Concussion protocols: At what point do we take things more seriously?

The research and facts are out there, so why isn't the NHL cracking down more harshly on head shots and enforcing concussion protocols?

With the recent release of the movie Concussion, I began to consider the seriousness of mild traumatic brain injuries in the NHL and what needs to be addressed in order to fully protect its athletes.

I reached out to some experts in the field; Saga Johansson, a neuroscientist by training based out of Sweden, and a graduate student (who has asked to remain anonymous) who has dedicated many years towards researching concussions in athletes.

What is a concussion?

"A concussion is an injury to your brain, resulting in pretty serious damage to the physiology that controls it and allows it to function. Although it is the result of contact, that contact can occur anywhere on the body, as long as some sort of force is being transferred to your brain. It's a functional (as opposed to a structural) injury, meaning it's going to affect how you function despite not being visible by any sort of available imaging tool; CT Scans, MR Images, etc., cannot detect a concussion."

Symptoms can include:

  • loss of consciousness
  • memory problems
  • confusion
  • headache
  • balance problems
  • slow reactions/

Interestingly, "although many sports will have regulations regarding how long a player needs to wait to return to a game following loss of consciousness, such regulations don't always exist for milder symptoms," Saga stated, perhaps explaining why we so often see athletes take a hit and end up back on the ice so quickly.

As my colleague stated, some symptoms can take minutes, or even hours, to appear, and they may not go away for years. His main concern? Currently, the NHL protocol states that athletes must remain seated in a quiet room and in a resting state for 15 minutes before any testing even occurs, to allow for that delay of onset of symptoms. But how often do we see an athlete take a hit and end up back on the ice within a few minutes?

Winnipeg Jets forward Bryan Little was taken to the dressing room in a game on January 2, 2015 after taking a hit (above) from Joe Pavelski. Within 10 real-time minutes, he was back on the ice playing.

A few days prior Kris Letang was the recipient of a boarding infraction by Toronto's Leo Komarov, with the Penguins' twitter account announcing he was removed from the game for a concussion evaluation. He returned to the game within three minutes.

"This appears to be a common occurrence throughout the league and is in pretty clear contradiction to the published guidelines," said Mr. X. "That’s a problem."

In addition to the physical symptoms, psychological issues can arise. Emotional disturbances and behavioural changes are often cited in concussion patients. Interestingly, a study published by Saga in 2012 showed that 50% of the U.S. Olympic team who had suffered concussions over the course of their training have now started experiencing depression and suicidal thoughts.

As my colleague stated, "In many cases, these are things players can and will try to hide from people in order to get back on the ice and play. It's truly a scary reality when you consider the long-term consequences of multiple concussions."

In addition to athletes not following protocol, what isn't being discussed enough are the pressures these athletes experience in terms of pushing their bodies in order to return to the sport quickly. Whether internal or external pressures, athletes can return too quickly, causing further harm.

Case in point, Michaël Bournival who dealt with concussion symptoms for quite some time while continuing to play last season, citing various 'flare-ups,' which, in all likelihood, should have ruled him out of action.

Johan Franzen of the Detroit Red Wings is another example of a current athlete who has simply pushed his body and his brain to the point where his concussions and their lingering symptoms affect not only his playing career, but his everyday life.

The Montreal Canadiens have had their share of controversy when it comes to following the NHL's concussion protocol. Just this season, Brendan Gallagher was hit by Dustin Byfuglien - who received a two minute penalty for elbowing - and Gallagher was right back on the ice within minutes.

The physical, mental, and emotional issues that can arise from concussions are still not well-understood. Research is beginning to showcase the necessity for better concussion protocols in the NHL and for its athletes. Though even with certain protocols in place, it is obvious that not all clubs are choosing to follow them.

Physicality is a big part of hockey and is something that I would never change about the sport. That being said, organizations and athletes need to be better-educated on the signs and symptoms of concussions, as well as their long-term effects. We have made so many technological advancements in order to create equipment that protects a player's body. Shouldn't we do all that we can to protect their brain, as well?

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