Photo: Fotolia
We need to fundamentally change how we treat concussions in Canada. It’s time to turn our attention to recovery and provide a higher standard of care. Although much of the media attention on concussions has focused on professional athletes, most people who suffer concussions are children and adolescents, many of whom aren’t involved in sports. Indeed, about 225,000 Canadians suffer from concussions each year.
Despite worthy and important efforts to prevent concussions (such as rule changes, strength training and improved equipment standards), there will always be risk. What we need is an immediate discussion on how we can help these 225,000 people navigate their recovery from a traumatic brain injury. We need to invest in research efforts to improve recovery management standards and education, so that we can get more people back to their daily lives. And we need to create a public dialogue where people feel comfortable sharing their stories and supporting others who have suffered traumatic brain injuries, with the goal of changing how everyone views such injuries.
Physicians — either in their family practice offices, or in the emergency room — are responsible for diagnosing most concussions. However, most general practitioners are ill-equipped to manage concussion recovery. This is because every concussion is different and even the experts can’t agree on the best way to manage the recovery. Recovery times are also highly variable and patients often need individualized rehab strategies.
Too many patients are left monitoring their own recovery — despite the fact that all recoveries should be monitored by a qualified health professional.
Health-care professionals are also competing against Dr. Google and some private clinics that purport to specialize in concussions. A recent study found that concussion clinics offer completely diverse services and “treatments,” and are operated by professionals with varying levels of training. In some cases, they offer medically questionable services and treatments.
Furthermore, athletes and parents too often rely on quackery and mixed messages from the pseudoscience world. Some examples of these “cures” include protein supplements, electrolyte drinks, cod liver oil and even liquid zinc. Most recently, this was highlighted by the controversy over the claim that a brand of chocolate milk was said to alleviate the negative health effects of concussions (it really doesn’t). These false claims take advantage of people who are vulnerable after suffering an injury. They need evidence-based advice to guide their recovery, not Internet cures, myths and false promises.
We started the EMPWR Foundation to change the way we talk about and treat concussion recovery. We will provide information and tools that will shine a light on recovery, in a manner that provides hope and support for all those involved. We are taking the best scientific evidence and making it accessible to the general public and health-care professionals.
Concussion management guidelines have historically focused on providing guidance for clinicians in making complex decisions about when to return an athlete to the field. These guidelines have resulted in improved care, but there still is a lack of consensus on how to guide a patient’s recovery so that they can return to normal life.
We are finally emerging out of the dark ages where concussion patients were told they needed complete rest until their symptoms went away. We cannot allow this misconception to continue. Although an initial period of rest is warranted, a plan that re-integrates patients into all aspects of their lives is far more effective.
At this point, there is no “magic bullet” to cure concussions. But there is a road back for everyone. Over the next several months, we will be releasing different toolkits that will empower patients, athletes, parents and clinicians through the recovery process. We have developed them to include returning to “Sport/Physical Activity,” “School,” “Work” and “Social” life.
These tools are designed to provide people with a step-by-step progression that allows the patient to transition through the milestones of concussion recovery in a manner that is transparent to all. We have depicted unique sets of rules for the school environment, sport context, as well as work and social settings. Everyone will be able to monitor the recovery of the person as they move through the steps in a way that tracks their progress. These guidelines were developed through clinical expertise, experience and research efforts over the last 15 years.
Together, let’s inspire, educate and empower patients by making them an active participant in their concussion recovery.
Professor Michael Hutchison is on the board of directors of the EMPWR Foundation. He is also the director of concussion program at the David L. MacIntosh Sport Medicine Clinic at the University of Toronto.