Brain Talk with medical Hall Of Famer

Hockey Now

By Andrew Chong

October 16, 2013 (ISN) – Dr. Charles Tator is passionate about hockey and is a Hall of Famer, in his own right—The Canadian Medical Hall of Fame, that is.

And Dr. Tator has been on a mission with the Chevrolet Safe & Fun Hockey Program – alongside Cassie Campbell and Bobby Orr – to raise awareness about concussions and to keep players safe.

Dr. Tator is a brain surgeon and a volunteer with two national injury prevention programs: ThinkFirst Canada (which he founded in 1992) and Parachute Canada.

He says the focus of his mission is not so much to put people’s brains back together after the injury has happened, but to help prevent injuries before they happen.

HockeyNow spoke with Dr. Tator on concussions in hockey and what parents and players can do to promote and develop a safer game.

HN: What have we learned about concussions that maybe we didn’t know a decade or two or three ago?

CT: There are about 30 things that we didn’t know just 10 years ago. For example, the adolescent brain seems to be most susceptible to concussion and takes the longest to recover. It’s rather unfortunate because that age is when kids are now big enough and fast enough that they are getting concussions—it’s also the risk-taking age.

Also, women appear to concuss more easily than men; and that holds for sports like hockey and basketball. We’re not really sure why that is but that’s what the data is telling us.

Unfortunately, there are still a lot of unanswered questions about concussions. We still don’t know the exact mechanism—although, rotational acceleration is more important in producing concussions than linear acceleration. And also, we don’t know how to detect a concussion on imaging techniques; for example, there is no telltale sign on a CAT Scan. And the MRI (magnetic resonance imaging) is still not showing us the effects of concussion. We are hopeful that some newer sequences of MRI will be more informative.

A concussion is still a clinical diagnosis, meaning that it depends on a knowledgeable examiner, like a physician, as well as a compliant patient. And not all patients are compliant; there are still people who want to hide the symptoms and signs of a concussion.

HN: What can parents do to keep their kids safe?

CT: Become familiar with the signs and symptoms of concussion—the nausea, the ringing in the ears, the sensitivity to light and sound, and the 50 or so symptoms that can occur.

HN: What can players do to be safer on the ice?

CT: Have respect for your brain and for your opponent’s brain. We don’t want kids to be encouraged to go get a particular player; we’ve seen coaches targets players. That type of behavior has to be taken out. We want to see no hits to the head, no checks from behind, no elbows to the head, no shoulders to the head. We also want to see some changes in the equipment—for example, there’s no reason why shoulder and elbow pads need to be like pieces of steel.

HN: How important is recognition of a concussion?

CT: All you have to do is look at Sidney Crosby—the fact that he got his first concussion on a Monday and it wasn’t recognized; and then on the Wednesday, he got his second concussion and it took a year to recover. It’s important to sit out until you’ve fully recovered and follow the six-step process of gradually incorporating more physical activity, so that your brain is ready to take another hit. If you run around the block and get a headache and get dizzy, that means your brain is not ready for the next hit and then you’re subject to the serious consequences of another concussion because your brain has not recovered fully from the first one.

HN: What does the game need in order to get through this?

CT: I think, like Football – which has seen a number of problems in the NFL – hockey also needs a wake-up call and the game needs to be more attentive to concussions, not only at the amateur level, but also at the professional level. Unfortunately, the amateurs tend to mimic the professionals; so, we can’t forget about the professionals—we have to include them in our efforts to save the game. I think the game can be saved; we just have to work together on this. I played hockey safely for many, many years and I’d like to see kids be able to do the same thing.

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