Friday, May 14, 2010

Hockey and brain injuries

The quote below is from BoC, sourced from a person discussing traumatic brain injuries and the game of hockey. I thought it was interesting, and it appeals to my sports injury-prevention interests, so I figured I'd let my reader(s?) take a look at it.

Author Bio: Chelsea Travers is an outreach representative for CareMeridian, a subacute care facility located throughout the Western United States for patients suffering from traumatic brain injury, spinal cord injury or medical complexities, such as neuromuscular or congenital anomalies.

Hockey and TBI

Hockey is arguably one of the most physical professional sports. Hockey players are constantly getting body checked, slammed into boards, falling to the ice, slapped by a stick, hit by a dense, speeding puck or getting punched during a fight. If that isn’t bad enough, hockey players take part in one of the longest regular seasons of any sport, effectively taking on harsher pain for a longer amount of time throughout the year. Risk of injury couldn’t be clearer as you all too commonly see hockey players missing their front two teeth. With all of the injuries that can occur, one of the most dangerous is a traumatic brain injury (TBI). A TBI is a silent injury that can cause harm to the mind and body of an individual. An injury to the head or brain can alter someone’s life and can even require long-term rehabilitation and care from a skilled nursing facility. These injuries are often far too common in the sport of hockey and if not properly treated can permanently leave a hockey player's life challenging than the game they play.

TBI is an injury that Philadelphia Flyers player Ian Laperriere knows all too well. In game 5 of an NHL playoff game with the New Jersey Devils, Laperriere took a slap shot to the face that immediately caused him to bleed excessively from the wound above his eye and lose sight. Laperriere was diagnosed with a brain contusion after having a MRI a few days later. While Laperriere may have originally thought that losing sight in one of his eyes was the worst of the two injuries, in reality the bigger concern could wind up being the long-term effects of the brain injury.

A concussions have been dismissed as minor injuries because the physical nature of most sports causes them to occur regularly, but, frequently occurring or not, they are still head injuries where the brain is forced to move violently within the skull and the way it functions could change permanently. When the brain moves in such a manner, it can bruise, bleed, and even tear, which can cause irreversible damage to the victim. For a sport like hockey, this type of injury is very common and unfortunately at times ignored. Many hockey players don't take into account the possible effects of the injury and because it might not seem like a serious problem exists at first, they keep on skating as if nothing occurred. Their unawareness of the injury makes the it so much more dangerous because a mild brain injury can turn into a life threatening injury in a very short period of time without seeking immediate medical treatment.

Studies by the National Academy of Neuropsychology's Sports Concussion Symposium in New York have shown that since 1997, 759 NHL players have been diagnosed with a concussion. Broken down, that averages out to 76 players per season and 31 concussions per 1,000 games of hockey. That is far too frequent of an occurrence for such a serious injury. It's a frightening statistic that should send up a red flag to hockey officials that actions need to be taken to further prevent this type of injury from occurring.

The best, and sometimes only, treatment for TBI is prevention. For the National Hockey League new rules are being considered that preserve the game but also help protect the players. Rule changes concerning blindside hits, rink size (which affects players' space from each other and their proximity to walls), and stronger helmet requirements all have been considered to help curb TBI and its effects. This demonstrates that the NHL is aware of the seriousness of the injury and is taking proactive steps to help prevent it from happening.

Hockey is one of the most popular sports in North America and has millions of people participating in it every year. Unfortunately, the sport comes with the risk of a TBI. With the right awareness of the injury and the necessary precautions in place, the game should be able to continue with players excited to lace up their skates and enjoy it.
Yes, that was long. If you didn't read it, here's the crux of the issue: Hockey players sustain a lot of concussions, concussions are really bad, and they are preventable.

There's a few ways of reducing the risk of injury, most of which would require fundamentally altering the game of hockey. One of those ways is removing hits, another is a rules change that slows the game, and another is playing with a marshmallow for a puck inside a rink of pillows. None of those options are realistic for a professional sports league that draws at least limited support because of its violence. The only viable solution, in my mind, is technology.

Looking back at Wayne Gretzky, it's now well known that his helmet wasn't really a hockey helmet. It was a broomball helmet, designed to keep the noggins of drunk college students safe while they lumber around an ice rink with brooms and a soccer ball while wearing sneakers. Ryan Smyth wears a slightly upgraded helmet today. Most players wear their chin straps so loose that their helmets fall off when they fall down, or rotate backward onto their necks when they throw their heads backward. Moreover, many players choose to play with absolutely no facial protection of any type, eschewing even the small clear visor that offers some protection to the forehead and eye region.

This is ridiculous.

If the NHL is serious about reducing injury, it doesn't need to focus on blind side hits. Fixing bad hits is one thing, but what if you could limit injury from blind side hits and nearly every other injurious action on the ice?

Improving helmets, and forcing proper usage, is a simple way to drastically reduce hockey head and facial injuries at every level of the game without requiring a fundamental change in the way the game is played. The NCAA mandates that the players wear cages, and play is halted if a helmet is lost, encouraging proper equipment fitment. The NHL loses nothing by forcing players to wear modern, carbon fiber/kevlar helmets with full face shields, except for a half second for the equipment to be removed before a fight.

Purists will, as they always do, whine about losing some "important" aspect of the game by adding a level of safety. But I disagree. Losing Kopitar, Crosby, Ovechkin, or Briere for a season because they got an errant high stick to the eye is far worse for hockey than requiring face shields. Having former players relegated to wheelchairs because they've severely damaged their brains in '70's-era equipment is far worse for hockey than requiring good helmets.

It's up to the NHL to do the right thing, or do nothing. But, like the NFL, the league risks creating a generation of brain damaged alumni if it continues to ignore the blatantly wrong safety practices it espouses.

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