Hundreds of thousands of concussions happen on an annual basis in Canada, most prominently in remote, rural communities. 

Unlike other injuries that might include a broken bone or a fracture, damage to the brain stays around longer and can result in a lifetime of repercussions. 

Much has been written about athletes who compete in sports where head collisions and concussions happen frequently such as hockey, rugby, football and boxing.  It should come as no surprise that athletes in these sports have a much higher exposure to traumatic brain injury

Repetitive traumatic brain injuries are linked to an increased risk of later-life cognitive impairment and neurodegenerative disorders, including CTE, otherwise known as chronic traumatic encephalopathy.  

One of the lesser known and rarely discussed aspect of repeated concussions and accumulative brain damage is what appears to be its common origin in too many cases –  intimate partner violence.  

According to a 2023 report by the YWCA, violence by an intimate partner causes more than 290,000 concussions among women, girls and gender diverse people in Canada every year. For one NHL concussion, it’s estimated that more than 7,000 women suffer the same injury by an intimate partner. 

Intimate Partner Violence and Traumatic Brain Injury 

Since 2015, cases of reported intimate partner violence in Canada increased up until 2022 when the trend stabilized. According to University of British Columbia professor Paul Van Donkelaar, many of those cases led to traumatic brain injuries – estimated to be anywhere from 35 to 80 per cent.  

“I came across this research through my partner who is also involved with it. I did my due diligence of looking up as much information as I could and there wasn’t much, if any. From there I used past research and tools I had when looking at young athletes who experienced brain damage and those who experienced intimate partner violence. As we know now, the evidence is clear, and it shows that there is a clear connection.”  

Donkelaar is a PhD and professor of health and social development at UBC and has been involved with this research for decades. His research specifically focuses on better understanding traumatic brain injuries caused by sports injuries and intimate partner violence.   

He is also a faculty member at the Djavad Mowafaghian Centre of Brain health.  

Intimate Partner Violence and CTE 

According to Donkelaar, studies are underway regarding a direct link between domestic violence, brain injury and CTE. CTE occurs after repeated hits to the head kill nerve cells in the brain, damaging required functions for a healthy life. 

For some, the abuse they face may come from a partner who is also suffering from the results of accumulative brain damage and possibly CTE. 

In the case of a person who is showing signs of CTE, Donkelaar stated that over time, the person no longer has the capability of performing everyday tasks. Heightened aggression, impaired judgement, memory loss, and depression are just a few of the many symptoms of CTE which, as of now, can only be diagnosed after death.  

“In the case of CTE, where there is a lot of damage that has been sustained for a long period of time, there is a challenge to do things that we might take for granted. That inability could show up as not being able to focus and frustration starts to build.”  

The Stigma of Victimhood 

One of the reasons why, according to Donkelaar, this issue isn’t spoken about is because historically speaking, it is challenging for women in a situation of intimate partner violence to get help.  

“We see a lot of it in the healthcare, law enforcement, and judicial systems where the stigma is engrained due to the patriarchy that exists, and many people blame the victim for not leaving when it’s never that easy.”  

He continues by saying there is a stigma present around women in abusive relationships. What happens behind closed doors is private and for many, domestic violence is seen as shameful. Feelings of shame and embarrassment are strong motivators to not speak up and get help, and so the abuse and brain injuries continue. 

Unlike those who suffer from concussions and traumatic brain injury because of participation in sports, women are often faced with impossible choices when in abusive relationships. 

Intimate partner violence survivors are often unaware they have sustained a brain injury, and with no coaches, team members or other supporters, they are unlikely to seek care. It is reported that up to 75% of women do not seek medical care for suspected brain injury. 

Watch the video below to understand symptoms of TBI. 

The Epidemic of Intimate Partner Violence 

Much attention has been paid to making collision sports safer; perhaps it’s time to start making people’s homes safer. To this end, 94 Municipalities across Canada have declared intimate partner violence an epidemic. 

If you or someone you know is coping with intimate partner violence, the situation can be delicate so tread carefully. If you have been assaulted and suspect a brain injury, head to your nearest hospital if possible, consult your primary care physician, or reach out to a health service provider you feel comfortable with. Call 911 if needed.  

Helpful Resources

Canadian Government Public Health Service Resources 

Guide to recognizing, understanding, and advocating on behalf of those affected by intimate partner violence related traumatic brain injuries. 

Shelter Safe – an online resource for women and their children seeking safety from violence and abuse. 

Women’s Shelters Canada 

Brain Injury Screening Tool 

If you know someone who is perpetrating the abuse, don’t look the other way. Ending sexual and domestic violence in all its forms is a shared responsibility.  

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