Changing the culture surrounding concussions in sports

Photo by Christopher Jones

Can you imagine being absolutely fine one moment, and then suddenly completely off the next? Can you imagine what it would be like to be an athlete on top of the world only for it to come crashing down around you? To be leading the American Hockey League (AHL) in goals one second, only to sometimes need help up the stairs the next?

That’s what happened to former UOIT men’s hockey coach, Craig Fisher. He was the coach of the Ridgebacks from 2010-2012.

On Nov. 12, 1999, Fisher suffered his third concussion when he took a knee to the head only to immediately fall again, hitting his head on the ice while playing for the Rochester Americans of the AHL.

Since that incident, Fisher has also taken a puck to the head while coaching the Whitby Fury of the Ontario Junior Hockey League (OJHL).

Fisher is still dealing with the symptoms to this day, which is why he felt the need to step aside as coach of the Ridgebacks.

But what does Fisher have exactly? He has a Traumatic Brain Injury (TBI) that has had lingering effects for almost two decades.

Fisher developed his TBI due to the three concussions he received throughout his hockey career.

Today, Fisher isn’t coaching anymore, but he’s taken on an advisory role for the UOIT athletics program.

“I have always been involved in counselling hockey players with TBI as it can really help to talk to someone who has lived through and is continuing to live through a brain injury,” says Fisher. “I continue to do this with both UOIT players and players from other leagues who contact me.”

According to Fisher, the difference in the level of understanding of concussions is immense.

“I was hurt in 1999 which was the very beginning of the new ‘concussion era’ in hockey,” Fisher says. “Before then, players were not aware of this issue – it really still was the ‘got your bell rung and go back out there’ era.”

Fisher isn’t the only one working with players who suffer from concussion symptoms. Jeff Watson, a strength and conditioning coach at UOIT says, “Virtually once they’re diagnosed with a concussion, the next thing to do is to wait until they’re symptom free for anything. So they have to be symptom free in just daily active living, and then once they can pass that test, then we put them through a little bit of a stress test.”

Watson says the stress test is when they get the athletes heart rate up. If any symptoms come up, they have to restart and wait until the athlete is completely symptom free once again.

Watson also says those in the athletic therapy department, such as Saul Behrman, would work closer with athletes.

Behrman is one of the main athletic therapists at UOIT, and he says that there are a few parts to UOIT’s concussion protocol. The first is recognition. This simply means recognizing the symptoms in athletes while they are in practice or competing.

“A lot of the studies are showing that the faster you recognize the concussions and get them into the protocol the better and faster their return to play is,” says Behrman.

After recognizing the symptoms, the athlete is put through testing. The SCAT3 test is the standard concussion assessment tool. It tests things ranging from memory and balance to sensitivity to light. Ultimately, this is to determine if the athlete is experiencing something out of the ordinary.

After the SCAT3 tests, Behrman and the rest of the Athletic Therapy department bring athletes into the clinic to use tools such as Impact, which, according to Behrman, helps test their reaction time and memory while comparing the results to how they were before the concussion.

Behrman also says the Athletic Therapy department gives the athletes advice on how to deal with their symptoms. “Things like initially cognitive rest and not using their cell phone or their computers. There’s a lot of instruction that we give them on how to rest in the goal of decreasing their symptoms,” says Behrman, who starts athletes into their return to play protocol. “Basically there’s a number depending on how the patient presents. We may differ the types of treatment we do. There’s manual therapy in the clinic if some of their symptoms are related to neck problems. And there’s visual testing we can do, and there’s exercise based therapy that we can give to help with symptoms.”

The return to learn protocol has athletes attend class and do some school work in order to make sure that cognitively no symptoms flare up. If all goes well, the athlete can be reintroduced into class. Athletic Therapists also work with the accommodations department at Durham or UOIT if the athlete needs any accommodations for their schoolwork.

In order to get the athlete back onto the field, Behrman says, “We have a graded return to play. What we do is we take someone who’s returning from a concussion and once their scores have returned to baseline levels and their symptoms have decreased, we would start to introduce a graded return to play.”

A graded return to play, according to Behrman, means starting at a lighter level of activity and seeing how the athlete responds to that. This could mean something like a 20-minute bike ride. If they pass that, then the athlete has to do some more strenuous exercise and Behrman keeps track of their heart rate and blood pressure.

From there, the athlete may be introduced into some sport specific drills. “If they’re a basketball player [that means] having them do some specific drills related to basketball,” says Behrman.

Behrman also says between all of these phases, the athletic therapists are leaving 24 hours to continue monitoring the athlete. If the athlete continues to progress well, then the athlete is introduced into non-contact practice, then to a contact practice and then back into play, according to Behrman.

“The difference [in concussion protocol] is immense as there is such a greater level of understanding about the long and short-term effects of traumatic brain issue,” said Fisher.

Concussions protocol at UOIT gives athletes who suffer from a head injury a chance to one day play again, which is something many athletes, such as Fisher, did not used to have.

After almost 20 years, Craig Fisher still has moments when his Traumatic Brain Injury affects him. He still sometimes has trouble getting up the stairs on his own. For Fisher, the room is still sometimes spinning. “All and all, the culture of [sports] has made real progress in raising awareness of this issue. Hopefully the next step will be better support and protection for all players,” says Fisher.

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Christopher Jones is a second year journalism student. He enjoys writing about video games, sports and politics. His work can also be seen on Riot Radio at Durham College and out of Montreal. In his spare time Christopher enjoys reading, playing video games and catching up on his long list of TV shows. He hopes to go into either video game journalism or into sports one day.