As chair of the Sport Injury Prevention Research Centre at the University of Calgary, Carolyn Emery’s research has led to policy changes at athletic organizations, including the banning of body checking in peewee hockey across Canada. However, Emery, who is currently working on studies with both Football Canada and the NFL, believes even more changes are needed in youth sports.
“Being able to contribute to a significant reduction in concussions and injuries in ice hockey through an evidence-informed policy change has been pretty impactful and a highlight of my career,” says Emery, who has been part of the U of C’s kinesiology faculty since 2004.
After working for several years in pediatric sports medicine, orthopedics and neurology, a desire to reduce the number of injuries she was seeing in the clinic drove Emery to obtain her PhD in epidemiology.
Changing the rules of body checking
Emery has partnered with Hockey Canada for several years, including on the study that led to the 2013 ban on body checking in peewee hockey. That study found the risk of injuries and concussions was more than three times greater in peewee leagues that allowed body checking compared to those that didn’t.
“I think it’s fair to say that the disallowing of body checking in games in peewee is an evidence-informed decision,” she says.
Paul Carson, vice president of hockey development for Hockey Canada agrees, saying that while there was a lot of information out there, Emery’s study was “certainly significant” in making the change.
Emery led a follow-up study which found that, after the ban was implemented, there was a 64 per cent decrease in the number of concussions and a 50 per cent decrease in total injuries. Emery acknowledges a lack of body checking experience in peewee can lead to a small increase of serious injury risk once players reach bantam age. However, the benefits of the ban far outweigh the risk.
“That increase [in serious injury risk] pales in comparison to the reduction in 11 and 12-year-olds where we’ve eliminated thousands of concussions in the earlier age group,” she says.
She also emphasized that peewee hockey players are still taught body checking skills in practice so they are not completely unprepared when they reach more elite levels of play.
Even though she is quite happy with her work so far, Emery says more rule changes are still needed as awareness and understanding of the impact of concussions continues to grow.
“I think that it’s important to be looking at the policy related to body checking in older age groups nationally. We know the impact that will have in reducing thousands of concussions in this country, so that would be a low-hanging fruit.”
Beyond zero tolerance
Another noteworthy change Emery highlighted was the work done by undergraduate student, Derek Meeuwisse, whose study of concussions in volleyball found the majority were happening during practices and warm ups, instead of during game play. The study led Volleyball Alberta to adopt policies to prevent players from going under the net to retrieve balls.
Emery says it’s also worth taking a look at tackling techniques in rugby, and the level at which tackling is introduced. She adds that while zero tolerance policies for head contact in elite levels of hockey and soccer have been shown to be effective, more work needs to be done to examine the impact of these rules and how officials handle those situations.
Emery is now working with Football Canada to understand the impact of non-contact practices and a policy that would only allow a certain number of contact practices a season, depending on the level of play.
She is also in the early stages of leading a $12-million NFL-funded study that will, according to a U of C news release, integrate “a variety of tools to detect concussion, predict recovery and inform best practice and policy in the prevention and management of concussions in youth sports.”
The study will involve researchers from universities across Canada, as well as a number of other stakeholders, looking at many different youth sports including football, hockey, basketball and soccer.
However, her work hasn’t been without opposition.
“There’s always barriers to change,” Emery says. “For example, coaches that have been coaching a certain way for a long time are sometimes resistant to change. Even if you have evidence that something works, there’s still a behavioral change aspect of everything.”
While social media has seen personal stories that mitigate the concussions’ health impacts, Emery says these anecdotes do not match what the evidence is saying.
“All we can do is provide evidence to support the health of young people and keep them playing sports,” she says.
Despite these challenges, Emery says she has seen an improvement in the way parents of athletes think about concussions.
“The culture has certainly changed over the last decade. I think that people are starting to understand the impact of concussions not just acutely but also the consequences of concussions,” she says.
Rowan’s law in Ontario proves the narrative is changing, Emery says. The 2016 law, which regulates concussion treatment and prevention in youth sports, was enacted following the 2013 death of high school rugby player Rowan Stringer, who suffered two concussions in the same week.
“No other child should die from repeated concussions,” says Emery.
- By Bill Atwood