Hockey Hits the Head Hard

Concussions occurring more often among male and female hockey players

(RxWiki News) Football has been in the news for concern over head injuries. Now it's hockey's turn. Concussions and on-going headaches are impacting both men and women hockey players.

The number of men and women getting diagnosed with a concussion was three times higher than in previous studies, new research has found.

"Don't hide your headaches if you get hit."

The goal of the study, led by Paul Echlin, MD, a sports medicine specialist with the Ontario Medical Association and Elliott Sports Medicine Clinic in Canada, was to find how often 45 male and female varsity hockey players got concussions during play. Researchers looked at one men's and one women's Canadian college hockey team between August 2011 and March 2012. More than half of the total number of players were male.

They also looked at how the brain responded to various psychological tests both before and after the regular hockey season.

At the start of the season, each player had an MRI to measure brain activity. Researchers also had players take the Sport Concussion Assessment and ImPACT tests to see if there was damage to the brain and its functioning.

The ImPACT, or Immediate Post-Concussion Assessment and Cognitive Test, measures patients' memory, ability to pay attention and the time it takes to respond and react.

Throughout the hockey season, a doctor and non-medical observer kept tabs on players and watched 20 percent of the games. The observers looked for blows to the athletes' heads or bodies and signs that the player lacked coordination or was unstable, in addition to the traditional headaches, blurred vision and dizziness that comes with concussions.

Each time a concussion was diagnosed, the injured player took the tests again three days later, as well as two weeks and two months afterwards.

Among the 55 observed games, 11 concussions occurred. For male and female players together, this came out to about 12 concussions for every 1,000 athletes over both regular and playoff seasons.

For men's collegiate hockey, this was three times higher than previously reported and five times higher than for women, researchers said, which may be because they relied on actual doctors' diagnoses rather than having athletes report the injury themselves.

Women were diagnosed more often with the head injury than men during the regular season; 15 women and eight men reported having a concussion.

Three of the male players did not miss any games after being diagnosed and were able to return to the game in less than a week. Two male players missed games after being injured, with one benched for the rest of the season.

The two women with concussions did not miss any games, although one waited until after the season to get checked out. The other completed the protocol required to return to play.

Brain and psychological functioning did not differ significantly between those who were and were not diagnosed with the head injury. Dan Clearfield, DO, MS, a primary care sports medicine physician and dailyRx Contributing Expert, is not surprised with the outcomes.

"Concussions that are properly managed should return back to a normal baseline of cognitive function," he said.

"Considering physicians and others involved in the management of concussions have learned when to more appropriately safely return concussed athletes to play, we are going to see a continued trend of players doing absolutely fine two months after suffering a concussion."

And researchers found those who were injured didn't have long-standing changes after the bump to the head.

"The sports that our children play enrich our society," researchers wrote in their report.

"Sport must evolve to minimize concussion incidence as well as improve the identification and treatment of this serious brain injury."

No concussions were reported during practice and only one was diagnosed during an exhibition game.

The authors note the two concussion tests may not completely measure the injury as directly as possible since the number of participants was small. And some athletes may be concerned about reporting their injuries for fear of getting benched.

The study, published in the December issue of the Neurosurgical Focus from the Journal of Neurosurgery Publishing Group, was funded by the Ontario Trillium Foundation, the Dave Irwin Foundation for Brain Injury, the Ontario Neurotrauma Foundation and Air Canada. No conflicts of interest were reported.

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Review Date: 
December 8, 2012