Researcher pioneers prevention of sport-related concussion in youth

As someone who has always been physically active, Dr. Carolyn Emery, PhD, has experienced first-hand the benefits — and the risks — of sport and recreation.

She enjoyed alpine skiing in high school, played water polo in university, and volunteered as a team physiotherapist and coach when her children played ice hockey.

A physiotherapist for more than 20 years, she focused on paediatrics rehabilitation and sport-related injuries in youth. She often treated kids in the hospital or in the clinic following significant sport- and recreation-related injuries.

“I felt like there was much to contribute upstream in the prevention of these injuries, specifically traumatic brain injuries — concussions,” says Emery, professor in the Faculty of Kinesiology and chair of the Sport Injury Prevention Research Centre at the University of Calgary.

As an epidemiologist, Emery’s research focuses on understanding risk factors and reducing the burden of concussions and sport-related injuries and their consequences in youth. She holds joint appointments in the departments of Community Health Sciences and Paediatrics in the Cumming School of Medicine and is a member of the Hotchkiss Brain Institute.

“Injuries and concussions in youth sport and recreation are predictable and preventable. There are strategies that can be implemented to prevent concussions and reduce their severity,” Emery says. Such approaches may include policy or rule changes, equipment recommendations, and training strategies including neuromuscular training warm-up programs.

One in three Canadian youth is expected to have a sport or recreation injury every year that requires medical attention and one in 10 sustains a concussion, she notes. Twenty per cent have had a previous concussion, and 30 per cent experience persistent symptoms beyond one month which may include headache, dizziness, sleep issues, cognitive difficulties and/or depression.

The Sport Injury Prevention Centre (SIPRC) is committed to achieving a 25-per-cent reduction in youth sport and recreational injuries by 2025. SIPRC is one of 11 International Olympic Committee (IOC) Research Centres for Prevention of Injury and Protection of Athlete Health.

Earlier this year, Emery was awarded the prestigious Canadian Institutes of Health Research Canada Research Chair (CRC) Tier 1 in Concussion, in recognition of her pioneering work and leadership.

“The opportunity to lead a pan-Canadian, multidisciplinary research program focused on the prevention, diagnosis, prognosis, management and treatment of concussion in kids following sport-related concussion is exciting,” she says. “The potential public health impact in reducing concussions and their consequences in youth through evidence-informed solutions in school and community sport is significant.”

The SHRed Concussions (Surveillance in High Schools and Community Sport to Reduce Concussions and their Consequences in Youth) team includes more than 40 researchers representing nine Canadian universities and more than 30 clinical community, government and industry partners.

“Having very strong clinical and community partnerships ensures the relevance of our research and the potential for real-world impact,” Emery says.

Emery also was appointed co-lead, with Dr. Keith Yeates, PhD, of the Integrated Concussion Research Program. With their UCalgary colleagues, they are focused on multimodal clinical trials to identify optimal treatments, including physiotherapy, rehabilitation, psychological, biomedical and pharmacological strategies, for sport-related and non-sport-related concussions in youth and across the lifespan.  

“We’re very fortunate to have someone as talented as Carolyn to help lead the Integrated Concussion Research Program, as well as develop the new Canadian Concussion Network,” says Yeates, professor and head of the Department of Psychology in the Faculty of Arts, and Ronald and Irene Ward Chair in Paediatric Brain Injury.

“This CRC is a testament to her many critical accomplishments in research, knowledge translation and training in the area of concussion.”

Expanding concussion research, education and training

Along with her CRC, Emery received a Canada Foundation for Innovation grant, to support the “SHRed mobile.” The 30-foot-long mobile laboratory will enable Emery’s team to scale up their research, education and clinical training in sport-related concussion beyond urban centres, to rural, remote and Indigenous communities.

The CRC is the most recent of numerous awards and honours Emery has received since joining UCalgary in 2004. They include the Medical Research Network Chair Sport Injury Prevention Research Centre (IOC, 2019), Christensen Visiting Fellowship (Oxford University, 2018), Canadian Academy of Health Sciences Fellowship (2016), Royal Society of Canada College of New Scholars (2014), and USA Hockey Excellence in Safety Award (2014).

Emery points to the late Dr. Cy Frank, a renowned orthopedic surgeon and the founding clinical and research director of UCalgary’s Sport Medicine Centre, as a mentor. “He always inspired me to keep the bar high and to always consider multidisciplinary perspectives in my research.”

Another mentor is Professor Emeritus of sport medicine Dr. Willem Meeuwisse, founder and chair (2009-2016) of the Sport Injury Prevention Research Centre. “He helped me realize that research with rigorous methodology could inform a significant public health impact in reducing sport-related injuries.”

For example, Emery’s research on evaluating body-checking policy and injury/concussion in youth hockey informed policy disallowing body checking, in leagues for 11- to 12-year-olds, by USA Hockey in 2010 and Hockey Canada in 2013. This change led to a 64-per-cent lower concussion rate and a 50-per-cent lower rate of overall injuries in these hockey leagues.

“The answer isn’t to stop letting kids do what they love,” Emery says. “It’s about how can we make it the safest possible environment to ensure lifelong participation in physical activity.”

Emery leads the only Canadian research team participating in the National Football League’s Play Smart, Play Safe initiative, to reduce concussions and their consequences in youth sport. The NFL’s scientific advisory board provided $12 million to fund the team’s SHRed Concussions program.

She says the most exciting aspect of her job is working with a diverse group of researchers and especially with students and postdoctoral scholars who bring different perspectives and novel ideas.

“Knowing that the future of concussion research is in good hands and will continue to have a significant public impact is a huge driver for me.”

The Faculty of Kinesiology is ranked the No. 1 sport science school in North America and No. 7 globally. The faculty’s researchers have played an integral role in shaping the international consensus on concussion in sport.

Photo of Carolyn Emery provided.