There should be concussion safety laws from coast to coast: ‘Waiting for another tragedy makes no sense’

The Toronto Star (Toronto, Ontario)

June 18, 2022

If Mark Moore can make a compelling case that more needs to be done to prevent concussions, certainly he can speak to their devastating effects.

His younger brother, Steve, had a promising NHL career ended by a broken neck and concussion suffered in a 2004 blindside attack by Todd Bertuzzi. Not long before that infamous act of thuggery, Mark saw his own hockey dream die after he experienced the first and only known concussion of his career, when a smaller teammate’s helmet unexpectedly struck him under the jaw during a collision in practice while playing for the Pittsburgh Penguins organization.

Mark’s ensuing symptoms, among them pressure in the head that can make him dizzy and disoriented, were life-altering enough that he had to turn down a tryout from the Montreal Canadiens.

“It was just awful to have to call the Canadiens and say, ‘I can’t play,’” Moore said. “It was like, are you sure? It seemed like they were wondering if I was crazy … I was willing to risk my life, but I literally couldn’t play.”

Nearly two decades on, some symptoms can still flare up if Moore, a 45-year-old father of two, isn’t careful. Which is a stark reminder: As much as there’ve been plenty of recent advances in concussion awareness and prevention, some brain injuries don’t fully resolve.

“There’s no cure (for concussions). For me, there’s no cure; for Steve, there’s no cure,” Moore said. “So my mind goes to prevention: What can I do to help make sure what happened to us doesn’t happen to other people?”

As a law professor at the University of British Columbia, Moore sees potential in national concussion safety legislation. In 2018, Ontario passed Rowan’s Law in memory of 17-year-old Rowan Stringer, an Ottawa-area high school rugby player who played through concussion symptoms in the days before she died from the effects of a head injury. And while Rowan’s father, Gordon Stringer, said at the time that he hoped the Ontario legislation would lead to similar laws across the country, some four years later that hope remains unfulfilled.

To that end, Moore recently collaborated on an academic paper with Dr. Charles Tator, the renowned Toronto brain surgeon and concussion expert, that called for concussion safety laws to be enacted in all of Canada’s provinces and territories. While Rowan’s Law came in reaction to a needless death — and while every other state acted after Oregon passed Max’s Law, named after a high school football player who suffered a traumatic brain injury — Moore said it’s his hope that another tragic impetus won’t be required for Canada-wide reform.

“Waiting for another tragedy makes no sense,” said Moore. “We’ve got these laws in all 50 states and in Ontario. We don’t need to reinvent the wheel. Let’s just get it done without having to wait for another preventable tragedy.”

Tator, in a recent interview, said there are misconceptions that needs to be set straight. The law, for one, isn’t designed to punish athletes who concuss fellow competitors in the course of play.

“People ask me, ‘Do you want to see youngsters put in jail because they bodychecked somebody?’ No,” Tator said. “The legislation doesn’t have big teeth. No one has gone to jail.”

But the law, Tator and Moore say, comes with many benefits.

One is education. Athletes and their parents, coaches, trainers and organizers are required to acknowledge their review of concussion awareness resources. Another is the establishment of concussion management standards. How long to hold out an athlete who has experienced a concussion and when it’s safe to return to play — the law aims to ensure athletes and their overseers base these decisions on the current science, rather than leaving them to chance.

And there’s yet more upside: The law would ideally require sports organizations to establish a code of community conduct that instills what Tator and Moore call “a concussion safety culture.” The hope, Tator said, is that predatory behaviour becomes tempered by common sense, not to mention an obligation to the common good.

“You hope you can instil an attitude in people where it’s not a matter of killing the opponent that’s important. There are other more important things,” Tator said. “We don’t want to see stretchers on the ice; we want to see players on the ice.”

Moore, for his part, said that when it comes to prevention of concussions, there’s a lot more than can be done. In hockey, for instance, he cites the enduring presence of equipment with hard outer shells that can do significant and needless damage, notably elbow pads and shoulder pads.

“There was once attention on the elbow and shoulder pads, but the attention gets diverted and it never gets solved,” Moore said. “Then it’s hard to get the attention back to it.”

Once-intense scrutiny on the toll of head injuries in hockey has also waned in recent years, which, along with the pandemic, could be responsible for the lack of follow-through on national concussion safety legislation. And though there’s not yet sufficient data to prove Rowan’s Law has produced demonstrable improvements, Moore and Tator don’t see that as a reason to delay.

“It’s something that can be done. I don’t know what the downside is. And you could save lives and potentially prevent many, many concussions,” Moore said.

Moore and Tator, in attempting to remind their fellow Canadians that concussions remain an intractable problem that shouldn’t be ignored, are hoping it won’t take another preventable tragedy to put the matter of national legislation back on the table.

“Even to someone who’s not a professional, these can be life-changing injuries. In cases like Rowan’s, they’re fatal. If there’s no cure, we sure better do everything we can to prevent them,” Moore said.

“If they came out with a cure tomorrow where you could be back to 100 per cent recovered by taking a pill, maybe I would be less worried about prevention, but that’s not on the horizon. I don’t think we’re anywhere close to having a cure.”

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