The real job of this author not only includes being an athletic trainer for a local high school, but also doing rehabilitation on the entire spectrum of the population. However, from time-to-time I am called upon to be a physician extender in a sports medicine doctors office. The past few weeks I have been doing that more frequently and have noticed a very surprising trend.
Granted there is no “scientific evidence” of this trend, rather just my observation and upon asking questions to the doctor and the rest of the regular staff, they too have noticed relatively the same thing.
As we have progressed in the concussion era the doctor that we work for has been near the front on the concussion issue. To his credit he used all the resources in the program to develop this progressive attitude and has taken all of his information along with others and developed a comprehensive concussion program. When he started many, including some athletic trainers in the sports med program were in disagreement with the longevity and “conservative” nature of the treatment/management. That quickly subsided with much of the evidence we have seen in the recent year, but it never really translated to acceptance among local coaches, school administrations, and players/parents.
All of the original skepticism about concussion care has slowly been washed away and this doctor has been accepted as one of the “go-to” guys in the area for this injury. This is not the trend I speak of, although it is very nice to see; all the hard work of the athletic trainers has begun to sink in.
Rather the trend I am beginning to see is something mirrored in the national/international press regarding professional sports concussions. What once was thought of “minor” and nothing more than an injury that could be handled without consult has completely changed for one particular sport. That sport is hockey, and I truly believe it has a lot to do with what is happening at the professional level.
In the office we would rarely – by rarely I mean never – see hockey players for concussions. That patient population has exploded, along with that, so has the acceptance and agreement on how to handle this injury. A little as a year ago only the most difficult cases stumbled in for management, usually at that time a very difficult recovery. Now players and their parents are coming in when the injury first happens. It is not a massive amount of people, not like there is a “scare”, rather the expected number of athletes compared to the other sports in the area.
What has struck me the most is the overall agreement and understanding of how this injury is to be treated. I previously worked with a hockey patient that was rather non-compliant with the orders of the doctor and wanted to rush back to the ice. Needless to say the outcome was not good, since that case last year it has completely changed. Now players come in to confirm their “self-diagnosis” (most hockey clubs (all) do not have athletic trainers, only parents and coaches to tend to injuries in this area) and get the proper treatment for concussions.
What once was a burden to sit out a period of time, now has been met with relief and optimism of full recovery. Hockey players and their infamous parents are much, much, much more accepting of the time off married with the graded return to play. In most cases this means missing serious ice time, a precious part of the hockey world.
As the NHL stars go out with injuries and prolonged recoveries we have observed the same exact thing at the adolescent level. I firmly believe that due to the openness of Sidney Crosby and his concussed brethren the younger players and their sometimes overbearing parents have become more willing to go along with the current concussion management plan we instill. In fact when explaining to a patient recently the player said something to the effect of “I really want/need to get back to the ice and playing but…”, this is the part that really made me warm inside, “if I have to take it slow like Sidney Crosby it will be just fine.”
Although the other players and parents I have crossed paths with did not use specific examples like the one above, the general consensus has been that of correct management no matter the time it takes. I truly feel this is ONLY because of the exposure of the NHL stars getting concussions and dealing with them. Just as they were hidden and less understood previously by the NHL, as awareness and extended management has been on the uptick the same can be said at the youth level.
So, as you can see, it is very important that the highest levels of the sport conform/get aboard the correct ways to handle the injury of concussion. It is important to note that we have yet to see or hear of parents taking players out of the sport in this area; according to the local clubs the opposite can be said, as the enrollment of hockey continues to grow in this area.
This phenomenon has not translated to other sports: basketball or football, for the exact reason the hockey has expanded. The coverage and openness of the players who have been affected by this brain injury. Hey NFL and NBA start taking notice that the youth and their parents take a clue from you. Make the necessary efforts to promote the correct management of concussions, and now, in order to keep kids playing.