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When it comes to concussions for peewee hockey players, we're in the dark about risks

Ottawa peewee hockey coach Sean O'Connor heard the crunch of two helmets colliding. His player, a top defenceman, bent over and held his head. Mr. O'Connor knew the 12-year-old had suffered a concussion.

It was the first tournament of the season for the Ottawa Sting Major Peewee AA and the first of many concussions for the top-level competitive team. As the season wore on, eight of 17 players would miss anywhere from a week to months of hockey, and in many cases school, because of the brain injury. It was difficult, Mr. O'Connor says.

"I know how bad the fire burns inside them to play. However, when it comes to concussions, I think coaches need to realize that it is a serious issue and supporting the parents and players is crucial."

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A concussion rate of close to 50 per cent in one season might seem like an exceptional number, but experts say it is closer to reality than most hockey parents and fans realize, especially for competitive teams. The injury often goes unrecognized by trainers, coaches, parents and doctors, says Kristian Goulet, an Ottawa pediatrician who specializes in treating concussions in children.

Bodychecking is one factor, and a controversial topic in leagues across the country.

Concussions occur when there is a rapid acceleration or deceleration of the head. The brain moves or rotates inside the skull, and different parts of it move against each other. Symptoms include headaches, confusion, amnesia and sensitivity to light or noise that can last days, weeks or months.

In recent years, researchers have gained insight into how concussions change the brains of professional athletes. However, very little is known about concussions in childhood and a number of Canadian studies are under way to learn more.

Research suggests the average rate of concussions on hockey teams is between 5 and 20 per cent. But those numbers are likely shy of the reality since so many injuries are missed or ignored, said Maryse Lassonde, a University of Montreal researcher who studies the injury in athletes. She suspects the actual concussion rate is closer to what the Ottawa Sting team experienced this season.

Isla Edmonds, an Ottawa Sting goalie, was shoved into the post in the third period of a game in December. She says it didn't feel any worse than getting hit in the head with a puck. But when she left the ice she became dizzy, and her vision became blurred.

"Bright lights and loud noises bothered me," she says. Even the glare of the ice was too much for her.

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Some symptoms cleared up after a few days, but she was lethargic for two weeks. At first, she could do as little as 10 minutes of math or other homework a day and missed three weeks of school and five of hockey.

"One of the symptoms I didn't know about was severe fatigue. You can't just shake it off," says her father, Dale Edmonds-Mutcher.

Isla, who turned 13 last week, was nervous about her first game back and feared she might be reinjured, but says she never thought about giving up hockey.

Three other players were also out for a month or more, including the defenceman hurt in the first tournament of the season. One boy hasn't been able to regularly attend classes since he was hit from behind in mid-December. He slammed into the boards head first. Illegal hits were the cause of three of the concussions, and the other teams were penalized. But other incidents were less dramatic. One player was hurt at a practice in late January in what looked like a simple bump to the head, but he hasn't played since.

"I think the big thing is that every kid's brain is different and they react differently," Mr. O'Connor says.

"A lot of the kids had long, drawn out recoveries. It was scary," says Patrick Blake, a parent of a player on the team and a medical doctor.

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The coaches, trainer and parents took a vigilant, cautious approach, one experts like Dr. Goulet wish more teams would adopt. They wanted to prevent any child from sustaining a second concussion before they had recovered from an initial one. This can cause a rare condition known as "second impact syndrome," which can lead to disability or death.

In three cases, players had symptoms after a game had ended. They were assessed, and sat out for a week to 10 days with suspected concussions.

"Six or seven years ago that wouldn't have happened," says Mr. O'Connor, who is in his 11th year of coaching. But there is growing awareness about the danger of concussions, due in part to injuries sustained by high-profile professional players like Sidney Crosby.

"I always err on the side of caution. I am not pushing anyone to go back until they are cleared," he says.

Experts like Dr. Goulet say they wish this careful approach was adopted by more minor hockey teams. He is putting together several studies to explore ways to reduce the rate of concussions, including assessing whether improving neck strength is protective.

The fact that susceptibility to concussions varies so dramatically from child to child adds to the difficulty of addressing the issue.

"I think the big thing is that every kid's brain is different and they react differently," Mr. O'Connor says.

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