By Jon Heshka, Associate Professor at Thompson Rivers University (British Columbia, Canada)
The legal challenges facing former Canadian Football League (CFL) players in their lawsuits may have got even more formidable.
In a study published in the Clinical Journal of Sport Medicine in January 2018, it was found that nearly eight in 10 football players who competed in the CFL in 2015 believed they had suffered a concussion and did not seek medical attention. Eighty-six of the 309 (27.8 percent) respondents who had played in the CFL during the 2015 season believed they had suffered a concussion during that season and 79.1 percent (68/86) did not seek medical attention during a game or practice.
The study was done by the McGill University Health Centre and endorsed by the Canadian Football League and the Canadian Football League Players’ Association. The study involved a questionnaire being sent to all nine teams and distributed to players by each team’s head trainer/therapist. There were 512 players on the CFL’s 2015 opening- day rosters and, due to player turnover, 662 players participated in at least one game over the course of the 2015 season. Four hundred and fifty-four players participated in the study.
The most common (48.8 percent) reason cited for “hiding” a concussion was that the player did not feel the concussion was serious/severe and felt he could continue playing with little danger to himself. Some 41.9 percent said they felt that they would be removed from the game by medical staff and didn’t wish for that to happen, 39.5 percent were fearful that being diagnosed with a concussion would result in missing future games or practices, 33.7 percent were fearful that being diagnosed with a concussion would affect their standing with their current team or future teams and 20.9 percent were fearful that being diagnosed and labeled with a concussion could affect their financial income now or in the future.
These results have the potential to diminish the veracity of the claims of retired CFL players who allege that they didn’t know about concussions or appreciate their risks.
It doesn’t take away, though, from other elements of the claims in various lawsuits wherein retired players allege that the CFL knew of the long-term harmful effects of concussions and actively concealed these facts, that the league breached its duty to take all reasonable and prudent steps to protect players’ health concerning concussions and failed to warn players of the long-term medical risks associated with repetitive head impacts, and that the league negligently misrepresented the science respecting concussions in order to induce players to play football.
It does, however, call into question the extent to which the teams and league are in a position to protect players who do not wish their protection. Without players honestly disclosing signs and symptoms to team medical staff, the team’s capacity to diagnose and treat brain injury is compromised.
Whereas current established practices in the NFL (CFL concussion protocols are not as robust) include unaffiliated neurotrauma consultants, spotters, team physicians, the blue injury assessment tents, and modified versions of the Maddocks questions and Sport Concussion Assessment Tool (SCAT 5), the starting point in concussion diagnosis and treatment is arguably in the players honestly self-reporting how they’re feeling after a hit (suspicious or otherwise) and suspected concussion.
Neurologists and physicians are trained and qualified to ascertain whether or not a player suspected of sustaining a concussion actually has one, but concussions need not be triggered by a violent blow to the head. Instead, there are myriad reasons why a less severe hit may result in a concussion, including the brain not having fully recovered from a previous concussion or the cumulative effect of many prior sub-concussive hits. So, it is difficult, if not impossible, for it to always be detected and therefore treated unless it is first self-reported.
The reasons cited for injured players not reporting that they’d been concussed (fear of being taken out of the game, fear of missing future games, fear of loss of current or future income) is, in a sense, understandable in leagues where non-guaranteed contracts motivate and incentivize players to squeeze everything they can out of their contracts and consequently play hurt. This can only be addressed through collective bargaining between the league and the players’ association.
There has been tremendous progress made and light shone on concussion prevention, diagnosis, treatment and return to play protocols in collision sports like football and hockey. Advancements in technology and rule changes have reduced the severity and frequency of sports concussions. The McGill University research which clearly shows the extent to which players hide concussions also shows professional football is not out of the dark yet.
It bears repeating that this study was specific to players competing in the Canadian Football League. In 2017 the Court of Appeal for British Columbia in Bruce v. Cohon et al. 2017 BCCA 186 upheld a judgment of the Supreme Court of British Columbia which dismissed a CFL concussion lawsuit holding that the disputes raised by Bruce arose from the 2014 Collective Agreement and can only be resolved through the grievance and arbitration process. The courts declined to look at the merits of the case. Bruce has filed an application for leave to appeal to the Supreme Court of Canada.
