With such an emphasis being placed on concussions these days, there is a lot of information circulating about how to deal with them. One big gray area that still remains, however, is when does a coach take a player out of the game because of a hit to the head?
Minnesota Hockey emailed this concussion video with their latest newsletter:
http://www.youtube.com/watch?v=E26fo4WQ ... ture=email
In it, Hal Tearse talks about the symptoms of a concussion, which include headaches, dizziness, confusion, blurred vision, and memory loss. He talks about erring on the side of caution and taking a player out of the game if you feel he may have suffered a concussion.
Obviously, if a player displays multiple symptoms I would sit them out of the game until they could be further evaluated. But what if a player takes a shot to the head, seems fine in all other aspects, but says they have a bit of a headache. Should a coach sit them for the rest of the game?
Or, take for example an out of town PeeWee tournament I was at last weekend. Our first game was pretty physical, and afterwards my son said he had a headache. I didn't see him take any shots to the head, and he said he felt fine the next day, so he continued to play.
What if a player goes down hard (maybe they stay down for a bit) but get up under their own power and after a brief rest say they are ready to go (no headaches, no other symptoms)?
My question is about that gray area and what criteria are other coaches are using in regards to concussions. When would you let a kid continue to play? When would you sit him for further evaluation?
Concussions
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jBlaze3000
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Lol, that's why I'm asking. It's a fine line and a tough call. I'd hate to play a kid when he shouldn't and have him get injured, but at the same time I don't want half my team sitting on the bench because they have a slight headache.C-dad wrote:Sure, ask the hard questions.
Maybe there's a neurologist posting in here who can answer these. I know I can't.
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YouthHockeyDad
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The following is nothing more than personal opinion from a non-expert. But I have watched my son get more then once concussion in his youth hockey career, and the same questions come up every time.
Maybe the answer lies in the precise fact that coaches cannot, and should not, be expected to play amateur neurologist on the bench. If a kid comes to the bench after a big hit, and has ANY symptoms of a concussion, isn't it better to play it safe and sit him for the remainder of the game? The cost of doing so (potentially losing a good player for a period or two) is greatly outweighed by the benefits if it does turn out there is a head injury to be concerned with.
My personal belief is that this isn't the NHL, my son is not being paid to play hockey, and his future health should not be jeopardized for a W or L in a given youth game. I would rather weigh in on the side of caution.
By the way, I can think of several times where a kid (sometimes mine) has been on the ice as if injured and I have said "he's fine....get up and play". The emotions and bravado that can come during a wel contested hockey game aren't lost on me as a father and coach. Maybe it needs to be taken out of our hands, and a policy should get developed saying IF a player shows any of the following symptoms......, then they need to take the pads off for at least the remainder of the game at hand?
Great question that is a long way from a definitive answer, but with these types of injuries becoming more prevalent (seemingly, at least) it needs to be addressed seriously by USA Hockey, MN Hockey, and all local associations or 'other" organizations.
Maybe the answer lies in the precise fact that coaches cannot, and should not, be expected to play amateur neurologist on the bench. If a kid comes to the bench after a big hit, and has ANY symptoms of a concussion, isn't it better to play it safe and sit him for the remainder of the game? The cost of doing so (potentially losing a good player for a period or two) is greatly outweighed by the benefits if it does turn out there is a head injury to be concerned with.
My personal belief is that this isn't the NHL, my son is not being paid to play hockey, and his future health should not be jeopardized for a W or L in a given youth game. I would rather weigh in on the side of caution.
By the way, I can think of several times where a kid (sometimes mine) has been on the ice as if injured and I have said "he's fine....get up and play". The emotions and bravado that can come during a wel contested hockey game aren't lost on me as a father and coach. Maybe it needs to be taken out of our hands, and a policy should get developed saying IF a player shows any of the following symptoms......, then they need to take the pads off for at least the remainder of the game at hand?
Great question that is a long way from a definitive answer, but with these types of injuries becoming more prevalent (seemingly, at least) it needs to be addressed seriously by USA Hockey, MN Hockey, and all local associations or 'other" organizations.
In my experienced hockey mom opinion, (don't bet your house on it), if you have to ask if a kid has a concussion than they probably don't. The concussions I have been involved in have been obvious to a casual observer.
Also, doctor's don't, in my limited experience, give you a definitive diagnosis on concussions. They are more worried about spinal column and bleeding issues when you take a kid in with a hit to the head. Especially if they are not obviously unconscious after the blow. So if a doctor can't say that a kid has a concussion than a coach on the bench in the middle of game might have a tough time.
Also, doctor's don't, in my limited experience, give you a definitive diagnosis on concussions. They are more worried about spinal column and bleeding issues when you take a kid in with a hit to the head. Especially if they are not obviously unconscious after the blow. So if a doctor can't say that a kid has a concussion than a coach on the bench in the middle of game might have a tough time.
You can ask the questions but the player sometimes give the answer he thinks will get him back on the ice.
I had one player who took a good jolt and when he came off I asked all these questions and he said he was o.k. I watched him carefully next shift and could tell he wasn't thinking straight, so I sat him the rest of the game. He then complained about a headache after he knew he wasn't going out. Turns out he didn't have concussion but better safe than sorry.
I had one player who took a good jolt and when he came off I asked all these questions and he said he was o.k. I watched him carefully next shift and could tell he wasn't thinking straight, so I sat him the rest of the game. He then complained about a headache after he knew he wasn't going out. Turns out he didn't have concussion but better safe than sorry.
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silentbutdeadly3139
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Re: Concussions
WARNING- I'M NOT AN EXPERTjBlaze3000 wrote:With such an emphasis being placed on concussions these days, there is a lot of information circulating about how to deal with them. One big gray area that still remains, however, is when does a coach take a player out of the game because of a hit to the head?
Minnesota Hockey emailed this concussion video with their latest newsletter:
http://www.youtube.com/watch?v=E26fo4WQ ... ture=email
In it, Hal Tearse talks about the symptoms of a concussion, which include headaches, dizziness, confusion, blurred vision, and memory loss. He talks about erring on the side of caution and taking a player out of the game if you feel he may have suffered a concussion.
Obviously, if a player displays multiple symptoms I would sit them out of the game until they could be further evaluated. But what if a player takes a shot to the head, seems fine in all other aspects, but says they have a bit of a headache. Should a coach sit them for the rest of the game?
Or, take for example an out of town PeeWee tournament I was at last weekend. Our first game was pretty physical, and afterwards my son said he had a headache. I didn't see him take any shots to the head, and he said he felt fine the next day, so he continued to play.
What if a player goes down hard (maybe they stay down for a bit) but get up under their own power and after a brief rest say they are ready to go (no headaches, no other symptoms)?
My question is about that gray area and what criteria are other coaches are using in regards to concussions. When would you let a kid continue to play? When would you sit him for further evaluation?
Plus dilated pupils. Outside of headache, If player shows any 1 of those, play it safe cause the NEXT hit is the one thats going to do the most damage. And that next hit doesn't have to be to the head or hard. I've seen kids crumple when hit on shoulder AFTER taking big hit previously. Obviously had concussion prior to shoulder hit. out for LONG time then
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jBlaze3000
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DMom - You're right, concussions (especially mild ones) are difficult for even doctors to diagnose. That's why they want kids to start taking baseline tests (basically a concussion test when they haven't had a concussion) so they have data to compare against when a kid does sustain a head injury. I don't know if concussions are more prevelant now than they were 20 years ago, I think we're just learning more about them.
YouthHockeyDad - you said your kid has sustained multiple concussions. Just out of curiosity, what was the recovery process and did they get progressively more severe or did he seem more susceptible to them once he had his first?
YouthHockeyDad - you said your kid has sustained multiple concussions. Just out of curiosity, what was the recovery process and did they get progressively more severe or did he seem more susceptible to them once he had his first?
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jBlaze3000
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Re: Concussions
Good info regarding dilated pupils. I think that even the "experts" aren't experts on concussions as we still have a lot to learn about them. I tend to agree that a mild headache isn't enough to sit a kid if they feel they can play, but any of the other symptons mentioned are cause to play it safe.silentbutdeadly3139 wrote: WARNING- I'M NOT AN EXPERT
Plus dilated pupils. Outside of headache, If player shows any 1 of those, play it safe cause the NEXT hit is the one thats going to do the most damage. And that next hit doesn't have to be to the head or hard. I've seen kids crumple when hit on shoulder AFTER taking big hit previously. Obviously had concussion prior to shoulder hit. out for LONG time then
I have been told that post exercise (game or practice) headaches are often caused by dehydration, and yet I still can't get my oldest to keep liquid on the bench during a game.
The dilated pupils are fairly obvious, again IMLE.
I know my oldest suffered a hard blow to the head and stayed in a game as a peewee. After that he made a decision he wouldn't normally make near the boards behind the net and was hit, hard, from behind. He got up right away and went to the bench but was later taken off on a stretcher per the emt who tended him on the bench. The EMT thought fractured vertebrae. My son did not suffer any obvious concussion symptoms but I now look back and wonder if he didn't have a very mild one because he did get a concussion as a bantam and that was fierce. He didn't move for four days, didn't eat (which all bantam parents know is huge) and lost ten pounds in 7 days. He was nauseas for three or four days and he had a headache with increased activity when he did finally get up. Was that one more severe because of what happened the year before or was the one the year before not at all about his head as the doctor's said. If his experience was the norm for a concussion, than that is why I say it is obvious. Other parents have had more subtle symptoms with their kids.
Two of my son's were old enough to take the Impact test this season and have it on file, though the oldest has had a concussion so it isn't baseline for him but his new altered baseline. We have had two of his teammates who took the test use it for their return to ice plan and it seems to work and detects the response time in a way that doctor's or parents or coach's cannot.
The dilated pupils are fairly obvious, again IMLE.
I know my oldest suffered a hard blow to the head and stayed in a game as a peewee. After that he made a decision he wouldn't normally make near the boards behind the net and was hit, hard, from behind. He got up right away and went to the bench but was later taken off on a stretcher per the emt who tended him on the bench. The EMT thought fractured vertebrae. My son did not suffer any obvious concussion symptoms but I now look back and wonder if he didn't have a very mild one because he did get a concussion as a bantam and that was fierce. He didn't move for four days, didn't eat (which all bantam parents know is huge) and lost ten pounds in 7 days. He was nauseas for three or four days and he had a headache with increased activity when he did finally get up. Was that one more severe because of what happened the year before or was the one the year before not at all about his head as the doctor's said. If his experience was the norm for a concussion, than that is why I say it is obvious. Other parents have had more subtle symptoms with their kids.
Two of my son's were old enough to take the Impact test this season and have it on file, though the oldest has had a concussion so it isn't baseline for him but his new altered baseline. We have had two of his teammates who took the test use it for their return to ice plan and it seems to work and detects the response time in a way that doctor's or parents or coach's cannot.
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YouthHockeyDad
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@jBlaze3000: The recovery process, as prescribed by his doctor, was to rest (no skating or physical activity) until ALL symptoms subsided, plus one week. The last time it happened the schedule was favorable, and allowed for a longer rest period. It has been said above that even doctors have a hard time definitively diagnosing a concussion without CT scans and/or the baseline testing that we are hearing more about now. I think your pediatrician would agree with this, though some symptoms are easier to recognize than others. Given this, it is hard to tell if they truly get progressively more severe, but it would seem logical that brain injuries would be progressive, particularly if they occur in close enough proximity.jBlaze3000 wrote:YouthHockeyDad - you said your kid has sustained multiple concussions. Just out of curiosity, what was the recovery process and did they get progressively more severe or did he seem more susceptible to them once he had his first?
To be truthful, his mother and I struggle with how to handle the future risk. Part of our collective "wisdom" tells us to pull the plug on his hockey career. This is not intended to be denegrating to his level of play, but he is a Jr Gold player now with no intentions (or likelihood) of ever playing above that level. It is tough to balance being protective (or over-protective?) with allowing him to choose his own path and play a game he loves to play.