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Head of the class

Mounting evidence about the long-term effects of concussions prompts Seven Oaks School Division to pay for certified athletic therapists at every high school football, hockey, lacrosse and rugby game

PHIL HOSSACK / WINNIPEG FREE PRESS  -   Maples Marauder #7 Mason Jesmer struggles to hold onto the ball going down in a swarm of Daniel Mac's Maroons Thursday afternoon. See Randy Turner story re: Concussions.   - Sept 21 2017

PHIL HOSSACK / WINNIPEG FREE PRESS - Maples Marauder #7 Mason Jesmer struggles to hold onto the ball going down in a swarm of Daniel Mac's Maroons Thursday afternoon. See Randy Turner story re: Concussions. - Sept 21 2017

Hey there, time traveller!
This article was published 23/9/2017 (978 days ago), so information in it may no longer be current.

When it comes to the growing concern over concussions in sport, one Winnipeg school division is putting its money where its students’ heads are.

Seven Oaks has hired a local athletic therapy firm to have spotters attend all high school football, hockey, lacrosse and rugby games played by its school teams, beginning this fall. It’s believed to be the first such initiative in Manitoba.

And Seven Oaks officials have initiated a city-wide education effort they are distributing to parents, coaches and athletes in Winnipeg’s six other school divisions. The program includes fact sheets and guidelines for symptoms and treatment of head trauma, along with an online course.

"We’re just trying to raise the standard level across the board," Seven Oaks superintendent Brian O’Leary says. "We’re wanting just a higher level of awareness and caution around concussions.

"It will become part of the way we do business in the future. If everybody’s more aware and conscious of (brain injury), it just changes the culture around those contact sports."

JOE BRYKSA / WINNIPEG FREE PRESS</p><p>Superintendent Brian O’Leary: ‘It’s an extra precaution we hope makes a difference’</p>


Superintendent Brian O’Leary: ‘It’s an extra precaution we hope makes a difference’

The debate and prevention issues surrounding concussions in sport have rocketed to the fore in the last decade, after the release of studies documenting evidence of cumulative, long-term, disabling damage in the brains of deceased pro athletes.

Last week, a study published in the medical journal JAMA found chronic traumatic encephalopathy (CTE) in 99 per cent of deceased NFL players’ brains donated for scientific research by their families. Symptoms of CTE include memory loss, confusion, impaired judgment, aggression, depression, anxiety, impulse control issues and sometimes suicidal behaviour.

Out of the 202 brains of deceased former football players in the JAMA study — which also included high school and college players — researchers diagnosed CTE in 177. The neurodegenerative disease was identified in 110 out of 111 former NFL players and found in three of the 14 high school players and 48 of the 53 college players.

Meanwhile in Canada, a 2013 study of children and teens participating in team sports found hockey accounted for half of all brain injuries.

The study looked at almost 13,000 injured children between the ages of five and 19 from 1990 to 2009, using data from the Canadian Hospitals Injury Reporting and Prevention Program, which tracks visits to emergency rooms at 11 pediatric hospitals and three general hospitals across the country.

More than 80 per cent of children and teens with brain injuries were male, and the average age was 13.

Seven Oaks’ program will cost less than $20,000 annually, based on paying $50 an hour for certified therapists to attend games, O’Leary estimates.

"It’s not huge costs," he says, adding Seven Oaks trustees believe the growing concern about the long-term consequences of head injuries necessitates the initiative.

Similar protocols are already in place for games played in Winnipeg Minor Hockey, Soccer Manitoba, Football Manitoba, Baseball Manitoba and Rugby Manitoba leagues.

"Our problem was our coaches are really focused on a game during the game," O’Leary says. "They’re probably counting whether there’s 12 kids on the field, rather than "is one of them coming off (the field) looking wobbly.

"You’re not going to catch every collision and every potential injury," he added. "It’s not an absolute, but it’s an extra precaution we hope makes a difference."

The company hired by Seven Oaks, NRG Athletes Therapy Fitness, began sending its four therapists to monitor Winnipeg High School Football League games involving the Maples, West Kildonan and Garden City teams.

Two concussions were diagnosed in a single game last week, says NRG owner Scott Miller.

NRG is located inside the new Seven Oaks Sportsplex. Miller is expecting delivery any day now of a $30,000 customized mobile trailer.

"It’s like a medical clinic on wheels, on site, " he says. "I think this is huge for the athletes and also the division to take this first step in the right direction. I foresee this being a very common trend among other school divisions in the near future."

While some high school teams have previously hired athletic therapists on their own, the practice has not been widespread.

Athletic Therapist Scott Miller tapes a Maples Marauder football club before a game Thursday.


Athletic Therapist Scott Miller tapes a Maples Marauder football club before a game Thursday.

In the Pembina Trails School Division, for example, many high schools have athletic therapists or student therapists on the sidelines or in the stands, but the division has no policy in place.

However, if a staff member, volunteer or administrator becomes aware of a student who has suffered a head injury, parents or guardians are informed and directed to have the student examined. In the absence of a doctor’s note clearing the student, guidelines include limiting or removing recess, gym time and school sport events.

If a concussion diagnosis in confirmed by a doctor, the school follows a six-step protocol that keeps students at home until they are symptom-free for 24 hours. A gradual return to academic and physical activities is followed, based on established national Return to Play protocol, until medical clearance is granted.

Still, policy for concussions in high school sports in a work in progress.

Last year, the Manitoba High School Football League entered an agreement with the Manitoba Athletic Therapists Association to have certified AT personnel at all games. Previously, the league used university student therapists, but eventually conceded they were increasingly being put in a "pretty precarious condition" to deal with concussions.

MHSFL commissioner Rick Henkewich says certified therapists are paid $25 an hour to attend games, where they serve as concussion spotters and first responders for other injuries.

"It’s the greatest deal I’ve negotiated, and I’m a business guy," Henkewich says. "Because it’s not about the money, it’s about the coverage. We’re ensuring players’ safety all down the line."

The MHSFL also has a medical committee working to improve safety and policy, such as return-to-play protocol, Henkewich adds.

There is, currently, no mandatory policy in the Manitoba High School Hockey League for athletic therapists at games, league president Mark Miles says.

A few teams ensure they have certified or student athletic therapists in attendance, Miles notes, while each team has a "certified safety person" who has basic first-aid and CPR training, but no training in spotting concussions.

Miles says, to date, the league has not discussed establishing a league-wide policy.

"It has not been an issue on our plate at league meetings," he says.

Chad Falk, executive director of Manitoba High School Athletic Association, says policy and staffing in sports programs are decided at the school and division level and can vary.

However, the MSHAA provides certified athletic therapists at all provincial championships, including basketball, volleyball, soccer and hockey.

Either way, Falk is encouraged by the Seven Oaks initiative.

"We always want the health and safety of our student athletes at the forefront," he says. "If a school division is taking that approach, we would definitely support that."

Both Henkewich and Miles say they, too, hope other divisions take action.

"There’s no question it would be peace of mind for parents," Miles says. "I certainly would have loved that when my son was growing up playing football, hockey and lacrosse; to have somebody there who actually knows what’s going on.

"I mean, we all have some training in first aid and CPR. But when it comes to concussions, that’s really tricky. That’s a great move to bring that into play... and set an example for other school divisions."

Dr. Michael Ellis, medical director of the Pan Am Concussion Program, applauds initiative. In fact, the neurosurgeon says he is currently working with both Winnipeg and River East Transcona School divisions to develop concussion protocols based on national guidelines developed by health and sport stakeholders.

"It is my hope that other school divisions will develop similar protocols so that all Manitobans will be on the same page about how to manage youth athletes with suspected concussions," Ellis says. "Having these protocols in place will also help school divisions meet the requirements of The Concussion in Youth Sport Act that our provincial government tabled in May and that we hope will become law this fall."

At the same time, Ellis acknowledges that some divisions may not be able to afford the cost of experienced athletic therapists at every game. But he adds: "Whether athletic therapists are available or not, it is important that all sport stakeholders work together to recognize suspected concussions and make sure that all athletes with a suspected concussion are removed from play and undergo medical assessment by a medical doctor or nurse practitioner."

O’Leary says he wouldn’t be surprised if other Manitoba school divisions followed Seven Oaks. The ultimate goal, he says, is to reduce as much of the potential long-term damage as possible.

"I’m not sure about the level of risk in high school sport, but I’m certainly aware of some very serious incidents at the college level and lots of documentation about serious incidents at the professional level," he says. "With everything, you can’t eliminate risk. But we’re certainly trying to limit it and manage it better."

Twitter: @randyturner15

Randy Turner

Randy Turner

Randy Turner spent much of his journalistic career on the road. A lot of roads. Dirt roads, snow-packed roads, U.S. interstates and foreign highways. In other words, he got a lot of kilometres on the odometer, if you know what we mean.

Read full biography


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Updated on Saturday, September 23, 2017 at 9:31 AM CDT: Headline fixed.

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