Jan 29, 2015
Hockey Faces Concussion Questions

By Patrick Bohn

Concern over head injuries in hockey is quickly gaining a share of the concussion spotlight and some sweeping changes to the game–from youth leagues to the NHL–could be on the way.

The most recent push came just over a month ago, at the “Mayo Clinic Sports Medicine Center Ice Hockey Summit: Action on Concussions” program. There, brain trauma researchers, USA Hockey, and Hockey Canada officials and coaches urged youth hockey officials to delay allowing the introduction of body checking in the sport until players are 13 years old.

Dr. Carolyn Emery of the University of Calgary compared the incidence of concussions among 11- and 12-year olds in two leagues; an Alberta league where checking was allowed and a league in Quebec, where it was outlawed. The results were startling: Players in the Alberta league sustained four times the number of concussions their Quebec counterparts did.

“The evidence is irrefutable that delaying body checking until age 13 has significant benefits to the health of young players,” Emery told The New York Times.

The conference also pushed for warnings to consumers that helmets and mouth guards are not especially effective at preventing concussions. Members also recommended that all amateur coaches pass an annual course on concussion safety in order to be re-certified.

One of the major concerns with head injuries in hockey is educating players and coaches on what constitutes a concussion and what the dangers are. Charles E. Tator, MD, at Western Hospital at the University of Toronto, was co-author on a 2010 study of concussions in Canadian junior hockey. The study of 52 games saw 21 concussions, but more shockingly, a lack of education on concussions among players and coaches.

“This study showed a disturbing lack of compliance by the athletes to undergo requested neuropsychological evaluations and multiple physician visits, as well as a lack of understanding about the seriousness of concussions,” he reported in the study. “Complaints from players, coaches, and parents about this testing gave further credence to the importance of raising awareness about the serious long-term implications of concussions through education.”

Education is critical because research shows the incidence of concussions is frequently underreported. Paul Sean Echlin, MD, a Canadian doctor who works on the Hockey Concussion Education Program followed two Ontario junior teams in 2009-10. The resulting study showed 21.5 concussions per 1,000 man-games. Previous studies, based on reports from physicians and trainers for NCAA Division I programs, saw a rate of 3.1 per 1,000 games.

Another challenge when it comes to hockey concussions is changing the sport’s culture. Regg Simon, Head Coach of the Des Moines Buccaneers, told the Des Moines Register that a culture of ignoring concussions has been in the game for a long time.

“As a young player, concussions were never even mentioned,” Simon said. “And I’m pretty sure that most of the guys I played with probably played through concussions just from misdiagnosis or whatever. It’s kind of a macho thing of, you see stars, but you go smell the salt and go back out and finish your shift.”

The NHL players’ union is also getting involved, and has agreed to a ban on lateral or blindside hits to the head on unsuspecting players. Violators will be hit with a major penalty and ejected from the game, and may also face supplemental discipline from the league.

Patrick Bohn is an Assistant Editor at Training & Conditioning.

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