Winnipeg concussion expert advocates for province-wide protocols

Young athletes suspected of having a concussion in Manitoba may be evaluated or treated differently depending on what sport they play and where. 

Now, one of the provinces leading concussion experts is working to see that change.  

Dr. Michael Ellis is the Medical Director the the Pan Am Concussion Program, which treats patients up to age 19. He would like to to see standardized concussion protocols in place for all of Manitoba's sporting groups, organizations and school divisions, to ensure all children and youth are receiving the same quality of care before returning to play. 

"I think the big issue with these, is they define what people's roles are in those situations," said Ellis. "Parents and coaches don't have to feel like they have to be doctors. They can kind of just suspect that there is a concussion and it also provides direction of what to do and then it really increases the chances that a kid or an adult with a suspected concussion get access to the care they need."

Concussions and treatment of head injuries have become front and centre in the world of professional and amateur sport in recent years, with superstars like Sidney Crosby being sidelined by the injury for nearly a year. 

The Pan Am Concussion Program, located at the MTS Iceplex, officially opened in October 2014 and has already seen nearly 500 new patients. All evaluated by Ellis.  

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"I think there is rare circumstances where it can lead to more tragic outcomes," said Ellis. "That's more the minority. But, the bigger risk is really that these things will go unrecognized and a kid will return to play and they will sustain another concussion. In those circumstances we normally see that those patients will have more severe symptoms and take longer to recover."

Based on patients evaluated at the clinic, hockey accounts for the most concussions (36 per cent), followed by soccer (18 per cent) and football (12 per cent). 

Ellis said so far the Pan Am Concussion Program has partnered with Winnipeg Minor Hockey to develop protocols and is currently working with Winnipeg Minor Hockey AAA to establish some for this upcoming season. Ellis said the program has also worked with several school divisions. 

Football Manitoba confirmed it's also moving towards implementing standardized concussion protocols for this upcoming season. 

"I think the main message is that any child with a suspected concussion should be removed from the field of play and then should undergo evaluation by a physician," said Ellis. "There should never be a circumstance in which a child is medically cleared on the sidelines and returned to play. Children aren't getting paid for this, and it's overall quite a dangerous situation for people that are untrained or aren't familiar with concussions to be making those discussions on the sidelines."

But, there is still more work to be done. 

Soccer brings 2nd most concussions to Pan Am

While soccer accounts for the second highest percentage of concussions seen at the Pan Am Concussion Program through sport since opening, the Manitoba Soccer Association currently has no policy or concussion protocols in place to identify or treat the injury.

Executive Director Hector Vergara said the association's board will be discussing concussion protocols in the next three to six months.

"We would expect them to be dealt through the club," said Vergara. "Obviously the club is responsible for players who register in their organization. The parents obviously play a big role in this, in figuring out if they suspect something like a concussion may have happened." 

Vergara estimates 9,000 youth are registered in the sport of soccer in Manitoba. He said the organization knows concussions are an important issue that needs to be looked at, but admits right now the association offers no specialized training for coaches to deal with the injury. 

"Once we do the research on it we will have to figure out whether that requires coaches to have specialized training," said Vergara.

He expects creating the policy could be complicated, especially since the organization depends on volunteer coaches. 

"At the end of the day it makes it difficult," said Vergara. "We are in a very difficult situation when you have to ask volunteers to spend some hours training for the technical side of the game, now you are going to ask them to train for concussions." 

Sport Manitoba supports province-wide protocols 

Sport Manitoba's Sport Medicine Director Rickie Walkden said the organization supports the idea of standardized concussion protocols across the province. 

"There's so much difference in between the different provincial sports organizations about how they manage potential concussion and there really does need to be some protocol in place," said Walkden.

Walkden said concussions continue to be an evolving area of research and many people still have questions about how they should be treated. 

"I think there's such a varied resources in the province for where people can go if they have sustained a concussion and there's a few different schools of thought and it becomes very difficult for the parent or the coach to help to kind of navigate their way through that system to get their athlete or their child the best care possible in terms of having a concussion," said Walkden.  "So, I think it does have to be province wide in terms of keeping up with the amount of research that's coming out both in Canada and the US and typically world-wide as well."   

Walkden said getting an athlete with a suspected concussion in front of the right medical professional is key to making sure athletes are evaluated properly.