How Complete Concussions are making Hockey a safer game

min - read
Tom Sychterz
min - read
If you only have a few minutes to spare, here's what you should know:
Concussions are so common but still a black box.
Lots of controversies and politics when it comes to treating concussions across hockey.
Evidence-based approach is clutch for innovator and Complete Concussions CEO Cameron Marshall.

Where it all began: the innovator

Here’s a challenge for you; Do you know what a concussion actually is? Could you define the term ‘concussion’ or spot one? Do you know what is involved in treating concussions?

If you answered no to any (or all) of those questions, don’t fear because you’re not alone. 

Concussions are massively common in sports, especially in hockey. Yet, they are one of the most unexplored topics within the medicinal side of sports.

Hockey has the second highest concussion rate of any sport on the planet, which is why the treatment of concussions is vital to the future of the sport.

One of the largest pioneers in concussion safety, providing that vital service to the hockey world is Dr Cameron Marshall, founder of the world’s largest concussion care network, Complete Concussions.

Dr Marshall came from a hunting-fishing background, growing up in the small town of Sioux Lookout in Northern Ontario. 

After graduating from Athol Murray College of Notre Dame in Saskatchewan, Marshall went to Western University to study Kinesiology (the study of human body movement.)

While studying at Western, he developed a strong interest in sports medicine and spent his senior year as the on-ice medic for the Mustangs men’s hockey team.

“I liked the idea of working with my hands and dealing with athletic injuries. I was looking at orthopaedic surgery, physiotherapy, and chiropractic.  It all just kind of came together and I realised it was something I’d like.”

After Western, Dr Marshall  successfully applied for the Canadian Memorial Chiropractic College (CMCC) in Toronto.

Dr Cameron Marshall

The birth of the network

Upon graduating from CMCC, Dr. Marshall began his postdoctoral specialisation in sports-medicine which, among coursework and research, involved accumulating at least 1,000 hours of on-field medical coverage; the majority spent ring-side at Taekwondo tournaments.. .

“We’d respond to 4 to 5 suspected concussions per day at these events”, Marshall recalls.  “We got really good at our neurological examinations,” he jokes.  

“We’d run through their symptoms and do a basic SCAT test and then get a score at the end of it, but it never really told us if the person was concussed or not.He goes on to explain that, for the most part, concussion diagnosis is based on self-reported symptoms, however athletes often hide their symptoms to stay in the match.  “In these cases, you have to rely on your test scores, but these weren’t much use either because we didn’t know what that person would score on a regular day.  Were they concussed? Or did they always have terrible memory?  or Balance?”

Concussion soon became the entire focus of his residency research when one of his supervisors encouraged him  to look into Sidney Crosby’s concussion injuries in the 2011/12 season.

“It was like this hole just opened up in front of me; and the more I dug, the more interested I became.”

Through his research, Marshall not only discovered a lot of new things about the effects of concussions on people and how they are treated, but also that they were a wildly unexplored topic within the medical world. 

“At the time, most people, myself included, didn’t know that you could treat a concussion.  But after immersing myself in the medical literature, there was evidence emerging for both physical exercise as well as early rehabilitation for the neck and vestibular system that was quite promising.”

In 2012, barely any medical schools in Canada covered concussions on their curriculum. And those that did, averaged only 30 minutes throughout the entire 4 years of medical school.

Dr. Marshall began to apply this research clinically. “I very quickly developed a reputation for treating concussions and people started contacting me from all overSouthern Ontario. I just started to realize how underserviced this whole population was.”

“Nothing I was doing was super special.  I was simply applying the scientific evidence.  In order to provide service to other regions, I knew I had to train other people;and Complete Concussions was born.”


How can this help the hockey world?

Fast forward 10 years and Complete Concussions is now the world’s largest concussion care network, having treated over 55,000 patients in 450 clinical locations across three continents..

 They work with thousands of sports organisations from grassroots up to the Olympic and Professional levels and operate as an extension of existing healthcare teams for patients with concussion symptoms and aim to provide high quality, evidence-based care catered for their patients.

Complete Concussions has also developed a universal, concussion-based software system which allows for the collection of de-identified treatment data from each of their clinic locations.  This system is now one of, if not, the largest concussion data sets in the world.

The mandate of the company is “Evidence-Based Concussion Care” - the goal is to apply the scientific evidence to  treat patients with concussion symptoms in the most effective and reliable ways possible; and, at the same time, collect robust data which can help inform future scientific research and understanding. To date there have been more than a half dozen research studies done using Complete Concussions robust data sets. 

Complete Concussions service offerings  range from conducting comprehensive baseline testing to treating patients who’ve suffered concussions and rehabilitating them in order to reverse the effects of their injury before they become too serious.

What makes Complete Concussions stand out is not only their affordability, but their accessibility, and intuitive methods: early initiation of exercise and rehabilitation as well as comprehensive pre- and post-injury testing and patient monitoring throughout return to school and sport. This has become a crucial part of concussion protocol as patients who return to their sport without fully recovering from their previous concussion could end up suffering severe, or in some cases, fatal injuries.

Dr Marshall explained this further as he said: “Repetitive concussions are a serious concern; especially when too close together.” . “After a concussion the energy production of cells in your brain drops off and can take 3 to 4 weeks to recover.. If someone suffers a second concussion before that energy production recovers,then that energy production will drop off at a massive rate and it can be fatal. It’s called second impact syndrome and it’s most common in children.

The use of correct and modern protocols to treat a patient who has suffered a concussion could prove to be lifesaving, which is why the research conducted by Complete Concussions is crucial to the sporting world.

As we have explored in our previous piece covering baseline testing, the youth hockey world is still grappling with coherence when it comes to addressing concussions. 

Hockey has seen a number of pioneers within the medical world entering the fray in the past two decades to help further the sport’s safety development. From the inception of the Concussion in Sport Group in 2001 by the heads of the IIHF, to the numerous rule changes made by hockey leagues across the world to improve concussion safety.

But it’s clear that we are far from the ideal safety standards in hockey with the number of concussions reported every year. According to the National Library of Medicine, 51% of NHL players miss at least one game every season due to a concussion.

Without adequate research and a correct system of safety measures and protocol, players are left virtually unprotected from harmful head injuries, especially children.

Hockey is still the number one cause of injuries for children in Canada, and concussions are the most common long-lasting injury within children’s hockey.

Concussions are undeniably a major problem in hockey. And due to how long it took for medical experts to realise this, it could take a long time to change that fact.

However, thanks to the help of such pioneers as Dr Cameron Marshall, that change is edging ever closer to the present day.

Pro Players