NHL Concussion Report 1/9/12

Comic Courtesy of NESN.com

Each week we scour the web to find concussions in the National Hockey League.  We will keep a running tally on that information as the season progresses.  However, it is not easy as the NHL has decided that listing injuries as “upper body” or “undisclosed” is a good indicator of actual injuries occurred.  Our list is believed to be as accurate as possible, even including injuries that have vague listings but through reports and video analysis should be classified as concussions.  We will also be using “Fink’s Rule” to include concussions in the listing.

The last TCB Concussion Report for the NHL noted a slight decrease of concussions over the same period of time in 2010-2011.  That has completely reversed, due to a very high incidence of concussions in December.  After November there was a 2% decrease of concussions after December and early in January there has been a 39% increase from the previous year.  Of note we did include Sidney Crosby and Mikel Samuelsson.

There can be a myriad of reasons for this, one that we hope is the actual case is: awareness.  Awareness and honesty are a good thing in uncovering the real issue of concussions in all sports.  It seems that the NHL is at least starting to take it serious by labeling all the injuries correctly.  Mind you that we did find some concussions that were veiled in an “upper body” listing.

Another reason is that the game itself may be in need for an adjustment to abate the sudden increase (if in fact it is an increase, just like the NFL this could be a static number, but since we have no foundation to compare it to we can only assume).

Now on to the stats for this month (using 40 games as the average); Continue reading

What Are Concussions Costing NFL Owners?

I was approached by a reader to figure out what concussions are “theoretically” costing owners/teams in terms of salary.  His thought, a good one, was to illustrate the economic impact to the NFL and owners that an investment in a completely independent concussion “think tank” could save money in the long run.  The last time we ran the numbers was in week 13, we are efforting the final numbers for 2011.

There were some limitations in determining this overall impact to the owners:

  • Finding exact contract information for each player
  • Determining exact loss of game time due to concussion
  • Exactly accurate listings of injury

To our knowledge there is no published information on this topic, therefore this presentation of information is the first of its kind, and we truly understand that this is not 100% accurate, but it does give an idea of what is happening in terms of concussion and lost salary.

Based upon our findings the average salary for a concussed player/game in the NFL through 13 weeks was Continue reading

NFL Medical Staff Allowed to View Replays on Sideline

According to NFL.com the league is going to let the head athletic trainer or head team physician to use video replay in assisting with injuries.  There are stipulations and monitoring from the league for its usage;

The league made it clear that the use of this equipment is for medical purposes only and not to gain any competitive advantage. The NFL plans to monitor the use of the video monitors and will determine if its availability will be expanded next season.

The league issued the following guidelines surrounding the equipment’s use:

» The equipment may only be used by a team physician or the head athletic trainer. Under no circumstances may coaches, players, or others have access to this equipment.
» The medical staff may only review video of a play to assist it in treating a player who suffered (or may have suffered), an injury during that play.
» The head team physician or the head athletic trainer must notify the league officiating observer in the press box prior to accessing the field video monitor.

We have clearly stated here that one of the best tools the athletic trainer has is his/her eyes and understanding the mechanism of injury.  That is why we as AT’s Continue reading

Puck Daddy Interview with David Perron

It has been difficult to get professionals to talk about concussions, not only the injury but the recovery from the injury.  Puck Daddy of Yahoo! Sports has posted an interview with St. Louis Blues player David Perron.  It is some good stuff to read;

What do you think is the biggest misconception about concussions?

It’s tough. When you look at the person, he looks normal. I know myself when I’d go in the room last year, I looked normal to the guys and they would ask how I was feeling. And after a while it kind of gets on your nerves a little bit to get asked 30-40 times a day how you’re feeling. You understand the people around your team are caring about you, but you’re trying to get your mind off of everything and hopefully recovering quickly.

I think the biggest thing is, Continue reading

Amino Acid Research for Concussions

Here is a press release from the University of Pennsylvania, Perelman School of Medicine regarding some initial research into amino acids and the effect on recover from brain injury, in particular concussions.  (I was forwarded this information via email, I cannot find it on the Penn website, but I have since found the exact copy over at SportsConcussions.org); UPDATE: The opening of the press release was written by the wonderful author/owner of SportsConcussions.org, Jean Rickerson.

Concussions are often called the “invisible” injury because they are usually not detectable by the average CT scan or MRI.  Even so, it is often very apparent that something is wrong.  That “something” is often defined as a metabolic imbalance, created by the impact of the brain against the skull. Healing means waiting for potassium, calcium, and glucose to return to their rightful places and proportions in the brain.

Amino acids may lend a helping hand.

In animal studies, researchers at the University of Pennsylvania discovered that administering three different amino acids restored the neurochemical balance and cognitive ability affected by the injury.

Peter LeRoux, MD, FACS, associate professor of Neurosurgery in the Perelman School of Medicine at the University of Pennsylvania, was awarded a 3-year, $250,000 Dana Foundation Clinical Neuroscience grant, to conduct a study using branch chain amino acids to treat concussion in athletes.

This translational effort started in the basic science laboratory Continue reading

Sport of Lacrosse: A view from Dr. Cantu

Have I mentioned that I really LOVE you readers?  In case you have missed it, I do love all of you; you make this blog better every day.  In the mailbag today was an article forwarded to me from a family about lacrosse.  The article is from Inside Lacrosse the January issue, written by Terry Foy.  The article is a question and answer with Dr. Robert Cantu and has wonderful-insightful questions and answers.

Because I cannot in good conscience rip off the entire article I will provide the questions by Inside Lacrosse and some quotes, but mostly summations of the answers by Cantu.  Make sure you visit the article for all the information.

  • How familiar are you with men’s and women’s lacrosse?
    • Just like our stance on woman’s lacrosse, Dr. Cantu is very adamant about putting head-gear on players in that subset of the sport.
  • Are helmets one of the primary actors in diminishing the amount of concussions in lacrosse?
    • Depending on the actual cause of the injury helmets can help in decreasing the amount.  Dr. Cantu’s information provides him with data that show most woman’s lacrosse concussions come from stick strikes to the head.  He is correct in estimating that putting helmets on woman would decrease concussions in that case.  He does echo what we have been telling you from day one; helmets do not prevent the primary reason for concussions in collision sports (rotational forces).
  • Because the NFL changed their rules to protect from head injuries, do you think lacrosse, aside from adding helmets on the women’s side, needs to adjust any rules to create the same protection? Continue reading

Injury Statistics

Statistics are seemingly becoming a major part of all of our lives; from your favorite baseball players batting average, to the graduation rate of the school system, to your fantasy football team, to the injury rate of particular activities.  Being an athletic trainer the later is important, not only does it paint a picture of “expected” injuries we should be on top of, it also provides information for us to use in terms of making solid decisions about return to sport.

If a player sustains an injury that occurs a high percentage of the time in the sport, then when returning there are different things we can do, in terms of preventative measures, to possibly avoid a re-injury.  Along with that, if a player sustains a “freak injury” and obtains complete recovery statistics can tell us if playing again is a good idea at all.

This is why it is important to have all the available information be correct and up to date; more and more decisions not only from athletic trainers but parents about playing are made from such injury statistics.  One of the “gold standards” of injury surveillance for athletic training is Continue reading

Recent Trend

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 Continue reading

Exposing Hidden Concussions in NHL

Thanks to the crack research from Senior NHL Researcher of The Concussion Blog – Brian Clarke, we are prepared to expose these injuries in the NHL for what they appear to really be: concussions;

We will be adding the above players to our official concussion list.  Once again, even though the transparency is better, it has not gotten to all the teams.  It would be nice if they all would be as concerned and forthright as the Avalanche.

*Disclaimer – each team can trump this report by simply making something up, but with so many eyes and very perceptive journalists covering the NHL I will be waiting for official news of something other (see made up) to change my position on this.

Bonnergate in Nashville

I missed this case of another NCAA athlete that quite possibly was mismanaged.  We discussed the Josh Huff case in the Rose Bowl yesterday, HERE.  Thanks to an astute observer and commenter, presumably an athletic trainer, here is what happened, thanks Bryan (BTW it is you the reader that help us with the stories that matter);

Watching the Miss St. / Wake Forest Bowl game yesterday, the game kicked off for the second half. WF returned the ball and Miss St. DB Wade Bonner (#7) assisted on the tackle on the WF sideline. At the end of the play Bonner lay on the sideline on his stomach pointed towards the field. For a few moments he didn’t move, then got up gingerly and attempted to run forward. He instead went directly sideways for 5 yards, nearly running over the side judge spotting the ball at the end of the return. The side judge obviously noticed he was not ok and held on to him and turned across the field and motioned for help.

At this point the camera switches to the WF QB who is doing the college football routine of “Stare at the sideline blindly waiting for the coach to make up his mind about the play call”. Assumed it was taking so long because they were getting Bonner off the field. Wrong, just as WF walked to the line, the same side judge had to hold the game, run to the defensive safety spot where Bonner was lined up for the next play and make the Miss St. staff come get him. Good for the ref for following his responsibility and making him sit out.

So what happens? You guessed it. Less than a minute later Continue reading

Tuesday Quick Hits

Kris Dielman would most likely do it all over again.  In a piece done by the Associated Press and posted on ESPN, Dielman explains that the drive for the ring would make him do dumb stuff;

“This was definitely a scare,” said Dielman, known for his hard-nosed, blue-collar demeanor. “Waking up in the hospital with my wife standing over me, that was pretty scary. I don’t scare easy, but that was something different.”

Dielman went on to explain that having a family and kids would most likely make the decision harder, if it were to happen again, to return.  This is the first opportunity the media has had to talk with Dielman, as players on the IR are not allowed to be interviewed by the press.


Marc Staal makes return to ice in Ranger uniform, outdoors in Philly.  Staal had been out since February last year Continue reading

Huffgate in Pasadena

In the second quarter of the Rose Bowl, Oregon wide receiver, Josh Huff, was hit in the head while attempting to make a catch.  He tried to get to his feet, then fell back down.  He was attended to by Oregon’s medical staff on field.  When he rose to his feet it was VERY CLEAR to those watching he had balance disturbance.  He could hardly open his eyes and squinted and grabbed his nose.  As he was walking off the field his “straight line” to the sideline looked more like someone who had too many to drink a few nights ago.  (here is the video and take from SB Nation), from SB Nation as well;

He tried to stand up, staggered his steps, then fell back down again. Huff is one of the best receivers Oregon has, at a position where the Ducks are already thin on the depth chart.

He was removed for the remainder of the half.  After the extended half time the “sideline princess” of ESPN, Erin Andrews notified all of us watching that Huff “only had his bell rung” and was going to return in the second half.


“Bell rung” = Concussion Continue reading