The Importance of Collegiate CTE Awareness

 

Dr. Ross Zafonte says that although the scientific community is still unsure about the age at which repetitive head trauma begins contributing to CTE, “there is some work that suggests very early exposure to contact sports is problematic.”

 

In collegiate ice hockey programs that have the potential to funnel players into sustained careers in the sport, understanding and handling contributing factors of CTE can be key in protecting players from developing CTE later in life.

 

“The situation with younger people is to make sure: A) they’re transparent; B) they know when to report and what to report [regarding] concussions; C) we need to be thoughtful about the types of exposure they take early on,” said Dr. Zafonte.

 

Hockey at Boston College

 

Boston College is home to one of the most respected collegiate hockey programs in the United States. In 2018, Boston College sent a record-high eight women’s ice hockey players to the Winter Olympics, and more than 75 BC Eagles have entered the NHL since the late 1960s.

 

Bert Lenz identified education as the primary method to prevent CTE in young hockey players.

 

“All sports, the biggest thing is education. … as far as addressing the kind of media frenzy that in some cases this has become, it’s a very important issue, concussions are real, educating the student-athletes on what the symptoms are, what the impact of them playing with symptoms becomes is one of the bigger pieces.”

 

Mitchell Denhartog explained that there's another side to education: technique.

 

"I firmly believe we need to find a way to teach some sort of hitting at an earlier age in a safe manner," he said, "Finding a way maybe to teach hitting without the risks early on so players have a better way to separate a player from the puck without excessive punishment. Teaching things like rub down techniques by skating and guiding a player into the boards without a full on check could be extremely helpful in teaching proper hitting without punishment."

 

While education does play a huge role in keeping players from suffering the kinds of impacts that can have serious effects down the road, Lenz also says that some of the responsibility is on the players:

 

“[T]hey’ve gotta protect themselves. Because it’s something where you can’t look at someone and tell if they have a concussion or not. So the individual has to report the symptoms. … So that’s the hardest piece, is getting them to accept the personal responsibility that goes along with this and then hopefully getting them to understand that a hard hit is a hard hit. There is no more ‘I just got dinged and I’m fine.’ Any symptom after a big hit is a concussion.”

 

Boston College falls under the jurisdiction of the Gameday Safety Ordinance, a measure proposed by Councilor Josh Zakim and signed into effect by Boston Mayor Marty Walsh in 2014.

 

This ordinance requires schools participating in Division I NCAA events to employ a neurotrauma consultant on-site at all football, hockey and men’s lacrosse games held in the Boston area.

 

When asked about how protocols have changed at Boston College, Lenz said that everything has largely stayed the same.

 

“I feel we were ahead of the curve. And a lot of that goes to us already having football and being ahead of the curve on including our physicians. We had a team already available. We didn’t have a 'neurospecialist.' But we’ve had sports medicine-trained family medicine physicians that have the extra certification, the extra qualifications that come under that ordinance that allow you to have the proper coverage at football games, and our team physicians have always had that.”

 

Denhartog believes that there should be more responsibility among coaches and referees as well.

 

"If the player says that they're fine, then the coach isn't going to question that," said Denhartog.  He continued by noting that more training for coaches and referees can help supplement the role of the trainers when faced with potential head injuries on the ice. 

 

Boston College’s Neurotrauma Protocol

 

According to Lenz, the protocol for dealing with a neurotraumatic incident is rather straightforward if the player self-identifies symptoms or is presenting with visible symptoms, but the situation gets stickier when the player does not self-identify.

 

“The NCAA pushes them, and they have to sign certain papers saying that they will report the symptoms. They still don’t report the symptoms. … It’s the kids that come back to the bench, you walk over say ‘are you alright,’ they look you in the eye, they say ‘everything’s fine.’ And then the biggest thing is revisiting them.”

 

According to Lenz, Boston College uses a five-day concussion protocol to ensure that players do not reaggravate or worsen a neurotraumatic injury.

 

“Once they’re symptom-free, there is a five-day return from the point they’re symptom-free, and during that day, after that 24 hour period after they’re symptom-free, they start a progressive climb towards return to play.  It used to be ‘okay, you’re symptom-free today, go back to your sport.’ Those days have changed. Now, it’s a progressive, pretty much a full five day, return to a full practice and then hopefully a game the following week.”

 

Lenz could not comment on whether this is an NCAA-enforced progression or a Boston College-specific policy.