Now that’s using your head

John Chehade is passionate about concussions.

The general manager at Clinical Medicine Research Group (CMRG) and former University of Western linebacker knows about concussions firsthand, along with the dangers of being young and not wanting to let down teammates.

“If you have an undiagnosed concussion or a mismanaged concussion in an adolescent athlete that is maturing they will have problems down the road and will be susceptible to concussions on less force,” said Chehade at a CMRG concussion management program held last weekend at the Woolwich Memorial Centre.

This year Woolwich minor hockey teams will be participating in the program, educating coaches, players and parents about the effects of concussions on young athletes.

Concussions are a major concern among adolescent athletes, especially girls who have the highest incident rate for concussions.

The main causes of concussions are player contact, surface impact and players hitting the boards, Chehade told a group of parents and coaches.

There are two types of concussions a direct blow or a rotational type injury.

“If you look at the Sidney Crosby hit, that glancing blow a cross the chin where the head keeps moving, the brain rattles on the inside of the skull, that rotational injury is the kind we see most commonly with females and what we deal with the most in hockey,” he explained.

CMRG will be providing education and information to coaches and players on the signs and symptoms of concussion and what to do when a concussion is suspected.

Each player in the league will be required to provide baseline and follow-up Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) neurocognitive testing through the program. Baseline testing is conducted at the start of each season.

A baseline gives medical specialists a starting point for each athlete and a referral after a concussion has been sustained. The idea is to rest and recover back to baseline scores.

“In any concussion there is a certain neurometabolic change that occurs when a concussion is sustained,” said Chehade. “Your brain becomes starved for energy and that is why there is no antidote to cure concussion – players just need complete physical and neurocognitive rest.”

In some 80 per cent of cases, symptoms will vanish within a seven- to 10-day period, said Chehade. The problem lies in figuring out whether an athlete is in the 80 per cent category or the 20 per cent category like Crosby.

“Doctors don’t know unless they do testing and have data they need, that is why we use the ImPACT test.”

It is extremely important that coaches and parents manage the concussions as they occur.

“If we let the athletes heal and give them the appropriate amount of time they are going to be fine but try and rush a kid back to play – he could face even greater dangers.”

The symptoms linked to concussions have athletes feeling dazed and confused; they act clumsy, answer questions slowly and have personality behaviour changes, headaches, nausea, double vision and photosensitivity.

The problem, said Chehade, is that these symptoms are all subjective.

“When I played football for the University of Western Ontario I had a diagnosed concussion.

They brought me into a room and I passed all my tests, I hid my signs and symptoms and I suffered with a lot of problems because I did that. I was the starting middle linebacker and I wanted to play, especially homecoming weekend, and I just told them I was good to go, but I was not fine and in no condition to play.

“I don’t want kids to suffer what I went through.”

A key to helping young athletes is strengthening their necks. Female athletes in particular need to strengthen their neck muscled as they have longer necks and “don’t have the stabilizers that male athletes have so their brains move around faster when they are hit and fall.”

Mismanaged concussion can lead to second impact syndrome where the brain loses its ability to control the amount of blood flow rushing to the brain, which squeezes the brain inside the skull causing permanent damage and can lead to death.

Second impact syndrome only occurs in athletes under the age of 21.

“We have to take our time when we are dealing with any younger athletes. There is no rush to get them playing again, they are not making millions of dollars we should be more concerned about their future.”

In that vein, the Waterloo Ravens from the Waterloo girls’ minor hockey league will be hosting a head injury prevention and concussion management certification workshop Oct.

19 in Forbes Auditorium at RIM Park from 5:30 to 10 p.m.

The workshop will be focusing on risk factors associated with sport related concussions, resources available in the Waterloo Region and improve care and outcomes through early diagnosis, prompt treatment and appropriate return to play.

For more information about concussions, visit www.impacttestcanada.ca.