A Plan in Motion

Three months later, GTHL’s new concussion policy is helping players get back in the game safely

How do you mobilize 1,200 coaches and trainers, in three short weeks, to effectively use a new concussion policy across the largest minor hockey league in the world? With thorough education and easy-to-follow protocols, the GTHL and Holland Bloorview Kids Rehabilitation Hospital’s concussion centre have accomplished just that.

The GTHL set out to create a new concussion policy this season to provide clearer steps for trainers, coaches, parents and players to make sure all suspected concussions are diagnosed and medically cleared by a physician before players return to the ice.

The 2016-2017 concussion policy is one of the most comprehensive of its kind for minor sports in Ontario. Taking it from plan to action has been an involved process, with coaches, trainers and families working in unison to ensure players are supported in every step of recovery so they can return to the game happy, healthy and ready to play.

UntitledKnowing the symptoms
The first step in implementing the policy was to make sure coaches and trainers were educated on how to prevent, identify and manage concussions. In August, Holland Bloorview’s concussion centre delivered eight two-hour sessions where each of the GTHL’s 1,200 coaches and trainers received evidence-based concussion information and training on their roles in the new concussion policy. 

To recognize a suspected concussion you have to know what to look for (see Signs & Symptoms to the right). Team staff were equipped with the knowledge and training to recognize these symptoms, regardless of severity, and with the instruction to remove a player from activity for proper care.

“With this new policy, players can be assured that the GTHL is looking after them,” said Prentice Toker, a trainer for Toronto Marlboros Minor Midget AAA team.

“Players don’t have to feel pressured to say they’re okay. Instead, the process dictates whether they are okay to return to play.”

Using the policy
Having the knowledge is one thing but implementing the training is key to the process, and to the future health of each affected player.

“Learning the signs and symptoms is one thing, but ensuring a player is safe to come back on the ice is another,” says Sean Abenstein, trainer for Forest Hill Minor Peewee AA team.

“That’s why we need these policy changes; to ensure we’re not only managing the early stages of concussions, but keeping kids healthy even years after.”Untitled2

The new policy makes sure all trainers, coaches, parents and players know their role in concussion recovery. It also includes crucial touchpoints with physicians to ensure diagnosis and medical clearance before players get back in the game.

Determining what a “gradual return” looks like in a hockey specific environment is another important aspect of the policy. Players are able to see their progress through clear guidelines in the return to play protocol that break down the recovery process into steps. It’s all about adding safe and manageable activity levels, seeing how a player responds and, if all goes well, adding more.

Recovery can take a long time, often weeks. Success at one stage in the recovery doesn’t guarantee an easy transition to the next stage. Sometimes players need to take a break, rest for a day, and go back to the previous step before moving forward.

As Toker points out, the new policy is already helping to educate people that this procedure – which is already accepted practice for other injuries – is what is best for the long-term health of the player.

“We hope for each of our players to grow up healthy and live long, happy lives. The better we are at managing concussions in the here and now, the better off our players will be in the future.”
-Sean Abenstein, AA Trainer

“Working in Minor Midget AAA, there is a certain amount of pressure to get players back on the ice. When a player breaks a collar bone, there is a healing process and return to play protocol that’s pretty understandable to everyone.

“With a concussion or a suspected concussion, the injuries aren’t visible so people don’t always understand what recovery looks like. The new GTHL return to play protocol gives me the support system I need to resist any pressure and make sure players are recovered before they hit the ice.”


What’s next?
The GTHL is already a leader for their proactive approach to concussion in the Ontario minor sports scene, but it doesn’t stop there. The League and Holland Bloorview’s concussion centre are also working together to propel concussion research forward.

During the August training sessions, 939 coaches and trainers completed a survey to participate in a collaborative research study, helping us learn what they currently know about concussion and how their knowledge, attitudes and practices in hockey may change over the next five years. This insight will help inform future concussion education efforts in sport.

Inform Yourself
Download the GTHL’s new concussion policy and learn more about concussion services at Holland Bloorview Kids Rehabilitation hospital by visiting

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