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Concussion and Winter Sports

Hockey goalie and players in front of net
U.S. Air Force photo by Mike Kaplan

Young ice hockey players may reduce the severity of a head impact when they are able to anticipate a collision, according to research presented during a webinar hosted by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) earlier this month.

Anticipation seems to play a role in the frequency as well as the magnitude of impacts sustained by young hockey players and football players, said Mihalik, co-director of the Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center at the University of North Carolina at Chapel Hill. Even if an athlete can’t avoid an impact, bracing for one seems to lessen the severity of the impact, he said. To reduce damage from concussions, doctors and coaches need to train players to see them coming.

“The idea from a preventative standpoint is how can we enhance visual function? How can we teach athletes to anticipate those collisions a little bit better?” Mihalik asked. Athletes need to be able to distinguish moving objects from those that aren't, and to be able to scan and interpret what they see in front of them and peripherally, he said.

Mihalik and Erin B. Wasserman, a fellow with the Gfeller Center, presented their findings on ice hockey concussions with the goal of sharing the effectiveness of prevention interventions and educational resources to reduce the risk, incidence, severity and consequences of concussion in that sport. Nearly four million recreational and sport-related traumatic brain injuries occur in the United States each year, costing approximately $56 billion, Mihalik said.

Unfortunately, ice hockey is the only winter sport in which data collection is standardized, Wasserman said. Ice hockey leagues report the number of concussions per 1,000 player hours, starting at the youth level and going all the way through the National Hockey League (NHL). Other winter sports may capture concussion data differently at different levels, for example as a percentage of all injuries or as the number of athletes sustaining injuries.

“We really can't begin to allocate resources or report appropriate treatment and knowledge of concussion in these sports” without standardized data, Wasserman said.

Ice hockey data shows that as the level of play goes up, from youth to high school to college to professional, concussion incidents increase. Preventive measures such as helmets and mouth guards go a long way toward minimizing the effect of concussion. While there are efforts to build a better helmet to prevent concussion, the modern helmet is pretty effective, Mihalik said.

“A helmet is designed to do two things and it does them very, very well. The first thing is to keep you alive and the second is to keep you recoverable,” he said. One successful advance in helmet technology has been their utility in concussion research, he said: Specially-equipped helmets can measure both acceleration and impact in head accidents.

However, preventing concussions during sports probably can’t be achieved with existing technology, Mihalik said.

“Until we can really stop that brain from traveling inside the skull, we're going to have a really hard time preventing all concussions from occurring,” he said.

A transcript and slides from the webinar “Concussion and Winter Sports,” are available from the Defense and Veterans Brain Injury Center.

The views expressed in the webinar do not reflect the official policy of the Department of Defense or DVBIC.

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