Mayo Hockey Concussion conference

Discussion of Minnesota Youth Hockey

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BadgerBob82
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Joined: Tue Feb 23, 2010 8:49 am

Post by BadgerBob82 » Wed Oct 06, 2010 8:24 am

The Maher mouthguard advertisement admits the mouthguard protects against a direct blow to the jaw. Does nothing to slow down the brain from crashing into the skull on a hit to the head. Mouthguards are extremely overrated for concussion protection in hockey. But I do love the refs that are on a crusade to make sure all kids have them properly fitted, hence sitting for 10 minute misconduct.

goldy313
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Post by goldy313 » Wed Oct 06, 2010 9:51 am

At the highest levels players are bigger and stronger than 20 years ago, rule changes and equipment changes allowed that to happen. The NHL, NCAA, and USA Hockey all used to have limits on the length of sticks which did a lot to prevent anyone bigger than 6' to play. Wood sticks have given way to other stronger materials, facemasks allow players to put their heads where they wouldn't have been, rule changes have done the same. Of course wearing the equipment improperly - Mark Pohl, can contribute as well.

This summer I went to a football officials conference and one of the seminars was on concussions, they had Neurologist from Ohio State and one from Tennessee giving the seminar. All in all even the best equipment won't stop them, a concussion can happen with no contact at all due sudden deceleration. Think of a seat belt, just because the car hits a bridge and stops the body is still moving forward and whiplash happens. You can have a concussion without you head ever hitting the windshield because your head stopped but the brain inside moved forwards and hit the inside of your skull causing trauma. Their end point was all the equipment improvement and penalty enforcement won't stop concussions, good coaching at early stages building good habits will and early detection of and relaying that information to informed parents, medical staff, and coaches who's primary concern is the well being of the player will also help. As officials the best we can do is, as the first ones on the scene and the ones closest to the injury is make our observations - mechanism of injury, immediate player reaction, etc. known to the coaches and medical staff so they can make informed decisions. Penalty enforcement is key but once at the high school level habits are ingrained and harder to break. Coaching and penalty enforcement early on is far more important than later on.

Football is lucky in the sense that there is no benefit from putting yourself in a risky position. Hockey isn't in the same boat as you can draw a penalty for putting yourself in a bad spot, how often do see kids drop to a knee and get hit in the head by a shoulder or forearm? Turn their back toward an opponent? The don't perceive the risk and there is no penalty on them and while by engaging in such behavior they can draw a penalty on their opponent.

One interesting thing out of the conference was the brain scans they showed of a Cinncinnati Bengal linebacker who died in an accident, he had never had a diagnosed concussion yet his brain scans post mortem showed numerous old brain injuries.

Another was football, as we know it, may end in the next 40-50 years for a couple of reasons....Nobody will make football helmets, the liability is to great and in the next couple of years a warning sticker will be on helmets similar to what's on cigarettes. Once parents become aware of the long term effects of concussions, and we're only starting to learn how detrimental they are, there will be less and less players because parents won't sign their kids up.

goldy313
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Joined: Tue Mar 05, 2002 11:56 am

Post by goldy313 » Wed Oct 06, 2010 10:01 am

BadgerBob82 wrote:Mouthguards are extremely overrated for concussion protection in hockey.
That's an extremely ignorant statement, all research shows a properly fitted mouthguard is a very important tool in the prevention of some concussions. It slows and absorbs the shock of the bottom jaws impact on the upper jaw. The mechanism is the key, it won't help if the blow is in the back of the head but if the blow is from the bottom it's the key because obviously there is no helmet there. Think of a boxer, a mouthguard has no effect on a blow to the side of the head but will on an uppercut. In amateur boxing boxers are required to wear headgear that protects the side of the head and mouthguards to absorb a blow to the chin.

stopthepuck
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Post by stopthepuck » Wed Oct 06, 2010 11:35 am

It's actually not an ignorant statement - the good research just isn't there yet. It HAS been shown to prevent oral maxofacial injuries but not concussions. Not saying that the mouthguard doesn't have a role in preventing concussions -- but the valid research just has not been done yet. The manufacturers of mouthguards continue to spout case reports and antecdotal research to support their sales. Use the mouthguard, buy the most expensive one you can afford, but REALIZE, the research that has been done is not conclusive, YET.

BadgerBob82
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Joined: Tue Feb 23, 2010 8:49 am

Post by BadgerBob82 » Wed Oct 06, 2010 1:21 pm

Goldy313: That was not an ignorant statement at all. I have personally talked to Dr's and research Phd's that said the mouthguard in hockey is of little use in the prevention of concussions, FROM PLAYING HOCKEY. Your boxing analogy is a good one, an uppercut to the jaw can be reduced with a mouthguard. But, today's facemasks have very well designed chin cups that keep the mask away from the chin. The foam material and the way the straps are attached provide shock absorption on the hits to the chin.

Concussions in hockey come from three main forces, head hitting the ice, head hitting the boards and head hitting a body part (elbow, shoulder, knee etc). Concussions from sudden stops from an open ice hit, without head hitting anything, are not too common. Same as from teeth clanking together.

So I am all for the mouthguard, but please don't advocate each player get a $100 mouthguard made by a dentist when a $2.00 one accomplishes the same level of protection, while playing youth hockey.

warmskin
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Post by warmskin » Fri Oct 08, 2010 12:26 pm

If you look at Cascades web site they are clear that they are one part of preventing concussions. No helmet manufacturer can come out and say they will prevent concussions since their have been no clinical medical studies in this area.
I am not sure what the end result of the Mayo conference will be other than recommendations on rules and possibly things that have been mentioned here on helmet fit and mouthguards.

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