I recently had the opportunity to moderate a conference on head injuries at St. Michael's Hospital in Toronto. Inspired by the work of Dr. Michael Cusimano, a neurosurgeon who is conducting a study on traumatic brain injury and violence in sport, Heads Up: Going Beyond the Playing Field is in its fourth year and with the onset of each hockey season the discussion seems to get more urgent.
This week, a fundraiser hosted by the University Health Network and the Toronto Rehabilitation Foundation, feting Team Canada '72 Summit Series stars Ron Ellis and Dennis Hull, brought together 600 guests and 50 celebrities, most of them from the world of sport including Olympians and professional players.
Their purpose was to raise money and establish a much needed Toronto Rehabilitation Institute Concussion Clinic and Research Program for Canada's largest city.
Head injuries are an affliction which increasingly cast a pall on the games we love to play.
Dr. Cusimano's findings have been disturbing.
At the outset of the conference, which brought together athletes, coaches, referees, parents, head injury survivors, educators and medical care professionals, the raw data revealed between 1.75 and 2.5 million concussions diagnosed each year in North America, with 20 to 40 per cent occurring in sport.
We spent almost four hours hearing from the experts about the prevention of concussions as well as the social and psychiatric management of patients. Schools and government agencies revealed concussion protocols whereby young people with brain injuries can be identified, get proper attention, and once they recover return to classrooms and sports activities.
Also weighing in was Dr. Gabriela Ilie, a psychologist at St. Michael's, who conducted research which proves that boys and girls who have endured traumatic brain injuries from their involvement in sport are more likely to engage in a variety of harmful behaviour such as substance abuse, bullying, even the contemplation of suicide.
"There are great benefits to sport," Dr. Ilie said. "But there are also consequences and unless we examine those consequences we'll continue to struggle with this problem."
"It is a problem of society and in many respects in Canada we are a sporting society," said Dr. Donna Ouchterlony, director of the head injury clinic at St. Michael's. "Having a concussion is like having a bomb go off in your entire life."
Our concern for the results of concussion has gained momentum because of the experience of hockey superstar Sidney Crosby. His career was threatened but the culture of violence which pervades sport has not subsided.
Fighting in hockey remains a defended part of the game, something which is seen as only natural and the enforcer instead of being vilified, in most cases, is lionized. At the minor level, a lack of respect for opponents and referees alike has become epidemic.
"Participation rates are declining dramatically," said Steve Wallace, the technical director of officiating for the Greater Toronto Hockey League. Wallace, who has been a hockey referee for 41 years at every level, both nationally and internationally, contends that the sport is heading in the wrong direction.
"Too much violence ... too much intimidation," he said.
Hockey is not alone.
At this summer's Commonwealth Games in Scotland, male amateur boxers could not wear protective head gear because the governing official felt it was somehow "unmanly." The result was a surfeit of concussion and blood in Glasgow.
Astonishingly, professional sports leagues are turning a blind eye to the violent behaviour of their star players off the turf while encouraging bigger and more devastating hits on it.
Injured athletes being carried off on stretchers are becoming all too commonplace.
Increasingly, baseball pitchers are throwing at the heads of opponents and making the highlight reels.
"The violent situation is beginning to be socially unacceptable," concluded Alun Ackery, an emergency room doctor and trauma team leader at St. Michael's who plays hockey in his spare time.
In general, there was consensus from everyone gathered that traumatic brain injuries, (concussions are injuries to the brain) have become a massive threat to something which had always been considered a passionate pursuit.
An insidious win-at-all-cost mentality has come to dominate all of sport. Not only has it overtaken the professional ranks, it has steadfastly filtered down to infect the amateur, even grassroots levels.
It seems to me we can talk about injury prevention, rehabilitation, equipment improvements and sanctions for violent offenders all we want. But until we get to the root problem we'll continue to be plagued by devastating injury, most notably concussions.
It strikes me that the current atmosphere which prevails in much of sport is leading to a health crisis instead of alleviating it. The crisis is not only physical but attitudinal.
Too often we are willing to accept the undue violence which is the ugly side effect of sporting intensity.
Great sport, in my view, should be a joyful thing marked by a sense of inclusion where rivals of similar abilities, at the height of their powers, engage in honest competition on a level playing field.
It should not be about injuring one's opponent in order to prevail.
Until we get over this propensity to allow dangerous head games, then too many ambitious stars of sport will see their potential wasted while languishing on the sidelines.
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