Concussion Conundrum: Protecting Heads While Playing Hockey

Hockey can be a brutal sport. Concussions, a mild traumatic brain injury common in contact sports, can be devastating.

But are they a scourge that will ruin hockey or a problem that can be managed?

The science is unsettled.

While the National Football League paid more than $1 billion to settle a lawsuit brought by former players over the long-term impacts of concussions, the NHL is apparently ready to go to trial in a similar class action pursued by more than 150 players. A study published in the April 2017 Journal of Neurology, Neurosurgery & Psychiatry showed no significant cognitive impairment in former NHL players, regardless of their concussion history.

Anecdotally, signals are equally mixed. Prior to the 2016-17 season, Pittsburgh superstar Sidney Crosby was sidelined indefinitely after suffering his third concussion — in the same week the NHL announced new concussion protocols. He sat six games — and missed one more with another concussion later in the season — yet still led the Penguins to their third Stanley Cup in eight years.

Can We Stop Concussions?

Hockey Canada has already banned body checking for kids under 13 years old.

Hockey Hall of Famer Ken Dryden says concussions will always occur, but their number can be greatly reduced. The former Montreal Canadiens goalie has long crusaded on the topic, and his 2017 book, “Game Change,” explores it in depth.

In an October piece for the Toronto Globe and Mail, Dryden wrote of how he’d begin to solve the problem:

“It begins with a simple ripple — no hits to the head. This ripple then runs backward, getting bigger, until it becomes a wave. In today's NHL, a stick to an opponent's face is a penalty — automatic — no excuses. A puck shot into the crowd in a team's defensive zone is the same, a penalty — automatic — no excuses. No big deal. Players adapt. The game goes on. … It can be the same with head hits.”

While We’re Waiting on Legislating

Short term, the best thing for concerned hockey players and hockey parents is education on how to recognize, treat and perhaps even prevent concussions. These are worthwhile goals, as concussions have been linked to disturbed sleep, difficulty concentrating and sleeping, and a higher risk of suicide, anxiety and depression.

Symptoms: Headache, nausea, vomiting, light sensitivity, dizziness/poor balance, slurred speech, atypical moods (irritability, sadness, anxiety), memory loss or other lack of mental clarity, and excessive sleepiness. When a concussion is suspected, a physician should be consulted.

(If a concussion is suspected during play, that player with the aching head should be pulled off the ice immediately and not allowed to return until medically cleared.)

Treatment tips:

• Advil and Aspirin are no-nos. Those products, in large amounts, can exacerbate bruising or internal bleeding. Tylenol is better.
• A worsening headache or persistent vomiting in the first 48 hours should prompt a trip to the emergency room.
• Screens (TV, computer, tablet or phone) make concussion headaches worse. They are to be avoided.
• Dim rooms are best. Sunglasses should be handy when dim rooms are not.

Prevention techniques:

• Proper skating (head up for rink awareness, knee bend for balance); how to give and receive a hit should be taught.
• Perform neck-strengthening exercises.
• Have a helmet that fits properly (most hockey equipment should not be purchased under the theory that the player will grow into it) and is properly fastened.

Returning to Play

In 2015, the Ontario Neurotrauma Foundation outlined a six-step “return to play” protocol for pediatric concussions:

1. No physical activity; limited schoolwork
2. Light aerobic exercise (walking)
3. Light skating, with no contact or abrupt stops
4. Drills, but no contact
5. Drills with body contact
6. Return to competition

Author bio: AJ Lee is Marketing Coordinator for Pro Stock Hockey, an online hockey store carrying pro stock hockey equipment. He was born and raised in the southwest suburbs of Chicago, and has been a huge Blackhawks fan his entire life. AJ picked up his first hockey stick at age 3, and hasn’t put it down yet.