When the game’s over: The link between contact sports and brain injuries

By Melissa Myers

After 14 years of fighting and over 100 fights including boxing, MMA and kickboxing matches, life is not the same anymore for Gary Goodridge.  Goodridge, who resides in Barrie, Ont., was an accomplished fighter and author of the book Gatekeeper: The Fighting Life of Gary “Big Daddy” Goodridge. Now retired, he has been diagnosed with a disease called Chronic Traumatic Encephalopathy (CTE), the result of numerous concussions.

“In a day I probably lose 70 per cent of what is happening,” said Goodridge, referring to his short-term memory. “I couldn’t tell you what I was doing a half hour ago.”

CTE, formerly known as boxer’s dementia, occurs when a protein called Tau builds up in the brain after several concussions.  Those diagnosed exhibit symptoms similar to dementia or Alzheimer’s.  Although Goodridge’s biography and the overtly aggressive nature of fighting in MMA and kickboxing are extreme examples, concussions are quite commonplace and the risks become even higher when participating in any contact sport.

“Concussions are the most frequent head injury,” said Dr. Paul Comper, Clinical Neuropsychologist in the Neuro Rehabilitation Program at Toronto Rehab, in an interview last month.  Dr. Comper says football/rugby, hockey and soccer are the most high-risk contact sports because of the associated speed and aggression.

Concussions, also referred to as mild traumatic head or brain injuries (MTHI’s or mTBI’s), occur when a person who is moving quickly comes to an abrupt stop and their brain hits up against their skull.  Although helmets can protect the skull, they cannot protect against concussion when high speeds are involved, as abrasions can still occur to the brain tissue when an athlete’s head comes into contact with another player or a hard surface.

This action often results in the symptoms we associate with concussions, such as blurred vision, nausea, dizziness, and in extreme cases, loss of consciousness. When athletes show no symptoms, their injury is called a sub-concussion. But just because it is not apparent a concussion has been sustained at the time, that  doesn’t stop its long-term effects from becoming apparent later on.

“It is an injury that can be managed and should be managed effectively,” said Dr. Comper.

He says that because symptoms may not arise right away, allowing an injured player to re-enter the game too quickly could have catastrophic results.  Dr. Comper stressed that educating parents and coaches about the proper steps to take after athletes sustain a concussion can make all the difference in the long run.

Dr. Comper also noted that the best treatments for concussions are removal from play, rest, and gradual reactivation. Spectators on the scene can have an essential role in initiating the healing process by ensuring the player does not return to play.

Dr. Comper, along with a team that includes Dr. Doug Richards and Dr. Mike Hutchison, have been working together in partnership with the University of Toronto to initiate an organized “return to play” model and practice. The University of Toronto/Toronto Rehab Varsity Athlete Concussion Program is the first of its kind in that “return to play” guidelines are science and evidence-based as opposed to being based on recognizing clinical symptoms.  This means that doctors work with players to create baseline neurological tests that can be compared with post-injury results later on, which allows medical staff to assess the athletes’ cognitive impairment after a concussion.

The return to play policy can be viewed in full at: http://physical.utoronto.ca/Concussion/Recovery.asp

In rare occurrences, returning to play too early can lead to a fatality. SIS, or Second-Impact Syndrome, can happen when a subsequent concussion occurs before the brain has had enough time to rest or heal from the initial injury. As a quick and proper response is the best way to lessen the permanency of concussion symptoms, awareness is the greatest tool in preventing potentially life altering injuries.

Dr. Comper and the U of T Athletic Department aren’t the only ones working in our community to raise concussion awareness and promote proper injury management.  The Canadian Football League (CFL) and the Canadian Football League Alumni Association (CFLAA) are also doing their part to get the word out and to protect Canadian football players of all ages.

Earlier this summer the CFLAA along with the Hamilton Tiger Cats Alumni Association (HTCAA) held a one-day concussion course featuring expert guest speakers in the medical, legal, therapeutic and coaching fields.  The course was called “Concussions 101” and was held in McMaster Innovation Park in Hamilton.

In May of last year, the CFL launched a countrywide concussion awareness campaign with the goal of distributing concussion awareness and management flyers to hundreds of thousands of coaches and athletes across Canada.

To view the flyer, click here

Although the connection between several concussions throughout one’s career and the onset of neurodegenerative diseases has yet to be determined, there is a steady pattern of serious brain damage in contact sport-athletes.  Former Toronto Argonaut and Hamilton Tiger-Cat Bobby Kuntz and former Ottawa Roughrider Jay Roberts, after autopsy, were both found to have had CTE.  Before passing, Kuntz and Roberts suffered from Parkinson’s and dementia, respectively.

It can be particularly challenging to come to terms with the realities of these diseases as those diagnosed struggle to remember their former lives.  The thrill of competing in front of an audience, the heady feelings associated with winning a cherished trophy or title, indeed the chance simply to get paid playing a sport one loves, are great rewards for athletes.

In fact some of the best mixed martial artists in the world, including UFC light heavyweight champion Jon Jones, will descend on Toronto this weekend seeking to entertain and gain fame at UFC 152.

However, as retired MMA fighter Goodridge knows all too well, there are serious repercussions associated with competing in contact sports.

“Had I known I was leading myself to be the way I am, I would’ve chosen a different path,” he said.

Melissa Myers is a member of BIST’s Communications Committee