Part of our mandate at OMNI Hockey is to share resources and information that promote a safer game for all who play it. With that in mind, our team recently reached out to Dr Kristian Goulet, the Medical Director of the Eastern Ontario Concussion Clinic & Pediatric Sports Medicine Clinic of Ottawa. In March of 2023, Dr. Goulet published an article titled: Sport-related concussion and bodychecking in children and youth: Evaluation, management, and policy implications, in the Canadian Paediatric Society, and has contributed to Parachute a Canadian charitable organization dedicated to the prevention of serious injuries, including concussions.
Dr Goulet graciously contributed the following article for OMNI Hockey, which gives readers a high-level synopsis of essential information on concussion awareness, prevention, and recovery.
Concussions, also known as mild traumatic brain injuries (mTBIs), remain a prevalent and important cause of global morbidity in children and youth. Traumatic brain injury is the leading cause of paediatric trauma, death, and disability worldwide, with concussions comprising 80% to 90% of all TBIs. An estimated 200,000 concussions occur annually in Canada, with children and youth primarily affected.
Any child or youth experiencing a significant fall or hit in a sporting event should be assessed for head injury and possible concussion. If there is any question that a child may have suffered a concussion they should not be allowed to return to the game until they are properly assessed. A concussion may result from a direct impact to the head, neck, face, or elsewhere on the body that transmits an impulsive force to the brain…so you don’t need to get hit in the head to get a concussion.
Symptoms of a concussion may start right away or may take a few days to develop after the injury. The most common symptom of a concussion is headache but may include many other symptoms such as sleep issues, emotional issues, trouble focusing or thinking, tiredness, nausea, vomiting, vision issues, dizziness, ringing in the ears, slurred speech, tiredness, and neck or back pain. A temporary loss of consciousness may occur but most concussions don’t involve being “knocked out.”
Worrying signs for a more severe brain injury include: more than 30 seconds of loss of consciousness, repeated vomiting, worsening of symptoms over time, seizures, an inability to control your urine or stool and persistent double vision to name a few. These patients should go to the emergency room as soon as possible.
Resolution of a concussion typically follows a sequential course, with the vast majority of concussions resolving within 4 weeks, without long-term complications. However, symptoms can also be more prolonged. If symptoms last more than 3 months, patients should see a doctor trained in concussions. Going back too early after a concussion while you are still experiencing symptoms or before you have been cleared by a medical professional may result in Second Impact Syndrome. This is a swelling of the brain which can result in permanent damage or even death. Increases in other types of injuries are often seen when players try to return to sport too quickly.
New studies recommend going back to school shortly after a concussion; typically within 2 days. A number of supports may need to be in place to make sure kids don’t push themselves too hard at school initially and make symptoms much worse. Staying out of school for too long in most cases does not help recovery and can delay getting better.
Light activity within 1-2 days after a concussion is recommended. This activity should not make symptoms significantly worse or put them at risk of hitting their head again. Activities such as walking and stretching are generally recommended.
Before getting back to team activities it is important for children to be back at school full time with little to no accommodations. Guiding kids through a “Return to Learn” and a “Return to Play” protocol should be done by a healthcare provider trained in concussions.
For more information on concussion protocols please visit:
Kristian Goulet MD FRCPC
Assistant Professor University of Ottawa
University of Ottawa Brain and Mind Research Institute
Medical Director: Eastern Ontario Concussion Clinic
and the Pediatric Sports Medicine Clinic of Ottawa