In the Loop

News and views from across Mayo Clinic

November 22, 2013

Concussion discussions hit with new force

By Hoyt Finnamore

Perhaps the most obvious indication of the importance of Mayo Clinic's two-day hockey concussion summit held earlier this month is what happened during the first eight days of this year's NHL season. In just over a week, three players were sidelined with concussions, one carried off on a stretcher after his second fight in one game. And the night before the summit, another player was rocked by a jolt to the head, staggered to the bench, and later (yes, later) left the game with an unspecified "head injury."

Then there was the junior hockey player -- an 18-year-old -- who had a seizure and was hospitalized after a fight just one day after Mayo's summit. He plays (and throws off the gloves, apparently) for the unfortunately named Dubuque Fighting Saints.

Fighting was the focus of much discussion at this year's conference. Mayo's Michael Stuart, M.D., says "the kind of blow delivered in a hockey fight … is as dangerous as it gets," according to The New York Times. Dr. Stuart speaks with some authority, not only as an orthopedist, co-director of Mayo's Sports Medicine Center, and chief medical officer for USA Hockey, but also as someone who has had three sons and a son-in-law play in the NHL.

The league has made some changes to its rules about head contact and concussion testing based on recommendations of those gathered for the first Mayo-sponsored concussion summit back in 2010. The environment today may be even more conducive to change. Concern for hockey players should be obvious enough. But folks involved in the game also have concerns for its future. “We don’t want for hockey what we’re seeing in football: parents not putting their kids in the sport because of fear of concussions,” Charles Burke, M.D., former team physician for the Pittsburgh Penguins and director of the NHL’s concussion committee, told the Times.

Research presented at Mayo's summit indicates "more strongly than ever that repeated hits to the heads of hockey players can cause serious harm," according to the Times. The NHL has justified its lack of action by claiming a lack of "conclusive evidence that fighting specifically leads to brain damage." (That despite some fairly convincing anecdotal evidence.) Researchers like Mayo's Aynsley Smith, Ph.D., however, aren't giving up the, um, fight. "We can’t wait for the data that tell us all the neurons that died with each head impact before we stop unnecessary fighting," she tells the Times.

They even pulled the goalie at the summit. Keynote speaker and Hall of Fame netminder Ken Dryden "has argued for years in favour of preventative action," according to "Canada's National Newspaper," The Globe and Mail. Dryden "put it perfectly," according to the newspaper, when he said: “Science has responded to the game on the ice ‑- now, it’s time for the game to respond to the science.” (Maybe they can do something about the Minnesota club's offensive production while they're at it.)

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