Everett, Wash.
Published: Monday, October 29, 2007

No more head games

Head injuries have always been a part of hockey. But leaders in the game, especially in the Canadian Hockey League, have taken an aggressive approach to diagnosing concussions and have strict guidelines on when players can return to the ice.

By John Sleeper
Herald Writer

 Zack Dailey doesn't remember the hit.

He doesn't remember lying prone on the ice.

He doesn't remember his body convulsing.

He doesn't remember waving to the Comcast Arena crowd from a stretcher.

"I just remember being in the ambulance on the way to the hospital," Dailey, a center for the Everett Silvertips hockey team, said of his first concussion. "There's about 10 minutes that I don't remember."

The violent body check came courtesy of 6-foot-5, 217-pound Spokane Chiefs defensemen Justin Falk on Oct. 3. Falk skated a good 10 feet before he lowered his shoulder and caught the 5-6, 156-pound Dailey in the head, instantly knocking Dailey out.

The hit was clean. It was well within the rules of ice hockey. Dailey simply had his head down and didn't see Falk skating toward him.

"He just got smoked," Silvertips general manager Doug Soetaert said.

Although it may seem that concussions are more prevalent in hockey now -- especially junior major hockey -- studies done on the subject are inconclusive. One thing is certain: The primitive days of diagnosing and treating concussions are over. Gone are tests by a coach who asks the player how many fingers he holds up. And popping an aspirin and sitting out a shift or two don't cut it anymore.

"We're paying more attention to it now," Silvertips head trainer Chris Walker said. "There's such a big focus on kids' training now. As we research more in sport and try to learn more about the brain, we've paid more attention to brain injuries than we ever have."

A study published in 2001 by researchers at Simon Fraser University looked at 440 players ages 15 to 20 in a 14-team hockey league. The players were watched during two 54-game seasons and completed a concussion-history questionnaire.

In all, 379 concussions were reported, with more than 60 percent of the players indicating they had suffered at least one concussion. The greatest cause was the head striking the boards, including the end glass. Elbow, shoulder or ice contact ran second.

Today, the Canadian Hockey League, which encompasses the Western Hockey League, the Quebec Major Junior Hockey League and the Ontario Hockey League, has strict return-to-play guidelines that involve a battery of computer-based neurological tests, reaction analyses and physical examinations.

Once a player passes the tests and no longer experiences recurring physical effects for at least five days, he may practice without physical contact. If no other problems arise, he may participate in full-contact practices, until he eventually earns medical approval to play in games.

Hockey is one of the more aggressive participants in return-to-play protocol, even if it was relatively tardy in its launch. Players in the NHL were required to wear helmets only in the last 20 years. It wasn't until the last decade that strict safety features of helmets were enforced by the league.

Still, the helmet cannot prevent concussions completely, even with recent improvements in its design. Players today are bigger, stronger and faster. Collisions are becoming more dangerous and it's often beyond the helmet's function to guard against concussions.

Dean Chynoweth, coach and general manger of the Swift Current Broncos, retired from a nine-year NHL career in 1998 after his 13th concussion. He was 28. Eric Lindros had six documented concussions between March 1998 and May 2000. Jeremy Roenick has had 11 concussions. Early in his retirement, Jeff Beukeboom was so debilitated by concussion-related symptoms that he was unable to help take care of his 2-year-old child. Today, he is relatively symptom-free, but the long-term effects remain to be seen.

"Helmets are primarily designed to prevent skull injuries and penetrating wounds," said Dr. Michael Czarnota, the CHL's official neuropathology consultant. "There have been some improvements in terms of fit and materials, but there will always be a tradeoff between more protective gear that is thicker, bulkier and heavier, the need for free movement of the athlete and the safety of other athletes.

"In addition, many concussions are caused by oblique blows that spin the head and twist the brain. These may start with force applied to the facemask or jaw and have nothing to do with the type of helmet the player is wearing."

Then, too, is the concern about a blow that injures the still-developing brain of players in the CHL, whose athletes fall between the ages of 16 and 20. Of special concern is the occurrence of second-impact syndrome. A second concussion while the brain is still recovering from a previous injury can be fatal.

"It's important that concussion awareness and concussion management is handled more conservatively in younger players," Czarnota said.

The debate is whether second-impact syndrome occurs only in adolescent athletes, although it does seem the younger, more immature brain's are less able to withstand a second blow when recovering from an earlier injury.

Thus, the caution in treatment and management.

"How many times can you have an injury to the brain before you have permanent results?" Walker said.

Former Silvertips player Jeremy Creurer took physicians' advice to give up the game following the 2004-05 season after he suffered his third concussion.

Dailey returned to action after having missed three games, one week after his collision with Falk. Dailey said he felt confident that his return-to-play tests were thorough. In his first game back, he slammed into Portland Winter Hawk defenseman Scott Gabriel, who stands 6-5 and weighs 225 pounds.

"I felt great," Dailey said.

Dailey's only experience with a concussion is a success story. Other players, regrettably, have been less fortunate.

Sports columnist John Sleeper: sleeper@heraldnet.com. To reach Sleeper's blog, click on www.heraldnet.com/danglingparticiples.
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