Misinformation: Hockey

I must admit I am being a bit “Pollyannaish” about using the correct terms and classifications of concussions.  But seriously it needs to stop, for the sake of the kids and general public.  All these terms do is muddy the water about concussions.

Case 1: Chris Pronger – “Concussion-Like Symptoms”;

Pronger has what general manager Paul Holmgren called “concussion-like” symptoms and is out indefinitely.

Braydon Coburn, when asked whether it had been easier to wrap his head around just three more weeks without the captain as opposed to the “indefinite” absence announced on Friday, said: “I don’t know. I don’t even know what day it is.”

Case 2 (my biggest pet peeve): Daniel Paille – “Mild Concussion”;

Paille did not accompany the team to Columbus, Ohio, yesterday, remaining in Boston with a mild concussion, according to coach Claude Julien. Paille suffered the injury during the Bruins’ 2-0 loss to the Florida Panthers Thursday. Krystofer Barch was assessed a charging penalty on the play, but after seeing replays, Julien said he thought the check was clean.

Perhaps teams and players forget quickly, as Sidney Crosby was sidelined for 10, TEN, months with a “mild concussion”.  Stop minimizing the injury and treat it correctly;

Hogwash!  There is NOTHING mild about a concussion, period.  However media, teams, players and even medical staffs continue to use this nomenclature with this injury.  It is simply counterproductive to label this injury with a “mild” tag, and hampers the effort of everyone trying to increase awareness.

During my public speaking I often relate being “mildly” concussed to being “mildly” pregnant…  You are either concussed or not, just like you are pregnant or not.

8 thoughts on “Misinformation: Hockey

  1. Joe Bloggs December 10, 2011 / 11:44

    I want to know who the hell coined the term “concussion like symptoms.” – add that to Fetsivus. The person or people who are repsonsible for this non-sense will need to be held to account. I first heard the term from Pittsburgh Penguins reporatge but the Steelers also used it. No everyone is using it.

    Mild concussion is the type of nonsense one would expect of the Army Surgeon General and the Department of Defense. It tried to palm off blast injuries as sports concussions, serious, in their own right, but nothing in comparison to a blast.

    How about we drop the term concussion and use the appropriate term, “mild Traumatic Brain Injury.” That is what it is.

  2. BryanATC December 12, 2011 / 15:45

    I agree that using the term “Concussion like symptoms” is completely ridiculous. You either have a concussion or you don’t. Having suffered an incident that results in such symptoms lasting for more than a transient period of time is exactly that “A CONCUSSION”.

    Now as far as the term “mild concussion” is concerned, why does the adjective matter? Especially since there are always “grading” systems out there concerning concussions? Would you be happier if they said a Grade 1/2/3 instead of minor/moderate/severe?

    The reason for ever quantifying an injury with a level is to indicate the most likely amount of recovery time needed. Does that quantifying make the injury automatically heal that fast? No. All it does is hypothetically compare one injury to another. Regardless of medical knowledge a concussion that “knocks someone out” for several minutes is going to appear more severe (less minor) than one where they get right up but still experiencing neurocognitive symptoms.

    Now I agree, as it pertains to concussions that no injury is ever the same and sometimes “minor” ones can recover faster than “severe”. As long as the injury is being labeled as a “concussion” and following the appropriate management protocols for a “concussion” does it really matter what the adjective is?

    I’m guessing the annoyance with the use of the term “mild” is because it seemingly minimizes the potential injury. Even changing to the appropriate “Truamatic Brain Injury” doesn’t again using the term “mild” cause the same problem?

    • edc_atc December 12, 2011 / 19:38

      This is why dropping the adjective matters:

      1.2. Classification of concussion
      There was unanimous agreement to abandon the Simple versus Complex terminology that had been proposed in the Prague agree- ment statement as the panel felt that the terminology itself did not fully describe the entities. The panel, however, unanimously re- tained the concept that most (80–90%) concussions resolve in a short period (7–10 days), although the recovery time frame may be longer in children and adolescents.2

      Taken from page 756 of the Zurich paper…

    • Dustin Fink December 13, 2011 / 06:46

      well put edc…

      Not only does the term “mild” suggest a shorter recovery period, it also insinuates that this brain injury is “mild”. There is nothing mild about any brain injury. Some have suggested that the term concussion should be changed to mTBI, at least mild would be associated with brain injury.

      Also some say the the term mild relates to the symptoms, but what is mild to you is not mild to me. Making blanket statements about concussions have lead us to where we are now, misinformed. Exactly like the example of the grading system, there is no more grading of concussions.

      The overall theme is that concussions are not the same from person to person; therefore encompassing tags, “adjectives”, grading systems and blanket return to play mechanisms do not work. We are discussing brain injury, as a whole the medical and research community know very little about the brain. What we do know is that the neurology and function of the brain is extremely complex, there is nothing simple about it.

      • BryanATC December 13, 2011 / 14:03

        Quote “there is nothing mild about any brain injury”, so then “should be changed to mTBI, at least mild would be associated with brain injury”.

        So we should call all incidences of concussion/mTBI just that?

        mTBI with no LOC that results in headache, blurred vision, tinitis and nausea that resolves in 6 days.

        same as

        mTBI with 1 min LOC resulting in severe headache, severe photophobia, vomitting, anterograde amnesia and concentration problems taking 5 weeks to resolve.

        Classifying both of those injuries as exactly the same will do nothing but make the public think we are ridiculous. One is obviously more severe than the other, so why can’t an adjective be applied to each even if there is no definitely medical diagnosis to directly determine “minor/moderate/severe”?

      • Dustin Fink December 13, 2011 / 14:58

        I guess my simple answer is that every comcussion is different… Why did a minor concussion result in 10 months of missed action for Sidney Crosby? How about a concussion that had LOC with amnesia that resolved in 13 days?

        They are so different from person to person, a mild ankle sprain for you is relatively the same for me… That cannot be said about concussions…

  3. Pingback: Red Light » Posts Crosby again the face of the NHL’s entrenched concussion problem «
  4. NJ Blue82 December 14, 2011 / 15:59

    All the hand-wringing over why concussions seem to be happening with more frequency masks two points: (1) They are. Players are bigger and faster than ever before and (2) while the other equipment (elbow pads, shin guards, shoulder pads) has gotten bigger, harder and lighter, helmets have not kept pace.

    I’ve been playing hockey for 30 years – at nowhere close to the speed of the NHL – and (CCM anyway) helmets are about the same. They’re a joke for concussion protection; if they do anything at all, they might help a puck bounce off. If the NHL is serious about concussions, they’ll mandate helmets closer to the NFL’s since the NHL’s players are similar in size to many NFLers and are moving at a much faster pace.

    The helmet I use has a styrofoam interior and, as I understand it, that’s a one-hit-and-replace item since styro has no bounce-back. How many NHL players get a new helmet every night?

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