One subject being heavily debated within the hockey community is that of head shots and the increase in both frequency and severity. Nobody wants to see a player injured, especially when that injury is a concussion sustained after a brutal hit which left the player knocked out cold on the ice. To me, however, it’s not discussion about the rules of the game that will address the entire issue. A concussion which comes from an illegal hit is the same, medically speaking, as one which comes from a textbook check. And as one will argue that an injury from an illegal play is avoidable, so to can one argue that any head injury in hockey can be, if not avoidable, than partially preventable.

There is a misconception that a blow to the head without the loss of consciousness will not cause a concussion. Athletes who have been taught and conditioned to play through pain, often rejoin the game without completely understanding the implications of a head injury. This has been shown time and time again in youth football. A cursory Google search found articles about two separate deaths–a 10 year old and a 17 year old–just in the past six weeks. But unlike hockey, football does not look to rules changes to cut down on such injuries. Rather, they have turned to better equipment and better awareness of the signs and symptoms of a concussion. It is a pro-active stance that hockey has been slow to take.

Former hockey star Mark Messier has launched “The Messier Project” which is an effort to create more effective head protection for hockey players. With the assistance of Cascade Sports, he has created the M11 helmet which is said to reduce the likelihood of a concussion caused by a “hard” hockey hit by 40%, when compared to the current high-end helmets. Currently, 6 players in the NHL and 3 in the AHL are wearing these helmets to compete and only time will tell if they are indeed effective in preventing catastrophic head injuries. Messier’s website is a valuable resource in educating oneself on the impact head injury has had on players, however, it fails to go into further detail as to why the prevention of concussions is so important. True, a head injury can immediately end a player’s season and even end their career but the repercussions of these injuries go much deeper than that.

I began to write this entry earlier in the week, after learning about The Messier Project, but prior to learning that he would be presenting the idea to the NHL at this week’s GM meetings. While working on clinic studies for patients with Major Depressive Disorder, I learned that aside from the obvious physical damage a head injury causes, the neurological damage can be far more sinister and there is little physical evidence to determine when that has happened.

An article in The Hockey News posted yesterday, correctly points out that “depression an issue hockey can’t afford to ignore.” But again, the article stops short of postulating why depression may be such an issue within the hockey world and why players may not even realize there may be an impetus for this depression. Imagine being a nationally known sports star, an olympic champion even, with a family and a career you love. Then imagine having inexplicable feelings of sadness, anxiety, and despair. Not understanding why you feel that way can be just as much a burden as the feelings themselves.

The Centers for Disease Control National Center for Injury Prevention and Control estimates that approximately 1.6 – 3.8 million sports and recreation-related traumatic brain injuries (TBI) occur in the United States each year, most of which are not treated in a hospital or emergency department. As well, the CDC cites a long list of neurological and psychological effects which have been seen in those with TBI:

Thinking (i.e., memory and reasoning);
Sensation (i.e., touch, taste, and smell);
Language (i.e., communication, expression, and understanding);
Emotion (i.e., depression, anxiety, personality changes, aggression, acting out, and social inappropriateness)

In 1996, former professional football player Andre Waters died from a self-inflicted gunshot wound. His suicide was considered a mystery to many; he had been described as an outwardly happy person. His family gave permission for an autopsy to be conducted on his brain and it was discovered that Waters’ brain tissue had degenerated into that of an 85-year-old man with similar characteristics to those of early-stage Alzheimer’s victims. The Center for the Study of Traumatic Encephalopathy, along with other research institutions, has now identified traumatic encephalopathy in the brains of late NFL football players John Grimsley, Mike Webster, Justin Strzelczyk, Terry Long, and Tom McHale. Grimsley died of an accidental gunshot wound to the chest. Webster, Long and Strzelczyk all died after long bouts of depression and McHale was found dead last year of an apparent drug overdose.

The blow to the head and ensuing concussions are worth discussing the NHL as they have been in the NFL. However, too often issues of safety turn into debates on fines, suspensions, and rule changes. Week-long suspensions for a malicious hit to a vulnerable player will not change how the hit will effect the player, nor do I believe they been proven to deter such hits. And, most importantly, head injuries in hockey can occur at any time, from any hit. Suspending a player for an illegal hit will not change that fact. It’s fantastic that The Messier Project has acknowledged the need for more effective head protection for hockey players. The next thing the hockey community must bring to the forefront of this discussion is the need to understand why concussions need to be prevented–and to recognize the true damage that can be–and already has been–caused as a result of these injuries.

Sources:
Expert Ties Ex-Player’s Suicide To Brain Damage From Football
CDC: Traumatic Brain Injury Fact Sheet
Dead athletes’ brains show damage from concussions

This entry was posted on Thursday, November 12th, 2009 at 1:43 pm and is filed under The Most Dangerous Game. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.