What do Ken Dryden and Gordon Stringer have in common? They both want action to help prevent concussion injuries in all Canadians who engage in sports. As Ken Dryden puts it, they want a “game change.” Both are moved by tragedies – in the case of Ken Dryden, his recently released book about defenceman Steve Montador is a call to action for the NHL to ban all hits to the head. For Gord, it was the tragic loss of his 17 year old daughter, Rowan Stringer, from concussion injuries sustained while playing varsity rugby in 2013 that has fueled his passion to make sport safer.
I had the honour of serving on a provincially appointed committee with Gord Stringer and a star-studded cast of experts (who knew that Eric Lindros was that tall??) struck with the task of reviewing all of the recommendations of the coroner’s inquest into Rowan’s death. We were to build on the changes already in Ontario since Rowan’s death: in 2014 all schools were mandated to introduce policies to address concussions; and in 2016 a new Sport Recognition Policy was introduced requiring provincial and multi-sport organizations to maintain a Concussion Management and Return to Play policy based on the International Concussion Consensus Guidelines. However, as we deliberated over nine months, we found that more could be done; in fact, more needed to be done. We need a change in sports culture.
Concussions are brain injuries that are caused by either a direct or indirect blow to the head. They cause changes in the brain’s function. Because they tend to be invisible, they can be concealed, especially in a culture where the emphasis is on getting back out there and playing to win. Protecting our children and athletes against the harm of concussions, whether it be death from a catastrophic swelling of the brain called “second impact syndrome” which killed Rowan, or a more chronic and insidious but equally tragic death from chronic traumatic encephalopathy, as in the case of Steve Montador, needs a shift in that culture. A shift that strives to prevent these injuries from occurring in the first place and a system to ensure that they are identified and managed according to the best available evidence.
Rowan’s Law Advisory Committee, as we were called, has now completed its work with a report that was introduced into the legislature in September, recommending that Ontario introduce legislation that would apply to all organized amateur sports, whether school based or not. This law, if passed, would make it mandatory for all sports to develop and adhere to codes of conduct with a zero tolerance for any dangerous behaviour associated with causing a concussion. Players, school staff, parents and coaches would all have to undergo annual mandatory education and training on the prevention, identification and management of concussions. Anyone suspected of sustaining a concussion would be pulled from play for immediate screening. If a concussion was suspected, they would be assessed by a qualified medical practitioner, who would then oversee their safe return to play. Information would be shared so that injured athletes could not play in another league or town or school until they were cleared. And all of this information would be collected in a way that we as a province could evaluate our progress and determine what further actions would be needed.
As for the NHL, Ken Dryden is calling on Commissioner Gary Bettman to change the culture and change the rules. Last month in New Brunswick, so many school-aged football players sustained head injuries that nine players were sent to hospital and the game had to be cancelled at half-time. We owe it to the families of Rowan Stringer and Steve Montador, as well as to the all the children and young people who just want to play sports, be active, and have fun to minimize the risk of concussions and make sure that they are properly managed when they do occur. My call is a call to all parents to settle for nothing less, and to support Ontario in taking bold and decisive action.
By Dr. Rosana Salvaterra, Medical Officer of Health, Peterborough Public Health