Hockey Players Must Face the Possibility of Brain Injuries

Nancy Deutsch

Hockey players who suffer repeated concussions in the course of play may want to think about watching the sport rather than participating. Research here shows that players who suffer three or more concussions likely have some form of permanent brain damage.

After several concussions, "the brain starts to do simple things differently," noted Michael Gaetz, a Simon Fraser University researcher and graduate student.

Gaetz spent last fall assessing the brain function of 300 junior league hockey players with EEGs and computer tests designed to measure motor skills, reaction times and co-ordination. He tested all players at the beginning of the hockey season for a baseline reading, then re-tested those who suffered a concussion within 24 hours of the accident, with follow-up tests at two weeks, one month and three months. Players were reached quickly following a concussion because Gaetz travels in a mobile testing unit.

Players who had suffered three or more concussions in their lifetime took 50 milliseconds longer in visual cognitive event-related potential than players who had never had a single concussion, he said.

While changes were noticeable after a single concussion, the brain did seem to heal itself quickly, he said. "Brain responses do recover quite a lot of function in three months" due to cell regeneration, Gaetz explained. "The brain is fairly good at reorganizing itself." However, after three or more concussions, "there seems to be a real cumulative effect."

Even before this research there have been signs that a career in a contact sport such as hockey can lead to changes in brain function, including problems with attention span, short-term memory, and mood, Gaetz said. In past years, players such as Brett Lindros and Paul Kariya have left hockey citing problems with brain function they blamed on the sport.

Brain function problems in hockey players can be compared to problems identified in people who have been in motor vehicle accidents, Gaetz said. The nature of these injuries is often similar, as there is quick acceleration and deceleration of the brain in the skull in both instances, he said. In the study completed last year, 60 of the 300 hockey players, averaging 16 to 20 years of age, reported concussions.

That is an incidence of one in five players, and "that is high," Gaetz said. He is conducting a similar study this year, and has found that only 25 of 280 players have reported concussions to date. The average number of concussions suffered by hockey players in any season is probably somewhere between the two, Gaetz said.

He believes some of the concussions go unreported because players are worried they will not be permitted to play due to concerns about their health in the wake of a concussion.

Most of the injuries reported occurred when a player slid headfirst into the boards. Other concussions were due to accidental blows to the head from shoulders or elbows. Scuffling actually fell low on the list of causes, Gaetz said. He noted that the sport does not seem to be equally dangerous to all. Some players have a lengthy hockey career without suffering a single concussion. "I've played hockey my whole life" (or, rather, 29 of his 34 years), and suffered only a single concussion at age nine. "I don't think it (hockey) is any more dangerous than any other contact sport." However, players should be aware of the potential damage, and take their concussion seriously, he said.

Gaetz recommends resting after a concussion, but could not suggest how long a rest is necessary.

"We're really at the forefront of this (research)." In addition to more research of this sort, Gaetz would like to do long-term follow-up on injured players. Data collection for his current project will not be completed until next June, and then the data will need to be analyzed, Gaetz said. Results of last year's study have not yet been published. While the research is being conducted out of Simon Fraser, the mobile unit has been lent to the university for a period of three years from the B.C. Rick Hansen Neurotrauma Initiative.

Reproduced from The Monthly News in Adolescence. Original article from The Medical Post, October 12 1999.