Thursday, January 17, 2008

The Dreaded C-Word!

1) The C-word in hockey is of course 'Concussion! They seem to be both epidemic and mysterious. Many times they seem to go undetected, undiagnosed or linger beyond what most would assume. First we asked our resident medical expert Dr. Varga to enlighten us as to what this 'injury' actually is. The Dr. said they are now called, in medical parlance, "mild traumatic brain injury" or an (MTBI) He said its actually a "temporary loss of brain function" (Not to be confused with Chris Simon) This can be caused by either a direct blow to the head or by quick acceleration or deceleration forces that can't be absorbed by the brain's cerebral-spinal fluid cushion. Depending upon the severity the damage can be temporary or permanent.

2) One of the worse case scenarios involves something called Post-concussion syndrome". "In this situation concussion symptoms do not resolve for weeks, months, or even years, and the patient may have headaches, light and sound sensitivity, memory and attention problems, dizziness, difficulty with directed movements". Some players have retired prematurely due to this. Keith Primeau, Eric Lindros and Pat Lafontaine come to mind. Here is the key phrase that the Dr. used: " The most serious potential complication of concussion is second-impact syndrome (SIS). "Patients who receive a second blow days or weeks after a concussion, before symptoms from the first concussion have gone away, are at risk of developing this condition".

3) There in lies the crux of the issue. There has been a problem of denial by BOTH the league and its players, and as a result players have suffered probably needless additional injury. Why? The main problem is BOTH parties have incentive to NOT list these injuries as concussions For players, having a concussion seems to bring them a stigma. Especially if they have had more than one. Teams begin look at them as being damaged goods so the players may be reluctant to be classified as such. Some may even recall a few weeks back the jerk Colin Campbell stating that he thinks "many players are faking career-ending concussions to collect insurance". Perhaps Colin suffered a few concussions during his forgettable career and his statement is due to his own brain damage?

4) Teams naturally want their players back in action ASAP, and an injury labeled a concussion would likely mean MRI's, neurological exams, etc that could place the player on an extended leave. So both parties would seem to have incentive to play down this potentially dangerous injury. This as a result can and will possibly result in even a higher amount of damage being done. Its a quandary that needs to be changed.

5) The first positive movement in this seems to be coming from the NHL Players’ Association, which thankfully seems to be taking a new interest in the problem. Its probably not a coincidence that this came with the recent appointment of Lindros to the organization. Many might recall his battles with the Flyers and in particular Bob Clarke. Clarke, like Campbell thought his player was milking the injury and apparently was trying to influence the team's medical staff. This incensed the Lindros family and led to Eric's loss of his captaincy and eventual ouster from Philly. He was not the same player after those series of under/misdiagnosed/mis-treated concussions. If Lindros can manage to change the mindset of the players and thereby allow the Association to push for standardization of care of this ailment from ownership it will go a long way to solve this troubling issue. As with many things, the first step to solving a problem is admitting there is a problem!


Shmee said...

Its really sad to see players rushed along from concussions, though it frustrates me to see players still skating around with loose chinstraps. I know that its considered "old time" hockey to be tough,keep the visor off and the chip strap loose, but it strikes me as dumb. I wouldnt take chances like that with my life, especially after some of the incidents that have happened in recent years....and the Lindros drama, which you mentioned and which cut a promising career off.

How many times have we seen a player laid out on the ice after absorbing a hit, with their helmet lying a couple feet away? This might not always be because of loose chinstraps, but that certainly plays a part in it. Again, it seems like a stupid risk to take with a 200lb man barreling at you.

Ok, a little off topic, and rant over:)

Scott said...

I've got a pretty good 20 page paper on MTBI and sports that I wrote a few years back for a physiological psych class if you're interested. Not trying to sound like a nerd - but seriously, it's pretty interesting.


1) Scott: We're all Hockey Nerds here so no worries! We'd always welcome intelligent comment on the subjects we put out there. Feel free and add your 2 cents.
2) Shmee: You're correct, that players, even now on many/most teams, are rushed back into service long before they should be, leading to further/worse injury

The Dark Ranger said...

Do you think it's possible that Jaromir Jagr, Chris Drury, & Brendan Shanahan have UNDETECTED CONCUSSIONS? You don't talk about this in your post, and even more rare is the psychological coach disorder, the Renneyitis.



1) Dark: LOL! Sorry, no such rumors! Not a good weekend in Ranger country! A must win against Atlanta coming up.


Informative post guys!


1) Thanks Vlad!

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