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Concussions in Hockey: Recognition, Management, Prevention By: Mike Pameli BScPT, Registered Physiotherapist, Nobleton Physiotherapy Ask yourself this simple question: "Do you know how to recognize a concussion and ensure your child returns to sport safely?" If you answered no, the remainder of this article will provide you with the information you need to know. Did you know concussion is the most common athletic injury? In fact, hockey rates are among the highest of all contact sports for concussion rates per player exposure (Cantu, 1996). As your son or daughter ventures out onto the ice this year its important to know the facts and treat these injuries efficiently, effectively, and safely! An injury to the brain is different. It cannot be iced, wrapped, splinted, or surgically repaired. A concussion is an immediate or temporary alteration of mental functioning due to trauma. This trauma does not have to be directly to the head; concussion can also occur from a whiplash effect of the head. Early recognition of signs and symptoms include (minimum of one indicates concussion!): headaches, dizziness, nausea, amnesia, poor concentration, loss of vision, vomiting, poor balance, feeling "foggy", "dazed", or "bell-ringer", and loss of consciousness. Signs and symptoms noticed hours to days later are classified as `Post-Concussion Syndrome'. These include: memory loss, fatigue, personality change, irritability, insomnia, vertigo, ringing in ears, and sleepiness. Now that we know what a concussion is and how to recognize it, how can we prevent it? Suggestions for hockey are as follows: the usage of correct, properly fitted and maintained protective equipment; ensuring the athletes understand correct technique (i.e. bodychecking in hockey); following the safety rules of the sport to ensure the athlete practices good sportsmanship and safeplay (i.e. eliminate hitting from behind, and hits to the head); and finally, administering pre-season baseline testing to establish pre-injury normative data. At Nobleton Physiotherapy we have designed a program for pre-season baseline concussion testing. Each athlete is administered a standardized test to establish a baseline score of mental function and status. In the event a concussion occurs during the year, the athlete is re-tested to identify the extent of injury and to objectively provide information for return to sport decision making. Asking the athlete if he/she "feels ok" is simply not good enough! We all know many kids will say whatever it takes to get back to playing the sport. Unfortunately, this poses serious health risks including more severe concussions, brain dysfunction, or death. Currently, there is no medical treatment that will help speed up the healing process. The most important treatment is recognition of symptoms and careful monitoring of the athlete along with proper `Return to Sport Protocol'. In summary, if concussion is suspected: 1) Remove player from game immediately; 2) Rest (physical and cognitive) and monitor symptoms ­ seek medical support; 3) Educate and reassure the athlete; and 4) Utilize `Return-to-Play' protocol once asymptomatic.

Concussions are serious! Knowledge, recognition, and correct action when it occurs will minimize long-term effects. Prevention is the only cure! If you would like more information regarding Nobleton Physiotherapy's `Pre-Season Baseline Testing Program' or `Return to Sport Protocols', please feel free to call us at (905) 859-6708 or email me [email protected] . Further information on concussion can be found on these helpful websites: and Nobleton Physiotherapy is an orthopaedic and sports injury clinic located in the Nobleton Plaza owned and operated by Registered Physiotherapists Giacomo Fabrizio and Mike Pameli. It has been providing healthcare to the King Towship since 2004. To learn more, please visit


Concussions in Hockey

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