With high-profile cases involving Sidney Crosby and other players dominating the news over the last year, concern over head injuries has filtered down to the youth ranks and a growing number of leagues are trying to address it.
They include the Minor Oaks Hockey Association, based in the Toronto suburb of Oakville, which is forcing all 2,600 of its young athletes playing atom or higher to go through baseline testing before the season starts next month.
"If we make it optional and one of the children who does not take the test gets hurt, we're still in the weeds, we haven't progressed," association executive Louis Ouellette said Monday. "We want to make it mandatory. We don't believe there's any valid argument not to take it."
Minor Oaks is the largest hockey association in the country to mandate the neuro-cognitive test, which is conducted by the Critical Medicine Research Group using the same so-called ImPACT standard used by the NHL, CFL and virtually every other pro sports league.
The baseline test is conducted online and takes about 25 minutes to complete. It provides a detailed clinical report that can be used by doctors as a comparison point when trying to assess if a player has recovered from a concussion.
Essentially, the testing is designed to ensure that athletes don't return to action too soon.
"A lot of the times you see multiple case concussions and that's what you're trying to avoid," said John Chehade, director of sales and marketing for CMRG, which administers the test. "We know that 80 per cent of concussion cases resolve in seven to 10 days, but how do you know who's in that 80 per cent category or who's in that 20 per cent category (that take longer to resolve) like Sidney Crosby?
"You just don't know unless you have some sort of objective measurable data."
Chehade estimates his company will give baseline tests to as many as 17,000 youth hockey players across Canada this season, including British Columbia, Alberta, Saskatchewan, Manitoba and various parts of Ontario.
Minor Oaks has pledged to foot the entire bill for its players — at $25 per test, it will cost about $65,000 in total — and is providing it to those from the lowest levels of house league right through to the top rep teams.
"We're absorbing the cost within our operating budget because we feel it's important," said Ouellette.
The practice is spreading to other youth sports as well.
For example, the Calgary Bulldogs Football Association is in its second season of mandatory baseline testing for the 180 players it has between the ages of seven and 18.
"The kids at this age are at their most susceptible (to concussions) and no one is doing anything about it," Bulldogs board member Terry Andryo said Monday. "Each kid gets a file just like a medical situation. Any symptoms or on-field contact is recorded. What we'd like to do is get it to the point where we'd like to pass that information onto the next level where that kid is playing."
Hockey Canada dedicates a section of its website to concussions and has developed a six-step protocol for athletes returning from head injury. It doesn't specifically mention passing a baseline test.
The organization is unable to provide specific numbers on associations or players who have access to that form of testing, but it has recently taken several phone calls on the subject from hockey administrators.
"With all the awareness around concussions and the prevention, I think a lot of minor hockey associations have certainly locally gone and looked at baseline testing," said Todd Jackson, Hockey Canada's senior manager of member services. "From our standpoint, it's just another step in the overall return to play process. They're taking some steps to make sure their kids are safe."
The issue took on even more importance for Ouellette when his son suffered concussions in back-to-back games last year. Like many parents, he didn't realize anything was wrong after his son took a hit in the first game so he encouraged him to play again the next day.
After those incidents, he started researching concussions in minor hockey and set about instituting the new policy that takes effect in Oakville this season.
"I would have done it anyway, regardless of whether my own son had sustained an injury or not," said Ouellette. "I've personally had teammates of my son that have got conflicting diagnoses from doctors and it baffles me. It baffles me that it can be different from one child to another. ...
"We don't want to put our children, the players, out in harm's way without understanding exactly how to control this and how to assess whether they're ready to come back."
With files from Donna Spencer in Calgary.