Concussion Protocol for Athletes

concussion protocol

I was reminded recently of a new law created a few years ago proposing a concussion protocol or code of conduct to protect athletes. Rowan’s law was established here in Ontario, Canada after she (Rowan Stringer) died in 2013 due to injuries sustained from several concussions while playing rugby. She was just 17 at the time.

Rowan’s Law for Concussion Protocol

Rowan’s Law requires:

that all coaches and team trainers review the government-approved Concussion Awareness Resources every year before serving in a sport organization or at a school. The legislation applies to sport organizations (as defined under the Act), which could include: public and private sport clubs. post-secondary institutions. municipalities throughout Ontario. Rowan’s Law is applicable to 65 sports in Ontario as well as educational institutions. In summary; From July 1 2019, all sports must have in place Concussion Code of Conducts for players/parents and coaches/trainers.

Coaches Association of Ontario

Second Impact Syndrome, AKA Repetitive Head Injury Syndrome

Second Impact Syndrome or Repetitive Head Injury Syndrome is defined as:

Second impact syndrome (SIS), also known as repetitive head injury syndrome, describes a condition in which individual experiences a second head injury before complete recovery from an initial head injury.

National Library of Medicine

This SIS is actually what Rowan Stringer died from. Two concussion-worthy hits within a short time frame (five days) while playing high school rugby. Apparently, she did not share her symptoms with either her parents or her coaching staff. She just wanted to play. Unfortunately, this is much too common amongst ambitious, talented athletes. At what point do the athletes themselves get to decide if they are “OK” or not? Especially those under the age of eighteen like Rowan was. Incredibly, her parents turned their anguish and grief into some progress in this area with the creation of Rowan’s Law.

concussion protocol
Rowan Stringer

Miami Dolphins Upset Buffalo Bills

Professional sports teams have concussion protocols in place, at least they are supposed to. How strict they are is suspicious. If you were watching the Miami Dolphins beat the Buffalo Bills last weekend, you know what I mean. Miami’s quarterback, Tua Tagovailoa sustained injuries causing him to stumble repeatedly after the play. Although his injuries appeared to be concussion-related, he was quick to tell everyone the injury was to his back:

“On the quarterback sneak, I kind of got my legs caught under someone and then they were trying to push back and then kind of felt like I hyperextended my back or something,” Tagovailoa said after Sunday’s game, per All Dolphins. “And then on the next play I kind of hit my back and then I got back up and then that’s kind of like why I stumbled. My back kind of locked up on me. But for the most part, you know, I’m good, past whatever concussion protocol they had.”

Tua Tagovailoa, Miami Dolphins QB

The NFLPA (NFL players association) is investigating Tua’s results of Miami’s concussion protocol that was passed quickly enough for Tua to return to the game to close out the unexpected win, handing the Bills their first loss of the season.

Conclusions for Concussion Protocols

As a hockey and soccer mom, I know concussion protocols have been in place for years. On some teams. of course, there is always room for improvement.

Hopefully, Rowan’s Law and stricter concussion protocols on all teams will educate players, parents, and coaches/trainers/team owners about the dangers of playing at all costs.

As well, Dolphin fans are hopeful that Tua did indeed pass Miami’s concussion protocol and his injuries won’t prevent him from playing tonight’s game.

Update on Tua

Ironically, Tua was stretchered off the field during the game last night, a mere few hours after I posted this article about concussions. For what? Concussion-like injuries after another hit. Coincidence? I think not. Is this another case of Second Impact Syndrome?

For Tua’s sake, not to mention Miami Dolphin management and coaching staff, I hope not!

CHEO Thumbs Up


CHEO, the Children’s Hospital of Eastern Ontario, is one of those luxuries that you don’t really appreciate until you really need it.  I must say, as the mother of three boys, we have been fortunate enough not to have been to CHEO often.

Ruptured Appendix sends us to CHEO

The first time, approximately 8 years ago, my middle son spent two weeks there with a ruptured appendix.  Of course, I lived there with him; it was a scary experience as we did not find out he had appendicitis until the appendix had ruptured and the subsequent infection spread through his system. I had taken him to the doctor several times before the diagnosis was made and was sent home each time thinking he had the flu.  It was only my persistence that they perform an ultrasound at CHEO because I no longer believed he had the flu that discovered the ruptured appendix.  I loved the fact that the nurses listened to me as a mother; this son is never sick and when he is, he never complains, just goes to bed and hopes to feel better soon.  Somehow I knew something was terribly wrong, and told the nurses so.  That was our first experience with the impressive care and convenience of CHEO.

Hockey Injury

Last week I had the opportunity to visit CHEO again.  This time my youngest son was injured in a hockey game, in the east end of Ottawa, just a few blocks from CHEO.  He dove for the puck, trying to get it away from an opponent on a breakaway.  He managed to get the puck away from the player and prevented a goal, but in doing so crashed into the net at full speed, hitting his head on the goalpost, and sending the net flying into the end boards.  Thankfully our goaltender and the opposing player got out of the way in time to avoid a pile-up, although that might have softened my son’s fall.   The noise was horrendous; I could only stand and watch as my son lay on the ice for what seemed like an eternity. When he finally tried to get up, he promptly fell back to the ice surface because his legs would not support his body.  With the support of our team trainer and a team-mate, my son slowly made it off the ice and to the locker room.  After an assessment by our trainer, we were given directions to CHEO, which was fortunately only a few blocks away.

By the time we got into the emergency department, his concussion-like symptoms of headache, nausea, and general fogginess had lifted, but his left thumb was four times the size of his right thumb.  Neurological, physical testing and an xray showed he had no concussion symptoms, but did have a fractured thumb.  We are not sure how it happened, but the injury, an avulsion fracture, is common in skiers and hockey players that sustain the injury when they take a fall while holding a ski pole or hockey stick.

The worse part is that my son is left-handed, so the simple things like tying his shoes, getting dressed, writing in school, taking a shower (he has to put a plastic bag on his cast), preparing a snack, and cutting his food, etc are difficult with a cast on his hand.  I am just happy it was his thumb and not his head that sustained the worst damage as concussions can be long-lasting, life-changing, and even fatal.

We have an appointment at CHEO this coming week to see an orthopedic specialist who will be able to tell us just how long he will have to wear the cast, not to mention when he can play hockey again…