Testing the waters

That's why the 15-year veteran of the east-end football club administers what she calls a DSST, or digit symbol substitution test – that is, a series of trials which helps to determine an athlete's susceptibility to concussion – at the start of each season.

"Every kid is tested (at the beginning of the season)," she says. The test, similar versions of which are used by other clubs and school teams in Canada and the U.S., was developed by the Ottawa Sports Science Center and involves a series of hand-eye coordination and cognitive tests.

"So if we have a kid diagnosed with a concussion (during the season), and he's cleared by the doctor to come back, we re-test him," she explains. "And then we look at the two tests. And if they don't match up, we send both tests, with the parents and the athlete, back to the doctor.

"And that's brought about phenomenal results."

Each Panthers athlete is screened during their initial practice sessions, Charron says, adding junior varsity and varsity players are scheduled for testing this March 29.

Indeed, Charron says vigilance is necessary in a contact sport like football. But some athletes prove more susceptible than others, she adds. "I had one kid who came up with us all the way to bantam, and he was highly susceptible to concussions – it was amazing," she says.

"He'd even fall forward and bang his forehead a little bit, and boom, he'd have a full-blown, really bad concussion."

There are several concussion- and head injury-related tests – the standard assessment of concussion (SAC), post-concussion symptom scale (PCSS), balance error scoring system (BESS), and ImPACT test are each quite common and administrable on-field – designed to gauge the mental and physical responses of the patient, says sports physiotherapist Eleanor Cox.

But perhaps the most common, says the therapist at the Sports & Spinal Injury Clinic on Carling Avenue, is the Glasgow Coma Scale (GCS). "It's the gold standard," she says, adding it evaluates eye opening speed, verbal responses and reaction time, as well as other motor responses.

Cox worked hand-in-hand with the Panthers a few years back to assemble their trainers' guide, she adds. And though she says pre-season testing may have some merit, she also says predicting a concussion – especially in an athlete with no history of head injury – is next to impossible.

"What things really come down to is 'returning to play' guidelines," she says. "A player can't return to play unless their symptoms are gone. And that is far more important than trying to predict a concussion.

"If anyone was showing symptoms, like loss of consciousness or memory, if anyone has any of these things then they wouldn't be playing in the first place," she adds.

Charron says every Panthers player must be symptom free for five to seven days before returning to the field. And though she says coaches, parents and even the players themselves take the issue of head injury far more seriously than a decade ago, there's still a long way to go.

"A lot of (general practitioners) don't know a lot about concussions," she says. "And sometimes you do hear coaches say 'Oh, he's ok, he just rang his bell.'

"But you really have to look at that athlete, and talk to the athlete. And if you know your kids you know that something's not right.”