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(The Globe and Mail)

Ken Dryden

Ken Dryden’s heads up: The need to know more about concussions Add to ...

No NHL games have been played this year but tens of thousands of minor hockey games have been played across the country. This is now Christmas tournament season. Days are about to be spent in arenas instead of in offices or schools, days filled with pizza, Tim Hortons coffee, motel rooms and hockey bags. For the kids, it will be days of bonding and trouble. For the parents, days of bonding and fear of trouble.

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The season is half over. This is a moment for parents and coaches to talk and catch up. The NHL lockout seems to be hockey’s biggest issue but, of course, it isn’t. It will be resolved, soon, or for next year. The game, not untarnished or unaffected by it, goes on. And if parents are talking about anything other than how much ice time their kid is getting or the cost of their child’s “family” experience in terms of money and time, it is about concussions. No NHL players have suffered concussions this year but hundreds of kids have. Parents think about this and worry. Coaches and minor hockey officials do too. Everybody knows a little about concussions. About their prevention and treatment, nobody knows a lot. Everybody is looking for guidance.

The 4 th International Consensus Conference on Concussion in Sport was held recently in Zurich. Most of the world experts – 180 doctors and researchers from 20 countries – were there. It was called a “consensus” conference because without scientific proof on so many matters relating to concussions, a consensus of the world experts represents the most definitive word available on concussions, and will remain so until the next conference four years from now.

For a lot of these experts, their life’s work has been dedicated to the brain and brain injury. A few attended the first conference 11 years ago in Vienna and have been at every conference since. They have seen what concussions can do to a career, to a childhood passion, to a life.

Awareness about concussions is undeniably better than it was. It’s become mainstream today for fans to cringe not just whoop at a big hit; for parents to wonder if their young son or daughter, with lots of choices available to them, should play hockey or football at all; and for obituaries of former players to mention that, at a younger age than seems usual, the player suffered from dementia, and that the readers understand – right or wrong – that the dementia was the result of severe and repeated blows to the head from playing his sport.

In today’s world, punch-drunk boxers aren’t funny anymore.

That’s progress, but if the public knows concussions are bad, it doesn’t know how bad the short-term or long-term effects may be, because for the most part scientists don’t know either. That was also clear at the Zurich conference.

To help the tens of thousands of volunteer coaches and trainers without medical training make medically-difficult, competitively-difficult in-game decisions – does an injured player come out, or stay in? – the Zurich conference agreed to a clear, certain message: “When in doubt, sit them out.”

The problem is that players don’t want to sit out. Players want to play. So wrapped up in a game, they’re often the last ones to notice what others can see. The fog will go away after a hit to the head – they’re sure of it. They’ll be okay. They’re trained to see past obstacles, to ignore pain to the point where they often don’t feel pain at all, and to focus on what, to them, is truly important – the game, the season, the championship to be won. They need someone around them whose interest is only them. A trainer, or coach or parent may not be ideal, but could be the best they’ve got. If the player sits out the rest of the game, the player gains time to see what symptoms persist and develop, time to see a doctor; time until the next game, time to give everyone a better chance of being right.

Every medical non-professional and professional needs the confidence to make that in-game decision. They can’t know if they are right. They need to know: the mistake of not allowing someone to play when they’re okay, is better than the mistake of allowing someone to play when they’re not.

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