So you want to be the next Sydney Crosby or NOT, News (Seaforth Stars Minor Hockey)

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So you want to be the next Sydney Crosby or NOT
Submitted By Hpercival on Monday, September 29, 2014
Hello SMHA Members.  Here is a Concussion article written by Dr. Heather Percival.  Dr Percival is our organizations main resource on health and safety of our athletes.

Please read the attached article.

So you want to be the next Sydney Crosby…or not.

The great “Sid the Kid”-unfortunately one of his biggest legacies will be bringing the concussion into the limelight and demonstrating just how debilitating a second impact can be.  There are lots of theories why we are hearing more about concussions, but the biggest two are that one, we are just much more aware, and two, with all the protective equipment normally invincible kids think themselves even more so. 

So, what is a concussion?  Simply put, it is a brain bruise.  Depending on where that bruise is and how large it is will determine the symptoms and some of the recovery time.  Picture an apple in a small cardboard box.  You shake the box and the apple inside will be bruised.  If you keep repeatedly shaking the box, eventually you will get applesauce.   Your brain is that apple and repeated hits in a short time can result in severe brain swelling and even death.  Over the long term repeated hits, even with significant recovery time, can lead to dementia type illnesses (think about Mohammed Ali).  Kids and teenagers with long spindly necks seem to be even more prone to serious concussions.  This is due in part to the brain development and that their heads do not have the same support from their necks, so they bounce their skull around more (the bobble head effect).

How do you get a concussion?  Anything that causes your brain to jiggle around inside your skull can cause a concussion.  So, it does not have to be a blow to the head or the head hitting the ice or boards.  Some of the worst concussions I have seen have been shoulder to shoulder contact and the head is whipped around, the classic whiplash.  Once you have had one concussion in a year, you are much more prone to getting another one-so less of an impact or brain jiggle can cause the same symptoms.  If you get a second concussion before the first one has completely healed, it can be months before the symptoms are gone.  And you never know how long a concussion takes to heal until it has.

So what are the symptoms?  Basically they can be as widely varied as your brain is.  The common ones are headache, nausea, dizziness, confusion and not liking the light, but can be behavioural changes, irritability, difficultly sleeping, balance problems, memory issues and hand eye coordination problems.  You do not have to be knocked unconscious to have a concussion.  In fact, that seems to be somewhat protective.  The memory loss may be of the time before, after or during the concussion and may be very concerning to everyone.   The other important thing to remember is that the symptoms can take 24 hours to appear.  So, you may have someone a bit dazed coming off the ice, but seems fine after a few minutes.  Then the next day he or she develops the headache and dizziness.  This is one of the more concerning things about concussions, and the reason the medical profession seems rather anal about pulling kids off the ice.  Because, as mentioned if you have a concussion and get hit again the damage is significantly greater and may be fatal (two deaths in the last two years in Ontario of teens with second impact).  So, when in doubt, sit them out. 

How do you treat a concussion?  Well, that is a really evolving science as we understand more about the brain and how it heals itself.  So, treatments are continually evolving and changing.  But, like any bruise or injury, rest is the best medicine.  Until the symptoms are totally gone you must completely rest-that means no school, work, tv or video games or texting.  Only once the symptoms are gone for 24 hours can you gradually increase your activity as covered in the concussion protocol.  This is accessed on the website and should also be given to every child who has a concussion.  If symptoms return it means you have done too much and you need to go back to the previous step and stay there for 24-48 hours again.

This is why the impact testing and the other concussion evaluations before playing are so important.  Basically these are tests that give a good snap shot of how the brain is working.  Unfortunately everybody’s brain is slightly different so that is why we need a baseline pre-concussion test to have something to compare too.  There are other tests I do to see if the brain is functioning normally but the impact is a nice standard tool.  Unfortunately it is only geared for age 10 and up, but likely over the next year or so there will be other tests available for younger kids.  You may think you are just fine, and then we do the testing a reveal that there is not total healing.  This helps avoid returning and causing further injury because sometimes people don’t realize they are having symptoms, or they are just so desperate to get back to playing they try and fudge things.  The good news, it’s hard to fudge these tests!

So, bottom line, listen to the trainer and coach, and if there is any doubt, or it just looks like a really bad hit, take 24 hours and make sure all is ok before returning to play.  If you or your child does have a concussion, go to the website and follow the directions regarding the healing stages, and also how to contact myself about doing the tests to see if you are significantly healed.  Concussions will happen, but if they are treated correctly they will not become a debilitating problem.   Just remember, Sid was out for 17 months, and one wonders if he really has completely returned to his pre concussion game.  Don’t be just like Sid-be better than that!         

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