A Primer on Concussions


If you are like me, and I am guessing most of you would never admit to it, you may have little idea of what exactly a concussion is. Sure, we can all pick up on the fact that it is a head injury, or even a brain injury, but what exactly is happening? What is the story with one guy coming back in two days, and another guy loses his career?

Since they seem to not be going away, make the jump for some video and some talk about what happens in a concussion and what exactly it means.

I talked to a handful of people, medical people mind you, but no brain-specializing medical people. They all said basically the same thing. They (medical folk) don't know squat about concussions. They know concussions are more serious than previously believed, and they know that they are aware that they know very little.

As our former Secretary of Defense Donald Rumsfeld once said in a way only he can, "as we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns -- the ones we don't know we don't know."

Still with me? No? OK, me either really. It is still a mind boggling quote. The basic idea stands, though. With concussions, the doctors and medical people at least know that they don't know much. It is a starting point at the very least.

Maybe defining what exactly a concussion is will help:

 

That wasn't as helpful as I had hoped, so here is an animation, a very basic one, of what happens to cause a concussion:

 

 

Basically, the brain sits in a sac of fluid, and it is traveling at the same speed as the body. When the body experiences a sudden stop, say from Mike Richards' elbow, the brain does not have the ability to stop itself from slamming into the front of the skull and bouncing back. Then it accelerates again, to the same sped the body is traveling only to experience another sudden stop caused by, say, a giant sheet of ice, and slamming into the back of the skull.

Until someone invents a type of seat belt for the brain, players need to rely on their helmet to protect them. The helmets currently used in the NHL do not seem to be useful in this regard, and so several competing versions of new helmets have popped up, the most popular being championed by Mark Messier.

Back to concussions and the severity of the issue. Players in the mid seventies would have been called all kinds of girls names and sent back on the ice after a concussion. Today, they are shut down for weeks at a time, only to show progress and months later suffer a set back and be shut down again.

What changed? The ability to properly diagnose the issue and to share data. In the seventies if someone died in Russia from concussion complications, no one in New York would have known. Today, we would be able to know that in a second. Doctors now have the beginning of a data base to properly diagnose what is happening and attempt to save the players career and / or life.

The difference between a player who comes back in a day (Victor Hedman) and a player who is still living in a world of hurt (David Booth, or Pierre-Marc Bouchard for the hometown fans) is a mystery. No one can pin point exactly when Butch suffered his concussion, and he has been out of play for a long time now. While Booth suffered an obvious and very traumatic collision, Bouchard did not. Both have missed long term playing time.

The most innocuous hit can turn into a disaster, and the most brutal hit can turn out to be nothing. What makes the difference is not completely understood. Shape of the players skull in relation to the brain? The amount of fluid protecting the brain at the time of impact? Angle and direction of travel? Most likely all of the above.

Until medical science finds a way to prevent concussions, they are not going to go away in contact sports. It is a menace we will have to live with for some time. New helmets and new research will continue to help. The fastest and best way for concussions to be prevented? How about a little respect out on the ice for your fellow human being? That would certainly be a good start.

One final thought on this, straight from my own twisted mind. Where are the enforcers of the league on this? Screw the instigator penalty. You are going to tell me that an extra two minute penalty, a penalty kill, or even the loss of two points out of a possible 164 for the year are going to stop you from standing up for your teammate? Come on. Jump the boards, skate over, and pound the guy into oblivion. It's your job. The team and the fans will understand that you have to take a suspension, and you know what? We will give you a standing ovation in your first game back. Your jersey will become the hottest selling in the pro shop, and the next time Mike Richards comes to town, he may actually think twice about leveling your boy skating through the neutral zone, head down or not.

-Buddha

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