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A case could be made that 2017 was the Year of the Concussion Discussion.
But the topic will hardly be resolved with the completion of the calendar. Given the scientific breakthroughs on the horizon combined with class-action lawsuits and personal stories related to concussions from sport participants, 2018 could make a bigger splash.
At the first annual Grey Cup Player’s Health Summit in Ottawa in late November, Queen’s University neurologist Dr. D.J. Cook was asked about new therapies for concussion treatment.
“That’s the trillion-dollar question,” Cook said. “To date there is no evidence-based treatment for concussion that is available. All we have is our best guess. Active recovery is what we do right now.”
Cook was the doctor who operated on Gord Downie of the Tragically Hip when it was discovered Downie was suffering from glioblastoma, a form of brain cancer.
“Are there things burgeoning, are there things in the pipeline? Yes there are things that are very close,” Cook said, elaborating on the complex nature of brain trauma.
“It’s more than just an injury of the brain,” Cook added. “It’s an injury of the entire nervous system, both inputs and outputs and as a systemic disease, we have a lot to learn. And a lot we can do for it.”
CTE REPORTS
In the past couple of years, concussion news has tended to trickle down from the NFL and NHL and cause ripples in amateur sport.
Data from a Journal of the American Medical Association (JAMA) release caused a stir when it was learned that 110 of 111 deceased NFL players’ brains studied showed evidence of chronic traumatic encephalopathy (CTE).
The degenerative brain disease is associated with repeated head trauma. It’s important to note the brain samples studied were not random, as they were promised to the Boston University CTE Center, either by concerned players prior to their death, or by families who recognized changes in mood and behaviour from the ex-player.
A total of 202 brains of former football players were studied by July of 2017. This included entries from the NFL, college, CFL and even a few high school samples. The results – 177 brains, or 87 per cent, showed signs of CTE. Forty-eight of 53 college players showed signs, while seven of eight CFL players and nine of 14 semi-pro players also showed signs of CTE.
The CTE levels ranged in severity from level 1 (low) to level 4 (extreme).
Former New England Patriots tight end Aaron Hernandez, a convicted murderer, was found to have extreme levels of CTE when his brain was studied following his suicide at age 27.
Ann McKee, director Boston University’s center for research into the degenerative brain disease chronic traumatic encephalopathy, or CTE, addresses an audience on the school’s campus Thursday, Nov. 9, 2017 about the study of NFL football player Aaron Hernandez’s brain, projected on a screen behind.
Daniel Daneshvar, a neuroscientist at the Boston University CTE Research Center, told this newspaper that even the experts at the university were taken aback by the findings.
“We’ve been studying CTE for eight years and it’s been in the literature since 1928,” Daneshvar said in an interview. “We knew CTE was related to repetitive head trauma, what was surprising to us was the sheer number of athletes we found that had CTE over a relatively short time period of study.
“To find 110 players (of 111) at the NFL level was pretty surprising.”
Daneshvar believes professional sport leagues have to get out in front of this ongoing issue.
“To a certain extent I can understand why leagues are reluctant, but the longer they choose to sit on the sidelines when it comes to making decisions to protect their players, the more likely they are to face an existential threat as we become more aware of the specific types of hits that are responsible for the development of CTE,” Daneshvar said.
“If they keep waiting to do anything, people are going to be less forgiving.”
NFL PAYOUTS
The NFL has been lauded for taking a position on the concussion story, admitting a link between football and brain trauma while providing a settlement of $1 billion with former players. Yet, there have been numerous reports suggesting the money offered in the settlement does not measure up to those initial headlines about a future payout. In November, data indicated that of the 1,400 claims submitted by ex-players, only 10 per cent had been approved.
Others have complained that the compensation was dramatically lower than expected, and the system has been fraught with delays and red tape to make it difficult for those in need to get their settlement money.
CFL Commissioner Randy Ambrosie talks about concussions as he responds to a question during his State of the League address Friday November 24, 2017 in Ottawa.
CFL DENIES LINK
The CFL also faces a class-action lawsuit, and hasn’t reached the point of settling with former players or even agreeing that CTE is caused by football contact.
“We know there are football players that have had CTE,” said CFL commissioner Randy Ambrosie during his state-of-the-union media conference at Grey Cup week in Ottawa. “It’s a terrible thing that we’re not going to dispute.”
But Ambrosie added, “we have to follow the science and the science … is inconclusive. The cause and effect is unclear, it just simply is.”
PRACTICE CONTACT LIMITED
Ambrosie, a former CFL lineman, was relatively new to the job when his league took the step of limiting contact drills during practice.
In September, the CFL and its Players’ Association jointly announced the elimination of full contact, padded practice during the regular season. By comparison, the NFL allows 11 padded practices through the first 11 weeks of the season, and then three more after that.
Marcel Bellefeuille, an assistant coach with the B.C. Lions, is in favour of limiting contact in practice.
“When I was at collegiate level, we had zero contact after training camp,” said Bellefeuille, who led the University of Ottawa Gee-Gees to a Vanier Cup championship in 2000. “There was no live tackling. It teaches players to play with their feet, and use their hands to be in good position.
Bellefeuille said the contact restrictions keep players fresher and reduce practice injuries.
The CFL also plans to extend its schedule by one week in 2018, to allow more time for players to recover from games.
Edmonton Eskimos kick returner Joe Burnett tackles Montreal Alouettes wide receiver Arland Bruce on a turnover during the first half of the game at Commonwealth Stadium in Edmonton, Alta., on Saturday, Oct. 5, 2013.
SUITS ON HOLD
Arland Bruce, a former star receiver in the CFL, is still awaiting an outcome on his bid to have the Supreme Court of Canada hear his case against the CFL. Bruce, who played 13 seasons for several CFL teams, said he has suffered permanent and disabling brain trauma from his football experience.
A separate class-action lawsuit in the province of Ontario is on hold awaiting the outcome of the Bruce case. The pending Ontario lawsuit involves players who saw action between 1952 and 2014.
Robyn Wishart, the lawyer representing Bruce, told the Ottawa Citizen in late September that she has more than 200 ex-players or their families signed on for the Ontario suit, a number that continues to grow.
CONCUSSION ‘CONVERSATIONS’
At the grassroots level, doctors and team trainers are being proactive.
Dr. Taryn Taylor, team doctor for all of the Ottawa Sports & Entertainment Group teams (Redblacks, Fury, 67s), estimates she sees about 20 concussion patients per week in her general practice.
Some of these patients require months, and even years, to recover from post-concussion syndrome. In yet another capacity, Taylor works in sport medicine at Carleton University, a place where she sees some serious issues related to head trauma.
“Unfortunately, at the university level, I have a conversation every year (with a college athlete) about retiring from the sport because of concussions,” Taylor said.
Taylor offers to take the brunt of the athlete’s frustration.
“I say, be mad at me. Don’t be mad at your parents, your coach or your teammates,” Taylor said. “I will let you back (to play) when it is safe. But be honest with me.”
Dr. Taryn Taylor, team doctor for all of the Ottawa Sports & Entertainment Group teams (Redblacks, Fury, 67s).
CULTURE CHANGE
Concussion treatment and diagnosis has advanced dramatically even in the 12 years Taylor has been practicing medicine.
“We went from having a hockey player on the sidelines stand on one foot and touch his nose — and if he could do it he could go back on — to now knowing it could take 24 hours to even have symptoms,” Taylor said at the Player’s Health Summit.
The motto from trainers working with amateur and professional teams is: “If in doubt, sit out.” Yet, we continue to find examples on TV of players taking head hits and returning to action.
On the whole, Taylor believes coaches are more aware of best practices when it comes to head trauma.
“I have seen a huge shift in the culture, it used to be a bit more of a challenge,” Taylor said. “I used to have to sell it. It wasn’t always a popular decision. I’m lucky to work with coaches who have had experience with concussions and are much more educated. It has made my life a lot easier.
“They know me well enough that taping up an ankle and letting them back on the field is reasonable, but we can’t do that with a brain.”
Unfortunately, while an ankle or knee injury usually comes with a specific diagnosis (example: two to four weeks of rest and recovery), concussions and their symptoms can be unpredictable.
“There is no magical treatment that makes them better, so I spend 30 to 40 minutes educating,” Taylor said. “What is the right thing to do now … how are we going to work together to get through this?”
ROWAN’S LAW TRIUMPH
The death of Rowan Stringer, a Nepean rugby player who returned to action too soon following a concussion, sparked the creation of the Rowan’s Law Advisory Committee Act in 2016. That is expected to lead to legislation in Ontario to provide comprehensive guidelines governing amateur sport in schools and communities throughout the province.
The next goal is to establish concussion policy across the country. MPP Lisa MacLeod, who spoke at the Grey Cup Player’s Health summit as well as the Concussion Legacy Foundation conference at Algonquin College, continues to champion the cause along with the Stringer family and advocates like retired hockey star Eric Lindros.
MacLeod works at the grassroots level but understands the importance of professional athletes taking their head health seriously.
“(They) are role models to so many kids, who are rushing home on Saturday night to watch (them) on television,” McLeod said. “So when (they) speak, and say I need to take my health seriously, kids listen.
“Kids playing sports are going to say, ‘Oh, I can’t mess with a head injury.’”
Retired NHL goaltender Ken Dryden addresses the “We Can Do Better” Governor General’s Conference on Concussions in Sport in Ottawa late last year.
DRYDEN CALLS FOR BAN ON HEAD HITS
The year ended with a national book tour by Ken Dryden, the Hall of Fame goaltender and former NHL executive. Dryden’s book is called Game Change: The Life and Death of Steve Montador and the Future of Hockey. The change Dryden advocates is a ban on any and all hits to the head, whether incidental or not.
To personalize his call to arms, Dryden builds the book around the life and untimely death of Montador, a journeyman player who died at age 35 with evidence of CTE in his brain.
Dryden, who attended the same Cornell University as NHL commissioner Gary Bettman, calls on Bettman to do the right thing.
“You focus on no hits to the head. No excuses,” Dryden told the Montreal Gazette. “Whether it was intentional or not, with an elbow or a shoulder or a stick or a fist. Whether the head was targeted. The brain doesn’t distinguish, it’s the same blow.”
Whether Dryden’s plea results in action remains to be seen. Many casual hockey observers don’t see a problem with a penalty for all head hits but guardians of the game — league general managers, among others — have shown reluctance to do so. Several years ago the NHL altered rule 48.1 to outlaw hits in which “the head was the main point of contact and such contact was avoidable.”
Where Dryden is especially brilliant is in describing the “finish your check” mantra, which wasn’t even a part of hockey in the 1950s and ’60s. Today’s speed allows players to get in on a check, a second or two late, and deliver a massive hit on a player who has already released the puck. Hit a guy without the puck and it’s an interference penalty. But hit him a second or two after he had the puck and – freebie!
“You’ve got a full head of steam going toward you, he’s kind of blind to you and plus, he’s the one who made the successful play by making the pass and you’ve been the unsuccessful one, except you get all the benefits,” Dryden told TSN.
Wscanlan@postmedia.com
twitter/@hockeyscanner
查看原文...
But the topic will hardly be resolved with the completion of the calendar. Given the scientific breakthroughs on the horizon combined with class-action lawsuits and personal stories related to concussions from sport participants, 2018 could make a bigger splash.
At the first annual Grey Cup Player’s Health Summit in Ottawa in late November, Queen’s University neurologist Dr. D.J. Cook was asked about new therapies for concussion treatment.
“That’s the trillion-dollar question,” Cook said. “To date there is no evidence-based treatment for concussion that is available. All we have is our best guess. Active recovery is what we do right now.”
Cook was the doctor who operated on Gord Downie of the Tragically Hip when it was discovered Downie was suffering from glioblastoma, a form of brain cancer.
“Are there things burgeoning, are there things in the pipeline? Yes there are things that are very close,” Cook said, elaborating on the complex nature of brain trauma.
“It’s more than just an injury of the brain,” Cook added. “It’s an injury of the entire nervous system, both inputs and outputs and as a systemic disease, we have a lot to learn. And a lot we can do for it.”
CTE REPORTS
In the past couple of years, concussion news has tended to trickle down from the NFL and NHL and cause ripples in amateur sport.
Data from a Journal of the American Medical Association (JAMA) release caused a stir when it was learned that 110 of 111 deceased NFL players’ brains studied showed evidence of chronic traumatic encephalopathy (CTE).
The degenerative brain disease is associated with repeated head trauma. It’s important to note the brain samples studied were not random, as they were promised to the Boston University CTE Center, either by concerned players prior to their death, or by families who recognized changes in mood and behaviour from the ex-player.
A total of 202 brains of former football players were studied by July of 2017. This included entries from the NFL, college, CFL and even a few high school samples. The results – 177 brains, or 87 per cent, showed signs of CTE. Forty-eight of 53 college players showed signs, while seven of eight CFL players and nine of 14 semi-pro players also showed signs of CTE.
The CTE levels ranged in severity from level 1 (low) to level 4 (extreme).
Former New England Patriots tight end Aaron Hernandez, a convicted murderer, was found to have extreme levels of CTE when his brain was studied following his suicide at age 27.
Ann McKee, director Boston University’s center for research into the degenerative brain disease chronic traumatic encephalopathy, or CTE, addresses an audience on the school’s campus Thursday, Nov. 9, 2017 about the study of NFL football player Aaron Hernandez’s brain, projected on a screen behind.
Daniel Daneshvar, a neuroscientist at the Boston University CTE Research Center, told this newspaper that even the experts at the university were taken aback by the findings.
“We’ve been studying CTE for eight years and it’s been in the literature since 1928,” Daneshvar said in an interview. “We knew CTE was related to repetitive head trauma, what was surprising to us was the sheer number of athletes we found that had CTE over a relatively short time period of study.
“To find 110 players (of 111) at the NFL level was pretty surprising.”
Daneshvar believes professional sport leagues have to get out in front of this ongoing issue.
“To a certain extent I can understand why leagues are reluctant, but the longer they choose to sit on the sidelines when it comes to making decisions to protect their players, the more likely they are to face an existential threat as we become more aware of the specific types of hits that are responsible for the development of CTE,” Daneshvar said.
“If they keep waiting to do anything, people are going to be less forgiving.”
NFL PAYOUTS
The NFL has been lauded for taking a position on the concussion story, admitting a link between football and brain trauma while providing a settlement of $1 billion with former players. Yet, there have been numerous reports suggesting the money offered in the settlement does not measure up to those initial headlines about a future payout. In November, data indicated that of the 1,400 claims submitted by ex-players, only 10 per cent had been approved.
Others have complained that the compensation was dramatically lower than expected, and the system has been fraught with delays and red tape to make it difficult for those in need to get their settlement money.
CFL Commissioner Randy Ambrosie talks about concussions as he responds to a question during his State of the League address Friday November 24, 2017 in Ottawa.
CFL DENIES LINK
The CFL also faces a class-action lawsuit, and hasn’t reached the point of settling with former players or even agreeing that CTE is caused by football contact.
“We know there are football players that have had CTE,” said CFL commissioner Randy Ambrosie during his state-of-the-union media conference at Grey Cup week in Ottawa. “It’s a terrible thing that we’re not going to dispute.”
But Ambrosie added, “we have to follow the science and the science … is inconclusive. The cause and effect is unclear, it just simply is.”
PRACTICE CONTACT LIMITED
Ambrosie, a former CFL lineman, was relatively new to the job when his league took the step of limiting contact drills during practice.
In September, the CFL and its Players’ Association jointly announced the elimination of full contact, padded practice during the regular season. By comparison, the NFL allows 11 padded practices through the first 11 weeks of the season, and then three more after that.
Marcel Bellefeuille, an assistant coach with the B.C. Lions, is in favour of limiting contact in practice.
“When I was at collegiate level, we had zero contact after training camp,” said Bellefeuille, who led the University of Ottawa Gee-Gees to a Vanier Cup championship in 2000. “There was no live tackling. It teaches players to play with their feet, and use their hands to be in good position.
Bellefeuille said the contact restrictions keep players fresher and reduce practice injuries.
The CFL also plans to extend its schedule by one week in 2018, to allow more time for players to recover from games.
Edmonton Eskimos kick returner Joe Burnett tackles Montreal Alouettes wide receiver Arland Bruce on a turnover during the first half of the game at Commonwealth Stadium in Edmonton, Alta., on Saturday, Oct. 5, 2013.
SUITS ON HOLD
Arland Bruce, a former star receiver in the CFL, is still awaiting an outcome on his bid to have the Supreme Court of Canada hear his case against the CFL. Bruce, who played 13 seasons for several CFL teams, said he has suffered permanent and disabling brain trauma from his football experience.
A separate class-action lawsuit in the province of Ontario is on hold awaiting the outcome of the Bruce case. The pending Ontario lawsuit involves players who saw action between 1952 and 2014.
Robyn Wishart, the lawyer representing Bruce, told the Ottawa Citizen in late September that she has more than 200 ex-players or their families signed on for the Ontario suit, a number that continues to grow.
CONCUSSION ‘CONVERSATIONS’
At the grassroots level, doctors and team trainers are being proactive.
Dr. Taryn Taylor, team doctor for all of the Ottawa Sports & Entertainment Group teams (Redblacks, Fury, 67s), estimates she sees about 20 concussion patients per week in her general practice.
Some of these patients require months, and even years, to recover from post-concussion syndrome. In yet another capacity, Taylor works in sport medicine at Carleton University, a place where she sees some serious issues related to head trauma.
“Unfortunately, at the university level, I have a conversation every year (with a college athlete) about retiring from the sport because of concussions,” Taylor said.
Taylor offers to take the brunt of the athlete’s frustration.
“I say, be mad at me. Don’t be mad at your parents, your coach or your teammates,” Taylor said. “I will let you back (to play) when it is safe. But be honest with me.”
Dr. Taryn Taylor, team doctor for all of the Ottawa Sports & Entertainment Group teams (Redblacks, Fury, 67s).
CULTURE CHANGE
Concussion treatment and diagnosis has advanced dramatically even in the 12 years Taylor has been practicing medicine.
“We went from having a hockey player on the sidelines stand on one foot and touch his nose — and if he could do it he could go back on — to now knowing it could take 24 hours to even have symptoms,” Taylor said at the Player’s Health Summit.
The motto from trainers working with amateur and professional teams is: “If in doubt, sit out.” Yet, we continue to find examples on TV of players taking head hits and returning to action.
On the whole, Taylor believes coaches are more aware of best practices when it comes to head trauma.
“I have seen a huge shift in the culture, it used to be a bit more of a challenge,” Taylor said. “I used to have to sell it. It wasn’t always a popular decision. I’m lucky to work with coaches who have had experience with concussions and are much more educated. It has made my life a lot easier.
“They know me well enough that taping up an ankle and letting them back on the field is reasonable, but we can’t do that with a brain.”
Unfortunately, while an ankle or knee injury usually comes with a specific diagnosis (example: two to four weeks of rest and recovery), concussions and their symptoms can be unpredictable.
“There is no magical treatment that makes them better, so I spend 30 to 40 minutes educating,” Taylor said. “What is the right thing to do now … how are we going to work together to get through this?”
ROWAN’S LAW TRIUMPH
The death of Rowan Stringer, a Nepean rugby player who returned to action too soon following a concussion, sparked the creation of the Rowan’s Law Advisory Committee Act in 2016. That is expected to lead to legislation in Ontario to provide comprehensive guidelines governing amateur sport in schools and communities throughout the province.
The next goal is to establish concussion policy across the country. MPP Lisa MacLeod, who spoke at the Grey Cup Player’s Health summit as well as the Concussion Legacy Foundation conference at Algonquin College, continues to champion the cause along with the Stringer family and advocates like retired hockey star Eric Lindros.
MacLeod works at the grassroots level but understands the importance of professional athletes taking their head health seriously.
“(They) are role models to so many kids, who are rushing home on Saturday night to watch (them) on television,” McLeod said. “So when (they) speak, and say I need to take my health seriously, kids listen.
“Kids playing sports are going to say, ‘Oh, I can’t mess with a head injury.’”
Retired NHL goaltender Ken Dryden addresses the “We Can Do Better” Governor General’s Conference on Concussions in Sport in Ottawa late last year.
DRYDEN CALLS FOR BAN ON HEAD HITS
The year ended with a national book tour by Ken Dryden, the Hall of Fame goaltender and former NHL executive. Dryden’s book is called Game Change: The Life and Death of Steve Montador and the Future of Hockey. The change Dryden advocates is a ban on any and all hits to the head, whether incidental or not.
To personalize his call to arms, Dryden builds the book around the life and untimely death of Montador, a journeyman player who died at age 35 with evidence of CTE in his brain.
Dryden, who attended the same Cornell University as NHL commissioner Gary Bettman, calls on Bettman to do the right thing.
“You focus on no hits to the head. No excuses,” Dryden told the Montreal Gazette. “Whether it was intentional or not, with an elbow or a shoulder or a stick or a fist. Whether the head was targeted. The brain doesn’t distinguish, it’s the same blow.”
Whether Dryden’s plea results in action remains to be seen. Many casual hockey observers don’t see a problem with a penalty for all head hits but guardians of the game — league general managers, among others — have shown reluctance to do so. Several years ago the NHL altered rule 48.1 to outlaw hits in which “the head was the main point of contact and such contact was avoidable.”
Where Dryden is especially brilliant is in describing the “finish your check” mantra, which wasn’t even a part of hockey in the 1950s and ’60s. Today’s speed allows players to get in on a check, a second or two late, and deliver a massive hit on a player who has already released the puck. Hit a guy without the puck and it’s an interference penalty. But hit him a second or two after he had the puck and – freebie!
“You’ve got a full head of steam going toward you, he’s kind of blind to you and plus, he’s the one who made the successful play by making the pass and you’ve been the unsuccessful one, except you get all the benefits,” Dryden told TSN.
Wscanlan@postmedia.com
twitter/@hockeyscanner
查看原文...
