Evidence of meeting #6 for Subcommittee on Sports-Related Concussions in Canada in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was concussion.
A video is available from Parliament.
7:35 p.m.
Souris—Moose Mountain, CPC
Thank you.
I want to get through it quickly because I have limited time. I'd like to hear from both of you.
Dr. Marshall, is it because we are more attuned to it?
7:35 p.m.
Division Head, Physical Medicine and Rehabilitation, University of Ottawa Brain & Mind Research Institute
It's a great question. The quick answer is I don't know.
What do I think? I think you're asking the question now if they had a concussion. I think we're old enough to know that previously, concussions were dismissed, and it wasn't even conceivable that people could actually have persisting symptoms. I think that now that we ask, we see them.
I think society has also changed. I think people are on board all the time with thinking of these sorts of things, with regard to technology and these sorts of things that can perpetuate symptoms.
I think it's because we're more aware of it. We're actually asking the question, whereas you were almost vilified before if you actually said you had symptoms afterwards. It was almost blaming the patient for saying they had ongoing symptoms, because no one would ever believe them. We have many examples of this through health care and through the insurance industry trying to minimize these things.
7:35 p.m.
Souris—Moose Mountain, CPC
Dr. Tator, quickly, I probably only have about 20 seconds.
7:35 p.m.
Director, Canadian Concussion Centre - University Health Network, Toronto Western Hospital
My take on it is that the forces on the brain now, in certain sports, are much greater than they were.
When I played hockey, I was an average-size player. Now, I'm a shrimp in comparison with the current crop of hockey players. The forces that they generate are much greater because of their greater weight. They're skating faster than I ever could skate because they have longer legs. What I learned from Pat Bishop is that force is a very important factor in the impact on the brain.
That's another reason they're lasting longer, because they're more serious.
7:35 p.m.
Mr. Peter Fonseca (Mississauga East—Cooksville, Lib.)
Thank you.
We're going to move to our last questioner, and that is Ms. Hardcastle for the NDP.
7:35 p.m.
Windsor—Tecumseh, NDP
Thank you.
Just to wrap up, then, can we go back to some of the research opportunities that we really need to be exploring about our understanding of the gender differences?
7:40 p.m.
Research Associate, The Ottawa Hospital, Centre for Rehabilitation Research and Development
I know that in terms of what's been done, there's been a lot more focus put on men, and a lot of male varsity teams, male rugby teams and that sort of thing, have been part of the research literature. It's starting to emerge a little bit more now that women are coming into the research and that people are becoming aware that there are gender differences between the way women present with things and the way men present with things, so I think that is promising.
It needs to really become a little bit more of a focus because, certainly in terms of the people who present at Dr. Marshall's clinic, for example, we know that two-thirds of them are women, and that has a huge impact on that segment of society.
7:40 p.m.
Division Head, Physical Medicine and Rehabilitation, University of Ottawa Brain & Mind Research Institute
Sure, I can comment.
First of all, I'm not sure if the committee has interviewed Dr. Angela Colantonio, but she actually has a CIHR grant to look at gender differences in brain injury and concussions in particular. She's an expert and an excellent resource.
I can definitely say that in my clinic, two-thirds or 70% of patients who have persisting symptoms are women. Their injuries are different. They're managed differently. I also think we have to consider a lot of psychosocial implications of this.
I can also comment that my clinic isn't just related to sport concussions. I see a lot of concussions outside of sport.
If I had one message, particularly if we're looking at adolescents, people in university and that sort of thing, sport has done so much for concussion, but there are people who have concussions because they are active, and concussion affects people who are active. People who aren't active don't get concussions. The truth is that you can even get one through recreation, through things that we don't consider sports, rock climbing and other things that aren't organized sport but people can get concussions. I think we have to ensure that this awareness occurs. People playing on the playground get concussions.
Certainly, the focus on gender needs to be researched. Women absolutely behave differently in relation to their response and in the treatment of their concussion.
7:40 p.m.
Windsor—Tecumseh, NDP
Dr. Tator, is that something you recognized early on that you'd like to see treated aggressively with research?
7:40 p.m.
Director, Canadian Concussion Centre - University Health Network, Toronto Western Hospital
Yes, absolutely. Trying to determine why women concuss more easily and why post-concussion syndrome lasts longer in women are questions that we are grappling with. In fact, last year we had a full-day symposium on concussion in women and girls. There is now a worldwide movement called Pink Concussions that we have joined forces with. That group is also trying to find the answers.
One answer that does appear to be firm is that women have less developed neck muscles, and strengthening neck muscles may prevent the jiggle of the brain within the skull that causes concussion. The stronger your neck muscles are, the less jiggle there will be of the brain if you get hit with a soccer ball or if you fall while skating. Strengthening neck muscles is a very attractive way to try to protect women from concussions.
7:40 p.m.
Mr. Peter Fonseca (Mississauga East—Cooksville, Lib.)
Thank you.
That will conclude our hearings for today.
We want to thank Ms. Curran, Dr. Marshall and Dr. Tator. Thank you for all your answers. With the papers and research that you've done, if there's anything further you would like to submit to our analysts such as recommendations, please feel free to do so. That would help us a lot.
You also mentioned a doctor but I didn't catch the name.
7:40 p.m.
Division Head, Physical Medicine and Rehabilitation, University of Ottawa Brain & Mind Research Institute
Dr. Angela Colantonio.
7:40 p.m.
Mr. Peter Fonseca (Mississauga East—Cooksville, Lib.)
If we could also get that information about Dr. Colantonio, that would be terrific.
Thank you for the legacy that you have built up here for Canada when it comes to concussions.
The meeting is adjourned.