Concussion knowledge and awareness among Indigenous ice hockey players

Background: Despite being a significant public health concern, concussions remain a poorly understood neurological injury. In contact sports, such as hockey, concussions frequently occur, yet there remains limited understanding regarding the specific effects and prevalence of concussions. Unidentified and underreported concussions heighten the risk of reoccurrences, potentially resulting in severe traumatic brain injury (TBI), second impact syndrome with profound neurological deficits, or even death. Indigenous (First Nations, Inuit, and Métis) youth face unintentional injuries at rates three to four times higher than the national Canadian average. In a sports landscape that is becoming more inclusive and diverse, it is vital to recognize the growing number of Indigenous athletes and prioritize ensuring equal access to resources, including education. This highlights the need for further research and increased awareness in this specific population. Objectives: This thesis evaluated the current knowledge and awareness Indigenous ice hockey players have regarding concussions and identified barriers to reporting and recovery. Additionally, it explored how Indigenous knowledge systems and cultural practices can be integrated into concussion education and management. Methods: A qualitative questionnaire was developed and administered to 48 Indigenous hockey players aged 15–24. The study wove together Indigenous and mainstream knowledge systems using a Two-Eyed Seeing framework. Thematic analysis was used to identify key patterns in participants’ experiences, understandings, and support systems related to concussion. Results: The results showed that while most participants could identify common concussion symptoms and had received some form of education, many still chose not to report injuries. Participants expressed a strong need for mental health support and highlighted the importance of traditional healing practices, guidance from Elders, and spiritual wellness in recovery. Conclusion: This study highlights the need for culturally responsive concussion education tailored to Indigenous athletes. Incorporating Indigenous healing practices, community involvement, and land-based approaches into concussion management can support a holistic recovery. Using the Two-Eyed Seeing approach, this research advocates for more inclusive, culturally grounded strategies in sports and healthcare. By centering Indigenous perspectives, it aims to improve concussion outcomes and support Indigenous athletes in recovering safely.