Go to the Globe and Mail homepage

Jump to main navigationJump to main content

Dr. Paul Echlin and Dr. Charles Tator, both experts in concussions, are seen with MRI brain scans at Toronto Western Hospital on February 6, 2011. (JENNIFER ROBERTS For The Globe and Mail)
Dr. Paul Echlin and Dr. Charles Tator, both experts in concussions, are seen with MRI brain scans at Toronto Western Hospital on February 6, 2011. (JENNIFER ROBERTS For The Globe and Mail)

JEFF BLAIR

Concussion fight is the good fight Add to ...

They are all doing God's work, really. Charles Tator, Matt Dunigan, Keith Primeau, Nick Kypreos and all the men and women in the lab coats - the whole lot of them.

Roll your eyes if you must whenever somebody calls a news conference and stands up and talks about concussions and research and the effects of brain injury. Most likely, that means you're not a parent.

More related to this story

It might seem quaint to the middle-aged guy fiddling with his fantasy draft over a beer, this notion of handing out wallet-sized cards to amateur football players listing step-by-step concussion warning signs. Piffle. Pansies.

Yet that is really all that can be done right now. Increase awareness. Solicit brains from former athletes for posthumous research into the degenerative effects of concussions. Because the sad fact is, for professional leagues - let alone amateur leagues and athletes - the economics of concussion determination and treatment are not on our side. And by "our" I mean players, administrators, coaches, doctors … and parents.

Still, some of us wonder whether it isn't time for leagues to do spot testing of players' cognitive abilities at various points during a season, especially in high-impact sports such as football and hockey. If we can test for steroids, we ought to test for this, no?

It beats taking a guy back into a "quiet room" for 15 minutes - especially, in light of a "joke" tweet from Indianapolis Colts quarterback Peyton Manning last month about tanking his baseline concussion test.

Tator, head of the ThinkFirst brain and spinal cord injury prevention program and a renowned neurosurgeon and researcher at Toronto Western Hospital, is not one to mince words when it comes to the topic of concussions and sports. (Just ask CBC hockey analyst Don Cherry.)

He realizes that some place in the middle between helping parents and youngsters and doing research on brains that have been donated posthumously lies a bottom line: Sports equipment companies and leagues are driven by profits, which means, simply, there is an unspoken yet obvious economic imperative for team physicians and players.

Put it this way: Do you think every CFL team would be able to afford 20 players on its disabled list with post-concussion syndrome? You think a 27-year-old import offensive lineman on his second CFL team who has bombed out of three NFL training camps is going to err on the side of caution? What about that journeyman fourth-liner in hockey?

As Tator says, absent definitive bio-markers - which science has not yet found - "the best method of assessing the effects of a concussion are through a trained observer, a trained physician and a compliant patient. If you have a physician who isn't trained and a patient who does not want to be compliant, you get nowhere."

It is sad but true that we are still very much doing the one-step-at-a-time routine with concussions while athletes are getting bigger and faster, equipment is getting lighter, and nutrition and medicine means they're staying in the game longer and absorbing more hits. Also sad but true is that it costs money to do this thing properly. Scads of it.

"There are two types of cognitive tests," Tator says. "There is the interactive test - 20 minutes, $50 - where you come up with a numerical score as a baseline and redo half-way through the season and see the difference. Sounds good on paper, but does it work? We don't know the answer.

"Some doctors and experts rely on these tests, while others say they're unproven. I'm somewhere in the middle, but I know this: I rely on formal, neuropsychological testing, by which I mean a few hours of a neuropsychologist's time to assess a player's cognitive functioning. It's very costly, unfortunately, so you can't apply it to everybody but I know that when I get back a report from a neuropsychologist after that type of an assessment that I can rely on that - and use that information when I make a decision on whether a player should go back into their action or terminate a career," Tator says.

"That's a big decision, so I insist on the gold standard, which is a non-20 minute, non-computerized, once-over-lightly test."

It's an ugly truth, but that doesn't mean this is a fight to give up. The exact opposite, in fact.

Forget hunting for steroids and performance-enhancing substances: This is the real issue. Even if its not as sexy or black-and-white moralistic.

Follow us on Twitter: @GlobeHockey

In the know

Most popular video »

Highlights

More from The Globe and Mail

Most Popular Stories