October 14, 2011

Hockey Related Concussions

Sports related concussions are an area of intense scientific research.  As more information is generated, guidelines for the prevention and management of sports related concussions have been rapidly evolving.  None the less, there are some basic facts that most experts would agree on.

1. Impact testing is useful. Having a baseline test done at the start of a season should be mandatory.  Recently the State of Massachusetts made this testing mandatory for all varsity high school athletes.  Many private and prep schools are requiring it of all middle school and high school athletes. The testing can be done on line if a player's school does not provide it.

2. Helmets count, although no helmet is concussion proof.  There has been no formal testing of hockey helmets.  However, studies in the last year have demonstrated a likely 30 - 50% reduction in concussions in football players wearing the newer generation of concussion resistant helmets.  It is likely that these findings will be extended to hockey helmets . All players should invest in a high quality, concussion resistant, helmet.  All helmets more than 5 years old should be discarded. All helmets should be discarded after a concussion has occurred.  Helmets need to fit to be effective.  Mouth guards are unlikely to play a significant role in preventing concussions.

3. Children need to be encouraged to report any symptoms suggestive of a concussion.  There is a natural tendency for children to under report or not report symptoms in order to continue playing their sport.

4. No 2 concussions are identical.  The decision to return to sports after a concussion is complex.  There is no set timetable.  These decisions are frequently beyond the expertise of the average pediatrician.  There are excellent sports medicine/concussion clinics in the Boston area that are a great resource in managing sports related concussions.

5. There is growing evidence that repeated concussions in high school age and younger athletes may result in permanent brain dysfunction.  A recent study found that high school athletes who had 2 or more concussions during their high school careers had a higher incidence of sleep disorders, headaches, and cognitive difficulties as adults.  Once a child has had 2 concussions, great care has to be taken if they return to their sport.

Dr. Jacob Rachlin

www.impacttest.com