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In hockey, I'm skeptical the brain damage is done mainly by fighting. The force of being checked and your head and neck whiplashed is much, much more than the force from a punch thrown from a guy on skates.
Two guys colliding at full speed does much more damage than a punch.
There's consensus getting punched in the head does some damage. But how much is an open question.
There's some data indicating soccer players suffer mild brain damage from all the headers.
What about the simple act of running? Does that mild shaking and jostling of the head from running do a tiny amount of damage with each jostle? There's so much we don't know.
Most humans lose cognitive functioning with age. This happens to nearly all of us if we live long enough. Any activity that involves rattling your brain seems to accelerate this process. By how much we don't know.
A friend's father got early onset dementia. He was 49. He wasn't an athlete, just a regular guy. What caused that?
If you were going to get dementia at age 70, but played pro sports and got it at age 65 instead -- is that a fair trade-off?
One theory is that the brain trauma destroys neural connections. But like a spider web, the web still functions despite losing some strands.
But the natural aging process destroys neural connections in all of us. For people who've had brain trauma when younger, they don't have the same reserve capacity as a regular person. So when the normal neural loss from aging starts -- and it starts in your 40s I'm sorry to say -- they hit the wall earlier. They hit the point where the brain can't recruit reserve capacity or route around damaged areas earlier than the rest of us and start displaying overt cognitive deficits.
It's a tough problem. Mainly we need a better understanding of the brain and what happens when it suffers mild and moderate trauma. It's increasingly clear that cumulative sub-concussive events can cause serious damage. But what is the limit of sub-concussive? How small of a force can cause damage? We don't know.
But fissures have formed in the once-pristine NFL edifice. More than 2,000 former players are suing the league over head injuries, and what they were and weren't told about the long-term damage of concussions. Junior Seau, among the greatest linebackers in league history, committed suicide last spring and was later found to have a concussion-related brain disease. Seau's family this week filed a wrongful-death lawsuit against the league. A study released last week shows signs of an ailment similar to Seau's in five living NFL alumni.
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"There's an uneasy feeling around the NFL, because although the league is arguably more popular than it's ever been before, there are also these glaring areas of deep concern about player safety on the field, and the players' health off the field and after their careers are over," said Michael MacCambridge, author of "America's Game: The Epic Story of How Pro Football Captured a Nation."
"I'm convinced that the NFL gets it, and is working very hard to make the game safer. But if you're a fan, you have to be concerned about some of the trial balloons that have been floated: an 18-game regular season is not just a bad idea for the people who play the game and watch the game, it's also totally out of step with the cultural mood of the moment. You want to believe that the owners are guided not only by revenue figures but also the greater good of the game."
Therefore, Roger Goodell, a commissioner who somehow almost makes Gary Bettman seem likable, goes out and talks at length about the NFL's concussion problem during his annual State of the League address, but anyone paying the slightest attention sees that it's all lip service. Nothing he has to say, or will force the league to do, actually does anything to change the culture that lends itself so readily to the problem. Hall of Famers like Deion Sanders saying that guys who get concussions are just milking it to keep drawing a paycheck just underscores the horrible problem the league has with how it views injuries in general. That the horrific Dan Le Batard story of Jason Taylor just about dying, and playing with a catheter so as not to miss a single game, didn't scare anyone into action tells you everything you need to know about the problem, and the NFL's myopic approach to the issue — which is to say, not doing anything — is troubling to say the least.
Again, the NFL isn't doing anything now, but it's at least getting some wheels in motion on the matter. Over the weekend, it announced a partnership with General Electric to develop ways to better protect against concussions, and detect whether they've occurred. Part of that includes contributions of $50 million over the next four years. In addition, the NFLPA finally pushed through its efforts to have independent neurologists present on sidelines during games to better assess whether players have suffered concussions during play; this after a PA survey found that 78 percent of NFLers trust their teams' medical staff "not at all," and only 43 percent consider their trainers to be "good."
So what does all this have to do with the NHL? It only scores to underscore how little the League is doing with regard to the rash of head injuries now being suffered league-wide, and to change the culture surrounding it.
Might be helpful to know NASCAR has approved baseline testing as part of its medical procedure after the Dale Earnhardt, Jr. "rest" during the 2012 Chase
Columbus Blue Jacket prospect Wade MacLeod, playing for their AHL affiliate Springfield Falcons, suffered a seizure after being hit into the boards. Reported to be stable and alert at hospital.
Columbus Blue Jacket prospect Wade MacLeod, playing for their AHL affiliate Springfield Falcons, suffered a seizure after being hit into the boards. Reported to be stable and alert at hospital.
The good thing is (according to some tweet that I can't find now), convulsions are no worse than other symptoms in terms of severity.
Columbus Blue Jacket prospect Wade MacLeod, playing for their AHL affiliate Springfield Falcons, suffered a seizure after being hit into the boards. Reported to be stable and alert at hospital.
The mandatory postinjury sideline concussion assessment tool, instituted for the 2012 season along with a baseline test done during physicals at the start of preseason, will now be used in app form by all 32 teams, a method that was tried by a handful of teams in a pilot program last season. The hope is that being able to compare the results of a baseline test and a postinjury test side by side in real time will speed diagnosis and help doctors and trainers recognize when a player should be removed from a game. The league also plans to have independent neurological consultants on the sideline during each game to assist the team physician in diagnosing and treating players.
The players union, which had pushed strongly for independent doctors to be on the sideline, said it was encouraged by the technological advance the new test represented, but it still had questions about how much power the independent consultants would have to make decisions about players. The union wants the independent sideline concussion experts to have almost exclusive authority in detecting concussions and administering tests, in part because it believes team doctors are often busy attending to other injured players, while the concussion experts are there for one reason.
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The postinjury test is quick — it takes about six to eight minutes — and shares many elements with the baseline test to allow a comparison that might indicate a decline in function. Both include a section on the players’ concussion history and a 24-symptom checklist; players are asked to score themselves on a scale of 1 to 6 in categories like dizziness, confusion, irritability and sleep problems. Both note any abnormal pupil reaction or neck pain. There is a balance test and a concentration test, in which players, who are usually brought to the locker room to be evaluated, are asked to say the months of the year in reverse order, to recite a string of numbers backward and to remember a collection of words three times. Then they are asked to recall them again, without warning, at least five minutes later. The words and sequence of numbers may be changed from test to test, so players cannot memorize them from a previous test to mask concussion symptoms — a fact that has annoyed players, according to Dr. Margot Putukian, the director of athletic medicine at Princeton University Health Services and a member of the N.F.L.’s Head, Neck and Spine Committee.
On the postinjury tests, there is one different element: a series of five questions designed to test orientation and glean how confused a player might be at that moment. They are: Where are we? What quarter is it right now? Who scored last in the practice or game? Did we win the last game? Those questions, known as Maddocks questions, were developed in the 1990s by an Australian doctor who worked with players in Australian rules football.
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The tests are far from perfect tools for diagnosing concussions. Some doctors are concerned the N.F.L. tests are trying to reduce concussion evaluation to ticking items off a checklist, a problem Putukian acknowledged, emphasizing the importance of having doctors familiar with the players evaluate them. ...
Last edited by LadyStanley: 02-27-2013 at 04:13 PM.
Something has changed. The broadcast I witnessed today I thought was really emphasizing the violent more physical aspect of hockey. The music was loud and tinny. The entire production felt garish. I watch a hit to the face not get called.
It was a pretty chippy game. Then when you get a comment like: "he bounced back wonderfully" it made me think of a rubber toy. This doesn't feel like the same hockey.
Touch screen tablet computers have given brain injury patients who have trouble speaking new ways to communicate at a fraction of the cost of speech synthesis equipment common just a few years ago.
The many medical uses of iPads and other tablet computers were showcased before some of the top brain experts in the nation, who gathered Friday for the Third Annual Santa Clara Valley Brain Injury Conference.
Canadiens' Blake Geoffrion, 25, informs team he plans to retire after serious head injury (including concussion) suffered this past fall playing in AHL.
For the first time in over 15 years, the American Academy of Neurology (AAN) has issued a revision to their standard guidelines for sports-related concussions. Despite endorsement by the National Football League Players Association, they are not endorsed by North American pro hockey organizations.
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It should be noted that while these guidelines were developed by a panel assembled by the AAN and are endorsed by other professional societies as well as the National Football League Players Association (NFLPA), they have not yet been endorsed by any professional hockey league or hockey players’ association, including the NHL and the NHLPA, which use their own evolving protocol.
It should also be noted that the new guidelines do not address the disease widely associated with repeated head injury and found in the autopsies of former NHLers Bob Probert, Reggie Fleming and Rick Martin, chronic traumatic encephalopathy (CTE). According to review co-author Jeffrey Kutcher, MD, of the University of Michigan in Ann Arbor, this is because these are evidence-based guidelines, and CTE is “an anecdotal diagnosis” supported only by case reports at this point.
One thing I will say is the players who turn their backs to opposing players who are coming in for a hit along the boards just to draw a penalty, should get a game misconduct and a suspension, because those are the IDIOTS who get half of the concussions. I have NO sympathy for stupid players who do that and get concussions at any level of the game! This is the play that needs to be eliminated from hockey. It's a cowardly play and a disgrace to the game.
An anecdotal account from Gulli (2011) reported that former professional hockey players experienced symptoms of depression, anxiety, and in some cases suicidal ideation after suffering a concussion. In partial support of this finding, functional magnetic resonance imaging scans of concussed individuals have indicated similar neural responses in brain areas commonly linked with major depression (Chen et al. 2008).
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..described challenges with his daily life, and certain endeavors in his post-athletic career.. wondered aloud during the interview, was whether his inability to recollect details such as names and phone numbers resulted from concussions or a natural aging process.. noted that multiple concussions altered his mood and he “became a different person.” He suggested that this altered mood contributed to his failed marriage.. was visibly frustrated with the quality of care he received from inside the game (i.e., team, league), and had it not been for what he called “chance encounters” with caring medical professionals, he feared things may have turned out much differently. Specifically, he admitted he contemplated taking his life as a result of his concussions and the ongoing pain he experienced from his headaches.. all five of the participants said they still experienced concussion symptoms (4–14 years after retirement) in their day-to-day lives..
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noted, “There aren’t too many days that go by where I don’t have some type of discomfort in terms of headaches or head pressure. I don’t think it will ever resolve.. You’re on your own little island. . . . You’re not really around the guys because the team doesn’t want you around the guys. They don’t want injured guys around. They don’t want that epidemic around and you’re cast aside.. I was at the point where I’d be driving along and would think about going full speed and hitting the wall. Just end it. The pain was unbelievable. I had headaches every day for a minimum of three and a half years. Not just a little headache where you want to take an aspirin. I almost wanted to scream. If I had a day off
from my headaches it was like I won Super 7. I was ecstatic, I could see, I could think..
Br J Sports Med. 2013 May 1. [Epub ahead of print]
A systematic video analysis of National Hockey League (NHL) concussions, part II: how concussions occur in the NHL.
Hutchison MG, Comper P, Meeuwisse WH, Echemendia RJ.
David L. MacIntosh Sports Medicine Clinic, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada.
This work aims to describe how concussions occur in the National Hockey League.
Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006-2010 seasons. Digital video records were coded and analysed using a standardised protocol.
88% (n=174/197) of concussions involved player-to-opponent contact. 16 diagnosed concussions were a result of fighting. Of the 158 concussions that involved player-to-opponent body contact, the most common mechanisms were direct contact to the head initiated by the shoulder 42% of the time (n=66/158), by the elbow 15% (n=24/158) and by gloves in 5% of cases (n=8/158). When the results of anatomical location are combined with initial contact, almost half of these events (n=74/158) were classified as direct contact to the lateral aspect of the head.
The predominant mechanism of concussion was consistently characterised by player-to-opponent contact, typically directed to the head by the shoulder, elbow or gloves. Also, several important characteristics were apparent: (1) contact was often to the lateral aspect of the head; (2) the player who suffered a concussion was often not in possession of the puck and (3) no penalty was called on the play
The incidence of concussion in professional and collegiate ice hockey: are we making progress? A systematic review of the literature.
Ruhe A, Gänsslen A, Klein W.
The fast, random nature and characteristics of ice hockey make injury prevention a challenge as high-velocity impacts with players, sticks and boards occur and may result in a variety of injuries, including concussion.
Seventeen studies met the inclusion criteria. The heterogeneous diagnostic procedures and criteria for concussion prevented a pooling of data. When comparing the injury data of European and North American or Canadian leagues, the latter show a higher percentage of concussions in relation to the overall number of injuries (2-7% compared with 5.3-18.6%). The incidence ranged from 0.2/1000 to 6.5/1000 game-hours, 0.72/1000 to 1.81/1000 athlete-exposures and was estimated at 0.1/1000 practice-hours.
The included studies indicate a high incidence of concussion in professional and collegiate ice hockey. Despite all efforts there is no conclusive evidence that rule changes or other measures lead to a decrease in the actual incidence of concussions over the last few decades. This review supports the need for standardisation of the diagnostic criteria and reporting protocols for concussion to allow interstudy comparisons in the future.
If they really cared, there would be a mandatory 4-6 week recovery period after a concussion. This has been conclusively shown to lower the reoccurrence rate going forward. Everything else is B.S., they (NHL and owners) don't give adequate recovery time because it might cost them money.
If they really cared, there would be a mandatory 4-6 week recovery period after a concussion. This has been conclusively shown to lower the reoccurrence rate going forward. Everything else is B.S., they (NHL and owners) don't give adequate recovery time because it might cost them money.
And the long history of players playing "through" concussions to be considered "manly" and tough.
Times change.
Perhaps there will be a mandatory "sit out period" once a concussion has been diagnosed.
But as can be seen with Crosby and even Pronger, is there really a "set time"? It's really on each individual and how they recover.
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