Fewer Brain Injuries But More Time Lost
This month’s issue of the Canadian Medical Association Journal contained a study of NHL hockey players over 7 seasons. The study indicated that while the number of concussions has leveled off the time that players were loosing as a result of the concussions appears to be increasing.
More Severe Injuries or Better Treatment?
The authors of this study question whether the increase in time off is because players are suffering more serious concussions or whether trainers and team physicians are being more cautious in their treatment of mild traumatic brain injuries.
Better Predictors
The authors pointed to a number of factors which tended to increase the amount of time off the players needed before returning to the ice. The factors included the presence of:
Headaches;
Low Energy or Fatigue;
Memory Loss;
Abnormal Neurological Findings.
The authors of the study conclude:
“Our findings also suggest that more conservative or precautionary measures should be taken in the immediate post-concussion period, particularly when an athlete reports or experiences a post-concussion headache, low energy or fatigue, amnesia, recurrent concussion or many different post-concussion symptoms, or when the athlete has an abnormal neurological examination.”
The findings are similar to the practice guidelines for managing mild traumatic brain injuries due to concussion published by the American Academy of Neurologists.
Spotlight on Concussions
The NHL has drawn attention to the problems of concussions in sports; particularly Zdeno Chara’s hit on Max Pacioretty that caused a severe concussion and a fractured neck as well as Sidney Crosby’s concussion which has put him off the ice for almost 3 months.
In March the NHL announced new concussion rules requiring trainers to conduct a neurological test of players immediately after taking an on ice hit.
Recent research has also revealed that up to 25% of all junior hockey players suffered a concussion.
Better Enforcement-Better Training-Better Testing
The public is slowly becoming aware of the dangers of concussions. People are finally starting to realize that a concussion is a brain injury and the damage from mild traumatic brain injury due to a concussion is cumulative and can be permanent and significantly disabling.
How Can We Protect Athletes?
Referees need to strictly enforce the rules against cross checking and head shots. Coaches, trainers and parents need to have a better awareness of the signs and symptoms of mild traumatic brain injuries.
New and more accurate testing such as the rules introduced by the NHL recently to detect brain injury need to be implemented at all levels of the sport and in any sport where head injuries are prevalent (hockey, football and rugby to name a few).