The implications of head injuries

It’s late October of 2015, about five games into the Wilfrid Laurier men’s rugby season and first-year flank Liam Domenici is sidelined from the action with a concussion sustained after a routine practice drill. It was a mundane error with tremendous consequences for any athlete — especially one with a previous history of concussions.

Domenici got a little too low on one of his teammates and took his knee on a soft spot around Domenici’s temple. He blacked out after.

“I had to take a good amount of time off. I was advised to defer all my midterms, stop going to class and stay in a dark room,” said Domenici. “After the three weeks that I took off and in the dark room with no phone, I had to study and I had to take my midterms because I was afraid for my grades.”

Head coach Ian McLeod implements a strong protocol with head injuries. The players complete baseline concussion tests and on-field protocols at training camp to keep athletes safe. If a concussion is suspected, the athlete is automatically out for two weeks, regardless of the actual diagnosis. McLeod then personally follows up with the players on a regular basis as well as conduct their baseline tests to monitor progress.

“Because of that baseline test, they would have to go back and have that same score they got in training camp in order to come back and not just a doctor’s note,” McLeod said. “If they are still showing abnormalities in that score, then they are not coming back.”

Jamie Carlson, an athletic therapist for Laurier’s department of athletics and recreation, said there’s a list of exercises he goes through to determine whether or not an athlete has a concussion. According to Carlson, a sport concussion assessment tool protocol has been developed and is currently in its third version.

“We can go through it and there’s a full list of symptoms. Headache, nausea, blurred vision, sensitivity to light,” he said. “There’s a long list of them that deals with physical signs and emotional signs.”

Carlson said that once a concussion is sustained, if it is severe enough, he advises athletes to go home to their parents and sit in a dark room away from technology for awhile, especially if their hometown is an hour away, like Oakville.

However strong a program is, unfortunate realities present themselves and accidents can happen. In a contact sport, simple mistakes can have high consequences. For Domenici, some of the worst symptoms manifested themselves. After a string of previous concussions, the one sustained at Laurier had serious consequences.

“I’ve had issues with mood swings, and I’ve had to follow the patterns that’s been going on with the hockey enforcers,” said Domenici, referring to behaviour enforcers exhibited from fighting. “I don’t like to use the word depression, but after my concussions I would see myself unhappy for no reason or lacking motivation. Just unhappy for no reason or not [able] to make myself happy when I had no reason to be unhappy.”

For Domenici, his symptoms went away when the fog of his concussion lifted and he returned to normal. But that isn’t always the case. Players who sustain a concussion can face an uncertain recovery process. Carlson said back when he first started, there were three types of concussions. A first-degree concussion was when you get “dinged” and the athlete would give their head a shake and go back in. Third-degree concussions meant the athlete was unconscious. While second degree was everything in between. Things have changed since then.

“Now, if you get anything, they shut you down,” Carlson said.  “And that works, especially because if it’s not significant, you can stop it early. Which is good. And then you tend to stay out the week before the next one and you have a chance. Whereas sometimes some athletes will try to play through it — they won’t say anything, then they’ll speak up after the game … By doing that, it escalated the problem exponentially.”

McLeod said he’s known athletes that are fine after two weeks, but that can go up to four to six months of recovery time.  McLeod has seen first hand what happens when a player is concussed. McLeod said that he had a player this year get concussed at the Canada U-18 camp and he didn’t realize it or tell anyone, and because it was his second severe concussion, he dropped out of school because he couldn’t study and had to stay in a dark room.

“Horrific story, but that’s the severity scale you go from. Sometimes a whack on the jaw is a whack on the jaw and sometimes it’s a much more severe concussion,” he said.

McLeod speaks with his players after any sustained concussion about putting the game into perspective and after multiple concussions, priorities have to be made. Especially after the second concussion, it may be time to have a talk about an athlete’s future.

“If it’s really severe I would say it’s worth talking about. Certainly after the second, it’s worth a discussion and if and when they come back and there’s a third one then I think it’s time to shut it down.”

McLeod believes rugby should be second to their academics. McLeod said at the OUA level, the conversation is about schooling — getting that education and moving on with your life, not worried so much about rugby. But in many contact sports, there’s a mentality to “get back on the horse” and play through the pain. This mindset is shifting and all the tests and protocols are relatively new and still going through their evolution to ensure player safety. Domenici doesn’t have any regrets or resentment from his journey. He regards his injury as being in the wrong place at the wrong time. He recounts a time when he got a concussion while playing hockey and he was hit from behind. He loved the sport more than anything — just like rugby, it was an absolute passion. Domenici has seen the other side of the process and took a lot from the experience.

“To be happy with where I am and recognize that there isn’t any reason not to be happy. Also recognize that a lack of motivation won’t get me anywhere. No one’s going to feel bad for me,” he said.

“It’s still a competition, you have to get motivated, you can’t let it affect you that much or else you’ll be out of school before you know it.”

– With files from Drew Yates