Sport P.E.I. is promoting new international guidelines designed to protect young athletes from sport-related concussions, and to speed up their recovery and return to sport if they do suffer one.
Many of the changes are focused around contact sports, including hockey, football and rugby.
“They now are saying that mouthguards make a big difference — a 28 per cent reduction in concussions with contact sports,” said Randy Goodman, Sport P.E.I.’s athlete health and performance director and a clinical specialist in sports physiotherapy.
“The other thing is reducing impact or collisions or hitting in hockey. If you reduce body checking in hockey in adolescents … it reduces concussions up to 58 per cent of the time.”
He said another prevention measure is “reducing full-hit practices in football so that you still do some, but you don’t do a lot of it, and you save that hitting for the games.”
Goodman said there are also updated tools for sideline evaluation of sport-related concussions, one for coaches and parents, and another for health-care professionals.
“They’ve recommended that you should do a fairly comprehensive assessment if you think the person’s had a concussion. So you need to pull them out of the sport, get them in a quiet area and do a full-on concussion evaluation that takes about 10 to 15 minutes,” Goodman said.
Another recommendation is that competition officials have health-care professionals present during events that are at a higher risk for concussions “to make those determinations, to make sure it’s safe for the player.”
Goodman said P.E.I. is gradually increasing the number of health-care professionals knowledgeable about sport-related concussions.
“We have many more practitioners now who are qualified to do concussion management than we had, say, five years ago. So it’s coming,” he said.
“We’ve posted the guidelines on our website so people can see what the changes are, and we’re doing some education for primary health practitioners, sport practitioners and coaches over the next six weeks.”
Goodman said there is a seven-step process to manage how an athlete will return to sport after a concussion, with some significant changes around how a person can recover.
“It actually shows that people get better faster if we actually do some early exercise, by day one, day two. But that needs to be supervised to manage heart rate,” he said.
“Exercise increases circulation to your brain so it helps it actually heal, but if you do too much, then you’ll push the symptoms over the edge and then you have to back off,” he said.
“The other interesting thing is they came out fairly strong saying that you need to limit screen time for 24 to 48 hours after a concussion, and I think that’s important, just to give your neurons in your brain a rest.”
Goodman said most people should show improvement in about 10 days, but should seek a professional trained in concussions for further evaluation after four weeks.
The new concussion guidelines come too late for brother and sister Keiran and Crosby Andrews, from Hunter River, P.E.I., who both suffered multiple concussions that forced them to retire from competitive hockey.
Keiran Andrews, now 22, had her first concussion at 14.
“I was playing soccer and I got hit in the head with a soccer ball. That one took about a month to recover from,” she said.
“My second concussion was playing hockey. I went head first into the boards, and then my third concussion was the worst. I fell during soccer and I hit my head on the ground.
“Unfortunately, because of the lack of knowledge that I had around concussions at the time, I didn’t identify that I did have a concussion,” she added.
I continued to play sports even after I had my third concussion, which I think made everything worse.— Keiran Crosby
“I continued to play sports even after I had my third concussion, which I think made everything worse, and I unfortunately still have migraines and double vision and noise sensitivity to this day.”
Crosby Andrews suffered his first concussion in March of 2021, when he got hit in the head while playing hockey.
He had three more concussions, also from hockey.
“My tolerance got lower and lower every single time,” said the 19-year-old.
“I felt it in my best interest to make the decision to stop playing, just given the information I had from different professionals, and talking it over with my family, and also seeing what my sister went through with her concussions.”
He calls that “probably the hardest decision I’ve had to make in my life. Hockey is all I’ve known, really. It was my favourite thing, it was my passion. So to make that decision was very, very difficult.”
Crosby Andrews still plays hockey, but it’s a non-contact type.
“Unlike my sister, I don’t have any symptoms still. So I lucked out in that sense, [it’s] but still very difficult.”
Keiran Andrews said she hopes the new guidelines will help other young athletes.
“When I first got my concussions, the protocol was to stay in a dark room until my symptoms went away. For Crosby, though, they changed it so that if his symptoms didn’t get worse, then he could start reintroducing activity and exercise into his daily routine, which I think is a lot better,” she said.
“It really took a toll on my mental health, to have to stay in that dark room for such a long time without doing activities or returning to my daily life. So I really like the new protocol.”
Looking back, she said, “Unfortunately, none of my coaches recognized that I had a concussion. None of them actually implemented the protocol. I had to go home to my parents afterwards and say that I wasn’t feeling well and that I think I needed to see a doctor.
“That is actually a big thing that I think should be implemented — training for the coaches to recognize when players may have concussions, and then also recognize when they may need to have a talk with them about stepping back from the sport.”
I know that I should stay away for the safety of my my brain health. So it’s a hard decision constantly that I have to make.— Keiran Andrews
It has been six years now since Keiran Andrews gave up hockey.
“I think about it every single day, actually. I think about wanting to get back into it.
“But I know that I should stay away for the safety of my my brain health,” she said.
“I’m hoping that these new concussion protocols will prevent anyone else like me having to make that hard decision to give up the sport that they love.
“I do wish that I had decided to quit before I got all these symptoms. It is hard for me, for sure.”