One Canadian concussion policy: 'Better safe than sorry'
December 6th, 2010
04:40 PM ET

One Canadian concussion policy: 'Better safe than sorry'

Calling its policy "better safe than sorry," a Canadian hockey league has instituted new rules that could keep players suspected of having a concussion off the ice for days, weeks, or even months.  The new guidelines' most forceful statement: "A player suspected of a concussion must stop play immediately."

Hockey Nova Scotia's new policy is designed to eliminate rink-side guesswork, insisting that the diagnosis of a head injury happen among medical, rather than bench staff.

"In reality most bench staff do not have the experience or medical expertise to recognize such an injury," according to the new policy. "When it comes to posing the question 'I wonder if he or she has a concussion?' a visit to the doctor or the emergency room is the only option to gain a definitive answer to this question."

Hockey Nova Scotia is one of a number of leagues proactively attempting to address the concussion problem in sports. In the U.S., organizations such as the American Medical Association and the American Academy of Neurology have suggested similar concussion guidelines for youths playing contact sports. And at the professional level the National Football League has convened experts to study the long-term impact of concussion.

The policy was developed "mainly out of concern for our players," said Darren Cossar, executive director of Hockey Nova Scotia, which has 17,000 participants who are mostly young people. Cossar added that there was no specific incident that led to the policy but that the league spent several months evaluating a body of scientific evidence about head injuries.

According to the new policy, if a player exhibits such common concussion symptoms as headache, loss of consciousness, slurred speech, double vision or vomiting, they must immediately be removed from play, ceasing activity both on and off the ice.

The player must then be referred to a physician for diagnosis and can return to play - with a doctor's note - only once he or she has undergone thorough evaluation and treatment.  Even returning to play will have constraints.  Players must participate in a six-step process designed to ease them back gradually.

The guidelines include suspension for players, coaches and parents who do not follow them.

"It's a lot of responsibility on our coaches, who are volunteers but it's the safety of our players that we're concerned about," said Cossar in an interview about the new policy with Global Network News.

"Sports are for fun, it's not the Stanley Cup finals or anything like that ," said Dr. Andrew Lynk, a pediatrician from Sydney in an interview about the new guidelines with Global Network News. "People have to just realize...the developing brain is much more important and [players'] health is much more important than playing in a game."

The new concussion policy goes into effect January 1.

soundoff (16 Responses)
  1. mtngrrll

    It's about time! LOVE Dr. Lynk's quote, "Sports are for fun..." What could possibly be more important to a parent than their child's life or health that they would rather their child risk becomming a quadraplegic or brain dead at 9 years old, just so the parent can feel good about themselves.

    December 7, 2010 at 03:42 | Report abuse | Reply
    • Mark

      Wow. Talk about overreacting. How many kids do you know that died at 9 years old because of concussion? ...None? That's what I thought.

      You know, we should never allow our child to play any kind of sport because for the physical dangers involved but rather let them play video games and surf the net instead since it's safer.

      December 7, 2010 at 05:01 | Report abuse |
    • nanobot

      The general public is unaware of the structure of neurons or any idea what generalized axonal injury (GAI) entails in that it rapidly increases slow death of brain. It's easy for people to simply say "tough it up kid it's for the team". Therefore it is necessary for medical professionals to evaluate concussion rather than parents, coaches, or friends. There is a lack of understanding that a molecular scaffold of microtubules create an actual "cytoskeleton" which is broken and scrabled upon blows to the head. MRI can be used to visualize this breakage, but only in research experimentation because the MRI protocol is too complex. NEvertheless, cytoskeleton damage is VERY slow to heal. Therefore, the cell membrane lacks key anchoring molecules and function of the cell is depleated. There is virtually no diagnostic tool in use for diagnosis of concussion, with one notable exception, brain waves. Because of generalized slowing, EEG can be diagnostic and is also proof of the mental decline in concussion. The precised methodology which has been well researched for decades is the QEEG. It is basically a variant statistical package used to assess cognitive variables rather than seizure. THE MEDICAL ESTABLISHMENT HAS NOT EMPLOYED THE WIDESPREAD USE OF QEEG. What needs to happen with the media attention to concussion is to promote this technology and the law needs to require it's use. In fact, the damage cased by multiple concussion virtuallly assures future brain shrinkage and loss of function. Children are in fact losing their futures because of medical and regulatory ignorance. The brain "cytoskeleton" is a perfect search term to find images that will amaze anyone in the intricacy and graceful, almost dancing patterns on a microscopic level. Imagine a spiderweb perfectly spun as large as a field of veined petunias. Post sequential concussion, it looks lilke a bowl of spaghetti.

      December 7, 2010 at 15:11 | Report abuse |
  2. Mark

    Typical of us Canadians. Overreacting once again. Sooner than later we are going to have so many rules and regulations that all we will be allowed to do in Canada is sit and breathe (and those may be banned because of the risks involved).

    December 7, 2010 at 04:56 | Report abuse | Reply
  3. Rabbit

    As someone who suffered two severe concussions before the age of 11, I can't help but thinking this is not an overreaction at all. To this day I still suffer small, but annoying, aftereffects, including vertigo and loss of balance, as well as having pronounced physiological reactions to even a mild strike to my head. In addition, I am more susceptible as I grow older to memory loss and dementia. My opinion is that this is not an overreaction, but a reasonable and *basic* response to a youth who has suffered a head injury. A head injury isn't like a broken arm or an ankle sprain; those heal over time, for the most part. But a brain injury isn't completely even understood yet, and the aftereffects can show up in strange and unexpected ways for years, even a lifetime.

    December 7, 2010 at 05:36 | Report abuse | Reply
    • nanobot

      @Rabbit- Thank you for your candid report on what it feels like to have generalized axonal injury. It is in fact very severe and additive when more than one jar to the head causes further degredation of the cytoskeleton. Awareness of this is increasing due to traumatic brain injury of soldiers in the vicinity of explosions, but even that doesn't seem to get better treatment. Also, the VA health system is difficult to navigate for those with brain damage, being a telephone, voicemail system. Being robbed of your mind, is one of the worst sufferings people face, yet people are generally unaware of this quiet inner torture. Thank you for sharing.

      December 7, 2010 at 15:29 | Report abuse |
  4. bill

    This is not an over reaction. The people saying this have obviously never had a child suffer a cuncussion....unbelievable.

    December 7, 2010 at 07:55 | Report abuse | Reply
  5. Breanna

    If a player wants to mess themselves up playing through a concussion it's their business. If the coach wants to LET them do that, that's also their business. Thing is, no coach would willingly let a player play with a concussion because it's just going to hurt the rest of the team, let alone the injured player. Handing it to the doctors is just going to make it so the guy has to sit out two months past when the thing is healed because of their inherent hypochondria.

    December 7, 2010 at 08:19 | Report abuse | Reply
    • nanobot

      @ Breanna- You seems to think that all coaches are ethical. Your experience in no doubt very limited, My experience is in Reno, NV and coaches don't care. A neighbor girl played basketball and constantly got "beat up" by the other team. Referees allowed the personal fouls on a regular basis. High school girls basketballl in Nevada? Might as well call it roller derby. The neighbor told me she had 3 concussions in the last 6 months and had recurrent severe headaches. She missed about 30% of school days because of migraine. The "coach" put her back in every time after 7 days off. Everything in this town is corrupt, so we must have federal insturction. This is not never neverland.

      December 7, 2010 at 15:35 | Report abuse |
  6. Breanna

    lol even if I had a kid and it got a concussion, bumps and bruises are part of playing a sport. You take on a level of personal responsibility when you enter into a contact sport. My husband broke both lower bones in his arm clean in half and almost forced them through the skin while skateboarding when he was 14 because of a simple mistake – putting the plywood they were using as a landing ramp over a gap shiny-side-up. His parents didn't prohibit him from skating and he still does to this day. And believe me, he got concussions from that AND snowboarding and they didn't stop him then either. You have to let your kids live, and along the way no matter what you do bad things are going to happen off and on. If your kid is willing to take the risk, what kind of wuss are you for saying "Now now Billy, play the Wii version, much safer"?

    December 7, 2010 at 08:23 | Report abuse | Reply
    • nanobot

      @Breanna- LOL. I sense a lot of mental decline from these injuries. In fact, YOU are not thinking clearly.

      December 7, 2010 at 15:37 | Report abuse |
  7. razzlea


    December 10, 2010 at 15:16 | Report abuse | Reply
  8. Football BC, Pat Waslen Executice Director

    Bravo, it was nice to see another Provincial Sport Association following through when it comes to dealing with concussions in Canada. Back in May 2010, Football BC insitutied a mandatory concussion policy, that echoed the current Washington State Lystedt Concussion Law passed in 2009. Our policy, included, education for parents, coaches and athletes. We distributed information throughout the province, including the distribution of 100000 concussion cards. The reaction, positive, positive positive. From Medical Doctors who are passing out the concussion cards, to parents, athletes, trainers, team medical personnel, and the team mom. All supportive of the policy and all getting a better undersanding of the dangers of concussions. As our concussion card simply says "when in doubt, sit them out', its a no brainer.

    March 4, 2011 at 02:45 | Report abuse | Reply
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