GUELPH, Ont. – Dan McIsaac recalls the play that would ultimately end his lacrosse career. In 2015, McIsaac was in his second year at the University of Guelph, a fixture as an attack on the Gryphon lacrosse team. They were on the road in Sudbury playing Laurentian when McIsaac got hit with an opponent's stick through his facemask. The Burlington, ON native was knocked down to the grass field – and his head hit the surface hard.
 
"I remember putting my hand in my mouth and there was a bunch of blood," says McIsaac, now a 23-year-old, fifth-year Biodiversity major studying insect DNA and climate change. "I went to the bench and I realized that I didn't feel so good.
 
"The trainer got my helmet off. I was very cold and she covered me with blankets and sweaters. I remember her asking me certain questions, like counting backward from 15 by three. I couldn't even do it by one. I didn't know the score or who we were playing.

 
"My Dad made a road trip to watch the game. Luckily, he was there. We went to the hospital in Nipissing."
 
That was the last time McIsaac ever played the sport he loved so much. He knew it was the end as soon as he was officially diagnosed with a concussion, his fifth. Prior to the incident in Sudbury, he was already told by a doctor that one more concussion would be it.
 
"It was tough," says McIsaac. "I've been playing since I was two years old. I've never not played."
 
Despite the unsurprising news, the effects of that final concussion were lasting, even now almost three years later. Soon after the injury, McIsaac had to take a month off from classes, which set him back in a demanding science program. His vision was impacted, forcing him to get new glasses. But worst of all was the black room.
 
"You just sit at home, no electronics, no anything," he says. "You literally sit at home, sleep, and stare at the ceiling. I did that for a month straight. My mind went everywhere. I would think about what would happen with school and the fact that I couldn't to play anymore."  
U of G's Head Athletic Therapist Gunner Obrascovs refers to a memorable quote from legendary CFL coach Joe Moss when the topic of concussions come up. About 30 years ago, Moss's starting quarterback on the Ottawa Rough Riders, JC Watts, was knocked out of action. Moss would tell media, 'Today's Saturday, JC thinks it's Sunday and hopefully by next weekend, we'll be on the same day.'
 
"That was the mentality then," says Obrascovs, suggesting that despite the many unknowns that remain about concussions, strides have certainly been made. "There was no health worry per se. It was whether his mind would work well enough so that he could play again."
 
Obrascovs is used to seeing kids with concussions. He deals with varsity athletes when they are hurt but participants in intramural, club, or recreation play, as well as people on campus outside of sport, also suffer concussions. It's particularly challenging addressing the injuries with athletes, who are conditioned to think a certain way to achieve success.
 
"Typically, they are taught to persevere, play through some discomfort, some pain, for the good of the team," says Obrascovs. "Now you tell people who have lived in that environment that they can't."


Concussion protocol is a must and while there is still some resistance to admitting when you're 'not feeling right,' there has been progress regarding diagnosis, treatment, and prevention.
 
"Sidney Crosby really did bring this issue to the forefront and since then, other famous players, hockey players but also in other sports, have become quite public with it," says Dr. Margo Mountjoy, a sport medicine physician at the university's Health & Performance Centre, who has been treating concussions for 30 years.
 
"Having these high-profile things in the media has raised significant awareness, as well as education."
 
Dr. Mountjoy says that a week doesn't go by without her treating a concussion, including this rainy August afternoon, in which she has already seen three people with the injury. She also notes that literature suggests concussions remain under reported because athletes don't want their opportunity to play taken away from them.


 
"I think we need a change of culture," Dr. Mountjoy says. "It's a difficult age we're dealing with here at the university, in terms of being able to be honest with themselves."
 
She refers to the accepted mantra surrounding concussion protocol: "When in doubt, sit them out."
 
The good news is that the University of Guelph is at the forefront of addressing concussions on Canadian campuses. U SPORTS require baseline testing for athletes in high-risk sports. How those baselines are tracked varies. At Guelph, the athletes are tested based on the International Olympic Committee guidelines established two years ago at a conference in Berlin, which Dr. Mountjoy attended. SCAT 5 (the fifth edition of the Sport Concussion Assessment Tool method) is one element of a battery of tests, including balance and eye tracking. Those combined tests, which take 12-15 minutes per case, make Guelph unique.
 
Intramural participants are required to watch a presentation prior to play, while official staff watch two videos as part of their training. Officials have a SCAT 5 sheet that requires completing in the event of an incident in play, just as a coach would have for a varsity player.
 
Awareness is important but so is diagnosis and treatment. Dr. Mountjoy says that even better tools are being implemented or are on the horizon – diagnosis with functional MRIs, visual treatments, and nutrition for both treatment and prevention (a study on the latter topic will be starting at the U of G in the future), as a few examples. Dr. Mountjoy adds that a blood marker test will be the ultimate tool, though that's still down the road.
 
"Science is trying to find more ways to diagnose more accurately the severity of a concussion, improve the treatment, and the prevention," she says. "The University of Guelph is involved in the research work being done."  
Dan McIsaac is thankful in many ways. The couple of years after his last concussion were brutal. In addition to vision problems, he would have severe headaches. He couldn't work out. When McIsaac had material to read for classes, he had to go over it several times just to retain the information, which wasn't the case previously. He attended sessions at Student Accessibility Services to talk about the mental toll the head injuries had on his life.
 
His head coach was able to help. Sam Kosakowski was concerned for his athlete, not from a sporting perspective but for his overall well-being.
 
"They are competitors and want to be on the field, but these are student-athletes and their first priority is their health and school," says Kosakowski. "We focused on making sure D-Mac was getting as much medical attention as possible to get him back to good health.  We knew that his playing career would likely be done so it was never about 'do you think you can play again?' or 'when are you going to be back?'  My focus was on him getting better and comfortable with everyday life and school work."
 
The two talked about McIsaac's future. They made a deal that when he felt better, there would be a spot for him on the coaching staff.


 
"D-Mac wanted to be involved and not just to hang out," says Kosakowski. "He still wanted to have an impact. We decided on him focusing on his strengths on the offence and that's where he helped.  We had him work with our offensive coordinator Dan Cannon and he ran drills and helped with systems. 
 
"Dan brought a certain level of maturity to the role and he transitioned well to coaching.  He had a great deal of respect from the players and he was confident to step in when needed.  From a head coach's perspective, it was clear to me that Dan was serious about the role and was able to keep his friendships with the guys separate from the professionalism of coaching.  He was a valuable aspect of our program and it was great to have him on our staff."
 
McIsaac did that for two years until relinquishing the role this season to concentrate on his studies. It was an influential experience on his road to recovery, which is ongoing. The headaches still occur and while he can exercise, McIsaac can't go for a run without feeling the effects.
 
It could be worse.
 
"It's a new year," McIsaac says. "I'm still not alright but I'm not black roomed anymore."
 

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More Concussion Resources

Parachute Canada - A non-profit organization with the mission of "Creating a safer Canada by preventing serious and fatal injuries through evidence-based solutions that advocate and educate." The site provides in-depth information on concussions, including a Guide for Athletes. 

Rowan's Law - Rowan Stringer was a 17-year-old rugby player who passed away on May 12, 2013 after sustaining multiple concussions. Her death was the impetus for provincial legislation designed to "protect amateur athletes and make sport safer on the field and at school." The final Wednesday of September (the 26th in 2018) is known as "Rowan's Law Day." Read more about Rowan's story at the following links: National Post, CBC

Apps - There are several concussion apps, including Parachute Canada's "Concussion Ed." It is available at the App Store.
 

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