Thank you.

Canada Soccer is the official governing body for soccer in Canada. In partnership with our members, Canada Soccer promotes the growth and development of soccer in Canada from grassroots to high performance and on a national scale. Soccer is the largest participatory sport in Canada and is considered to be the fastest-growing sport in the country.

I am an academic child neurologist with epidemiology and biostatistics training. My clinical practice of the last two decades has primarily dealt with the clinical management of complex pediatric concussion along with research and training.

In 2010, I joined Canada Soccer's sports medicine committee. Our committee comprises cardiology, rehabilitation, sports physiology, orthopaedics, physiotherapy, emergency medicine, sports medicine and child neurology. We are advisory to Soccer Canada in medical affairs as they apply to our players.

On behalf of Canada Soccer, I am also a member of the federal, provincial and territorial concussion in sport working group, which has worked effectively to get sport, health, education and governments working in concert on concussion. Our chairs, Jocelyn East and Greg Guenther, will be presenting before this committee in an upcoming meeting. However, our sports medicine committee and Canada Soccer's focus is the nearly one million registered active participants within the 1,200 clubs that operate in 13 provincial and territorial member associations. In 2017, we had 640,000 youth players under 19 years of age registered to play soccer, of whom 40% are female.

Concussion is a significant acquired brain injury, whether acquired through sport, play, mishap or other ideology. Soccer concussions occur as the result of player-to-player collisions and aerial challenges. Our female soccer players are disproportionately exposed to this injury, with injury rates as much as 50% higher when compared to male soccer players.

Prevention is the key, but preventative efforts are in their infancy. We know that by keeping our goalposts anchored to the ground, the balls light and not overly inflated and the rules of the game enforced, there will be an impact on the incidence of brain injury.

Secondary prevention of the complications of concussion through the early recognition of potential concussion, removal from play, referral for diagnosis and the subsequent confirmation that a player is clear of concussive symptoms before they return to full game play is likely to ensure that this generation of players is much safer than the previous generation of players who played sport without these directives.

The concussion landscape is changing very rapidly in Canada. Canada Soccer saw the adoption of its first global concussion policy for the broader membership, subtitled “Players' Health and Safety First”, in 2016. As a team sport, Canada Soccer was excited to become compliant with the Canadian concussion guidelines in 2018, joining the nearly two dozen national sports organizations with a national standardized approach to concussion. No longer is there the variable patchwork of protocols for some sports at national levels.

Over the next year, we expect that our provincial soccer organizations will move to compliance with the Canadian concussion protocol, further expanding a consistent national approach to concussions.

Within the sports medicine committee, we continually monitor published and unpublished information about concussions in general and specifically brain injury in soccer, sharing the press and public's appetite to understand this injury. We also share the frustration that the necessary research to make the best evidence-based decisions for our sport and our players has been slow to arrive.

On behalf of Canada Soccer's sports medicine committee, I welcome your questions.

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