The Dallas Stars website announced today that the AT&T Metroplex High School Hockey League is implementing a new concussion policy. The website announced that "Texas Health Ben Hogan Sports Medicine and the Dallas Stars are implementing a strict, new concussion policy for the AT&T Metroplex High School Hockey League."
Concussions have been a heated area of discussion in all sports, but the more hockey is played in the metroplex, the more incidences of concussions occur. The Centers for Disease Control and Prevention estimate there are 300,000 sports concussions among children and adolescents in the United States each year. Yet, according to trained observers, 71% of concussed athletes returned to play in the same game.
Even in the NHL, concussions plague players. According to statistics provided by the NHL, 60 players had concussions in 1997 during the regular season and playoffs. According to the an article on Mark Messier's War on Concussions, "Since 1997 over 750 players have experienced a concussion .... Over the course of one season (from 2005-06 to 2006-07) the number of NHL games missed due to concussions rose by forty-one percent."
In April 2010, NHL implemented a new rule which prohibits “a lateral, back-pressure or blind-side hit to an opponent where the head is targeted and/or the principal point of contact.”
According to Mark Lovell, Ph.D., of the University of Pittsburgh Medical School, "... a concussion is now recognized as a critical medical issue with potentially permanent consequences."
A paper on ice hockey and concussions by Aynsley M. Smith, RN, PhD , Michael J. Stuart, MD, and Dave Dodick, MD, says that it isn't just professional NHL hockey players how get concussions and that children are especially vulnerable because "children and adolescent hockey players are more susceptible to concussion because of a larger head size to body size ratio? weaker neck muscles and less stability on skates when checked or pushed. Videotape analysis of Bantam players identified on ice skating characteristics that helped explain why certain players sustain concussion. These players tended to skate with their heads down watching the puck, positioning themselves in the “danger zone”, which is between 816 feet from the boards, and didn’t optimally position their body to receive a check. Thus, when checked, these players were more often flung into the boards. Collisions too often occurred when their heads were down."
According to the Dallas Stars, "the new polices requires an ImPACT™ baseline test for all athletes prior to starting play. The computer-based ImPACT™ test establishes each athlete’s baseline neuro-cognitive function."
This new policy will be implemented in the 2010-2011 season for the AT&T Metroplex High School Hockey League.
One of the new guidelines designates when a player can return to the game after a concussion. According to Anthony Marchie and Michael D. Cusimano,with the Division of Neurosurgery and the Injury Prevention Research Centre, St. Michael's Hospital, University of Toronto, Toronto, Ont., too much emphasis is placed on when to return to play and not enough on whether to return after an initial traumatic brain injury.
If a player has signs or symptoms of a concussion, says the new rule, they can’t go back into that game —and are automatically put on a 14 day disabled list. They may return sooner if they see an ImPACT* credentialed physician who can use the post injury ImPACT* test for comparison to their baseline test.
Need some stats to back up the claims?
According to the Canadian Medical Association Journal, "Direct fatality and injury rates for football are half those for hockey: 1.8 per 100 000 football players in high school and 7.0 per 100 000 in college. Nonfatal catastrophic spinal cord and brain injury rates are 2.6 per 100 000 hockey players and 0.7 per 100 000 football players among high school athletes."
The younger developing brain is at an even higher risk of injury than other ages. Repeated concussions may lead to permanent learning disabilities and other neurological and psychiatric problems.
"Teenagers’ brains are still developing, and we now know that they don’t recover from concussions as fast as the pros,” said Keith Andresen, Senior Director of Hockey Programs for the Dallas Stars/Dr Pepper StarCenters.
On head injuries reported each season, 10%–12% are minor league hockey players 9–17 years old, most commonly a concussion. Concussions are most often caused by bodychecking, according to Marchie and Cusimanio, and rarely by being struck with a puck.
Despite advances in equipment design, the number of concussions is increasing.
“Concussion symptoms can be very subtle,” Dr. Sterling said, “but can be significant enough to pose a great risk to the athlete. That’s why this new policy is so important.”
After the player receives written permission from his physician and delivers the note to the team’s athletic trainer, then a player who had suffered a concussion may return to the rink.
Even if a concussion occurs outside the rink, or in practice, the player is required to report their injury.
Any way you look at it, hockey is a contact sport and concussions are not only rampant, but underdiagnosed and mistreated, especially among youth hockey where there may not be adequate professional medical services. More and more hockey organizations are cracking down on concusions and other injuries for hockey players. If you or your child plays hockey, research into all hockey injuries and with concusions, don't assume all is well just because the injury isn't in plain sight.
For more information about the Concussion Management Program at Texas Health Ben Hogan Sports Medicine, go call 214-345-5010 or go to www.texashealth.org/benhogan. Visit impacttest.com for more information about the ImPACT Concussion Management Program.
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