Karolina Urban remembers most of the game. It was the last of her 2008-09 season. As captain of the University of Toronto women’s hockey team, she followed the puck on the ice.
“The puck popped out and I got it,” she said. “The girl … just smoked me so hard that I twisted in the air before I landed.”
That was Urban’s first concussion. She has suffered two since. They haven’t discouraged her.
“If I wasn’t to play, just because I might get a concussion … it would affect me,” Urban said. “It’s part of who I am.”
Incidents involving concussion diagnoses have become more common than ever at all levels of hockey. In a 2010 study by Neurosurgical Focus, physicians observed players aged 16 to 21 in 52 junior games and 17 players suffered 21 concussions – or one every three games.
Dr. Charles Tator, professor of neurosurgery at U of T, partly credits a greater understanding of concussion for the rise in incidents.
“Twenty years ago, the definition of concussion was very different than it is today,” Tator said. “In the old days, you had to be knocked out to be labelled as a concussion … Probably 95 per cent of concussions do not have loss of consciousness.”
Studies also show that females could have more of a predisposition to the injury. The National Collegiate Athletic Association (NCAA) recently found concussion rates in women’s hockey as the highest of all sports surveyed. For example, 2.72 incidents occurred per 1,000 player hours (men’s hockey had 1.47 and football 2.34).
Urban can attest to this. Studying concussion academically, she’s seen the severity from both sides of the boards.
“Last year, I did a study with a prof on our team (about) incidence of injuries and, out of 22 injuries, 11 were concussions,” Urban said. “I can’t say anything about our team this year yet, because we’re still in play, but there’s been a few.”
These numbers support the NCAA’s findings; concussions accounted for 25 per cent of their women’s hockey injuries.
A ban on checking in women’s hockey doesn’t end contact or opportunity for injury. Dan Church, president of Canadian Interuniversity Sport’s (CIS) Women’s Ice Hockey Coaches Association, believes officials can encourage safety in games by dictating tempo – a tougher task than it seems.
“How you manage the game and how you call penalties early on, I think really influences whether the game gets out of hand,” Church said. “It’s tricky in female hockey especially when the players start to advance. I think the challenge (is to) understand the standard that they need to call.”
Tator, a founder of “Think First,” a brain and neck injury prevention organization, hails recognition training as the strongest deterrent of occurrence.
“We now feel that in order to reduce the incidence of concussion and to improve a person’s chance of getting better, that everybody should know about concussion,” the doctor said. “Everybody should know how to recognize a concussion. This is gradually happening, especially because of recent high profile (incidents). The public is getting more information about concussion than ever.”
The STOP (Safety Towards Other Players) Program in minor hockey, features a stop-sign patch sewn to the back of player’s jerseys. STOP claims a 69 per cent decrease in spinal injuries among players 18 and over. The study by Tator in the Clinical Journal of Sports Medicine suggests the effectiveness of early education.
Church who coaches York University’s women’s team wants players to do more than just recognize the problem. He believes respect must also be taught.
“There has to be a level of respect between players, both in male and female hockey,” Church said. “If you see an opponent in a vulnerable position … take that into account. We have to do a better job of talking to our athletes about exactly what respect is.”
Hockey Canada, the CIS’ rule-maker, has implemented new guidelines to address hits to the head including stiffer penalties for “head checks” – much like in the NHL. Urban believes that, while the rules help, they won’t change the game.
“Girls get checked to the head and the penalties aren’t called,” Urban said. “There’s going to be contact … You can only do so much. The game’s so fast.”
Despite her history of injury and what she’s seen, Urban doesn’t plan to hang up her skates anytime soon.
“I just love the game,” Urban said, “the speed, the physicality. I love skating … Sometimes we’ll play teams and you’ll get hit and it drives you nuts, but you get back up; it makes you go harder.
“You can’t stop someone from playing the game they love.”