. Cusimano is adamant that prevention is best, even if it’s not quite so exciting. “Making people more aware and speaking out about things like body checking in hockey are going to save more brains than developing a new drug or instrument to look at the brain,” he says. “At St. Michael’s we save people one at a time, but those things can help millions of people worldwide.”

Dr. Cusimano says it’s possible to sustain a concussion doing any sport, or by slipping on an icy sidewalk or falling down stairs. “Of course the incidence is highest when there’s player-to-player contact, like in hockey, soccer, football, rugby, basketball, even baseball and ringette,” he adds. “And since mixed martial arts is rapidly growing, there are concerns when young children are doing that.”

The good news, according to Dr. Cusimano, is that there are simple things we can do to protect our brains. “People have to educate themselves about the risks of doing certain activities, and how to minimize them,” he says. “If you’re going for a bike ride, try to separate yourself from traffic as much as you can. Make sure the bike is in good working order, and wear a helmet and reflective clothing and lights so people can see you if it’s dark.”

If your child plays organized sports, find out where the league stands on injury prevention. “For every dollar we spend on helmets, we save 33 dollars in health-care costs,” Dr. Cusimano points out. “Parents could ask about the league’s position on body checking and fighting, if protective gear is mandatory and if they encourage fair play and respect for other players. They can make sure the coaches and trainers have been educated about concussion, and that the children and parents have had some information too.”

In the end, Dr. Cusimano asks adults to also think of the effect their own actions have on children, such as wearing safety gear. “Children are very impressionable, and research shows that if they see adults doing these things, they will adopt the same habits,” he says. “So people really can be agents of change in their own way.”

Concussion Symptoms

  • Headache
  • Dizziness
  • Difficulty concentrating
  • Depression or irritability
  • Drowsiness or difficulty sleeping

If you suspect a concussion, see a doctor. It’s important to provide a full and honest reporting of symptoms to your doctor. The latest research suggests mental and physical rest for 24 to 48 hours, and a gradual return to normal activities as the symptoms subside.