A Rant About Concussions in Hockey

You can’t watch a hockey game without hearing the word concussion at least 4-5 times.  Last night I was watching the Leafs lose to the Devils (ho HUM) and they referred to James Reimer’s return from “concussion-like symptoms”.  What the….?  I think you meant to say his return from concussion – it is not a dirty word, you can say it.  What the heck are ‘concussion-like symptoms’ anyway?  What next – ‘torn ACL-like symptoms’.

In my 15+ years in the industry I have worked with a lot of hockey players to help them achieve their goals.  You don’t help a player carry their hopes and dreams without becoming emotionally involved, you must care about the player, their success and their health to be good at this job.  So I have seen more than a handful of players suffer after concussion.

I have been on the bench as a trainer when a player takes a hit that looks like nothing at all, but ends up back on the bench acting goofy as can be with ‘concussion-like symptoms’.  I also know that players learn quickly what to say so they do not have to sit out.  It becomes a game to hide the symptoms from a coach or trainer because they want to play.  Heck, we want them to play – it would be much easier to bury our head in the sand and make believe that they ‘just got their bell rung’ than it would be to tell the kid to take a seat on the bench.

By now we know that the cumulative trauma of concussion has a compounding effect.  The first hit may be okay, the second, not too bad, but by the third, fourth, fifth…major trouble.  How many times where you rattled in the brain by the time you were 16?  Think of the cumulative trauma that a kid sustains during his or her minor hockey career.  This is before they even get up to the junior level where the players are bigger, faster and stronger.

I still get kids or parents who tell me – ‘oh, it’s okay – just got my bell rung a little’.  NEWSFLASH – saying you got your bell rung is the same as saying you got concussed.

Let’s Bust Some Myths About Concussions in Hockey…

• You do not have to hit your head to get a concussion – it is not so much the impact to the head that causes the brain trauma.  When the head is shaken the brain sloshes around inside the skull, bouncing off the bony structure causing injury to the brain.  You see the brain floats inside the skull in a fluid.
• A helmet can reduce the impact of direct blows to the head, but will not prevent the brain from getting rattled around.
• Different players have different tolerances to concussion – so just because a guy does not take a jaw shattering hit, that does not mean that he or she will not be concussed.
• There are no short cuts to returning from concussion – it takes time and patience.
• When you hear the term concussion, what you should be hearing is ‘brain injury’ – that’s what it is, so let’s call it by its proper term.

So, as a player, parent, coach or trainer let’s take a look at the signs & symptoms again these are from the Hockey Canada website…

Signs and Symptoms of Concussions in Hockey Players

And you do not need to wait for more than one symptom to present itself.  As the parent, coach or trainer, it is your responsibility to err on the side of caution, to do what is best for the athlete (even if it is the 17th minute of the 3rd period of the championship game).

Let me ask you a question…

A player has been concussed.  They felt a little dizzy after a body check, so you pulled them out of play.  The dizziness goes away in an hour or two and they feel completely fine.  When can they return to play?

If you answered anything less than ONE WEEK, then you get a big EENNNNNNNNNNNN (trying to sound like a buzzer there).  If a player has any symptoms of a concussion, then they have at least a grade one concussion and the earliest they should return is one week.  Here are the steps a player should take if they have sustained a concussion based on Hockey Canada’s guidelines…

What To Do If You Suspect A Concussion

• If there is any loss of consciousness, call an ambulance and assume there could be a spinal cord (neck) injury.
• Remove the player from the game/practice
• Do not leave them alone and document any signs or reported symptoms
• Make sure the coach and parents are aware of the injury – do not just let the player go home
• Have the athlete evaluated by a medical doctor – preferably a sport medicine specialist who may have experience with concussions.
• Once the player has received medical clearance they can start the return to play sequence:
  • Complete rest until symptom free
  • Very light aerobic exercise – walking or stationary bike
  • Light skating – no contact, no drills
  • Drills without contact – may incorporate light resistance training
  • Start drills with contact if cleared by medical professional
  • Return to play
• If at any point during this process a player experiences symptoms, then they must go back to the previous step.
• Players cannot go through more than one step in a day as they may feel fine during the exercise, but feel symptoms later in the day.

I hope you read this post and did not find it informative at all.  I hope you all knew this stuff and thought to yourself – ‘well d-uh’.  I hope I am preaching to the choir here about concussions in hockey….but just in case, I thought I should write it anyway.