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Minor and amateur hockey players still getting concussed

A pair of separate studies seem to point out that the effects of checking and collisions in various levels of hockey lead to, surprise surprise, more injuries than previously thought.

The first study, which I think is a little more complete, was a joint study between researchers at the University of Laval and the University of Calgary (due to recent football results, I'll refer to this as the 'Laval' study). They followed 150 minor hockey teams featuring peewee players ages 11 and 12 and compared the health effects on players in Alberta, where checking is allowed at that level, versus Québec, where it is not.

The players from Quebec walked away with one-third the number of injuries as the players in Alberta, and they also sustained fewer concussions: 73 Albertans over the period of a year, to just 20 Québecois kids. Going further, 14 concussions were listed as "severe" in Alberta to just four in Québec.

"We know that the long-term effects on concussions were underestimated in the past. For a long time, we thought that the effects of injuries on young, developing brains could diminish with time, but this is wrong" explained the co-author of the study, Dr. Claude Goulet, an injury specialist at Laval. [La Presse - Translation mine]

I don't like to editorialize when it comes to objective data found, but the amount of physical harm on developing children before they're old enough to decide whether they want to continue playing hockey does make me think Hockey Canada is well behind the times when it comes to checking. Bob Nicholson stressed at the Hockey Canada kickoff event the importance of teaching kids fundamentals when it comes to checking, and that's also a focus of the new app released by the organization.

But at some point it needs to be noted that perhaps methods of coaching contact aren't having the intended effect when it comes to head hits. Young players are still keeping their head down, and in checking leagues, they're the ones who are more likely to sustain harmful brain injuries as a result of the play. It's easy enough to tell a forward in the Ontario Hockey League or the National Hockey League that he shouldn't put himself in a vulnerable position, but much more difficult when you're dealing with a minor hockey-level player.

The second study, which focuses only on two university teams—one women's, one men's—found that the frequency of head injuries was much higher than previous research had found. That's not necessarily the section I want to focus on, though, since it's already known concussions are apparent in hockey.

Almost 70 per cent of the hits that caused a concussion were to a player's head and more than 80 per cent of those knocks were deliberate versus incidental, the observers found. [CP]

These hits aren't accidents. Deliberate, malicious hits to vulnerable opponents still seem difficult to police. The second aspect of this is that it's also difficult to police coaches from sending players back into the game:

"I find that the players and coaches often downplay the symptoms in an effort to get the athlete back into action," said one physician-observer. "I think it relates to the culture of hockey.

"Players are scared to be seen as weak and almost always want to play. Coaches expect their players to 'shake it off' and 'take it for the team' and get back on the ice. I think coaches fail to admit the significance of the symptoms."

The Canadian Press article details an incident where a player was diagnosed with a concussion, but sent back on the ice for the third period despite her feeling "iffy" or "off" and experiencing dizziness. That was the case after the game as well.

The absolute number of reported concussions or injuries going up doesn't necessarily trouble me, since it also means fewer un-reported concussions (although we do have no way of knowing that for sure). I guess the tests will always best be conducted by specialists who can independently observe players and collisions and see if the rates are increasing or not. It's a particularly hairy subject, but since a change of culture and rules has led to less overall fighting in the game, perhaps it can also be made a little safer between the whistles as well.

At this point, the chief concern is finding out what causes concussions, and while Nicholson is right that good fundamentals relating to checking and skating will cause fewer injuries, the reality is that the talent level of minor hockey players also stipulates you'll need other restrictions on contact to make players safer. Kids are bigger, faster and stronger than they were 20 years ago, and the game is only just starting to catch up.