Editorial: "Hockey hit ban makes sense"

[cw]

Lew Carpenter Brain Injury: NFL Champ Had Chronic Traumatic Encephelopathy At Time Of Death
Lew Carpenter never had any concussions ? or at least none that his family knew about back in the 1950s and '60s, when he played for the Lions, Browns and Packers and there wasn't as much concern over them as there is now.
...
This week the results came in: Carpenter had an advanced form of Chronic Traumatic Encephelopathy.

"Concussions aren't necessary for CTE to exist," said Dr. Robert Cantu, a Boston University researcher working on the project in conjunction with the Veterans Administration Center for the Study of Traumatic Encephalopathy. "Even if he didn't have any concussions, the amount of subconcussive trauma that he had ? he probably had between 1,000 and 1,500 subconcussive blows a year, just from practice and play in games."

Carpenter is the latest former athlete to be diagnosed with CTE, and the results are leading researchers down a new, perhaps more troubling, path: Damage may be caused as much or more by the low-level, or subconcussive, blows to the heads as by the big hits replayed on the highlight shows that leave a player wobbly.

"It's the total brain trauma. Tens of thousands of subconcussive blows all add up," Cantu told The Associated Press. "You can't draw a line between number of concussions and risk for CTE. You have to factor in the subconcussive trauma. It's equally ? if not more ? important."
...
"We don't know for sure, but we expect that repetitive subconcussive blows play a tremendous role in the development of CTE," said Dr. Robert Stern, one of the researchers working on CTE at Boston University. "And if subconcussive blows do play a role in the development of this brain injury, then bigger changes have to occur."

And again, from a previous post, some folks can have a bunch of concussions and not get CTE.

Regardless, the above finding has to increase concerns with contact sports.

 

[L K]

Lew Carpenter Brain Injury: NFL Champ Had Chronic Traumatic Encephelopathy At Time Of Death
Lew Carpenter never had any concussions ? or at least none that his family knew about back in the 1950s and '60s, when he played for the Lions, Browns and Packers and there wasn't as much concern over them as there is now.
...
This week the results came in: Carpenter had an advanced form of Chronic Traumatic Encephelopathy.

"Concussions aren't necessary for CTE to exist," said Dr. Robert Cantu, a Boston University researcher working on the project in conjunction with the Veterans Administration Center for the Study of Traumatic Encephalopathy. "Even if he didn't have any concussions, the amount of subconcussive trauma that he had ? he probably had between 1,000 and 1,500 subconcussive blows a year, just from practice and play in games."

Carpenter is the latest former athlete to be diagnosed with CTE, and the results are leading researchers down a new, perhaps more troubling, path: Damage may be caused as much or more by the low-level, or subconcussive, blows to the heads as by the big hits replayed on the highlight shows that leave a player wobbly.

"It's the total brain trauma. Tens of thousands of subconcussive blows all add up," Cantu told The Associated Press. "You can't draw a line between number of concussions and risk for CTE. You have to factor in the subconcussive trauma. It's equally ? if not more ? important."
...
"We don't know for sure, but we expect that repetitive subconcussive blows play a tremendous role in the development of CTE," said Dr. Robert Stern, one of the researchers working on CTE at Boston University. "And if subconcussive blows do play a role in the development of this brain injury, then bigger changes have to occur."

And again, from a previous post, some folks can have a bunch of concussions and not get CTE.

Regardless, the above finding has to increase concerns with contact sports.

I'd like to know the parameters of these studies however.  Are they checking random brains for signs of CTE?  We keep hearing about the random athletes who have it, but what if this is just something that is a form of genetic predisposition to brain damage.  Without running a proper study you can't conclude much of anything.

 

[Kin]

I'd like to know the parameters of these studies however.  Are they checking random brains for signs of CTE?  We keep hearing about the random athletes who have it, but what if this is just something that is a form of genetic predisposition to brain damage.  Without running a proper study you can't conclude much of anything.

Isn't it relatively safe to assume that the people at BU know that?

 

[L K]

I'd like to know the parameters of these studies however.  Are they checking random brains for signs of CTE?  We keep hearing about the random athletes who have it, but what if this is just something that is a form of genetic predisposition to brain damage.  Without running a proper study you can't conclude much of anything.

Isn't it relatively safe to assume that the people at BU know that?

Speaking as a member of the medical profession, no, it really isn't.  The quality of a lot of medical/scientific research is quite subpar and is filled with half-valid studies that don't stand up to significant findings but get reported as such anyway.

 

[Kin]

Speaking as a member of the medical profession, no, it really isn't.  The quality of a lot of medical/scientific research is quite subpar and is filled with half-valid studies that don't stand up to significant findings but get reported as such anyway.

Really? Even at a pretty well respected university like BU? I'll take your word for it.

 

[L K]

Speaking as a member of the medical profession, no, it really isn't.  The quality of a lot of medical/scientific research is quite subpar and is filled with half-valid studies that don't stand up to significant findings but get reported as such anyway.

Really? Even at a pretty well respected university like BU? I'll take your word for it.

To be honest, yeah.  And quite frankly its a big issue, especially with physician led studies...one of the worst groups for making conclusions from things that aren't really there.  Stats are poorly taught from the get-go and even when they are, it's basically on the basis of try not to screw up like these examples. 

I'm certainly trying to imply that Dr. Cantu isn't meeting those scientific standards, but based on what has been published in the literature at this point, it's far more individual case studies of athletes who donate their bodies/brains to evaluation - whether they are amateur's or professional athletes. 

And the majority of the funding for these studies is coming through grants provided by the major sports leagues, particularly the NFL and a number of Alzheimer's and Dementia societies.  That certainly provides the potential for conflict of interest in order to reach a long-term positive outcome.

There have been a series of minor case reports of other individuals having similar tauopathy with repeated head trauma (self-injurious autistic girl with a history of head bashing and eye gouging; a circus performer, etc.) but most of it comes from athletes at this point.  And while there are a few research groups looking into the field, all of the study tools and brains for assessment are coming through the Boston University CTE program at this point.  That in and of itself isn't a problem, but with data that is limited to case reports, the field of evidence is just extremely small at this point.

All that being said, there is no way to repeated head injuries can be viewed as a good outcome.  Better measures need to be taken, and should be done proactively to improve equipment design and to minimize direct blows to the head simply through common sense, but it is way to early to link it in any way to simple head injuries.

The tauopathies themselves are your standard "brain plaque" categories with Alzheimer's, ALS. 

 

[hockeyfan1]

From: http://sports.yahoo.com/nhl/blog/puck_daddy/post/The-thin-red-line-between-concussions-entertain;_ylt=AtZZqVqiSI39UOYOmNvVEy17vLYF?urn=nhl-wp20892

Some opinions on the why of concussions in the NHL...

Eric Lindros, whose experience with head trauma has made him the de facto spokesperson for its prevention in the NHL, frequently advocates for the game to be slowed down. From the Kingston Whig-Standard this week:

"The game's has gotten too fast," he said outside the Frontenacs dressing room after his one-hour morning session.
That speed comes at a price for the players' safety, he said. "The red line is out and the game's quicker. It's inevitable there's going to be more (concussions). They knew that when they took the red line out. So they sacrificed that for speed."

Bobby Clarke says:
"When the lockout was over, the red line came out and the things the players could do ? if you saw someone coming you could hold him up, make him break his stride, that was all taken out of the game,'' Clarke said.

So what you had was something akin to pond hockey abandon, only with boards and glass to mitigate that feeling of open ice.
"Now you have players of this size, plowing into each other, they can't protect themselves,'' Clarke said. "They can't protect their teammates ... you just have to take it. "When the red line came out, it sounded like a great idea. It was supposed to end the trap, but it didn't. Players are on top of each other so fast. Some of these concussions happen at the red line. You can't have players skating all over the place, running into each other with no resistance.''

It's here that Clarke and others make a salient point: How many concussions occur because of speed created through the neutral zone? How many dangerous hits happen off long suicide passes, which put unsuspecting players at risk?

Fort Wayne Komets President Michael Franke, of the CHL, favors putting the red line back as well:
"When the red line was eliminated several years ago, they wanted to create more scoring,'' Franke said. "There may be a little bit more, but statistics are showing that scoring is up minimally. The repercussions of the red line being out and now two-line passes is the fact that these players are flying through the neutral zone and into the attacking zone. They don't have to worry about being offside on a two-line pass any more.

"And you have these 220-, 225-pound bodies that are flying into the offensive zone or in the neutral zone, and in my opinion this is why we are getting the concussions. The speed is so great and the body mass is so great that there's no way you can't sit here and think injuries are not going to occur. These are like Mack trucks running into each other.''

Anyone agree on the above?

 

[nutman]

one more thing, they should look at the armor the player are wearing a well, at what point do you stop letting this get stronger and harder.

 

[Madferret]

This is getting ridiculous - a hit ban? This isn't ball hockey!

 

[nutman]

This is getting ridiculous - a hit ban? This isn't ball hockey!

Like i said a long time ago, maybe the squeemish should turn the channel. hits should never be stoped, they need to re-address the equitment.

 

[Madferret]

This is getting ridiculous - a hit ban? This isn't ball hockey!

Like i said a long time ago, maybe the squeemish should turn the channel. hits should never be stoped, they need to re-address the equitment.

No slapshots over the shoulder nutman!

 

[OrangeBlack]

These concussions have been happening on both clean & dirty hits.  Even on clean hits, players are hitting each other differently than they did in the 80's.  The main problem today, vs. the 80's is that the players have no respect for each other.  The zebras control the games now, the players don't police each other anymore.  Even when a hit is clean, the players on the ice know if a hit is excessive or needed during a particular sequence.  That's why you see players go after someone when they delivered a clean hit.  With that said, the NHL should get rid of the instigator penalty & see how that changes the way that players hit each other.  I guarantee there will be more respect on the ice for fear of retribution.

Secondly, speaking of the Flyers (Roenick, Couterier, Giroux, etc.) many concussions happen by getting hit with a slapshot or by accident.  Advances in helmet design would help greatly in that area.

 

[hockeyfan1]

An article from a doctor with an expertise in exercise physiology, nutrition, and sports performance....

http://www.thehockeynews.com/articles/43881-Dr-Boucher-How-do-concussions-impact-the-body.html

....science tends to focus on the neurological and cognitive consequences of a concussion. What should not be ignored, however, is the fact that when an athlete?s brain suffers damage, it loses its ability to send proper signals to the rest of the body. The only way to improve the fitness level of an athlete is through mechanical stimulation (i.e. training). If your brain cannot send the proper signals to your body, you cannot train and you lose fitness during the recovery process.

Some scientific evidence suggests the powerhouses of the brain cells (mitochondria) get disrupted following a concussion. The powerhouses of the brain cells are quite similar to those found in your muscles. The question is: if the powerhouses of your brain cells get disrupted and your brain loses its capacity to send information to your body, could the powerhouses of the muscles get disrupted as well? If so, not only will your fitness level decrease due to a lack of training, your fitness level will further deteriorate as a result of this muscle powerhouse disruption.

This aspect has not yet been scientifically validated, but I think it is a legitimate question.

I have noted, in some cases, that the oxygen uptake kinetics (global aerobic and anaerobic reserves) of people affected by a concussion are even less efficient (anaerobic threshold and maximal aerobic capacity appearing much earlier) than those of normal sedentary people. When abnormal oxygen uptake kinetics are observed, constant fatigue and failure to recover can easily be explained and proper rehabilitation strategies can then be put forward. According to my observations, this type of problem may persist as long as two years after a person sustains a concussion.

...should we consider bringing an athlete back to the game with an almost totally functional brain, but without a fully recovered body?

...if the body has not yet fully recovered and, as a result, has to spend more energy to reach pre-injury intensity levels, which increases fatigue, will the athlete be fit enough to sustain the next impact without any consequences?

 

[hockeyfan1]

Mammoth research project planned on effects of concussions in various sports including hockey...

http://ca.sports.yahoo.com/nhl/news;_ylt=AmQgli0zLPxj91pOWFXGrthShgM6?slug=nc-3periods-concussions-playoffs-power-rankings-040512

 

[Corn Flake]

This is getting ridiculous - a hit ban? This isn't ball hockey!

This is what happens when nerds try to find a way to have an impact in sport.

I'm being facetious, mostly

 

[hockeyfan1]

A sports management conference discussing partially player safety in sports in general. 


What alarmed most was the Stampeders QB Drew Tate who claimed he had no recollection of the first half of the game in which he was playing in, (in the CFL's Western Semi-final this past weekend), after having been pretty viciously by a 'Rider defensive player.  Tate could be seen clutching his head after the play.

Also, the hit on Blake Geoffrion of the AHL's Hamilton Bulldogs, who suffered a "depressed skull fracture" after being hit by a bodycheck and hitting his bead on the ice.  Geoffrion was taken to hospital to the ICU but is expected to recover fully.

Here's the story:

http://ca.sports.yahoo.com/blogs/eh-game/player-safety-one-many-topics-discussion-sports-management-201312510.html


The Geoffrion hit...
http://ca.sports.yahoo.com/blogs/nhl-puck-daddy/blake-geoffrion-takes-big-hit-rushed-hospital-hitting-142832993--nhl.html

 

[hockeyfan1]

Ronny Keller, a player in the Swiss league, left paralyzed (spinal Cord injury) aftec a hit from behind -- similsr to Kaleta's hit from behind on the Rangers Mike Richards.

Goes to show just how dangerous these hits one once again...and with career- ending consequences.

http://nationalpostsports.tumblr.com/post/44802183101/ronny-keller-a-defender-for-olten-in

 

[TML fan]

If the league really cared about player safety, they'd sacrifice seating capacity for bigger ice.

 

[Corn Flake]

If the league really cared about player safety, they'd sacrifice seating capacity for bigger ice.

Didn't help the swiss league player who was just paralyzed. 

 

[TML fan]

If the league really cared about player safety, they'd sacrifice seating capacity for bigger ice.

Didn't help the swiss league player who was just paralyzed.

That's a different issue. I was speaking in reference to what Clarke and Lindros were saying.