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CONCUSSION SERIES ‘Our approach has changed a lot’: Antigonish concussion expert

Football is a physical sport where hard collisions are inevitable and, sometimes, result in injuries. While knees and shoulders seem to be the most common, the head can sustain an injury as well. Fortunately, there is greater awareness and treatment when it comes to concussions.
Football is a physical sport where hard collisions are inevitable and, sometimes, result in injuries. While knees and shoulders seem to be the most common, the head can sustain an injury as well. Fortunately, there is greater awareness and treatment when it comes to concussions. - FILE

Concussion awareness and treatment continues to progress: Cudmore

ANTIGONISH, N.S. - A new school year is coming, and along with that is the start of fall and winter sports such as football, rugby, soccer, hockey and basketball.

There will be contact.

There will be injuries.

There could be concussions.

“They can happen in a lot of ways - it can be a hit to the head or a fall, a whiplash sort of thing,” says Tara Sutherland, the veteran St. F.X. head athletic therapist.

“What you’re looking for, the obvious would be someone lying motionless – loss of consciousness would be an obvious one. Slow to get up, inability or slow to respond to things, disorientated, confused, a blank or vacant look, certainly some sort of balance or gait walking issues like stumbling. Those are the observable things we look for and, certainly, complaining about headaches, light-head, dizziness, balance, nausea, vomiting.”

Sutherland has worked closely with St. F.X. sports physician Dr. David Cudmore, who is well-known for his work on concussions. In 2016, he was the recipient of the Brain Injury Canada Special Recognition Award.

It's not just athletes that have to worry about concussions, he says.

“We’ve been running a concussion clinic in Antigonish for more than 10 years now, for the community,” Cudmore said. “We’ve been involved in concussion management for 30 years at St. F.X. and it has evolved tremendously. The last 10 years, we’ve seen huge changes in the way it’s treated and I think people do make quicker recoveries, better recoveries … our approach has changed a lot.”

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Just being more aware and responsive to concussions is a big part of that, says Sutherland.

“The return to play is much better. Even the last four or five years, the care has changed dramatically. We went from keeping them in a dark, dark room until they felt better and now, it’s a couple of days after (the injury), you need to get them back to normal. Obviously not playing a sport or any kind of contact, in any kind of danger, but one of the real tricks these days is we need to get them back to school, active, life of some sort. When we kept them in a dark room all we had was sad, depressed people,” she said, referring to the varsity athletes.

Concussions in youth

But what about younger athletes?

Cudmore says encouraging a healthy, active lifestyle for kids is important, but acknowledges that could include a contact sport.

“The majority of kids are going to play without a concussion and, when a kid gets a concussion, probably 80 to 85 per cent of them are going to be better within a couple of weeks and do well,” he said.

“We try and reassure people - contact sports, if you play with good equipment, if you follow the rules, and it’s well run in terms of officiating and people making sure that kids do follow the guidelines, we try and reassure them about that."

That also means educating coaches and people working with kids about recognizing the signs of concussions.

“If someone does get injured, you want to make sure they don’t play, that they completely heal. The last thing you want them to do is go back before they’re ready," he added.

“It’s a whole spectrum of things but we, certainly, don’t want to discourage kids from being active and living healthy lifestyles.”

Remaining vigilant

Concussions aren't necessarily evident at the time of the incident, he cautions, and urges parents that see their child involved in a heavy collision on the sports field to remain vigilant.

“I think that is one of the big misconceptions we try to deal with in public education: you don’t have to be knocked out or visibly dazed immediately,” he said.

“Most people will have symptoms early on but not loss of consciousness, and some people, they don’t feel it for a few hours. Up to a day would be reasonable; it would be rare you see something starting out of the blue after a day.”

Cudmore said under-recording is a problem as well.

“Sometimes, people shake it off, don’t think it’s anything too serious, and then, an hour or two later, they really feel unwell. It’s in the locker room afterwards, it’s during the drive home, and that is when it’s really important for the parents to step in and say ‘OK, you’re not going back to the sport – particularly if it’s a contact sport – until you’ve been assessed'," Cudmore said.

“The current standard is – if you suspect a concussion, it should be medically assessed and then we’ll make the determination if it’s OK to continue (playing) or not.”

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