Concussions in Hockey
Kyle Johnson Concussions In Hockey The sport of hockey is an intense test of power and will, and as a result of the injuries in sport are common realities that players and coaches are faced with. Among these injuries are concussions, arguably the worst injury of all. A significant blow to the head that causes the brain to shake in the skull and sometime even swell causes a concussion. These serious and sometimes life threatening injuries have always been a part of hockey, and up until a few years ago, little was being done to combat the cause.
Although great strides have been made to help athletes recover from a concussion, the question arises, why are hockey players so susceptible to these terrible head injuries in the first place? From that question we can categorize sub questions that will help us determine whether or not this rapidly increasing injury can be stopped, or at least reduced in all levels of hockey. Speed, strength, as well as player height and weight differentials are often blamed for the recent outburst of concussions in hockey. These are variables that cannot be interfered with in order to protect the core values of being a hockey player.
Therefore, we must find a way to eliminate the injury without ruining the integrity of the sport. Rules such as no-touch icing, elimination of head shots, hits from behind and blindside hits are just some of the ways the NHL has decided to help battle concussions. These rules have not all been approved as of yet, but specialists anticipate a drop in concussions once they have been approved and integrated into the game; however, many remain skeptical. Player equipment is another variable that could be improved in order to reduce the amount of concussions in sport.
Equipment changes such as mandatory full-face shields and elimination of plastic or hard material covering shoulder and elbow pads are other solutions that may possibly reduce the risk of concussions. In order to combat a concussion, we first have to understand what a concussion is and how it affects players. We must also familiarize ourselves with what the NHL is doing properly in the fight against concussions and what they can do better to initiate a decrease in the amount suffered every year. The term concussion describes an injury to he brain resulting from an impact to the head. By definition, a concussion is not always a life-threatening injury, but it can cause both short-term and long-term problems. A concussion results from a closed-head type of injury and does not include injuries in which there is bleeding under the skull or into the brain. A mild concussion may involve no loss of consciousness (feeling “dazed”) or a very brief loss of consciousness (being “knocked out”). A severe concussion may involve prolonged loss of consciousness with a delayed return to normal.
In 2010, the American Academy of Neurology called for any athlete suspected of having a concussion to be removed from play until a physician evaluates the athlete. Upon return they have implemented a unique and universal 4-step plan: 1. Remove the athlete from play. 2. Ensure that a health care professional experienced in evaluating for concussion evaluates the athlete. Do not try to judge the severity of the injury yourself. 3. Inform the athlete’s guardians or spouse about the possible concussion and give them the fact sheet on concussion. 4.
Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says they are symptom-free and it’s OK to return to play. (American Academy of Neurology, 2011) A repeat concussion that occurs before the brain recovers from the first – usually within a short period of time (hours, days, or weeks) – can slow recovery or increase the likelihood of having long-term problems. In rare cases, repeat concussions can result in edema (brain swelling), permanent brain damage, and even death. AAN, 2011) A concussion is detrimental to the progress of young hockey players and can be career threatening for professionals. Like all sports, the ability to think the game and mentally prepare is arguably the most important aspect. After suffering a concussion, players often explain to doctors and trainers feelings of cloudiness and the inability to think without distraction. As a result this can lead to a decrease in major areas that directly correlate to player performance. The NHL implemented a new policy for “in game” concussion testing.
During a game, a player that is suspected of having a concussion will be removed from the game and sent to a quiet place free from distraction so the on-site team physician can examine them. The physician will then apply the SCAT (Sports Concussion Assessment Tool) test to evaluate the player, and determine whether or not he has been concussed. In the past, players were simply assessed on the bench by the team’s trainer. If it is determined that the hockey player has indeed suffered a concussion, the player is immediately sent for observation and testing at a hospital or private clinic.
Rest is recommended and athletes are not allowed to return to game play until they are symptom free. There are however, certain steps to be followed upon a player return to practice and game play. The following is a mandatory 6-step process used by trainers, physicians and coaches to determine the readiness of a player who has suffered a concussion. Step 1: No activity, only complete rest. This means no work, no school, and no physical activity. When symptoms are gone, a physician must be consulted. The physician will be able to clear the player to slowly return to some activities.
Step 2: Light aerobic exercise, such as walking or stationary cycling. Someone who can help monitor for symptoms and signs should supervise the player. No resistance training or weight lifting. The duration and intensity of the aerobic exercise can be gradually increased over time if no symptoms or signs return during the exercise or the next day. Symptoms? Go back to Step 1. No symptoms? Proceed to Step 3 the next day. Step 3: Sport specific activities, such as skating can begin at step 3. There should be no body contact or other jarring motions such as high-speed stops. Symptoms? Go back to Step 2. No symptoms?
Proceed to Step 4 the next day. Step 4: Drills without body contact. Symptoms? Go back to Step 3. No symptoms? Read below: The time needed to progress from non-contact exercise will vary with the severity of the concussion and with the player. Proceed to Step 5 only after medical clearance. Step 5: Begin drills with body contact. Step 6: Game play Please remember: these steps do not correspond to days; it may take many days to progress through one step, especially if the concussion is severe. As soon as symptoms appear, the player should return to the previous step and wait at least one more day before attempting any activity.
The only way to heal a brain is to rest it. Never return to play if symptoms persist. A player who returns to active play before full recovery from the first concussion is at high risk of sustaining another concussion, with symptoms that may be increased and prolonged. Although this is not the exact NHL protocol for returning to game play, it is similar and represents the same idea. The protocol represented is strong enough to ensure player safety upon return. However, athletes must remember that after suffering a head injury like a concussion, you become more susceptible to future concussions.
As mentioned previously, it is common for players to receive more than one concussion after their first. The problem the NHL is faced with is how to manipulate certain aspects of the game in order to reduce the amount of contact to a player’s head. General managers of every NHL club often meet and discuss this problem and the media has called these meetings “head shots meetings”. Although the effort put forth is commendable, there are certain rule changes that have not been implemented that may decrease the amount of headshots resulting in concussions.
The NHL is testing 3 major rule changes that will hopefully diminish headshots from the sport of hockey. One rule change that is being tested is what constitutes icing, and how to eliminate the race to the puck among players. This rule change will eliminate any player race to the boards at full speed, which can hopefully stop all injuries due to the infamous icing race. Skating at full speed towards the boards is dangerous even before you add the second player charging behind you. This rule should be passed within the next year to eliminate all icing related concussions.
The variables changed in this case will not have a direct result in a team winning a game. A headshot in hockey is when a player from an opposing team targets a player’s head and uses blunt force with a shoulder, elbow or hands to separate the man from the puck. For obvious reasons the NHL deemed this illegal in 2010 and has done a commendable job enforcing this rule. Over 20 regular season suspensions have been handed out this year to show players that this will no longer be tolerated in the sport of hockey. This was a good start to putting a stop to the increase in concussions in hockey.
A blind side hit in hockey occurs when a player hits an opposing player while he or she isn’t looking. The term “blind side” refers the player’s inability to see the hit coming. This type of hit is the reason that NHL power forward Sydney Crosby has been sidelined for almost half of a regular NHL season. It was after his hit that the league started looking at better ways to combat concussions in hockey as losing the games best player had put the NHL under a spotlight for athlete injury. Another area the NHL must look at in order to decrease the amount of concussions is the protective equipment that is currently being used by the players.
The first piece of equipment to be analyzed is the most important, the helmet. The protective shell on a helmet is composed of hard plastic and rarely breaks or cracks from trauma. The reason most hockey players become concussed after a hit to the head is due to the face shield. If a player has no face shield on, then the forehead, temple, and mandible (jaw bone) are all exposed and vulnerable to be hit. In a recent study, Dr. B. W. Benson from the British Journal of Sports Medicine found that the use of a full-face shield does in fact decrease the amount of concussions in hockey.
Players who wore half face shields missed significantly more practices and games per concussion (2. 4 times) than players who wore full-face shields (4. 07 sessions (95% confidence interval (CI) 3. 48 to 4. 74) v 1. 71 sessions (95% CI 1. 32 to 2. 18) respectively). Significantly more playing time was lost by players wearing half shields during practices and games, and did not depend on whether the athletes were forwards or defense, rookies or veterans, or whether the concussions were new or recurrent. In addition, players who wore half face shields and no mouth guards at the time of concussion missed significantly more playing time (5. 7 sessions per concussion; 95% CI 4. 40 to 6. 95) than players who wore half shields and mouth guards (2. 76 sessions per concussion; 95% CI 2. 14 to 3. 55). Players who wore full face shields and mouth guards at the time of concussion lost no playing time compared with 1. 80 sessions lost per concussion (95% CI 1. 38 to 2. 34) for players wearing full face shields and no mouth guards. (Benson, 2002) It is understood that if people are unable to see the faces of the players than it could be bad for marketing in most hockey leagues.
When the time comes the NHL will have to answer the following question: “Is the amount of money made from players not wearing face shields more important than player safety? ” Other protective gear players wear that may cause an injury to opposing players are shoulder pads and elbow pads. These items are usually made with a hard plastic and can cause sever trauma if used to hit another player. In a perfect world the head shot rule would eliminate the need to change these materials in players’ protective equipment. If a ofter, more forgiving material was used that was still strong enough to put up with the wear and tear of hockey, some concussions may be avoided. Although this theory has yet to be tested, one can imagine that it would cause more injury if one were hit with a hard plastic shell then dense foam or rubber. Aside from protective equipment, rule changes, penalties and suspensions, there is one element that can completely eliminate concussions in the sport of hockey. Players in hockey today are bigger, stronger, faster and more agile. These are factors that must be respected.
Respect can present itself in many forms in hockey. Don Cherry is a sports analyst for CBC and has had coaching and playing opportunities in the NHL. He has created many videos called “Rock em Sock em” that feature players for their hits and fights over the course of an NHL season. In these videos he encourages hitting players to hurt them. He also talks about how in hockey you should have the mentality that if someone isn’t expecting a hit; you hit him or her to let him or her know you’re there. This is the exact mentality hockey has to separate itself from.
Respect among players is the one key element that no rule or change in the game can fix. It has to come from within the game and the NHLPA (National Hockey League Players Association). Respect can be shown when a player doesn’t have the puck but also when they do. If you see a player carrying a puck and you have the opportunity to hit them to gain control of the puck, you should do so. The fact that you should hit the player does not mean that you have to try and hurt them. If what you are trying to accomplish is separation from the puck then a thunderous body check isn’t necessary and shouldn’t be tolerated by any player.
For example, if a player is skating full speed along the boards, has his head up and passes the puck in order to not get hit, then what is the point in finishing the check on that player other than to hurt? Hockey is a contact sport and should remain so. Injuries are going to happen to almost every player who plays but the frequency of serious injuries resulting from the lack of respect between the players at the highest level of hockey is growing all in the name of “winning”; which is the real problem that needs to be addressed by the league, the organizations, and the players.
Concussions in hockey have quickly become an overwhelming negative aspect in the game of hockey and although the NHL is trying to combat the problem, more can be done. Changing certain rules to manipulate the player’s ability to injure one another is one way the NHL has stepped in to stop this problem. Concussions in hockey are often caused by player negligence and could be avoided if players would eliminate the “hit to hurt” mentality. However, The NHL has done a good job trying to implement new rules that will save players from being put in vulnerable situations that may cause injury to the head.
If every measure possible was taken to reduce concussions in hockey the sport may look different, maybe even for the better. Hopefully it doesn’t take a life ending hit for the NHL to make sure they are taking the appropriate measures to eliminate this black cloud which is being cast over such a pure game. References Agel, J. , & Harvey, E. J. (2010). A 7-year review of men’s and women’s ice hockey injuries in the NCAA. Canadian Journal of Surgery, 53, 319-327. Retrieved from http://go. galegroup. com. libdbauth. nait. ab. ca/ps/i. do? &id=GALE%7CA238271000&v=2. &u=naitl_main&it=r&p=SPJ. SP12&sw=w Benac, N. (2011). American doctors urge medical evaluations for all concussed athletes. 183(1), Canadian Medical Association Journal, E29. Retrieved from http://go. galegroup. com. libdbauth. nait. ab. ca/ps/i. do? &id=GALE%7CA246449190&v=2. 1&u=naitl_main&it=r&p=SPJ. SP12&sw=w Benson, B. W. , Meeuwisse, W. H. , & Rose, M. S. (2002). The impact of face shield use on concussions in ice hockey: A multivariate analysis. (original article). 36(1), British Journal of Sports Medicine, 27. Retrieved from http://go. galegroup. om. libdbauth. nait. ab. ca/ps/i. do? &id=GALE%7CA83448630&v=2. 1&u=naitl_main&it=r&p=SPJ. SP12&sw=w Benson, B. W. , Burke, C. J. , Kang, J. , Meeuwisse, W. H. , & Rizos, J. (2011). A prospective study of concussions among national hockey league players during regular season games: The NHL-NHLPA concussion program. 183(8), 905-945. Retrieved from http://go. galegroup. com. libdbauth. nait. ab. ca/ps/i. do? &id=GALE%7CA257125571&v=2. 1&u=naitl_main&it=r&p=SPJ. SP12&sw=w Benson, B. , Emery, C. , Goulet, C. , Hagel, B. , Kang, J. , McAllister,