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Group takes aim at concussion risk with national guidelines

Steve Podborski, seen in 2012, was part of a news conference to announce new Canada-wide guidelines for physicians, parents, coaches, trainers, teachers and athletes to use to diagnose, manage and treat concussions.

Todd Korol/Reuters

When Steve Podborski talks about head injuries, he ends up talking about broken hearts, about parents who see their children killed or left brain-damaged for life when the right decisions may have prevented it.

On Friday, the former 1980 Olympic downhill medalist was part of a news conference to announce new Canada-wide guidelines for physicians, parents, coaches, trainers, teachers and athletes to use to diagnose, manage and treat concussions. The guidelines are the result of international work spearheaded by the increasing understanding that the condition is deadly and can have an impact on every athlete, from amateur to elite.

"Part of being a kid is being physical and maybe getting a broken bone," Mr. Podborski said. "We are about not getting a spinal injury or a traumatic brain injury. We don't want our hearts broken."

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Only Ontario has a law committing to establishing guidelines to ensure children in sport are protected if they may have suffered a concussion. But Parachute Canada, a national charity aimed at reducing preventable injuries, which Mr. Podborski leads as president and CEO, has helped drive the creation of the national guidelines.

They include a basic definition that notes a concussion can be the result of a direct blow to the head or face, but also to the neck or somewhere else on the body where force is transmitted to the head.

The guidelines flag common misconceptions. For example, they note that an athlete can experience a concussion without losing consciousness – in fact, loss of consciousness usually doesn't accompany a concussion.

The document also offers straightforward advice for coaches, parents and doctors on what to do when an injury may have caused a concussion and how to manage it afterward. Some of the guidance may not be well known: A child who has suffered a concussion, for example, should rest not only from sport, but from "cognitive exertion" such as going to school, using a computer at home and playing video games.

As for prevention, the guidelines make plain protective equipment is important, but not a foolproof way to protect against concussion. "There is no such thing as a concussion-proof helmet," the guidelines state in bold.

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The guidelines are based on a statement issued by more than 400 academics from 24 countries who gathered in Berlin last October. Their conclusions were published in the British Journal of Sport Medicine in April.

Parachute's 15-member advisory committee – co-chaired by Toronto doctor Charles Tator and Winnipeg doctor Michael Ellis – then created a concussion approach that works for all comers. The work had the support of Health Canada funding.

To assist in the ongoing battle against concussions, the federal government said on Friday it was contributing $1.4-million toward preventing concussions by raising public awareness.

"What we wanted was for the recommendations to be the same for a child playing Timbit hockey in Newfoundland to a national team soccer player in Vancouver," Dr. Ellis said.

"These guidelines are important because they incorporate the most current evidence-based recommendations in the field to create a uniquely Canadian harmonized framework. … In this way, all Canadian sport stakeholders are on the same page about what their specific roles and responsibilities are in keeping our nation's athletes safe."

Mr. Podborski noted the Canadian guideline is available to "our 54 national sports organizations" as well as for parents of children who can be exposed to additional head trauma if permitted to return to play too soon.

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According to Parachute, injury is the No. 1 killer of Canadians between the ages of 1 to 44 and one child dies every nine hours.

The issue came into sharp relief after the death of Ottawa high school rugby player Rowan Stringer. She was 17 when she played through two concussions in one week then died four days later on May 12, 2013. A coroner's report listed 49 recommendations to enhance concussion protocol.

Those recommendations became Rowan's Law in Ontario last June thanks, in part, to the work of Eric Lindros, whose NHL career was cut short by concussions. He serves as the honorary chair of the University of Western Ontario's annual See The Line symposium, which brings experts and advocates together to talk about issues of the brain.

Last year, hockey legend Ken Dryden called on sports executives to catch up with the science that shows a relationship with head trauma and long-term brain injuries. Mr. Dryden has long been an advocate for talking about concussions, holding symposiums across the country.

Statistics provided by Parachute show more than half of the child and youth injuries treated in Canadian emergency departments are from sports or recreation activities while 39 per cent of those who went to emergency were diagnosed with concussions and another 24 per cent suspected of having concussions.

The new Canadian Guideline can be found at Parachutecanada.org.

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About the Author
Sports writer

Allan Maki is a national news reporter and sports writer based in Calgary. He joined the Globe and Mail in 1997 with an extensive sports background having covered Stanley Cup finals, the Grey Cup, Summer and Winter Olympics, the 1980 Miracle on Ice, the 1989 Super Bowl riot and the 1989 earthquake World Series. More

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