Protect Children From Catastrophic Hockey Injuries

By Dr. W. Gifford Jones

January 11, 2004

What should parents know about concussions in hockey? To find out I recently attended a seminar on this problem at the Air Canada Centre in Toronto. Today there's a huge debate raging over whether body checking should be allowed in players under 17 years of age. Unfortunately, the "big hit" does more to the brain than meets the eye. Today our national sport has become a violent past time.

During the meeting we were shown videos of devastating NHL body checks. It's a reality check to see superbly conditioned players lying unconscious on the ice. Then, Ken Dryden, former goal tender for the Montreal Canadians, pointed out that we forget the game has changed drastically.

Today NHL players are 27 pounds heavier, taller and shifts have decreased from 2 minutes (Henri Richard routinely had a 3 minute shift!) to 40 seconds. The result? Players go all out for 40 seconds with increased speed. And when two 225 pound bodies collide during a body check both heads are vulnerable to concussion.

Teenagers are not NHL players. But they all aspire to be in the NHL and try to mimic their heroes. That comes as a price. A recent study showed 86 per cent of all hockey injuries among players 9 to 15 years of age are due to body checking.

New modern equipment such as helmets with visors has prevented the loss of eyes. But helmets make young players believe head injuries cannot occur. But the brain isn't firmly attached by screws inside the head. A sudden violent hit to the head throws the brain against the bony skull causing a badly bruised brain.

Concussion causes a variety of symptoms such as headache, double vision and a feeling of "having my bell rung". Players lose coordination and are unable to answer simple questions such as "what is the score?" But they do not need to be unconscious to suffer concussion.

Bruised brains are hard to diagnose. A torn muscle is easily to locate. But there is no way to physically assess actual brain damage during concussion.

Dr. Karen Johnston, a neurosurgeon at McGill University, stressed one cardinal rule. If a player shows any sign of concussion he must stop playing and if there's any doubt "sit him out". It's wrong for coaches to tell players to "shake it off". And players must never be left alone after a suspected concussion and quickly seen by a physician.

Following concussion complete rest is mandatory. Once symptoms have subsided players can start limited activity such as walking, the use of a stationary bike, an easy skate and a step-wise return to hockey. But if symptoms return along the way it's back to square one.

Dr. Charles Tator, a Toronto neurosurgeon, says that when players should be allowed to return to hockey is the $64.00 question. Players invariably want to downplay concussion. They're afraid someone will take their place and they want to act tough. But since there's no sure way to assess how well the brain has healed it's prudent to allow more time than less to prevent long-term brain damage.

Suffering a first concussion is one thing, the second is another matter. Dr. Tator stressed that a second strike to the bruised brain before it has healed will cause additional damage and on rare occasions death from sudden swelling of the brain.

Brain concussion is a terrible price to pay for a game that is supposed to be fun for young hockey players. It appears that hell will freeze over before club owners stop senseless fighting and vicious head checking in the NHL. But it should have no part in amateur hockey. And there's reason to suspect that concussion is under-reported in teenagers.

Hockey is a contact sport and will never be 100 per cent safe. But if parents have respect for their child's brain they will press officials to ban body checking in amateur hockey. It's a sad commentary on our hockey culture when TV commentators gleefully report the number of "hits" in the last game.

Making the ice surface Olympic size would decrease concussions in NHL players and provide more room for classy players to display their skills. Why hasn't it been done? It's called greed. It would mean a loss of seats and dollars!

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

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Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod