NHL Power Brokers to Meet

As the weather warms that means the General Managers of the NHL go south to Florida for the meeting of the minds.  Last year the Commissioner laid out a plan to help curb the concussion issue in the NHL with ideas that included: the quiet room, expansion of Rule 48 and increased penalties from Shanahan.

Where has that gotten the sport in relation to concussions; if you look by pure number it would be an actual increase, however I do believe those measures have indeed helped.  But there is more they (GM’s) and league can do, if they want to.  Part of fostering a game/sport is to realize that there needs to be changes, often ones that go against tradition and the good ol’ days.  People, including those that run hockey seem to forget that this game was not invented with today’s player in mind, the speed and skill has far outgrown this pastime, change is inevitable.

What can the NHL do to make the concussion issue better – don’t ask the Deputy Commissioner; Continue reading

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Fencing Response On Ice

As you followed us during the football season there were many times we referred to the Fencing Response, mainly after hits.  This response is a clear sign that the individual has suffered a concussion (at the least) and should be on top of your observable signs you should be looking for.  If you are new or don’t recall that term click on the link above.

Just as concussions can happen in any sport so can the Fencing Response, take the hit on Jakub Vorcek of the Philadelphia Flyers;

After seeing this last night I noticed that “Puck Daddy” had his take (also a better version of the video) on the hit; Continue reading

NHL Concussion Report 2/24/12 – 98 – Same as 2010 Total

Each week we (TCB & @nhlconcussions)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.

At the NHL All-Star Break we reported that there was a 60% increase in concussions over the previous year.  To which the NHL stated that they only have noted a 10% increase.  Yes, we use Fink’s Rule but that only comprises of four players, hardly a number that would provide a 50% difference in the numbers.  We have found that there are AT LEAST nine players listed as “upper body injury” that have either been found to have a concussion or the video/reporting of the injury holds clear evidence of a head injury.

Speaking of UBI and undisclosed; I know I am beating a dead horse, but why the need to hide the injury?  Why misinform the public Continue reading

In His Own Words: Nathan LaFayette

A group reached out to us recently to present something they are doing to help with the awareness issue.  This is a common occurrence in the TCB Mailbag, however rarely do you get to see them, call it screening, as I do not want to promote just to promote, I believe that if you have a good product, plan, or story you can get on the blog.

When Chartis, an insurance company approached us they had a unique way to get their message across, a first person account from a former professional athlete.  Keeping with the hockey theme I present you Nathan LaFayette and his story about concussions, as part of a promotion for aHead of the Game®.  An initiative to reduce the risks of concussions and other head injuries in youth sports. Through greater awareness and education, we want to help coaches, parents and young athletes learn signs and symptoms of concussions, seek proper treatment and follow appropriate return to play protocols to avoid the significant dangers of multiple concussions.

Concussions and Youth Sports:

My Lessons Learned in Pro Hockey

and How We Can Teach Children to Play Smart

By Nathan LaFayette Continue reading

League of Fans Open Letter

Recently I have been introduced to “League of Fans”, a sports reform project founded by Ralph Nader to encourage social & civic responsibility in sports industry & culture.  Although the name sounds  non-germane on the surface if you dig deeper into their core principles you will see they are starting to delve into the concussion issue.

One of their first salvos is an open letter to Gary Bettman, Commissioner of the National Hockey League – oft criticized by me and the blog as well.  Below is the letter signed by Ralph Nader and Ken Reed (reproduced with permission of League of Fans);

An Open Letter to NHL Commissioner Gary Bettman: 

It’s Time To Ban Fighting

  Continue reading

Crosby Follow Up

As expected the Sidney Crosby news made the numbers move, especially in Canada, along with that I have only heard more questions than actual answers.  The inbox was full of speculation and “told you so, it’s not a concussion”, or “told you so Crosby was being a (insert your expletive)”, however there was NOT ONE email that could shed light on an actual diagnosis.

I asked all the emailers if I could re-print their submissions and none took me up on the offer, except one, and his opinion is one of clarity and perspective.  This email also provided the closest thing to what could be the actual issue.  Below you can read it in full (in the email correspondence we never hammered out if he wanted his name published, so it will remain anonymous); Continue reading

Crosby Issue “Not a concussion”??

The most scrutinized concussion of all-time has now evolved into something completely different.  With this new information how many people will be rushing out to spinal trauma experts to find out if they are dealing with this “soft tissue” injury?  If nothing else this has provided some hope for Sidney Crosby, especially after it was again confirmed that he did not have any evidence of a neck fracture;

“There’s a pretty big possibility that I could be causing some of the issues and I hope that’s the case,” Crosby said. “I hope that it’ll improve and that’s hopefully the end of it.”

BE CAREFUL, although his team of experts have now ‘discovered’ this issue (can someone provide us with specifics including an actual diagnosis) Sidney Crosby did/still has a brain injury.

With this injury to the neck it is a wonder that Continue reading

NHL Concussion Report All-Star Break 2012

Each week we (TCB & @nhlconcussions)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.

We last updated you early this month after a very arduous month of December.  Due to the sheer volume and player effected by concussions the All-Star Game will be without many of its “Stars” this year.  I would like to preface this by saying that a lot of the new numbers can be attributed to the better awareness and perhaps the players themselves taking this injury more serious.

That being said we noted via Twitter that last year at this time there were 54 concussions reported/found in the NHL, it is an understatement to say there has been an increase, ROUGHLY A 60% INCREASE.  Hits like this one on Jochen Hecht, are very innocent looking at first glance, but these are the occurring, in my opinion these are more common due to the cumulative effect of subconcussive hits; Continue reading

Computer Concussion Testing Issues

Thanks to an alert reader an article was sent to the inbox dealing with neuropsychological testing, specifically the ImPACT test.  The author of the article published on Slate, Christine Aschwanden, provides a very well written reason as to why some are starting to take a much harder look on these types of tests;

On closer inspection, though, the whole thing begins to fall apart. “It’s a huge scam,” says physician Robert Sallis, past president of the American College of Sports Medicine. “They’ve done incredible marketing, and they’ve managed to establish this test as the standard of care with no evidence that it has any benefit.”

Dr. Sallis is not the only one, in fact we receive numerous questions about all the NP tests, and recently we have seen more and more research regarding the downfalls of this type of testing.  Research like this one (sourced in the article) written by physical therapists and a physician are being done by independent parties and seem to reveal there is a problem.  According to one of the developers of ImPACT some of the information is not viable if only because of the particular journal it appeared in; Continue reading

Tuesday Quick Hits (UPDATED)

Bending the rules for a star is not uncommon, heck we see it almost every week in the NFL as players are initially reported to have “dirt in the eye”, or “back spasms”, etc.  However it is rare that you see an overt “relaxing” of rules to possibly allow them to play.  It has happened in the UK in Premiere League Soccer, the team is Arsenal Manchester United and the player is Rio Ferdinand (bold my emphasis);

Ferdinand claimed on Twitter that he ‘could not remember’ what happened during United’s 3-0 victory over Bolton at Old Trafford on Saturday.

He also admitted  he had suffered concussion, which under previous FA rules meant he would automatically miss the next 10 days.

But the FA have relaxed the guidelines and Ferdinand, 33, will now be put through a thorough medical examination.

Thanks to twitter both @SportsDocSkye and @SportsDoc_Chris find that the article as I have presented it and was reported in the link is inaccurate.  I appreciate them following and correcting this issue (also my stupidity when it comes to European Futbol).  The issue that needs correcting is that the current FA concussion guidelines follow the Zurich statement and a player will follow graduated return to play, meaning the 10 day issue is moot…

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I was reading an editorial in the Star Tribune about how the concussion laws could be a detriment to coaches and teams, when I came across some good Continue reading

Tuesday Quick Hits

We have been offering suggestions to the NHL on how to change the game for the past few weeks (see here and here), as you go through the searches more and more people are doing the same, especially up north.  The Globe and Mail with author David Shoalts proposed most of the same information we had;

  • Culture change (respect)
  • Equipments
  • Treatment
    • “The NHL should tap into the long list of reputable concussion experts willing to help and develop a sensible plan for treating concussions. Then it should get the National Hockey League Players’ Association to join it in strongly encouraging the players to follow it.”
  • Rule changes (see outlawing all head contact)
  • Game changes (see speed)
  • Fighting

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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

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

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.

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.

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

Russ Bitely: NHL All-Concussed Team

From the inbox, an article;

Man oh man do I feel really bad for these guys — and for you and me too. Bad for them because they are the ones going through the trauma of the head injury and all the terrible symptoms that follow with the diagnosis of a concussion. It is one thing to lose the ability to stick handle a puck, take a check at center ice without feeling like your brains got scrambled, or even jump the boards for your next shift. That’s the game. It is totally a whole different story when you forget where your daughter’s school is, what date your wife’s birthday falls on, or even the desire to get out of bed in the morning — that’s life.

What else is awful about the concussion plague spreading around the hockey community? Well the fact that these players have devoted so much time, energy, and life into getting to the top professional league of the hockey world and in a moments flash the dream is or could be gone. How the hell would you feel if since age 4-5 you have been skating and where told no more. How the hell would you feel if you have been traveling all-around North America and beyond since the squirt/atom or pee wee days only to have your life-long dream in the NHL cut short. How the hell would you feel about all the sacrifice and commitment your family made over the years so you could do the thing you love, now perhaps just a distant memory.

That is how Russ Bitely, @russbites, started his article Continue reading

NHL Concussion Thoughts

Recently there has been a spike in awareness and number of concussions in the National Hockey League.  Last year we began compiling the injuries in our database to see where the sport stands (we also do NFL, NCAA football, and Aussie Rules Football).  When Sidney Crosby sustained his initial concussion in the Winter Classic last year it seemed that NHL has begun to take notice.

It was refreshing to see The Star of the NHL deal with the brain injury with some transparency, although he endured some criticism what Crosby did was set into motion the awareness of concussions.  Last season prior to the new year it was very difficult to find actual listed concussions; they were veiled in “upper body” or “undisclosed” listings.  In some cases the injury was improperly reported as a neck or shoulder injury; a sign that the concussion was either a) not understood (unlikely) or b) needed to be hidden.

Before you read on it is important to understand the position of the blog and this author about concussions.

Concussions, brain injuries, are an inherent part of collision sports.  There is very little in the way of equipment that can prevent concussions, the only way to impact a positive change (see decrease) is to address the culture and mechanics of sports.  This does not mean that professional sports should be outlawed, rather subtly changed to protect those that play, not only for the immediate time, but for the long-term health of the athletes.  With this; Continue reading

Is Hearing Them Cheer for You too Much to Concede to Concussion?

Conceding, rather the inability to concede is one of the traits high level athletes have in common.  The dive to succeed and be the best at all costs is what makes some better than others; it makes teams champions.  This quality is also what has put the concussion issue at the forefront.  Blinded by the ‘need’ to overcome and win/perform injuries are often an after thought; this cannot be the case with concussions.

As I was reading one of my favorite sites I came across an article put together by Sean Conboy.  The article was rerun from The Classical and below are some excerpts as to why hearing your name cheered on keeps the mind clouded;

Despite a stunning last-minute loss to Baltimore, Harrison was elated after the game. Things were different. There was an unfamiliar silence in his head, and his cranium did not ache like a mother****er. He was so comfortable, in fact, that, according to the release, “Mr. Harrison called Rob Vito, UNEQUAL’s CEO, to thank him for putting UNEQUAL CRT™ in his helmet, proclaiming it was the first time he did not experience post-game head pain or ringing in his ears.” In seven years.

James Harrison admitted to having symptoms after almost every game, which is not surprising given his propensity to lower and use his head a weapon.  Tell me again why he feels that he was “wronged” Continue reading

Irv Muchnick: UPMC Concussion Scandal Ground Zero

Irv Muchnick writes for BeyondChron and for his website ConcussionInc.net about the concussion issue facing sports today.  What began in WWE wrestling for Irv has migrated to the mainstream sports.  Below is an excerpt from the introductory article about his new e-book titled “UPMC Concussion Scandal Ground Zero”.

Another major North American sport, hockey, now faces its perfect storm with the second and, for all we know permanent, sidelining of its greatest and most athletically artistic star – Sidney Crosby, his generation’s answer to Wayne Gretzky. Had Gretzky, in the 1980s, been disabled long-term or for good by concussions, then the National Hockey League either would be vastly smaller-time today or would not exist at all. It is impossible to calculate the tens or even hundreds of millions of dollars in ticket sales, rights fees, and merchandise revenue that the loss of Crosby might mean for the contemporary NHL.

During the continentally televised Winter Classic game on January 1, 2011, the Pittsburgh Penguins’ Crosby was concussed by a shoulder Continue reading

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”; Continue reading

NHL Concussion Report 12/8/11

Last month during our concussion report for the NHL we noted an encouraging decrease (23%) in concussions/head injuries over the previous year.  Now that difference is (2%) as 13 more injuries have been exposed over the past month.  One situation we will not be classifying is the current Sidney Crosby issues.

Crosby and the Penguins are making a bold and correct statement by not traveling with the team during the current road trip.  Reportedly Crosby is not quite 100% and the team does not want to take the chance of another concussion occurring after a big hit he sustained in the previous game.

It is worth noting that in the associated article that Sidney “passed” his ImPACT test but still is being held out of action.  We have heard from many entities (including uninformed school boards/districts) that passing a nerocognitive test (ImPACT in almost all cases) would be enough to allow a player to continue.  Continue reading