words: Matthew Coyte
photography: Adrian Knowler and Matthew Coyte
cover photo: Adrian Knowler

Louis De Beaumont looks back at his time playing hockey in the 90s fondly. From winning the Air Canada Cup, the national midget AAA championship, to pursuing his bachelor’s degree at the Université de Montréal while playing junior hockey.

But he also remembers witnessing the realities of playing a contact sport: watching his friends and teammates take hits to the head. “They would just sniff some smelling salts and get right back out there,” he remembered.

Now, almost 30 years later, he’s looking to change the way contact sports such as football and hockey treat suspected concussions.

De Beaumont is a clinical neuropsychologist with a PhD in psychology from the Université de Montréal who holds a research chair at Centre de recherche de l’Hôpital du Sacré-Coeur de Montréal. He’s spent most of his career researching head injuries, more recently, sports-related concussions.

A concussion, by definition, is a mild traumatic brain injury. Headaches, light sensitivity, amnesia, and nausea are just some of the symptoms. The biggest issue with concussions in sports is that they often go undiagnosed, or worse, ignored.

De Beaumont is looking to remove the subjectivity from concussion diagnosis with a new study with Concordia University Stingers athletes that will begin at the end of February 2019 with the university’s football players.

By subjectivity, he means removing any doubt in concussion diagnosis by using objective data. Even with the strides being made in diagnosis, many professional leagues, like the National Football League, employ “spotters” during games that make the call of whether a player should undergo concussion protocol based on their opinion. Having objective data at the disposal of athletic trainers would leave no doubt about the presence of a head injury.

“It’s necessary for research to be done. Research has changed the way people think about their eating habits, smoking. That’s exactly what needs to happen with concussions.”

The research team will combine baseline testing using brain imaging technology with in-game data collected through sensors in the helmets of players. The end goal will lead to players being taken out of play based on objective data gathered in real-time.

“What we want to do is follow players in a way that’s never been done before,” explained De Beaumont. Each player will undergo magnetic resonance imaging before the season starts to get baseline information on every athlete that can be used to contrast their healthy results to results found throughout the season.”

“The brain doesn’t recover in the same way a knee or bone can. Once those brain cells are damaged, that’s it,” says De Beaumont.

The study will combine two different technologies.

The first part involves having players undergo brain imaging using an advanced MRI adapted to detect iron in blood before and after games. If a player suffers brain trauma during the game, the blood that would have leaked would be detected as iron. If any iron is detected, that indicates the possible presence of a concussion.

The second part involves placing trackers, about one cubic centimeter in size, in the helmets of players. These trackers will be able to detect impact force and direction from the hits that those players receive and deliver during games. This data will then be live-streamed to a trainer in the stands. There have been studies using one or the other aspects of analyzing concussions, but by combining the two, De Beaumont hopes to gather as much data as possible.

The trackers being used for the study will be placed on the inside of the helmet. Each tracker is about one cubic centimeter. (Trackers not shown in this photo. This helmet is not part of the study.) Photo by Matthew Coyte

For now, this data will just be gathered and analyzed, but the end goal is to use this data to determine if a player should sit out or get back in the game.

When asked for an interview, Concordia athletics provided the following statement from D’Arcy Ryan, the director of Recreation and Athletics: “The Department of Recreation and Athletics appreciates the importance of conducting quality research, especially in the university environment, and endeavours to lend assistance and support projects wherever possible.”

With the football team set to begin spring training camp in a few weeks, De Beaumont and his team, which includes renowned concussion researcher Dr. Alain Ptito, are ready to begin the pilot testing of their work in preparation for the regular season that starts in August.

“Our aim is to arrive at a reliable diagnosis. It so happens these tests aren’t sensitive to someone exaggerating their symptoms. They’re reliable tests that give us reliable measurements,” explained Ptito.

Another issue with concussion diagnosis comes from self-diagnosis, or the lack thereof. According to De Beaumont, about 50 per cent of athletes don’t report their concussions.

“The brain doesn’t recover in the same way a knee or bone can. Once those brain cells are damaged, that’s it.”

Once the 2019/20 season begins, selected players will undergo the same MRI testing before and after games to see if there are any changes in brain activity.

“We want to see if the athletes recover from game to game, or see if [damage] accumulates on the brain,” explained De Beaumont. “We suspect that most athletes won’t get concussions, but they’ll still take hits. We want to see if those hits cause changes or damage to the brain with or without the occurrence of a concussion.”

After the season is finished, the players will head to the MRI once more to see what the impact of the full season can have on the brain.

“In football you can get hit about 25 times per game,” said De Beaumont. “The accumulation of those hits can cause brain damage.”

Exactly how many hits needed to cause brain damage varies from athlete to athlete. The consistent MRI testing and impact tracking is attempting to gather data to be able to figure out what each athlete’s concussion threshold is.

One of the biggest worries current and former contact-sport athletes have is the possibility of chronic traumatic encephalopathy, or CTE, a degenerative brain disease found in people with a history of repeated head trauma such as athletes or military veterans. Former athletes found to have CTE had symptoms that included memory loss, depression, confusion, impulsive behaviour and suicidal thoughts. Currently, the only way to diagnose CTE is from an autopsy.

One 2017 study analyzed the brains of 111 former National Football League players. 110 were found to have had CTE. During the 2015 season, another study found that 23 per cent of players in the Canadian Football League felt as though they had suffered a concussion. Out of that 23 per cent, at least 82 per cent didn’t seek treatment. These are the kind of numbers that De Beaumont is looking to eliminate.

De Beaumont hopes to expand across different sports, and eventually across Canada to various universities to keep gathering data. This includes expanding the number of sports studied as well, including hockey, soccer, and boxing.

If De Beaumont’s study expands in the future to include more universities and more sports like he hopes, hockey is one of interest for him.

A fact that may be surprising to the casual fan is that a 2015 study of college level athletes in the United States found that over the 2009-2010 and 2013-2014 academic years, women hockey players, a sport with no body-checking, reported concussions at a higher rate than tackle football players.

Katherine Purchase, starting goalie of the Stingers women’s hockey team, suffered a concussion back in September during a training session with the Canadian national team fall festival camp.

“I knew I had gotten hit hard. I waited a second and then [the pain] really hit me.”

Katherine Purchase says that the toughest part of her concussion was feeling disconnected from her teammates. Photo by Adrian Knowler.

The team was playing an exhibition against a Junior B men’s team. During a 2-on-1 in the second period, one of the incoming players sent a pass through Purchase’s crease. The second player crashed into the net, but with Purchase in the way, he leapt over the goalie in an attempt to avoid contact. While in the air, that player’s knee hit Purchase right in the head.

“Right away I felt pain and pressure,” said Purchase. “The first week was a lot of fogginess. I had trouble remembering things. One day I drove to school to pick something up. When I got out I had forgotten where I parked. Weird stuff like that.”

“I knew I had gotten hit hard. I waited a second and then [the pain] really hit me.”

Purchase’s worst symptoms were gone after a month, but something still felt off. That feeling of being “off” kept her off the ice for the majority of the regular season. After five months of sitting out, she played her first game of the season on January 12.

When it comes to the “purists,” those who believe that sports are at their best when they are at their most violent (think the Don Cherry’s of the sports world), well, De Beaumont just doesn’t care.

“What is the responsible thing to do? What is the right thing to do?” asked De Beaumont. “I’m a parent of three. My son isn’t playing hockey for one reason. I think it’s dangerous.”

Despite the optimism about the study’s potential results, there is a long, winding, and expensive road ahead. De Beaumont estimates it will take about seven to eight years, and millions of dollars before they can finish their work and analyze the data. While some of the funding comes from De Beaumont’s research chair, he is hoping to get more support from grants such as the AUDACE program for innovative projects from the Fonds de recherche du Québec.

Even with the wait, De Beaumont feels like it will be worth it.

“It’s necessary for research to be done. Research has changed the way people think about their eating habits, smoking. That’s exactly what needs to happen with concussions.”