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A new way forward in concussion culture

By Dave Pond, 10/09/18, 4:45PM MDT


Q&A with Concussion Legacy Foundation's Chris Nowinski

In September, more than 200 organizations, including USA Hockey, participated in the third annual Team Up Speak Up Day. Athletes across multiple sports came together and pledged to take care of their teammates, by reporting potential concussion issues they might see on or off the ice.

Team Up Speak Up’s mission to give young athletes the responsibility and permission to care for one another is so powerful that USA Hockey and the Concussion Legacy Foundation (CLF), which started Team Up Speak Up Day in 2016, have now embarked on a weeklong campaign to bring the message to USA Hockey participants across the country.

In advance of Team Up Speak Up Week (October 22-26), we sat down with Chris Nowinski, Ph.D., to talk about the growing partnership between the CLF and USA Hockey, and how our players and coaches can help their teammates thrive.

Nowinski, a former WWE star and All-Ivy League defensive tackle for the Harvard University football team, is no stranger to concussions. After suffering an in-match concussion during WWE competition, he realized that a lack of awareness about concussions and brain trauma among athletes, coaches and even medical professionals threatened the health and well being of athletes of all ages.

This led Nowinski to write the critically acclaimed 2006 book Head Games: Football’s Concussion Crisis, and a year later, to co-found the CLF to solve the sports concussion crisis through education, awareness, policy and research. In 2008, Concussion Legacy Foundation partnered with the Boston University School of Medicine to found the Center for the Study of Traumatic Encephalopathy, the first research center in the world dedicated to the study of chronic traumatic encephalopathy (CTE), a degenerative brain disease associated with brain trauma.

USA Hockey: You played almost every sport as a kid, then moved into college football and professional wrestling. Looking back at your career, how many concussions have you had?

Chris Nowinski, Ph.D.: As kids, we never thought twice about every time we saw stars, had a headache, or didn’t remember what was going on. I just thought it was all normal because none of those things ever lasted long enough for anybody else to really notice. I was never formally diagnosed with a concussion until I was 24 years old, after I got kicked in the head during a WWE match. I immediately forgot where I was and who I was, and had a massive headache.

I was able to finish the match, and things came together, but my headache just wouldn’t go away. And every time I got my heart rate up, I’d get nauseous. I didn’t know how serious my injury really was, and for five weeks, I wasn’t forthcoming about how I felt. So, I continued to work out and wrestle (and take additional hits to my head) until I developed a sleep disorder in which I started acting out my dreams and hurt myself even further.

USA Hockey: What lead you to retire from the WWE?

Nowinski: I’d had plenty of doctors ask me how many concussions I’d had in the past. The answer was always “none” because I’d never been diagnosed. The turning point for me was when Dr. Robert Cantu, my co-founder at the Concussion Legacy Foundation, asked me about my symptoms – like double vision, ringing in my ears, seeing stars, and forgetting where I was. Immediately, I could recall five separate times over the previous four years in football and wrestling that it had happened to me, but I just never thought to mention it to anybody.

Dr. Cantu explained that these are basically concussions by another name, and they’re what forced me to retire. Basically, I had not recognized my concussions and managed them appropriately, and that’s what cost me my career and my health.

USA Hockey: Tell us about the Team Up Speak Up initiative?

Nowinski: This is one of my favorite programs because it’s a real solution to the problem of undiagnosed concussions. We’ve always known we need concussion education – I know from my own experience that we tell athletes what concussions are, that they are very serious and that if you don’t take care of them, they can end your season, your career or you could even die from second impact syndrome. Those are all things athletes need to know, and we’ve spent the last decade encouraging them to pull themselves out of games when they have a concussion to give themselves the best chance to get back on the ice quickly.

USA Hockey: But that’s not enough, is it?

Nowinski: That approach hasn’t really worked to change behavior, and we all have to fall back on our own experiences as athletes to realize that, of course, it makes perfect sense that it wouldn’t work. Even when you’re educated about concussions, athletes still want to put their team first. You’re still part of a culture that says to make sacrifices for the greater good.

So, even educated athletes are still staying in games when they know they shouldn’t. On top of that, we need to realize the limits around educating athletes about concussions. Not every athlete with a concussion even realizes they have one – concussions have a very special way of making your brain malfunction to where you might not even know you’re hurt. One of the ways we’ve been trying to solve this is by educating parents and coaches. There are limits to what they can do because coaches are managing an entire game and a bench while parents aren’t always there.

USA Hockey: So you made a decision to focus on peer-to-peer, teammate connections to grow awareness and safety within youth athletics?

Nowinski: Yes. The most obvious group we’ve never talked about is teammates, and that’s where Team Up Speak Up comes in. We often forget that the person an athlete is going to confide in the most is a friend, a teammate – because you care about your friends, you want them to be healthy, and to do well. So, one of the best ways to become aware of the concussions we’re currently missing is to ask teammates to speak up when they realize a teammate might have a concussion.

USA Hockey: What does that look like?

Nowinski: A teammate might tell you they have a headache or that they’re not feeling well. Or, you might notice they’re just not acting like themselves. Even if a teammate says it’s no big deal, say something. You may think a teammate knows what he or she is doing, but they might not realize they’re really hurt. So, you’re not selling them out – you’re actually doing your teammate a favor by speaking up.

USA Hockey: In a sport like hockey, where contact is part of the game, how can we change the culture to assure teammates that speaking up is a good thing?

Nowinski: USA Hockey has done an incredible job as a governing body of prioritizing athletes’ health. You have tremendous education programs and have shown tremendous leadership in raising the age for the introduction of body-checking to 13 years old. You are great stewards of the sport, and the Team Up Speak Up initiative is a perfect fit.

We want to make sure every team’s culture is one in which players hear from their coaches and captains, to talk about looking out for each other on and off the ice. That way, if they see anything that makes them concerned about a teammate having a concussion, the players all know that it’s their job to speak up to a coach, an athletic trainer, or a parent and tell them that they’re concerned. It’s all about that a teammate with a concussion may need your help, and that it’s your job to speak up.

USA Hockey: This is a much different approach than when you played sports, isn’t it?

Nowinski: I can remember back in high school, hiding teammates’ concussions. I remember having teammates who couldn’t remember the plays by the time they walked from the huddle to the line of scrimmage – they’d forget everything over those five seconds. So, we’d point at a guy and tell our teammate to block him, because he couldn’t remember what he was supposed to do. We thought that was just normal and cool, and that’s how you help a teammate out.

We’re so excited to partner with USA Hockey to promote USA Hockey Team Up Speak Up Week. There are so many passionate hockey players in America, and we’re excited for them all to hear this message so that none of them end up like me, where a concussion ends their career before they want it to stop.

USA Hockey: If you had a chance to speak to USA Hockey players directly, what would you say?

Nowinski: What’s great about being on a team is that all your teammates are looking out for you, both on and off the ice. Unfortunately, there’s an injury that might happen to some of you that’s invisible – it’s called a concussion. It’s a brain injury that changes how your brain functions and can show up as problems in thinking, problems with balance, headaches, confusion and forgetting plays. When that happens, you need to get off the ice and see a doctor.

The problem is that if your teammate has a concussion, they may not know it. So your job as a good teammate is to protect your teammates. So if you think they might have a concussion, it’s your job to speak up to one of your coaches – let an adult know that you’re concerned about a concussion. That makes you a great teammate because you’re looking out for your teammate’s long-term health – and that’s the kind of player every coach should want on their team.

Team Up Speak Up Week is October 22-26, 2018. Share your Team Up Speak Up videos online – record your team’s speech and post it to social media, using the hashtag #TeamUpSpeakUp. Your message will go beyond your team, your league, and your rink, and could impact athletes around the world!