When hits to the head hit close to home

Jarrett Humphreys drew a blank.

For a split second, the former Wilfrid Laurier University men’s soccer goalie couldn’t for the life of him bring himself to utter the sounds and syllables of his lifelong friend’s name.

“I thought [to myself], ‘I know this person,’” said Humphreys, sitting in Laurier’s Hawk Lounge in the Athletic Complex, surrounded by studious athletes hitting the books for midterms.

But there, in a staff meeting, Humphreys couldn’t identify his pal that he had known since the age of eight.

And that scared him.

“There are so many symptoms [of concussions] that people aren’t aware of. Memory loss is one of them,” he said.

Humphreys’ career was a tumultuous one. The goal-keep was diagnosed with five concussions over the span of his life, and those are just the ones that have the formal label slapped onto them by doctors.

“What I really learned during the diagnosis is just the sheer number that you can sustain over the course of your lifetime. Just think back to when you’ve taken a bump on the head and you’re a little kid running all over the playground — just little things that you wouldn’t think of in that context,” said Humphreys. “But they all count.”

In his first year at Laurier, Humphreys established himself as the number one netminder early on.

The business major eclipsed his competition by providing not just a steadying influence on the team’s back-end, but also a much-needed vocal presence, a leadership aspect that head coach Mario Halapir deemed too valuable to overlook.

But in the midst of his freshman campaign, disaster struck.

Humphreys was sidelined with a concussion resulting from a hit to his head.

He sat out the remainder of the season and the team eventually missed the playoffs. Humphreys won the team’s rookie-of-the-year honours.

The Kitchener native recovered, but his return was short-lived.

“In the summer [following that year], playing in the PDL (Premier Development League), with Forest City London, I ended up having a ball come [toward the crease] and another player tried to head the ball and our heads collided.”

“I went unconscious,” said Humphreys. “It was very severe and that one really set everything off.”

Humphreys was prematurely cleared to play after his trip to the hospital. His head needed stitches as a result of the collision.

“At the time, I thought it was safe; medically I had been cleared.”

But hindsight has 20/20 vision, and Humphreys now knows his decision to return was a mistake.

In practice during his sophomore season as a Hawk, Humphreys received literally a “flick to the ear.”

“Instantly I felt dizzy, nauseous, and extreme sensitivity to light. It was really rough very quickly. I went down to the clinic and everything was just blurry.”

“At that point I knew I was in a lot of trouble.”

The goalie went to London and consulted one of North America’s leading experts on head injuries, Dr. Paul Echlin.

Echlin helped him back to health, but a third incident resulting in just a few stitches playing against the same Toronto team in the PDL ended his career for good.

“I couldn’t lift my head,” he said after the finishing blow knocked him out of his life’s passion.

“I’ve been medically advised not to play, period.”

Humphreys is just one casualty in the emerging world of career-ending, and at times, life-threatening head injuries.

It’s never easy to say goodbye to
something you love.

—Jarrett Humphreys, WLU men’s soccer goalie 2009-10

What was once dismissed as a minor nuisance, an annoying speed-bump of a sports injury; concussions have come to dominate the media and political landscape of the sporting world.

They have been attributed to memory loss, depression and even suicide (in the National Hockey League), with three players’ lives prematurely ended in one summer and all having a history of head trauma.

How much of a factor are brain injuries in these cases? How prevalent a role do these players’ head injuries take in their returning playing careers and day-to-day lives? How much smoke will the media wildfire create before hard evidence is presented to suggest what severe concussions are really capable of?

Wilfrid Laurier University researcher and kinesiology professor, Michael Cinelli is taking a critical look at the effects of concussions and their role in the world of sports injuries.

“It basically took a couple poster boys, if you will, to really raise the profile,” said Cinelli.

Of course, he refers to Sidney Crosby.

Even if someone hadn’t watched a game of hockey in their lives, Sidney Crosby is a name that is recognized almost universally in Canada.

The Olympic gold medal is next to the maple leaf under ‘reigning men’s hockey champions’ largely because of this young superstar.

Crosby hasn’t played a game of hockey since January and for concussion victims like former WLU hockey player Ashley Stephenson, the concussed defenceman should be grateful for his slow recovery schedule.

“He’s been adamant that he’s not coming back until he’s ready,” said Stephenson, the 2006 Laurier MVP. “For the best player in the world to say his health is more important than his hockey career, maybe other players will start to think that too.”

Crosby has a choice, as do all players knocked out of their respective sports with hits to the head. They can come back a little early and risk it all, or they can take the slow route, the route that is increasingly seen to be the smarter option for longevity.

For these athletes, the methodical measuring of symptoms, whether they be mental, physical or emotional, are extremely critical to return to their sport. That’s where Cinelli and his team come in.

Working with fellow professors and graduate students, Cinelli is gathering research from players and trainers at Laurier and beyond, to test the progress of the athlete’s recovery.

“That’s my part,” explained Cinelli. “To identify the physical state, cognitive state and the neural state of the athlete following the concussion.”

Cinelli uses a variety of tests that measure balance, co-ordination and cognitive function in a concussed athlete that can take anywhere between 15 and 40 minutes. Cinelli is a year into his five-year research plan that will lead him to be able to track a patient’s post-concussed state.

He is even developing an iPad app to distribute to willing teams to measure symptoms. The app will be ready for the new year, and will help Cinelli and his team overcome the obstacle of busy student athletes who don’t have the time or patience to see researchers.

Before the hit

“Media attention right now is around prevention of [concussions]; identification of them. And what we’re more concerned about is after you’ve sustained the concussion. [During that process, the priority is] person first, athlete next,” said Cinelli.

Efforts to reduce concussions altogether through means of equipment size, rule changes and the like, are all very good, he says, but concussions will always happen. And they don’t just happen in the high-attention sports.

“Track and field, figure skating, cheerleading. People in these conditions aren’t wearing equipment, and since [cases] aren’t as common [in these sports], people tend to brush them under the rug,” said the researcher.

Cinelli wants to see as much attention devoted to the smaller cases of concussions, as given to the extreme samples — because they can multiply.

“They’re cumulative,” said the professor. “Once you get one, it’s easier to get another one. So you’ve got a bunch of these little ones along the way and you wonder why there’s that one freakish hit where the player is out a long time [afterwards.]”

And these little ones are easy to miss. It’s the external cues, says Cinelli, that drive players to want to get their heads checked. Cinelli cited a CBC article that stated most defensive linebackers, by the time they reach the NFL, have suffered about 1,000 concussions.

“We have to look at what preceded [that one tipping point of a head injury], and the media doesn’t focus on that.”

Symptoms

Concussions are extremely variable injuries. They differ from case to case, but most share commonalities. Depending on the location of the brain that suffers damage, the symptoms and severity of a concussion will vary.

Blurry vision, vomiting, headaches and memory loss are only some of the effects of head trauma. Light sensitivity is also common.

“I spent as much time as I could in a dark room. No lights, no TV, no phones,” said Humphreys.

During a routine soccer match, the goalie had a defender pass the ball back to him. It was like nothing he had ever experienced.

“I saw three balls coming at me,” said the goaltender. “I put my foot out and the ball rolled behind me.” Double and even triple vision is not uncommon for concussed victims.

Stephenson described her own plight.

“My friends and I were goofing around in rez. I bumped heads with one of them and she hit me right in the temple. I might have even blacked out for a second.”

For days after another elbow to the head from a hockey game, Stephenson had trouble focusing on the most mundane of tasks.

“When people talk to you, you know they’re talking to you but it takes so long for you to understand what they’re saying and then to get an answer out, it’s really delayed.”

Stephenson would attend lectures and take notes. She would look over at her neighbour, who had written two pages of notes, and look back at her own work and find two lines inscribed.

“I knew I was out of it, but not that bad,” said the hockey player.

To this day, Stephenson can’t get in a hot tub or a sauna.

“I can’t take hot showers too long,” said the Ontario University Athletics’ (OUA) champion. “Steam gets to me.”

This is because Stephenson’s vision has been affected, Cinelli proposes.

“The steam clouds vision,” said the researcher. “In order to focus, the eye needs to adjust to various sources of light. Once that focus is obstructed, or the light source changes intensity, the pupil dilates or retracts.”

This is why fans often see trainers shine light into the injured player’s eyes; to see if the player hasn’t lost this basic function of the eyes, said Cinelli.

Head trauma and depression

The extent to which head trauma plays a role in depression is still under critical review.

“Depression is something that comes a little later on,” said Cinelli. Athletes have been taken out of the only role they’ve ever known, and for them, being displaced from their sport can sometimes lead to a loss of identity.

“They don’t know how to deal with it,” said the Laurier professor. “So there’s pressure in coming back too early to relieve that stress and emotion.”

Cinelli has even experienced athletes who, not usually prone to crying, will openly weep for minutes on end immediately following their injury.

“If [the training staff] is smart, they’ll link it to the concussion,” he said.

Studies have emerged that link blows to the head with depression later in life, with the frontal area of the brain (prone to fists to the forehead by hockey ‘enforcers’) a main argument of the concussion-causes-depression thesis by some scholars.

Life after the injury

“It’s never easy to say goodbye to something you love,” said Humphreys.

The goaltender is now working as an assistant coach to the men’s soccer team, and he knows the squad desperately needed his leadership, missing the playoffs this past year.

“I’d love nothing more to be out there, screaming and motivating them and working hard. You hope the guys still see you as a role model, still as a leader, with anything you love, you can always find a way to be involved with it.”

Stephenson is still active in hockey, but will hang up her skates for good this year after her concerns over her long term health take more and more prevalence over her immediate desire to play the sport she loves.

“A shift is starting to happen,” said the Laurier grad. “You look at Brendan Shanahan [the NHL’s disciplinarian and his no-nonsense attitude towards head shots], and these players are starting to take their time coming back into the game.”

Stephenson cites the Boston Bruins’ Patrice Bergeron who waited a year before lighting it up in the playoffs and contrasts him with the Boston’s Marc Savard, whose career has effectively ended from prematurely returning.

“The shift is coming. [The culture] takes a while to change, but I think it’s coming.”