Even after suffering three concussions — two of them on ice — competitive hockey player Ryan Sutton still felt pressure to stay in the game.

Despite the seriousness of his injury, the 22-year-old told Cross Country Checkup host Duncan McCue, that he felt alienated from his teammates because they didn't appreciate the gravity of a concussion.

But when Sutton suffered his fourth blow to the head during a pickup hockey game, and began to experience dizziness and vision problems, he gave up his favourite sport.

"I had to make that decision. I was told by a doctor that I couldn't play competitive, contact sports anymore," he said.

Concussions in competitive sports reentered the arena last week after the NHL agreed to a tentative settlement with 318 former players who have suffered long-term effects from concussions sustained during games. The NHL acknowledged no responsibility.

According to young athletes and parents who spoke with Checkup on Sunday, a stigma surrounds a concussion diagnosis, leading players to stick with games despite the dangers.

I just I knew that if I kept playing, I wouldn't be able to finish my studies at school. - Emily Kananoja

Sutton, who studies sports management at Brock University in St. Catharine's, Ont., founded Headsup, an organization that advocates for concussion awareness.

"It's empowering in a way to get people to tell their stories, and it just brings more information and knowledge out there to people that otherwise wouldn't have known it," he said.

An easy choice

The decision to leave the game was easy for soccer player Emily Kananoja.

After her third concussion in as many years — the last from being hit in the head with a soccer ball — Kananoja hung up her cleats in 2017.

"I just I knew that if I kept playing, I wouldn't be able to finish my studies at school," she told McCue.

"It's hard to think of going back into a game and knowing your last concussion kept you out for months just from being hit in the head with the ball, so what happens if it's something worse than a hit to your head?"

Emily Kananoja played competitive soccer with the Ryerson University Rams but quit in 2017 after a third concussion. (Alex D'Addese/Ryerson Rams Athletics)

Kananoja still experiences symptoms of her concussion. The Toronto university student wears special glasses to help her eyes focus and she has headaches as a result. She also struggles with anxiety when it comes to playing other impact sports.

But she's optimistic about the increase in concussion awareness since her first diagnoses four years ago, especially with the introduction of Rowan's Law in Ontario — legislation designed to protect amateur athletes from head injuries and educate coaches on the dangers.

The legislation is named after Rowan Stringer, who died in 2013 as a result of head injuries sustained during two separate rugby games.

Conflicted feelings

Despite the apparent dangers of concussions, the decision to leave a sport because of its threat isn't cut and dry for many.

Kathleen Stringer, mother of Rowan Stringer, told Checkup that she felt conflicted about whether she should have pulled her daughter out of rugby.

"Rowan, from a really young age, had to be active ... She just thrived on very physical games," Stringer said.

I would say that — knowing all these things — that yes I would put her in rugby if I knew what I knew now. - Kathleen Stringer, mother of Rowan Stringer

"I did see that it [rugby] was a rough sport, but if the game is played properly, and you wrap your arms around someone's legs ... it can be a safe game to play."

Stringer says that rugby teams have made efforts to ensure the game is safe, and that's where other amateur sports teams should focus their energy.

"We need to look at [concussion] detection and removal from play," she said.

"I would say that — knowing all these things — that yes I would put her in rugby if I knew what I knew now."

Written by Jason Vermes with files from Bria John