Skip to main content

alt text

CEREBRAL

BY PAUL GAZZOLA

Dr.Dhiren Naidu is in a meeting room on the seventh floor of HYS Centre. He stares through clear-framed glasses, buttoned-up in a sky-blue dress shirt with small red paisley patterns under a grey tweed blazer.

In this setting, he's President of HealthPointe Medical Centre Dr. Naidu, who heads a physiotherapy and rehabilitation facility that provides treatment to patients with neck, back, knee, shoulder and joint pain, as well as soft-tissue issues and concussions. 

It's a recovery centre possibly similar to the one he found himself in when he was 19 and had just torn his ACL, undergoing his own rehabilitation and, at that time, discovering an interest in sports medicine. It was enough to prompt his entrance into the University of Saskatchewan's medical program then continue his education in Edmonton by undergoing his specialty, physical medicine and rehab, at the University of Alberta.

When he's not here tending to his patients, one might find Dr. Naidu, the University of Alberta Associate Professor in the Department of Medicine, Division of Physical Medicine and Rehabilitation, hosting lectures about the musculoskeletal block at the U of A during the months of December and January. If not heading a seminar on campus, he could be somewhere conducting research - another one of his duties as a prof at the university. 

If the lab lights are off, one might catch sight of Edmonton Eskimos Head Team Physician Dr. Naidu at Commonwealth Stadium or Golden Bears Football Team Physician Dr. Naidu at Foote Field. Not only does he diagnose Canadian Football League players and university athletes, but he sits as the Research Chair of the CFL and is a member of the League's Health and Safety Medical Advisory Board.

At 41 of 41 home games, Oilers Head Team Physician Dr. Naidu can be found sitting in the stands among Oil Country's faithful. He cannot, due to National Hockey League rules, be more than 50 feet from the playing surface because in the event that an injury occurs on the ice, the doc must be close to the action. This Dr. Naidu is also part of the NHL Team Physician Society and acts as an NHL Protective Equipment subcommittee member.

Wherever he finds himself, from medical centres to sidelines, ice rinks or seminars, Dr. Naidu takes great pride in his profession and strives to provide cutting-edge rehab and research to the Oilers, Eskimos, Golden Bears and the world of collision sports. 

"My role, when I get a player and they're hurt, is to diagnose and make up a treatment plan for them," Naidu, entering his 11th season as the head physician with the Oilers franchise, said. 

"Whether it's Connor McDavid or whether it's a junior player or call-up player, my role is exactly the same: it's to diagnose."

But Dr. Naidu, cerebral in every sense of the word, also puts his head towards research into concussion diagnosis, prevention and treatment, sharing his discoveries with both the athletes he medicates and the scientific community he's working to advance.

Like the team on the ice, there's a team off it. 

Dr. Naidu leads a group of specialists and therapists dedicated to ensuring the safety of Oilers players are the No. 1 priority. The healers collaborate when injuries are suspected or arise and communicate endlessly on game days. The Oilers Head Physician would be remiss if he didn't acknowledge his colleagues and the collaborative efforts they exert to administer proper diagnosis and treatment on a nightly basis.

"We'll have a total of two sport medicine docs at each game," Naidu, explaining the workflow of an Oilers match, began.

That could be Oilers Team Physicians Dr. David C. Reid, Dr. Jeff Robinson, Dr. Michael Wagner or Dr. John Clarke.

Robinson began his tenure with the Oilers in 2008. He, like Naidu, Clarke and Reid, serves as a physician with the Eskimos. He had also previously been involved as a doctor with many former Edmonton-area baseball teams including the Edmonton Trappers, Cracker Cats and Capitals.

If not Robinson working on game night, it could be Dr. Wagner, a sports medicine and family physician with a particular interest in working with high-performance athletes.

Hailing from Ireland, Dr. Clarke is a retired family physician that still practices sports medicine and had formerly worked with the University of Golden Bears Hockey program.

Then there's orthopedic consultant Dr. Reid, who started as a surgical consultant with the Oilers in 1988 and became a member of the medical staff in 1989. He was a physiotherapist before taking sports medicine and was the Oilers Head Physician before Naidu became part of the medical staff. Reid welcomed Naidu to the team in the 2005-06 season after Naidu worked the '04-05 NHL lockout with the American Hockey League's Edmonton Roadrunners.

"We really have docs that complement each other's skillsets," said Naidu. "My specialty is different than Dr. Robinson's. I'll have an expertise in certain areas and they will and we make sure we run things by each other."

The two sports medicine physicians present at Rogers Place on game nights will maintain communication with the rest of the medical team during games. Head Athletic Therapist T.D. Forss, Assistant Athletic Therapist Chris Davie and Massage Therapist Stephen Lines are wired with the physicians by radio, communicating constantly if an on-ice mishap occurs or is noticed.

"Our radios are attached to all the docs and to all the therapists," Naidu continued. "So, if T.D. is on the bench and he's like, 'Hey, you know what, I think this person might need you. Meet me in the dressing room,' then we'll go to the dressing room."

One physician watches the game from inside the Oilers Dressing Room to be near medical equipment. The dressing room doc will observe with four separate camera screens available, assisting in the inspection of certain collisions. Some are broadcast angles and others are in-house views.

"If I'm in the stands, and I say, 'Hey, Dr. Wagner, can you take a look, I didn't see this play. I think the player might have hit their shoulders into the board.' So, he'll go to the computer and say, 'Yeah, you're right Dhiren, or no, it was their stick.' We have four different camera angles that we can look at as docs," Naidu elaborated.

alt text

If an injury happens during the game, Naidu and the medical team will assess the skater right at that moment. The doctors are the first people a player sees after fans watch them will their way to the bench then retreat to the dressing room. Depending on the severity of the injury, support specialists are also present on game days to provide additional assistants. Emergency meds and orthopedic surgery consultants ready to step in should cardiac, airway or bone breaks and fractures occur. 

At intermission, Dr. Naidu and the physicians will converge in the Oilers medical room. It's a quiet retreat for the players during a hectic 60-minutes of action. Some of the players find solace in the med ward before returning to the ice.

"We really try to make the medical room very peaceful," Naidu said. "There are no coaches in there, there are no media in there, there's no pressure. When you come to the medical room - whether you're minus-three in a game or you have three goals - we treat you the same way."

After the game, skaters with active afflictions will be screened by the physicians and therapists. The night ends after the last hurting player has been assessed.

Early in his tenure with the Oilers, Naidu learned how important the team within the team is. He has no shortage of stories with his colleagues, from treating injuries to winning championships to joining special event medical staffs.

Like when Jarret Stoll was playing for the Roadrunners and had been cut on his calf, causing a gruesome injury that needed attention from every physician and trainer in the vicinity.

"There are some injuries where we definitely need all hands on," Naidu said, recalling the instance. "He was freaking out. He thought he was losing his leg and in that case, you've got to be pretty quick to rule out whether it's an artery that's bleeding, which is limb-threatening, or if it's just a cut. Luckily that was his and we cleaned it up and we settled him down."

Naidu was a member of the Esks medical team in 2005 when the organization won the Grey Cup, and Forss was the Head Athletic Therapist. That same season, Naidu, alongside Dr. Reid and Dr. Clarke, were in Carolina for the Stanley Cup Final.

"I thought, 'Oh jeez, we won a Grey Cup and then now we're in the Finals. It's going to be like this every year!'" said Naidu.

Two years ago, Naidu and Forss worked with Team North America at the World Cup of Hockey 2016 and just a few months ago, they travelled with the Oilers to Europe for the NHL Global Series.

Through all his years practicing sports medicine with the Roadrunners, Eskimos, Golden Bears or Oilers, Naidu can't help but praise the team within the team.

"I think just as the players are on a team, the medical staff is on a team. We make sure we're always communicating and we want to make sure players don't get confused with what we're saying. That's our team."

But when Dr. Naidu isn't with his respective sports teams, he's leading an innovative research one.

Ten years ago, Dr. Naidu wondered. 

As an associate professor at the University of Alberta, he questioned whether his lectures and seminars on concussions were resonating with the athletes attending them. Whether or not his audience was absorbing the information and whether or not that information was being put to use when those same athletes were affected by a concussion.

Naidu teamed up with a few U of A professors and graduate students to begin research on the unknowns of the injury because of the lack of scientific literature available. Research into the awareness, the attitudes, the rehabilitation and the recognition of concussions in competitors.

"I wondered, on all the concussion presentation we do, whether we're actually getting the message across to athletes," Naidu, explaining an early study, started.

"We took all the athletes including pro hockey, junior hockey, CFL and university athletes, and what we did was an educational presentation. We did a questionnaire before, a short one - like 15 questions - and one after. What we found was the athletes thought you needed to be hit in the head to have a concussion."

Concussions don't solely stem from head contact, Naidu explained. That misconception by the athletes, along with the belief that an MRI is needed to diagnose a concussion, set the research stage.

"That was an eye-opener," Naidu said. "So, now we have to change the way we teach people to make sure they know that yeah, you can get hit shoulder to shoulder and if your neck whips around, you can still have a concussion."

The findings from the study altered concussion diagnosis protocols. 

"It actually changed the way the baseline assessments are done now, which is kind of neat," said fellow University of Alberta Associate Professor and the Oilers designated neuropsychologist Dr. Martin Mrazik, who's conducted extensive research as a partner of Naidu's.

"Because of the interview effects, they tend to minimize how many issues they may be having. But if you have them just fill out a self-report questionnaire, they tend to endorse a few more symptoms."

Naidu, Mrazik and their research team then concentrated on athletes' attitudes towards concussion. What do they know and how did they learn it? Do they understand the symptoms, are they willing to report them and what are the reasons for why they wouldn't? Comparisons were made between junior athletes and pros, with some telling conclusions uncovered, deepening the pool of peer-reviewed publications.

"We said, 'OK, who knows more about concussion?'" said Naidu. "We felt that for the most part, the pro athletes knew more but the junior and university kids still knew quite a bit. Everybody kind of knew it wasn't good to have a concussion and they knew the symptoms but the junior athletes said that they would ignore their symptoms and play more."

The study found that 50 percent of junior athletes felt they needed treatment after experiencing a concussion whereas 100 percent of professional athletes would seek it.

alt text

"It either tells us a couple things: that they don't know or they're teenagers and teenagers just make bad decisions… or is this the fact that they just want to make it to the next level and they don't want to show they're hurt, whereas pros are there.

"The one thing that we found, though, is if athletes had had concussions in all three levels - whether it was junior, university or pros - then they were quite knowledgeable and they were more cautious. They learned more about it and they respected it more."

It was another analysis which yielded attention within the sports medicine community, proving that not all the information and education shared was being retained.

"That was published in the British Journal of Sports Medicine and was a pretty important article because it really showed that what we're doing is giving athletes a lot of information," said Mrazik, the lead author of the study. "But we have to be much more interactive and have to look at their attitudes and understand what leads athletes to report symptoms and why they would not report symptoms."

Another examination looked at the King-Devick Test, a sideline concussion assessment tool used in football. In 2015, the National Football League spearheaded a multisport conference in London, UK, inviting Naidu and Mrazik to a meeting with representatives from the NCAA, NHL, World Rugby, International Ice Hockey Federation, jockeys and many more. 

"Jockeys fall off horses 15 times a year, so they have lots of concussion problems," said Naidu. 

While at the symposium, the King-Devick Test was heralded as an effective diagnosis method, simple enough for youth sports coaches and parents to use on their own players and children. 

Naidu and Mrazik were apprehensive. Backed by the NFL Head and Spine Committee, the Oilers head physician was the lead author in exploring the test's applicability in concussion identification.

"It showed us that the King-Devick Test is useful but it's not one where you should buy off the street and say your kid has a concussion," said Naidu. "I think it was responsible in that way."

In October, Naidu chaired a similar forum featuring many of the same representatives from the previous NFL-led convention. This time, the CFL took the lead in facilitating the meeting. Discussions were had on concussion innovations and advances, as well as mental health and its connection to the injury, which is where much of the research is heading.

"I think there's something to be said about the genetic part of concussion," said Naidu, noting that there is research being done. "We shifted a little bit of the meeting to also look at pre-existing conditions or family history of conditions. We called those 'concussion modifiers' so if you have a history of learning disability, ADHD, migraine headaches, depression or anxiety then your concussions are probably a little bit different because you already have something going on in the brain."

Since 2012, Naidu and Mrazik merged to produce 16 peer-reviewed publications. They've helped unearth new insight and information in the sports medicine community, particularly regarding concussion prevention, treatment and diagnosis. Many of it within football but not necessarily exclusive to it.

"When we first started asking questions about what can we do in the field of concussions, there was a lot of unknowns about better ways to educate athletes, better ways to assess athletes and those type of things," said Mrazik.

"That was kind of our main goal: how can we do this better? We've come up with some pretty interesting outcomes."

Dr. Naidu's neurons fire at a higher rate. 

It's the only explanation for someone that holds so many titles, from president to head physician to associate professor to research chair to committee member and lead author. 

Like the neuron, the brain unit dedicated to transmitting information to other parts of the body, Naidu operates in a similar manner. He shares his research, treatment and diagnoses to the athletes and medical professionals he's surrounded by and is constantly moving, seeking a deeper perspective or discovery.

"The team's been very good at supporting any research we want to do or any state-of-the-art conferences we want to go to," Naidu, reflecting on his time with the Oilers, said. "That's helped me learn as a physician and obviously helps our athletes."

The central nerve stimulating the doctor is his wife, Allison, and six children. Three daughters and three sons - four hockey stars, a baller and dancer - all better off because of the work of their father. There's no stopping Naidu's impulse, as he's wired to advance concussion education, assessment, treatment and prevention.

"The thing about Dhiren is that he's an incredible person to work with because he's very smart but he's very humble," said Mrazik. "For me, I'm very fortunate to work with such a good thinker and good people person like that.

"When I look back, I'm very pleased that our affiliation and our work together has really contributed to the concussion literature and to the science behind it, and earned the respect, I think, in different professional sports."

VIEW MORE IN DEPTHS

Each and every second Sunday during the season we dig deeper into Oilers storylines with our long-form features.

VIEW MORE IN DEPTHS | RETURN TO EDMONTONOILERS.COM