"We had come to think that concussions were a rather benign trauma, but that is not the case," said physician Charles Tator, founder of ThinkFirst, a non-profit organization that educates coaches, parents and children about safe sporting practices. "…Unfortunately, there is no drug, no exercise that has been discovered that has any beneficial effect on concussion. Those are the scientific facts."
To compound matters, Dr. Tator said, physicians aren't always aware of the best way to manage concussions. Wanting to brush off the injury, sufferers may go back on the ice - or the football field or the toboggan slope - unaware they risk a second injury.
"If you have a continuing headache, feel abnormally fatigued, you are not ready to go back," said Dr. Tator, a neurosurgeon at Toronto Western Hospital. "Any one of those lingering symptoms means you have not recovered."
The study results have prompted renewed calls for changes to competitive hockey. Playing four on four, insisting on well-fitting, tightly buckled helmets and wearing softer shoulder and elbow pads - instead of the hard plastic ones - would go a long way toward reducing the number of collisions, injuries and concussions, Dr. Tator said.
"Concussion is a good word," he said. "So long as people make the jump that concussion equals brain injury."
Each year, an estimated 45,000 Canadians suffer a concussion, said Peter Rumney, physician director of the brain injury rehab program at Bloorview Kids Rehab.
What no one can predict, however, is which ones will be left with long-lasting effects.
"Some people get away quite well, others don't," Dr. Rumney said. "We don't have any method right now to know who is going to be lucky."
Dr. Rumney has suffered three concussions: at age 4, when he took a sharp turn on his wagon; at 11, when he was playing defence in hockey; and at 13, when he was tobogganing with his brothers.
Today, he wonders whether those concussions have had any ill effects.
"I'm terrible on names, maybe it was just the way I was built," Dr. Rumney said. "Or maybe it was made a bit worse by the concussions."
Since concussions are an invisible injury - no abnormality typically shows up on a CT scan - and doctors are left to diagnose them through symptoms relayed by their sufferers.
Many patients are not even aware that they've suffered a concussion, wrongly believing losing consciousness is the key requirement. In fact, unconsciousness occurs in 5 per cent of concussions - the remaining 95 per cent include any one of about 20 symptoms, including confusion, headache, dizziness, feeling dazed, vomiting and poor concentration.
'It's not worth it'
Marty Cairns saw his 16-year-old son, Ryan, go flying into the boards at full speed last summer.
"I was the coach at the time, I was up in the stands watching," said Mr. Cairns of his son, who has fully recovered. "I cringe every time he goes into the boards or gets hit. It's a concern to everybody, especially after Sanderson died."
Don Sanderson, a 21-year-old rookie defenceman for the senior AAA Whitby Dunlops of the Ontario Hockey Association, died this month after hitting his unprotected head - his helmet came off - on the ice during a fight.
But William Trudell, a 23-year-old who used to play AAA hockey in Winnipeg, said head injuries have always been a risk of the sport.
"It's a hazard of the game," said Mr. Trudell, who has had 13 concussions from hockey and football, and who suffers from migraines. "You can't have a contact game without somebody getting hurt."
Now a carpenter in Toronto, he suffered his last concussion when he was 21 and playing competitive hockey.
"It was one of those where I am standing up and I thought, 'Wow, this sucks. It's not worth it,' " he said. He now plays house league for fun.
Similarly, 35-year-old Stephen Lepper of Brandon estimates he has had four concussions after skiing and hockey accidents, not including a couple of "blackouts" he experienced playing hockey in his youth.