Five years ago, a young hockey player at the top of his game sustained a couple of heavy blows to his head. The resulting concussion was devastating – sidelining his career and putting his health in serious jeopardy. With June being Brain Injury Awareness Month across Canada, we immediately think of this man’s accomplishments and struggles with brain injury.

This week, that young man is making a triumphant return to the arena where he has long made his mark. You may have heard of him. His name is Sidney Crosby. And this week he is making his third appearance in a Stanley Cup Final – the first since sustaining a serious concussion in January of 2011.

Of course, Vancouverites will know Sid the Kid by his Golden Goal. The whole city – indeed the whole of Canada – cheered ecstatically when he brought down the curtain on the 2010 Olympics with that breathtaking goal in overtime against the American squad.

Sadly, a year later, Number 87’s spectacular career was thrown into a tailspin following his concussion. His recovery lasted years. So as he laced up this week for his latest appearance in the Stanley Cup Finals, we remember the long road he took to get here.

Of course, you don’t have to be an Olympic or Stanley Cup champion to know or suffer the impact of a brain injury. That’s what Brain Injury Awareness Month is all about.

According to the Brain Injury Association of Canada, 160,000 Canadians sustain a brain injury each year and over a million live with the effects of an acquired brain injury. The statistics also show that half of those injuries result from falls and motor vehicle accidents.

The good news is that many brain injuries are preventable, especially in sports. The first tip is to always wear a helmet when biking, playing contact sports, or engaging in activities like rollerblading, skiing, or snowboarding where falls are common. Helmets do not always prevent concussions, but properly designed and fitted helmets are your best first line of defense.

Of course, not everything in life can be prevented. Car crashes, falls, and other events can’t be anticipated. Fortunately, the majority of brain injuries are treatable if diagnosed early enough. If you’ve been in an accident or fall and think you’ve sustained a brain injury, go get treatment!

A brain injury is always something to take seriously. Without proper attention, diagnosis, and treatment, the situation can easily worsen with further problems developing down the road. The impact of a brain injury can take only seconds to happen but it can last a lifetime.

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There’s no denying that the NFL has a serious issue with concussions. After years of trying to sweep it under the rug, they’ve since come around to establishing procedures for dealing with concussed players. But what about the NHL? Is the group that governs the professional league of Canada’s most loved sport playing in the same headspace?

A leading expert on traumatic brain injury (TBI) speaking in Vancouver last month suggested that professional hockey may be in the same state of denial football found itself in a few years back. Examining the incidences and consequences of concussions and brain injuries on NFL players, there are parallels and concerns for all players – whether they’re sporting cleats or skates.

Dr. Frank Conidi presented findings of an initial study of 40 retired NFL players (the study has since expanded to include 80 to 100 participants). Most shockingly, he reported that almost half of those in the study showed evidence of brain abnormalities.

Speaking in April at the 2016 annual meeting of the American Academy of Neurology held at the Vancouver Convention Centre, Dr. Conidi pointed out that players came to him with other serious problems resulting from their head injuries. Anxiety, depression, sleep and attention issues, as well as executive functioning, learning, and memory problems were experienced by many of his patients.

“You see NFL players retiring over head injuries,” Condini added. Given that the median age for the players in the study was just under 36 years, these are serious concerns for a group of men in the prime of their lives.

In the defensive zone

Dr. Conidi is no stranger to treating patients with sports related brain injuries. He’s the director of the Florida Center for Headache and Sports Neurology, specializing in the treatment of sports related neurological disorders. He’s also team neurologist for the Florida Panthers and a consulting neurologist for the Miami Dolphins and NY Mets.

A former hockey player, Conidi knows the risks associated with our national pastime: “Hockey has the highest incidence of concussion per participant, at any level.”

With many high profile hockey players experiencing concussions, Conidi’s research shows that our love for sport must be tempered by an equally dedicated drive for protecting players from brain injury.

 

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A Virginia Tech study concludes that at least 28% of all hockey helmets are unsafe to wear based on their ability to prevent concussions. These tests include helmets worn by both the NHL and youth leagues.

Hockey helmets were awarded one to five stars based on a grading system that took three years and $500,000 to develop. No funding was received from the helmet industry.

32 helmets were tested.

Hockey players wearing the “not recommended” helmets risk incurring at least six concussions per season, and in some cases more than eight, according to Virginia Tech.

Football has adopted a new standardized system for rating a helmet’s effectiveness in protecting against concussions. It has been credited with helping parents and players make better decisions about what helmets are best at reducing concussion risks.

The new standard is a five-point rating scale called the STAR system. It was developed by scientists and engineers at Virginia Tech, later used by the school’s football team in 2011. The football helmet rating system quickly caught on, encouraging manufacturers like Riddell and Rawlings to improve their helmet’s design.

Parents, too, have been listening. Sales of helmets with a five-star rating have spiked, whereas sales for low-rated helmets have plummeted. Even the NFL promoted the STAR rating system and posted ratings in every locker room around the league.

It’s now time for hockey helmets to improve.

A simple blood test may be all it takes to diagnose a concussion, according to new research out of Sweden. The study identified total tau protein (T-tau) as the unique biomarker able to confirm concussion diagnosis and predict the severity and duration of symptoms.

T-tau is typically found only in cerebral spinal fluid. But a blow to the head may cause it to get into the blood if the blood-brain barrier is damaged.

T-tau is one of the biomarkers also found to predict the onset of Alzheimer’s or dementia in otherwise healthy individuals.

Research led by Canadian concussion specialist Dr. Paul Echlin proves that all it takes is one concussion to alter the brains of young athletes.

Working in collaboration with neuroscientists around the world, Echlin analyzed the brains of 45 male and female hockey players aged 19-26. MRI imaging revealed microscopic changes that could be linked to cognitive deficits and long-term brain disease like Chronic Traumatic Encephalopathy (CTE).

Part I of the study focused on changes in the brain immediately following a concussion. Eleven of the 45 hockey players suffered concussions throughout the season.
MRI scans revealed microbleeding in all 11 concussed brains.

Part II examined the brain’s white matter three days post-injury (white matter transmits signals from one part of the brain to another). Scans revealed inflammation in the brain that constricted the space between white matter cells.

Part III compared MRI scans at the end of the players’ season to original baseline scans. All showed varying levels of microscopic change in both injured and uninjured brains. The microscopic change “could be the first sign of long-term pathologies,” said Martha Shenton of Harvard Medical School.

Prevention is Key

Some believe improved safety gear will play an important role in brain injury prevention – equipment like concussion-reducing helmets that are starting to hit store shelves.

But Echlin believes brain injury prevention must happen at the social level. “It is time to consider a cultural shift to address the prevention and treatment of [concussion] that is occurring at epidemic proportions,” says Echlin.

Dr. Michael Cusimano, neurosurgeon at a Level 1 trauma centre in Toronto, says we need to find new ways to keep kids in sport while keeping them as safe as possible. He believes professional leagues like the NHL must set the tone. “Whatever is done at the professional level in sports is emulated almost immediately by children who idolize their heroes. NHL players also have to be aware of this and set a better example for our kids,” says Cusimano.

Cusimano also believes that parents must teach kids what is and is not acceptable in sport. Do you shout words of encouragement when a fight breaks out on the ice? Do your words and body language show your excitement? This response to violence tells kids that fighting in sports is okay. It’s time to send our kids a new message.

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It’s been 12 years since Canucks fan favourite Gino Odjick played in the NHL. He was a left-winger known for fighting, not goal scoring (he scored just 64 goals in his 12 NHL seasons). Odjick spent 2567 minutes in the penalty box, putting him in the 17th spot for career penalty minutes.

Today, Odjick’s fight is with mental illness. He says his condition is linked to the pounding he took on the ice. “When you eat headshots, it’s hard on the brain,” says Odjick. He’s spent nearly three years in hospitals across the country since retiring in 2002. He’s only 43 years old.

Odjick’s appearance at Pavel Bure’s jersey retirement ceremony last November drew attention to his current condition. 

Concussions occur when the brain rotates within the skull after an impact. The movement causes axons in the brain to tear or stretch, leading to symptoms associated with brain injury.

Helmets that meet today’s standards do not protect against the “rotational acceleration” of the brain that can cause a concussion.

It’s time for something better.

MIPS Helmet Lessens the Rotation

The Multi-directional Impact Protection System (MIPS) helmet is designed to protect against the rotational acceleration that can injure the brain.

A class-action lawsuit has been filed against the NHL alleging that the league has not done enough to protect players from concussions. The lawsuit was filed last week in Washington and now includes over 200 former players.

The issue of concealment is at the centre of the lawsuit. As one excerpt reads: “The NHL’s active and purposeful concealment of the severe risks of brain injuries exposed players to unnecessary dangers they could have avoided had the NHL provided them with truthful and accurate information and taken appropriate action to prevent needless harm.”

News of the lawsuit against the NHL comes only three months after the NFL agreed to pay $765M to former players now suffering from dementia and other concussion-related health problems. By settling, the NFL did not have to admit any wrongdoing.

Sports law expert Eric Macramalla says it must be proved in court that the NHL chose not to share information about the long-term neurological impacts of repeated head shots. Without evidence, “the case will ultimately fail,” says Macramalla.

NHL deputy commissioner Bill Daly acknowledged the seriousness of the issue but admits no wrongdoing. “We are completely satisfied with the responsible manner in which the League and the Player’s Association have managed Player safety over time. We intend to defend the case vigorously.”

News of the concussion lawsuit comes just days before the NHL announced a $5.2B deal with Rogers Communications, giving the media mogul all broadcast and multimedia rights in Canada. It’s the largest deal of its kind in the NHL’s history and will cover 12 seasons, beginning in 2014/15.

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hockey_fightThe NHL is back for another season. And so is the fighting.

Controversy resumed after a fight in the league’s opening game left Montreal enforcer George Parros out with a concussion. It was Parros’s second fight of the game against Colton Orr. Unable to get up, Parros was taken off the ice on a gurney.

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