1. Education and Protocols for Safer Sport
Concussion:
Education and Protocols
for Safer Sport
Stephanie Cowle,
Parachute 

2. Would you skydive without a parachute?
Canada’s national charity dedicated to preventing serious and fatal injuries
Evidence-based solutions, advocacy and education

3. About Me 10 years in Injury Prevention
Knowledge Translation = Evidence to practice
Collaborate with more than 40 sports, including Skate Canada’s Safe Sport staff
Am *this close* to learning how to skate backwards

4. The Plan In this session you will learn: the basics of concussion
key components of a concussion protocol
resources available to help you build safe sport

5. Concussion:
The Basics

6. A concussion is a brain injury.
It can affect the way a person thinks, feels, and acts.
It can’t be seen on X-ray, CT or MRI.

7. A concussion can happen without a direct hit to the head.
A concussion can be caused by:
a blow to the head, face or neck
a blow to the body

8. force of the blow causes the brain to move around inside the skull

9. Skate examples:
colliding with another skater
hitting your head on the ice
sliding hard into the boards
falling during off-ice training

10. Most concussions are not sport-related.
Concussions can happen in sport and non-sport activities.
Youth (10-19) are most likely to have a sport-related concussion.
Falls and car crashes are common causes.

11. Females are at risk, too. Higher number of concussions in males.
Higher risk among females.
Longer recovery among females.

12. You don’t need to be knocked out.
Only about 10% lose consciousness.
Losing consciousness could be a sign of a more severe injury. (Red Flag)
Most common symptom: Headache

13. Rest, but not TOO much rest.
Rest and sleep are important for brain healing.
Don’t wake the person through the night.
24-48 hours initial rest. No more “bedroom jail”.

14. Most people get better in 1 to 4 weeks.
Youth: up to 4 weeks
Adults: up to 2 weeks
Longer than this? “Persistent symptoms”
Most people don’t need specialty care.

15. Safe Sport:
Concussion Protocol

16. A Canadian Approach to Concussion
F/P/T efforts since 2016
Public Health Agency of Canada
Sport Canada
45 NSOs including Skate Canada
Coaching Association of Canada
SIRC

17. Canadian Guideline on Concussion in Sport
parachutecanada.org/guideline
parachutecanada.org/lignes-directrices

18. Concussion Best Practice
Pre-season education
Head injury recognition
Medical Assessment
Concussion management
Return to school, work and sport ⇣

19. 1. Pre-Season Education Everyone should be aware of:
what a concussion is
potential causes and symptoms
prevention
their organization’s protocol + agree to follow it
how to safely return to regular activities and sport

20. Education: How? Provide education resources
Post information at rinks and training facilities
Hold pre-season team meetings
Include concussion at meetings/events (just like this!)
Provide access to free training resources

21. 2. Head Injury Recognition Recognition is not diagnosis.
Everyone has a role to recognize
It only takes one sign or symptom
Recognition is not diagnosis.

22. Recognition: How?
If a skater sustains a significant impact to and reports any symptoms or demonstrates any signs of a concussion.
If a skater reports any concussion symptoms to one of their peers, coaches, trainers, parents, teachers.
If anyone witnesses a skater exhibiting any signs of a concussion.

23. Recognition: How? Common signs and symptoms:
Headache or pressure in the head
Dizziness
Nausea
Trouble concentrating or remembering
Unusual emotions (e.g., irritability)
Drowsiness or fatigue

24. Red Flags: Signs of a more serious injury
Loss of consciousness
Seizure or convulsion
Neck pain
Vomiting more than once
Getting more and more confused
Headache is severe and getting worse
Double vision
Weakness/tingling in arms or legs
! Call 911

25. 3. Medical Assessment Emergency? (Red flags)
Emergency medical services will assess and transport to hospital

26. 3. Medical Assessment Not an emergency? (No red flags)
Safely remove the skater to a quiet area.
An experienced, licensed healthcare professional (e.g., AT, PT, MD) can do an initial assessment.
The skater should be checked as soon as possible by a medical doctor or nurse practitioner.

27. Medical Assessment: How?
Remove anyone with suspected concussion from training or competition immediately.
Contact the skater’s parent/guardian or emergency contact to pick them up. Don’t leave the skater alone.
Let the skater/parent/guardian know they need to get checked out.

28. 4. Management
No concussion?
Return to activities

29. 4. Management Diagnosed concussion?
Follow a step-wise return to school, work and sport-related activities
Medical clearance before full return to sport

30. Return-to-Sport Strategy
Principles:
At least 24 hours per stage
No new or worse symptoms 1
Symptom-limiting activity 2
Light aerobic activity 3
Sport-specific exercise 4
Non-contact training drills 5
Full contact practice 6
Return to sport

31. Return-to-Sport Strategy
24-48 hours initial rest.
Stage 1: Symptom-limiting activities
Daily activities that don’t provoke symptoms
Moving around home, reading, etc.

32. Return-to-Sport Strategy
Stage 2: Light aerobic activity
Light intensity stationary cycling or jogging
No resistance training.
Start increasing heart rate

33. Return-to-Sport Strategy
Stage 3: Individual sport-specific exercise with no contact or head impact activity
Skating drills (e.g., stroking, then turns)
Core, stabilization, flexibility exercises
No twizzles, jumps, spins, lifts, throws
Add movement

34. Return-to-Sport Strategy
Stage 4: Non-contact training drills
Run through skating program, starting with singles and progressing to doubles
May progress to off-ice triple jumps
May start progressive resistance training
Coordination and increased thinking

35. Return-to-Sport Strategy
Stage 5: Full contact practice following medical clearance by a doctor
Full skating program with jumps
Try adding spins outside program
Full training, conditioning (limit jumps)
Restore confidence and assess skills

36. Return-to-Sport Strategy
Stage 6: Return to sport
Normal on-ice and off-ice activity with no restrictions

37. Management: How?
Use the strategy as a guide, but individual recovery will differ
Communication among coach, skater, trainer, parent/guardian – possibly others
Return to school and work before full return to sport

38. Gradual return to sport and activity.
Education
Recognize
& remove
Get assessed
Gradual return to sport and activity.
Communication

39. Safe Sport:
Concussion Resources

40. Education & Awareness Skate Canada Safe Sport poster, brochure
Concussion Ed mobile app

41. Education & Awareness
Parachute concussion guides for coaches/trainers, parents, and athletes
Pre-season concussion education sheet

42. Education & Awareness: Free Training
Making Head Way

43. Education & Awareness
Campaign materials at sirc.ca/concussion

44. Concussion Recognition
Skate Canada Safe Sport concussion recognition tool
Concussion Ed mobile app

45. Medical assessment and clearance
Medical assessment letter template
Medical clearance letter template

46. Access these resources and more:
skatecanada.ca/safe-sport
parachutecanada.org/concussion

47. Thank You!
@parachutecanada