Concussion Awareness (Mississauga Girls Hockey League)

Concussion Awareness

The Mississauga Girls Hockey League realizes the dire state of concussion in sport. The Executive has declared it a priority to ensure all families are aware of the severity of concussions and their effects.

As an easy way for all of our members to educate themselves, the MGHL has created this page, and the accompanying Concussion Awareness document, as a reference. If you have questions about the MGHL's commitment to the safety of our players, contact the MGHL at the information below.

Concussion Laws became mandatory in Ontario in 2018.
The following outlines concussion awareness and the MGHL’s concussion management protocol.

Concussion Code of Conduct and Mandatory Requirements

Concussion safety legislation requires every player, and all rostered bench staff, to review the Concussion Code of Conduct on an annual basis and sign and submit the OWHA Rowan's Law Acknowledgement.

This form must be signed electronically in RAMP before you can be registered as a player or rostered participant with the MGHL.

Hockey Canada, alongside various organizations including Parachute Canada, have standardized information for the prevention, identification and management of concussion and suspected concussion. Effective May 6, 2025, the following mandatory updated policies and protocols include:

DOCUMENT	PURPOSE
Hockey Canada Concussion Policy	Provides a resource that will enable those in the sport of hockey to recognize and manage concussion injuries, and to provide prevention strategies to reduce the incidence of those injuries.
Hockey Canada Concussion Protocol	Helps to guide the management of players and on-ice officials who may have a suspected concussion.
Hockey Canada Concussion Protocol Summary	Provides parents, athletes and others with an overview of Hockey Canada’s Concussion Protocol. It is intended as a communication tool and does not replace the full protocol document.
Improved concussion resources:
Concussion Pathway	A decision flowchart to clearly guide members through proper procedures following a head injury.
Pre-season education requirement for all participants:
Players / Parents Team Staff Officials	All Players, Parents/Guardians, Coaches, Trainers, Safety Personnel, and Team Staff are required to review and submit a signed copy of the Pre-season Concussion Education Sheet directed to their Coach, or team designate, prior to the first practice of the season, with officials submitting their form to their administrator prior to officiating their first game of the season.
Clarification of onsite, emergency, and sideline head injury recognition / medical assessments processes:
Concussion Recognition Tool 6 (CAT6)	Designed for use by non-medical personnel to help identify concussion in children, adolescents and adults; all individuals with a suspected concussion MUST be referred for assessment by a Medical Professional before returning to any hockey related activity (including dryland training) or beginning the 6 Step Return to Sport Strategy.
Sport Concussion Assessment Tool 6th edition, age 13+ / adult (SCAT6)	Designed for use by physicians / health-care professionals for baseline testing and evaluating concussions, ideally within 72 hours (3 days), and up to 7 days, following injury; this document can be provided to a licensed Medical Professional upon request.
Child Sport Concussion Assessment Tool 6th edition, age 8-12 (Child SCAT6)	Designed for use by physicians / health-care professionals for baseline testing and evaluating concussions, ideally within 72 hours (3 days), and up to 7 days, following injury; this document can be provided to a licensed Medical Professional upon request.
Enhanced concussion assessment, management and return to school/sport process:
Concussion Communication Tool	Designed to help with communication related to the safe return to school and hockey following a concussion; diagnosed concussion is managed under the supervision of a Medical Professional with this document completed in collaboration between the team Trainer, Player and Parent/Guardian.
Medical Assessment Letter	Provides clear diagnostic results on the assessment of a suspected concussion from a Medical Professional with reference to Return-to-Sport strategy.
Medical Clearance Letter	Provides clear diagnostic results on the appropriate management of a concussion from a Medical Professional with reference to Return-to-Sport strategy.
Return-to-School / Hockey-Specific Return-to-Sport strategies	Provides clear descriptions and progress for each stage of the strategies.

Concussion Awareness & Actions - What is it?

A concussion is a head, face, neck or body impact by either a direct blow or indirect transmission of force that causes a sudden jarring of the head which can be associated with a serious and potentially fatal brain injury.

Suspect a concussion if an impact to the head, face, neck or body is sustained, and:

• One or more observable signs of suspected concussion are present, OR
• The person reports one or more symptoms of suspected concussion.

Observable signs of a suspected concussion include:

• Lying motionless on the ice
• Slow to get up after a direct or indirect hit to the head
• Disorientation or confusion, or inability to respond appropriately to questions
• Unresponsiveness
• Unsteady on feet, balance problems, poor coordination, wobbly
• Blank or vacant stare
• Facial injury

A person doesn’t need to be knocked out to have a concussion; common symptoms of a suspected concussion include:

• Headaches or head pressure
• Dizziness
• Nausea or vomiting
• Blurred or fuzzy vision
• Sensitivity to light or sound
• Balance problems
• Feeling tired or having no energy
• Not thinking clearly
• “Don’t feel right”
• Feeling slowed down
• Feeling more emotional, easily upset or angered
• Sadness
• Nervousness or anxiety
• Difficulty concentrating
• Difficulty remembering
• Feeling like “in a fog”
• Sleeping more or sleeping less
• Having a hard time falling asleep

If there are significant concerns, including any of the red flags listed below, then activate emergency procedures and arrange urgent transport to the nearest hospital:

• Neck pain or tenderness
• Double vision
• Severe or increasing headache
• Vomiting
• Seizure or convulsion
• Loss of consciousness
• Deteriorating conscious state
• Increasingly restless, agitated or combative
• Weakness or tingling/ burning in arms or legs

Concussion Awareness & Actions - What to Do

If no symptoms, use the facts of the situation to assess the situation (player to sit a shift or two and reassess symptoms after adrenalin starts to wear off.)
Trainer has final decision on return to play that day.

Evidence of ONE (1) symptom means player must stop playing right away

• The player should not be left alone and should be seen by a doctor as soon as possible that day
• If a player is knocked out, call an ambulance to take them to a hospital immediately
• Do not move the player or remove athletic equipment like a helmet as there may also be a cervical spine injury; wait for paramedics to arrive

A player with a suspected concussion must not return to play that day, even if they report they are feeling better

• Problems caused by a head injury can get worse later that day or night (especially in children and adolescents) and can take up to 48 to 72 hours to show up
• Player cannot begin the Hockey-Specific “6 Step Return to Sport Strategy” or return to sports activities until they have been assessed and cleared by a Medical Professional

Hockey-Specific 6 Step Return to Sport Strategy

MANDATORY MEDICAL ASSESSMENT Begin the Return to Sport Strategy with Medical Professional’s clearance
STEP	DESCRIPTION
Step 1	Activities of daily living & relative rest (first 24 - 48 hrs) Typical activities at home (e.g., preparing meals, social interactions, light walking.) Minimize screen time.
AFTER MAXIMUM OF 24-48 HOURS AFTER INJURY, PROGRESS TO STEP 2
Step 2	2A: Light effort aerobic exercise: Walking or stationary cycling at slow to medium pace for 10 - 15 mins. May begin light resistance training that does not result in more than mild & brief worsening of symptoms. Exercise up to approximately 55% of maximum heart rate. Take breaks & modify activities as needed.
	2B: Moderate effort aerobic exercise: Gradually increase tolerance & intensity of aerobic activities, such as walking or stationary cycling at a brisk pace for 10 - 15 mins. May begin light resistance training that does not result in more than mild & brief worsening of symptoms. Exercise up to approximately 70% of maximum heart rate. Take breaks & modify activities as needed.
IF THE PLAYER CAN TOLERATE MODERATE AEROBIC EXERCISE, PROGRESS TO STEP 3
Step 3	Individual hockey-specific activities, without risk of inadvertent head impact. Add hockey-specific activities (e.g., skating, changing direction, individual drills) for 20 - 30 mins. Perform activities individually & under supervision from a Parent/Guardian, Coach, or safety personnel (e.g., Trainer). Progress to where the player is free of concussion-related symptoms, even when exercising. There should be no body contact or high-speed stops. Players should wear a “No Contact” identification pinny.
MANDATORY MEDICAL CLEARANCE IF PLAYER HAS COMPLETED RETURN-TO-SCHOOL (IF APPLICABLE) & HAS BEEN MEDICALLY CLEARED, PROGRESS TO STEP 4
Step 4	Non-contact training drills & activities. Progress to exercises with no body contact at high intensity, including more challenging drills & activities (e.g., shooting & passing drills, multi-player training, & practices). Where possible, give extra space around other players to avoid collisions or falls on the ice. Players should wear a “No Contact” identification pinny. The time needed to progress from non-contact to contact exercise will vary with the severity of the concussion / injury and the player.
IF THE PLAYER CAN TOLERATE USUAL INTENSITY OF ACTIVITIES WITH NO RETURN OF SYMPTOMS, PROGRESS TO STEP 5
Step 5	Return to all non-competitive activities, full-contact practice & physical education activities. Progress to higher-risk activities including typical training activities, full-contact hockey practices & physical education class activities. DO NOT participate in competitive gameplay.
IF THE PLAYER CAN TOLERATE NON-COMPETITIVE, HIGH-RISK ACTIVITIES, PROGRESS TO STEP 6
Step 6	Return to sport. Unrestricted sport & physical activity. Full gameplay. The earliest a concussed athlete should return to play is approximately one to two weeks if it’s a first concussion.

Note: Players should proceed through return to sport steps only when they do not experience symptoms or signs and a Medical Professional has given clearance. Each step should be a minimum of at least 1 day, usually 2-3 days.

If symptoms or signs return, the player should return to the previous step, and be re-evaluated by a Medical Professional.

The Return to Sport Strategy applies to ALL injuries, not just concussions!

Websites

For more information, questions, or comments, please contact:
Stacy Marnoch | Development Director | [email protected]