Assembling a human: Putting together fragments from a brain injury

t has been almost seven years since I suffered my worst concussion to date. As many have read on the blog about the recovery and the initial trauma of the injury, I thought it would be interesting to do a piece on how life has moved on and find out, whether I was able to assemble a person from the fragments that were left as a result of the blow.

To recap briefly if you haven’t followed this blog long. I suffered a brain injury (which I refer to here as concussion) whilst playing hockey about seven years ago. I can’t remember much from the day it happened or the months following, but what the doctors told me is that I had a bleed in my brain and I was being monitored very closely by medical professionals. Being an idiot that I am, I ignored the doctors’ advice and caused myself more harm, returning to play after a week off (which was WAAAAY too soon). My symptoms were severe. I had to spend days in a darkened room due to intense photophobia, my head was pounding like I’d been on a week long bender, I was iritable, I could not remember what I’d done two minutes prior and I was laughing hysterically one minute, only to break down in tears the next. I felt I lost myself.

The recovery from the concussion took almost a year and a half, mainly because I refused to rest, so I suffered from headaches, dizziness and low mood/irritability for a long time. These symptoms are usually quite persistent in the early phase of concussions and should subside if you follow the appropriate recovery protocols.

In the early phases of the injury, my handwriting changed dramatically and my decision making was impaired. I also did things like try and dry myself after having a shower, whilst still standing underneath the shower. There were also difficulties associated with concentration and anything that required a prolonged period of attention, were difficult to deal with as I got a blistering headache from it.

However, now nearly seven years later, have I and my family managed to assemble a person of the mess that was left from the concussion? Neurologically, speaking I am fine. All my reactions and nervous system work as they should. Also, scans of my brain show no sign of permanent damage. That’s all well and good, however…

Despite getting a “clinical” all clear, I am still left dealing with concentration problems, usually in day to day life and at work. I am good at starting on a task, but then my mind wanders and I’m left thinking, what the hell it was that I was doing. Usually, I have to park the activity for a bit and come back to it once I catch the thread of my thought.

Additionally, some may have noticed in conversations with me that my eyes wander when I’m speaking to them. This again is associated with the concentration problem. Where I am listening to whoever I’m speaking to and paying attention, it is a monumental challenge to maintain eye contact. So, if you are speaking to me, and I’m not looking at you, please don’t be offended.

It is weird as when it comes to game day and the minutes leading up to when we take to the ice, that’s where I find I’m most focussed. Though having said that, it too has been an area where I’ve struggled. I’ve since been seeing a sports psychologist and have been using various techniques from hypnotherapy to NLP to help me achieve a better level of focus before games. I have to do the same in professional life when it is time to give a presentation, for example.

Prior to the concussion I had a pretty good memory. I would be able to recite circulation figures of publications, who the editor of a magazine was, which player played with what number and what sticks they used etc. Today… No chance. I struggle to remember names of people I’ve done business with for a long time and also I get easily confused on how many reps or sets I’ve done at the gym, despite having a workout log in front of me.

I am also maybe a touch more irritable than I was seven years ago. I seem to let little things get to me and eat away at me for days on end. However, I’m not a 100% convinced that my irritability is due to the brain injury, as my close friends and family have often described me as the most wound-up laidback person they know prior to the injury.  

The other aspect which has become more prominent in the wake of the concussion are my depressive cycles. I had been battling depression before the injury, but it seems like it has exasperated the problem, in that my depressive ‘episodes’ are more frequent and tend to be a quick decline, rather than something that happens gradually. Another issue which I remember vividly from the symptoms was that I looked myself in the mirror one day, must’ve been 2-3 months after the initial injury and I broke down in tears. I remember telling my wife that I don’t like the person that is staring back at me in the mirror and that I wanted to change. It was almost like the line in the Springsteen song Dancing in the dark: “I wanna change my clothes, my hair, my face”. Body image was never really a big deal to me, but that was a defining moment in my life and I still have the same feeling everytime I see myself in the mirror. And that is despite losing loads of weight and putting on more muscle. With depression, I’ve reached a good place and have become better at identifying when I’m starting to ‘lose it’ and can seek to rectify it. I am likely to eat pills for this for the rest of my life. With the body image thing… who knows.

Coordination is something that has been affected. It may be brash to say that it’s all coordination. I am completely fine and in control when I’m playing, working out, driving etc. I’m absolutely fine, but tell me to do start jumps, I’m boned. I get there eventually, but I have to run through everything in my mind as to how it all comes together.

Those are in the main the areas where I still struggle a bit or that I know that have changed. What of the answer to the question: Am I still the same person as I was before the concussion? The answer is no. And to be truthfully honest, no one would be after 7 years. I feel I’ve grown and evolved as a person since then so it is impossible to say whether or not I am the same as I was back then. To what extent the concussion affected that process, I don’t know. but it definitely had an impact.

However, what I do know is that I am incredibly lucky in that my injury was not as bad as some of the ones I’ve seen while I was recovering. In comparison, I felt like a fraud next to people who are having to re-learn to walk, eat, write etc. The drive these people have is astonishing and I have nothing but the highest levels of admiration and respect for people who are going through that level of arduous recovery. 

 

However, whether or not me and those around me have managed to assemble a person of the fragments that were left: I think we’ve done alright. It hasn’t been easy, particularly in the early weeks and months post injury, but I’m a relatively respectable citizen.

 

Will We See a Riddell-esque Lawsuit in Hockey?

I blogged recently about an ongoing lawsuit that was targeted at football helmet manufacturer Riddell. A Colorado jury has awarded $11.5m to Rhett Ridolfi, a teenager who suffered brain injuries in 2008. The Colorado jury determined that Riddell was 27% responsible for the injuries, which equates to approximately $3.1 million of the damages. The court found that the helmet was not defective in design, but that Riddell had not done enough to promote the risk and awareness of brain injuries. Riddell is currently facing a similar lawsuit in Los Angeless and a complaint by thousands of former NFL players, who are also taking aim at the NFL.

 

What sparked my interest with this story is that I can see this happening in hockey as well. Head injuries and concussions have become increasingly – and sadly – common in the NHL and other European professional leagues. Whilst there have been advancements made in hockey helmet technologies to improve protection there has also been a huge uptick in the claims made by manufacturers that their products provide best protection against concussions and reduce impact forces.

 

What intrigues me is that, is hockey and the manufacturers open to a similar lawsuit? Some helmets that are in use today, do not make adequate reference to brain injuries or make clear enough clarifications that helmets do not protect fully from brain injuries. Remember, the brain is like a passenger in your skull and no helmet in the world can stop impact (be it with another player or ice) from causing a brain injury.

 

Having suffered through a brain injury and it leaving me with long lasting, permanent damage, it is a topic that is close to the heart and it will be interesting to see, whether there will be similar law suits considered against professional hockey leagues and equipment manufacturers as a result of the Riddell decisions. I know there are many professional players whose careers were cut short due to a brain injury and some who still struggle with symptoms on a day-to-day basis, years from their respective injuries.

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Saying Alfredsson is a “Game Time Decision” Was Irresponsible

Like I have written on here several times, concussions are probably one of the worst injuries I have had to deal with. When I was suffering with a severe concussion and post concussion syndrome at the back end of 2010-2011 season, I effectively hid it from my coaches, which halted my recovery and kept putting it back by several months.

 

Last night as I was at home and browsing hockey news from several different outlets, I was astonished to stumble across a headline that said “Daniel Alfredsson is a game time decision”. What shocked me about it was that A) Alfredsson had already said to the media that he was suffering from a “brain injury” and B) the coaching staff even letting Alfredsson take part in the game day skate and to even entertain dressing a player who has a “brain injury”.

 

I know its the playoffs and “because its the cup” are on every players’ mind at this time of the year, but what the Ottawa Senators did with even considering Alfredsson for the game was irresponsible, full stop. The NHL has been for the better part of two years been saying how detrimental concussions can be to a player and has implemented several guidelines to aid and speed recovery and here we are with a team and a player who is quite willing to, quite frankly, shit on that code.

 

Luckily Alfredsson did not play, but let’s think if he would’ve. The Rangers vs Senators series has already seen some bad blood in the form of Matt Carkner’s antics in game two and let’s face it, the physicality of hockey always steps up a couple of notches in the playoffs. Imagine if Alfredsson got hit really hard. I’m not talking about being hit on the head, but a shoulder to shoulder hit. Normally that hit would’ve been no big deal, but for a concussed player the ramifications of getting nailed on the boards can have serious consequences, worst of which is the Second Impact Syndrome (SIS) which can lead to death. Whilst we don’t know the severity of Alfredsson’s concussion it is important to note that SIS can happen from even the mildest concussion.

 

Speaking from my own experience here, I was scared that it would happen to me when I was playing with a concussion. “Luckily” for me, I was aware enough of my state that I did not go into corners or play on the boards and literally got rid of the puck as soon as I had it. Now is that a way to play hockey? No! Is that a way that Senators fans, or Alfredsson’s teammates would want their Captain to play? Absolutely not!

 

Let’s also not forget that Alfredsson had back issues, which by and large ruined his 2010-2011 campaign. He has come back from that stronger than imagined and said in an interview earlier this season that as long as he was healthy and could put his body through the rigours of training he would extend his NHL career. Now at Alfredsson’s age (39) he needs to be smart with his training and work on perhaps more areas of his physique than a younger player would.

 

Alfie even training is pushing the boundaries with concussion. I am only imagining here that he has at least a Grade 2 concussion (depending on which Grading system you use), but any strenuous exercise he puts himself through at such an early stage of the injury is going to delay his recovery, which if it does will delay the amount he can train through the summer, which in turn will affect his game readiness for 2012-2013 season.

 

I don’t know how many times the NHL and other experts in the field of brain injury have said this, but concussions are not a laughing matter. They can have serious long-term if not permanent symptoms that can change one’s life for good.

 

While I can applaud Alfredsson’s desire to put himself on the line like that, I would much rather see him take his time and recover properly. The finger I’m wagging at, is at the Seantors’ coaching and medical staff to even entertain the idea of playing him by saying he is a game time decision. Surely the Cup is not worth risking the face of the franchise’s career?  I doubt any Senators fans would like to see their Captain forced into retirement because of a brain injury.

2011-2012 Season: A Look Back

The blog has been dormant of late, but hopefully that is about to change. I have had many different posts in the works, but for one reason or another I thought that they were complete drivel and decided to ditch them along the way.

It’s with some joy and some sorrow that I write this post as it is the ‘end of season roundup’ that I’ve done a few times in the past. The 2011-2012 season was pretty eventful. I read through a few of the older posts I made, I had one goal for the year and that was to have an injury free season, but that didn’t quite work out the way I planned it. As you might recall I twisted my ankle in May and in October I went under the knife to have an operation to fix the damage that I had done. It was unfortunate, but something I had to do as my ankle swelled up to a size of a tennis ball after I took my skate off. It was also getting in the way of life both on and off the ice.

Then the other injury obviously was the concussion I sustained from the car accident. In the process of the car accident I also hurt my neck, which is still giving me grief and as my physio therapist reckons I’ve torn the rotator cuff in my shoulder.  So for that goal we’ll just have to put a big red cross on and mark it as unsuccessful.

I think this season has taught me more than any season before, though I say that pretty much after every year, but there is something different about this year. I think I grew as a person (que fat jokes) and as a player, but perhaps most importantly I feel I became mentally tougher. Specially after our game on the Isle of Wight. For some reason that place is always difficult for me as I always seem to come away from the island frustrated and really pissed off. We won the game there which was great, but for me personally, I came away from that game and felt like I had zero confidence in my ability or skills as a player. I had to re-focus myself again and do some soul searching to find out what it was that I liked about the game and do a lot of visualisation to get the good vibe of playing well back. From there things started to fall into place again.

It’s lows like that and how you manage them that help you become mentally stronger and a better player. Things like that often happen in hockey and they can be pretty mind boggling, but if you really want to play the game and enjoy it, you have to refocus your mind and commit to it 100%.

The other thing I think helped me grow was the captaincy. I was not expecting the guys to vote for me and to be honest when it was clear that I was to be wearing the ‘C’, I had an “oh shit” moment. I had no idea what it is like to be a captain or what the responsibilities were. I think I was more afraid of letting the guys down than anything else. It was a learning curve at first, but once the season rolled on, it became easier and easier after each game. Sure there were times when I lashed out and said things I shouldn’t have, or didn’t always have the most encouraging things to say if we were down in a game, but all in all, it wasn’t as daunting as I feared. I’m not going to start grading myself as that would just be pompous and it’s up to the guys on the team to grade me.

Overall, I think that our season has been a success. There have been times when we were out played and times when we didn’t turn up to play. Going from last years last place and leaping to a solid mid table finish is a great feat. All in all there have been some great character players on the team. We maintained the core of the team from last year and added some new guys into the mix who fit in really well. We had guys who battled for us the whole year, some through injuries and guys making 120 mile round trips just to get to training, which just goes to show the dedication the guys have for the sport.

As a team we improved, a few individuals really picked up their game and improved steadily throughout the season and we saw new guys chipping in those crucial points/goals. We also had guys on the team that were willing to do anything and everything to help us win. I personally think that this team has the chance to do something great down the line. Hockey is a consistent learning process and as long as we can push ourselves as a team and as individuals, there is an infinite number of things we can achieve, however, if we are happy with what we’ve got, we will become stagnant.

Hockey does take a lot away from you and asks a lot of balancing between work and other social engagements. The six months that the season goes on for puts a certain strain on relationships as well. It takes us players away from our loved ones and our loved ones planning their lives around our schedules. I therefore would like to extend a thanks to my wife for making the sacrifices she makes to enable me to play and the same applies to the other hockey girlfriends/wife’s of my teammates.

As an overall thought, I tweeted a few days ago saying that both the ENL leagues need playoffs and it is a very valid point. I had a chat with Boone Jenner, a Columbus Blue Jackets prospect and he asked how do we play with seemingly nothing to play for. We definitely need playoffs and a proper promotion/relegation system in place for the league. It is hockey we play, not soccer and we need a hockey style playoffs in place, not soccer where team on top is the champion.

So now what then? Well I’ve got the off season/dry land to get on with. I’ll do the same as last year and start skating in June but before that it will be gym, running, plyometrics and other exercises. Most of all, I’m looking forward to some downtime and catch up with friends I haven’t seen in a while and take my mind off hockey, apart from the Stanley Cup playoffs and for the World Championships.

Hockey doesn’t just start in September and the work we do for it doesn’t end in March. It’s a 365 day a year process that doesn’t give you a break. It is a sport that never stops, even if we are not on the ice. Once you’ve been bitten by the bug and want to improve and play at the height of your ability it is a process that means, sweat, pain, aching muscles and making the gym and the road your best friends.

Like HBO’s 24/7 said; Hockey engraves itself on the body. Boy don’t I know it, but man do I love it.

The Silent Sufferers: Concussion and its effect on family life

I recently tweeted saying that I would have a guest contributor on the blog as I have been talking about my ‘journey’ through concussion. I wanted to lift the lid on the other aspect that we harldy ever get to hear about; It’s effect on families and family life.

The below is an open and honest account from my wife – Libby – and her story through my concussion and how it affected us. You can follow Libby on Twitter at: https://twitter.com/littlered_libby

Thank you for agreeing to share the story. I know it hasn’t been an easy ride.

I hope you find her story of interest:

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I don’t normally do this kind of stuff so please bare with me while I try and explain my side of things.

As you all know Janne suffered a major concussion in March last year and it has had a major impact on his hockey career, but more importantly, on his personal life. The following is the impact the concussion, had on me his, girlfriend/wife of seven and half years.

I was watching the game when Janne got hurt. The hit that changed our lives didn’t seem that out of the ordinary for a hockey game. I didn’t really think too much beyond my normal “please get up, don’t be hurt.” However, I had no idea how badly injured he was and how drastically our lives would change as Janne got up and finished the game.

After the game, we were due to go to my uncle’s house in Ebbw Vale, Wales. I tried insisting on driving, but Janne being stubborn he was adamant to drive the distance. By this stage, he had mentioned that he didn’t feel quite right. It wasn’t until the next morning  that the symptoms became apparent. I was only slightly worried at first, as I’ve grown up around sportsmen (mainly rugby players whose mentality is similar to hockey players) my whole life, I’ve even had a couple of concussions myself.

As the morning went on, I realised it wasn’t like any other concussions I had experienced before. Janne’s eyes weren’t responding and it was like he was totally spaced, I had to talk very slow and simply for him to understand anything I asked. The uncle who we stayed at had just had a baby girl who to this date Janne will call Faith, despite it not being her name. Further to that, today he has to pause and place faces to my uncles’ names as he struggles to remember which is which.

He had no idea where he was or what he was doing but he refused to go to the hospital. I was panicked and scared. My whole family was gathered at Ebbw Vale for my cousins christening and the advice we kept getting was to take him to the hospital, which got Janne incredibly irate. This made me worry even more and we left the christening early to drive home. During the drive back Janne dosed in and out the whole time. When we eventually got home he kept asking me the same things over and over again. I found this very frustrating as Janne couldn’t remember anything from a few moments before and I could see how confused Janne was with my reactions. I wasn’t angry but having to repeat myself over and over made me have anxiety attacks.

Following from the injury and as the PCS  symptoms persisted, life got difficult at home. Janne was having trouble remembering anything that he was told or asked, which made me feel ignored, even though I kept telling myself it’s the concussion and I knew I had to be patient with him. However, I started to get increasingly worried as I started to notice Janne’s personality change. He wasn’t happy with the way he looked. He grew a beard and grew his hair, which was really out of character for him. He also said that he hated the person he saw in the mirror every morning.

When I offered to help him and speak to him, Janne refused it. He was constantly going through mood swings, which would make him happy at one minute and completely reduced to tears the next. His moods would be anything and everything between those two extremes. I was afraid to speak to my husband, because I wasn’t sure if what I said was going to be greeted with smiles or with shouting.

Janne put himself into a shell and started to shut down. He found solace in blogging. At one stage I felt I found out more what he was going through by reading his blog, than from his own mouth. Janne said that he didn’t want to worry me or his family over nothing and that is why he was turning to the blog and to social media to air his feelings. However, it made things worse as he wouldn’t  talk to me or the rest of his family about the issues. Janne’s parents and my parents were just as much in the dark about his state as I was.

Janne always had a sparkle in his eye, which showed his love and affection as well as his cheeky 5-yearold boyish side. With the concussion and as the symptoms worsened, the sparkle was gone. I was afraid that I was losing my husband and I started to feel unwanted and lonely. It wasn’t till after he recovered that Janne admitted that he felt like he had shut down emotionally.

I don’t want to sound needy, but at times I got so lonely and upset I would cry myself to sleep and Janne wouldn’t even notice, I didn’t tell him as I was scared that he would snap at me or worse leave me. His moods were getting worse. One time when we were in town, Janne was visibly suffering. He was pale, he was sweating and his eyes had, what can be called the 1,000 yard stare. I asked him if he was OK and if he needed to go home, but my suggestion and concern for his wellbeing was met with anger and shouting.

Sometimes I would try and force him to pay attention to me by jumping on his lap and kissing him with all my passion I felt inside for him, but the reaction back was on the verge of repulsion, which was so hurtful that after awhile I couldn’t cope with what felt like rejection, so I stopped trying.

As things moved on and Janne seemed to distance himself more from me and the outside world, I became worried. While he was still going to training, which in hindsight I should’ve stopped him from doing, Janne wasn’t really interested in engaging in social situations. We started to argue more as Janne’s moods changed. I insisted that he was keeping things from me, while he didn’t see it the same way and kept saying he wanted to protect me and not burden me with all his issues.

As months went by, Janne was starting to feel better. He was still suffering from constant headaches, mood swings, light sensitivity and he was constantly frustrated as he was not as fit as he wanted and kept blaming people (me, doctors etc.) for holding him back. In fact every time we went to see the doctors for a control visit and when the answer was “It is going to take a lot of time” Janne would get really angry and depressed about it. I think deep down, where he kept saying he felt lost, he longed for normality again.

Our relationship also suffered. Yes we loved each other, but we were on autopilot mode. We would go through the motions but not really spend any quality time with each other. Janne kept saying he felt so lethargic and that he felt like he had lost himself.

I tried my best to support him the whole time, but I felt like I had no one to talk to about it. It almost felt like the concussion was stigma as others kept saying Janne looks fine, if maybe a bit depressed. I was too proud to admit to other people I was struggling with it as well. I just kept plodding along and kept telling myself things will get better and that the sparkle in his eyes I had fallen in love with would come back.

It has been a gruelling year marred with ups and downs. We have had to face up to the problems that the concussion caused on the long term. It wasn’t just a knock that would’ve healed in a couple of weeks time, it took good 6-8 months for us to really get our lives back. During the time of the concussion and PCS we were drifting apart and we have had to work hard on our relationship to make sure that we are fine. We almost lost each other, but we have come out a lot stronger from it, so in a way it has had a positive impact on life, but it is something that I would never want to go through again.

However, every time Janne steps onto the ice, I’m scared that he will be seriously injured again and that we would have to endure the hell again. I was scared after his car accident that the concussion he suffered would set him back, but at least we both have learned valuable lessons from the last experience to better manage it. Where it doesn’t seem as bad as the last one, I still have this constant worry over it.

I hope this helps people to realise that concussions and PCS have a major impact not just on the person but everyone around them. It’s hard to cope with all the changes, but as long as you deal with them and don’t ignore the “illness” you can get through it.

Opinion: Tretiak suggests NHL move to bigger rinks to reduce concussions

The legendary goalie, Vladislav Tretiak, suggested to allhockey.ru that the NHL moves to larger rinks, such as the ones played on in Europe. According to Tretiak, this would reduce the number of concussions in the sport as the playing surface is bigger and there would be not as much chance of high speed/forceful contacts.

 

Tretiak says that concussions are not a daily concern or an epidemic in the KHL or in Russian hockey as they are in the NHL. I would agree that in any European league the issue of concussion isn’t as big as it is in the KHL. However, it is not to say that they do not happen in the European sized rinks. We’ve seen a few nasty hits that have lead to a concussion in the Swedish leagues.

 

I have a few issues with Tretiak’s statement and a few things I would like to see before I could back the decision. The KHL hasn’t made a big play of the injuries that players suffer. In-fact the only time I find out about an injured player is if it is a Finnish player and it has been reported in the Finnish media. The KHL is pretty well covered in Finland in that it has games shown with Finnish commentary on the TV, but beyond the Scandinavia, does anyone actually care about the KHL or follow the league with same intensity as they would do their native leagues or the NHL? There are people who do, don’t get me wrong, but I think reporting of injuries and finding out about the types of injuries is pretty difficult due to the language barrier in place and the navigation of some of the team websites is, well, tricky at the best of times.

 

Then there is the issue of the game itself. The NHL has always prided itself on being the toughest league in the world and it is THE league any hockey playing kid wants to play in. Even if you are just playing street hockey with your friends, the chances are you are playing the dying seconds of Game 7 of the Stanley Cup final. I haven’t yet met a hockey player who says that the dream for their career would be to hoist the KHL winners’ trophy. And I don’t mean that in the sense that players in the KHL wouldn’t want to win, but that the Stanley Cup is the ultimate prize of hockey.

 

The few games of KHL hockey I’ve seen and in fact European hockey, the lack of hitting is noticeable. Not saying there isn’t any hits, but the number of hits is not as high as in the NHL. Sure there is more space to create plays and play skilful hockey, but I think European hockey, for the most parts lacks in the physicality. I tweeted about an experience in a Finnish league game saying that there was hardly any hitting.

 

Whether I have gotten so used to the physicality of the NHL games and I genuinely enjoy watching that, or that the European brand of hockey is more based on skills and creativity rather than the brute physical strength. A case and point of this would be the U-20 world championships. When Finland played against Canada the Finns were unable to meet the Canadians in physicality and rather sprayed snow on the opponent rather than hit them. I don’t mean that as ‘euro players are soft’ but kids playing in European leagues need to learn to finish their hits if they want to play in North America where the physicality is one of the key aspects of the game.

 

I doubt any fans of the NHL would like to see the league move towards larger rinks. Not only would it change the game and alienate fans, but it would also come at a huge cost to teams and rinks as they would need some serious renovation to accommodate the bigger space, which would ultimately lead to lesser seats in arenas. Where I think Tretiak’s idea in general is good and has the right idea, I don’t see it happening. If anything, I’d personally like to see the European leagues move to a smaller ice size to make the games just slightly more physical.

Helmets, they protect your head, but what of the brain?

This post has also been published by Pucks Across The Pond in my diary: http://pucksatp.hockeytutorial.com/2012/helmets-protect-head-brain/

 

As I’ve been out with another concussion (non-hockey related), I’ve thought about the so called concussion epidemic that has plagued the NHL and the sport of hockey for a long while now. I’ve started to think that despite the equipment us hockey players wear on the ice, there is very little there that would actually protect a players’ brain from a concussion.

Where the helmet has been designed to protect the head from potential injury if hit by another player, stick, puck, board or the ice itself, there is (at least in my opinion) very little in the way that a helmet would actually protect  a player from concussion.

I’m not a doctor, but my understanding of concussion is that the fluid that surrounds the brain is unable to protect the brain from severe impacts or forces associated with rapid acceleration/deceleration where the head would jolt violently causing the fluid not being able to protect the brain from these motions.

Helmet shells are commonly made from vinyl nitrale which do form a strong and durable shell to protect the head from impacts. The sole purpose of the shell is to disperse the energy of a point of impact, similar to a car in an accident where the body of the car has been designed to absorb the forces of impact in an accident to protect a passenger. The insides of the helmet are either made of the same material (the white stuff that majority of the pros wear) or polypropylene foam, which is supposed to absorb forces of impact to reduce the chance of a concussion.

A quick history lesson before we move on. As far as hockey goes, helmets are a relatively new piece of equipment. It was only in 1979 the NHL made helmets mandatory. Though at the time of making helmets mandatory 70% of NHL players were already wearing them. Sure helmets had been around before then, but it was the first time that players were required to wear a helmet full time. I had to do a Google search for hockey helmets to find that George Owen of the Boston Bruins was the first player to wear a helmet in 1928-29 season.

It wasn’t until the death of Bill Masterton in 1968 that the discussion of helmets became prominent and lot of the stigmas about wearing helmets started to dispel. A similar stigma now surrounds the use of visors. Majority of players do wear a visor, but there is still a debate ongoing whether the use of visors should be made mandatory to avoid career threatening eye injuries.

As for helmets and concussions, there has only been one company (Cascade Hockey) that has made concussion protection its USP. With it’s M11 helmet Cascade tried to create a helmet that would significantly reduce the risk of concussion. The M11 was designed to significantly reduce the forces from high speed linear impacts which Cascade determined caused most of the concussions in hockey. Additionally Cascade developed a system to adjust the setting of the back of the helmet to give it a more customised fit feel  and ensure tight, but comfortable fit. A lot of the times when watching hockey you see the helmet move on the players’ head from hits on the boards or player getting up after a hit and re-adjusting the helmet, which means that the helmet is does not sit right and therefore is not providing adequate protection.

Going back to the fitting and adjusting feature, I’ve not seen a similar system on any other helmet. The Reebok 8K helmet, however had something similar to it, with its FitLite technology. This has obviously evolved in the 11K helmet. Though I don’t want to take a snipe at the technology or design, Sidney Crosby the face of Reebok was out for 10 months with a concussion and is now sidelined again with a neck injury and concussion. People can make their own judgements of that.

I think aside from Cascade, only one other manufacturer has made a play on the reducing the risk of concussion and that is Bauer, with its RE-AKT helmet. The helmet has been specifically designed to manage rotational impacts, as is the M11 from Cascade. The collateral from Bauer says that the helmet helps to protect the brain from excessive intra-cranial movement due to the helmet’s liner, which Bauer has named VERTEX FOAM. I have asked Bauer how the helmet actually protects from concussion or how the liner in the helmet reduces the risk of concussion, but I have not received an answer yet.

But the real interesting thing is, at least in Europe, whenever you buy a helmet you’ll have a CE safety certificate on it to say that the helmet has passed required tests, but might not protect you from serious injury. As far as I’m concerned there simply isn’t, or hasn’t been enough done by manufacturers to address the concussion problem, but then again, how do you stop the brain moving around inside your skull? How do you stop a violent jolt of the neck/head from causing concussion?

When the issue of head shots raised its ugly head in the NHL, there was a lot of discussion among GMs on how you can take it out of the game and as a result a new rule was introduced (Rule 48). The NHL also set up a task force to better manage concussions and players who suffer a suspected concussion, hence the quiet room players are lead to mid game if there is a suspect concussion. If the NHL set up a task force to look into the issue and how to better manage the issue, why wasn’t helmet safety and safety features a part of this discussion?

To me it only seems obvious as one of the things that always crops up in concussion and hockey conversations is that “the players are bigger and faster and the padding has gotten better and bigger so players feel more protected”. Yes true. I do feel safer and protected when it comes to shoulder pads, shorts, elbow pads etc, but looking at the helmets over the last few years, I feel that the development has not been as rapid as with other pieces of equipment hockey players wear.

The other issue that comes with helmets is that the common advice is that a helmet should be replaced after heavy impact to the shell as it might lose its protective features. Again the Cascade M11 helmet is the only helmet that I know of that can sustain more than one impact.

Which leads us to the issue of price. Where the pros will have access to free equipment in most instances, guys who have to pay for their own kit might not be able to afford the top of the range helmet that provides the safety features that have been promoted by Reebok, Cascade and Bauer with their top of the range helmets.

A quick look on Hockey Monkey shows that CCM’s V10 helmet is the cheapest top of the range helmet around and retails at sub $100 at Hockey Monkey. I use the V10 helmet and since my last on ice concussion, I’ve been looking at the helmet and thinking how on earth does this protect my brain from concussions. Sure it protects my head/skull from impact from puck, stick, boards etc, but there is very little in the helmet to re-assure me that this will also protect my brain from concussion.

Also let’s not forget that Marc Savard wore the CCM V10 helmet when Matt Cooke deliberately hit him in the head in 2010. In fact, the V10 helmet has changed very little since then.

I haven’t been able to find the prices for Bauer’s RE-AKT helmet, but the M11 retails at $129.99 (reg: $159.99), the RBK 11k at $169.99 (reg: $179.99), The Easton E700 at $149.99 (reg: 179.99) or the Easton S19 Pro stock helmet which regular retail price tops the $200 mark. Please note that those are the prices as per Hockey Monkey and can vary from retailer to retailer.

Then there is of course the mirror test. I remember that the V10 helmet especially at the time of its launch was promoting itself with the tag line of “Guaranteed to pass any mirror test”. The mirror test should not be the first thing on your mind when buying a helmet. The fit and protection should be the top priority when choosing a helmet. You only get one head and unfortunately the brain is a delicate thing that can’t take too many beatings or injuries.

But like I said in my interview with Aaron Murphy, the contact and physicality of hockey is something that draws people to the sport and was a reason why I started to follow it in the first place. If you take the hitting out, we are left with something that resembles the All-Star game and no-one in their right mind would want to watch that type of hockey for 82 games (plus play-offs) a year. I guess concussions are something that you can never fully take out from a contact sport, but you can always make sure that players are protected to the highest standards and that there are medical checks to ensure that players with concussions are given the best possible treatment.

What I would like to see is equipment manufacturers include some of their ‘concussion prevention technologies’ into all their helmets. Remember all it takes is a funny fall in a game of shinny to cause a concussion. It’s not just professional, semi-pro or amateur players who are at risk from concussions, it is hockey players from all levels.

Think of it this way and using my car analogy from earlier. A car that does not meet the safety regulations in collision and impact testing by EURONCAP is not allowed on the road. As your brain is a passenger in your head, wouldn’t you want it protected to the highest standard when you play any contact sport?

Concussion: Six Months On

As this blog has documented in detail my struggles with concussion, I thought it would be a good idea to give you an update on what the after effects have been. You tend to read a lot about the symptoms of concussions, but once a player/person has gotten over the symptoms it is presumed that you carry on as normal.

 

Please do bear in mind that concussions vary from individual to individual and what I have experienced might not be applicable to some.

 

It has now been over six months since the concussion and I am symptom free from the actual concussion, but there have been several things that have not been the same. If you hear people who have suffered from concussions say that they have good and bad days, it is true. I have days when I feel normal and days when I still have to lock myself in a dark room due to intense migraine like headaches that have become more frequent since the concussion. When the headaches come they are pretty bad. It feels like someone is yanking at the inside of my eyeballs and I literally cannot move my head or I feel nauseous. There isn’t a set thing that I’ve noticed what would set it off, but sometimes it can be certain smells or even things like flashing lights.

 

The flashing lights is another thing that I can’t deal with. If I’m in a nightclub (rarely) I can’t be in for a long time as the lights they have really get to me and make me feel dizzy and that’s before I would’ve drank anything. The worse are strobe lights, if there is a strobe light that’s going off, I feel like I’m going to be sick. Other lights, what you normally see in clubs or at parties, give me a headache and ultimately ruin my night. Then again, I wasn’t that big on the club scene anyways so I’m perfectly happy to sit down at a bar or a pub.

 

The strobe light issue doesn’t have to be in clubs or on nights out. It’s also in films or TV when there are flashing lights or scenes that flash back and forth. Like in the movie Black Swan, the night club scene really made me turn away. Also I have trouble watching shows like the X-Factor (apart from the terrible singing and the mundane judges) due to the light show/screens they use.

 

The third biggest thing that I have noticed are short term memory problems. I still have a trouble remembering things that I have done or what I’ve been asked to do. A good example of this is from a few weeks ago when I left training and I could not remember where I had parked my car. I was wandering around the parking garage with a couple of teammates not being able to remember what level I had parked my car or where on the level I had parked it.

 

Then there is head banging or sudden jolts of the head i.e. if I sneeze. The head banging to music has stopped as I can visibly feel my brain move around in my head and it is an uncomfortable feeling. Similarly if I have a cold/flu and I sneeze and my head jerks because of it, it feels doubly bad.

 

So despite being over the main issues of the concussions it has had a profound effect on my life and the things that I do. Most of the time I don’t think about the concussion, but I still get reminders that I have suffered a blow that has altered things. Despite this, I still love to play and I am thankful that I am able to carry on playing, but most of all, I’m grateful that I can lead a normal life most of the time.

Off season lessons

This off season/pre season has been different from others that I’ve had, for many reasons. I don’t think that ever during my career my body (and mind) were so beat from the season. The mind pretty much due to the concussion rather than the mental strain from the season.

 

So for the first time in my life I was faced with a wholly new challenge. My hip was in a pretty bad shape, my head was a total mess and I was tired. Pretty much from finishing the last game of the season I knew that the summer was going to be far from easy, but then again, hockey doesn’t really give you a long summer holiday.

 

I think I gave myself about a week off from the ice and then started to hit the gym. While it probably wasn’t the smartest thing to do with the ongoing concussion symptoms, I needed to do something. Running made my head feel worse and the doctors said that I was OK to do light weights and go easy. Too bad I have a different idea of going easy to the doctors.

 

So I was able to train really hard through April and I thought that I had overcome the concussion issues. My body started to feel better and I felt stronger physically, but I was still hitting a wall. I was helping out at one of my wife’s trainings on the ice and I was doing a regular skating drill we did throughout the season. I was probably going at about 60% and I just literally didn’t know what the hell was going on. I went pale, blacked out and almost passed out. From skating at about 60%.

 

This then lead to heated debates and arguments about what I should and shouldn’t be doing and being a bone head I told everyone to STFU and let me decide what’s best for me. As a compromise I agreed to take a week out of training to give myself some extra time to re-coup.

 

If you follow me on twitter, or are unlucky to have me as a friend on Facebook, you know what happened to me on my first run after I resumed training. I was about 800meters from the office and I was doing a visualisation and mental exercises while running. I was so focussed that I didn’t see a pothole and I ran into it and twisted my ankle…. BAD! Where the ankle hurt for a few days, I was back at the gym lifting weights and on the bike 3 days after I hurt it. My thinking being, if I focus on exercises where there’s no risk of the ankle buckling or giving way, I’ll be OK.

 

The other issue I dealt with was the hip, which I mentioned at the start. As soon as the season had finished I entered into a rigorous physio therapy programme with Matthew Radcliffe, who is a the head physio for Southampton FC. Matt did a great job with me and seriously put me through the paces. I don’t think that I’ve ever worked so hard at physio, which I enjoyed as it was actually doing functional stuff that I knew would help and it kept me interested as I felt like I was actually having a workout.

 

The physio for the hip has worked as the times I’ve been on the ice, I’ve been skating pain free, which has shown me how much fun it can be. I was officially discharged from the hip physio and where I’m happy to know that I’ve been discharged and fit, I still have to do continuous exercises to ensure that the hip doesn’t flare up, that combined with a new pre-activation session.

 

Additionally, I’ve also been discharged from the ankle physio, which effectively brings to an end a regime of physio therapy that started in April. I think this summer I’ve been in physio for a longer period of time than ever before.

 

On the other hand though, my gym workouts have gone so well that I am actually feeling really good about the shape I am in and it is a definite step up compared to where I was starting from at the start of last season. Maybe more importantly the off season training has taught me more about mental toughness and discipline than anything else. I feel like the work I’ve put in, both in training and in physiotherapy has made me a stronger person and helped me to examine the game from a entirely new point of view. Despite the off ice training being hard and difficult at times, I have actually had fun doing it and I’m actually smiling at the gym, the same can be said of the times that I have been on the ice. Hockey is definitely fun again, which is something that I’ve missed among all the injuries I suffered with.

 

As for last season, well it is just that, it’s last season. I will take lessons from it, but for now my eyes are fixed on the 2011-2012 campaign. I think the most important lessons I have learnt this off season are those of patience, hard(er) work and trying out new things. I feel that I’m mentally stronger and I feel that I’ll be able to have fun instead of whitekncuckle the stick. There’s 6 days till we take to the ice as a team again, so I’ll be looking forward to seeing some of the guys I’ve not seen over the summer.

 

I can’t come up with a better ending to this than what a Finnish hockey journalist Jari Mesikammen (aka Karhuherra on twitter) said in his recent column: Forget about summer, drop the puck already!

First Off-Season update

It has been a while since I updated anything on the blog, so I thought that a quickie would be in order. Despite still spending time off the ice, I’m feeling really good. My off ice training is going well and I’m getting consistent good workouts in and I find that I am pushing myself to lift more weight, which is encouraging. As I come to complete the first month of the regime, I’m going to start adding more into the workouts and routines. At the start of May, I’ll be adding cardio and plyometric work into the mix. Hopefully it will pay dividends when I’m allowed to get back on the ice and resume full contact training.

I’ve also been doing a lot of physio work and my physio, Matt Radcliffe has been putting me through the paces. He’s definitely one of the better physiotherapists I’ve had the pleasure to work with. It’s been painful but I can feel that it is working so I’m keeping my fingers crossed that I will not have to have my hip operated on.

The concussion related problems still bug me though. I still get head-aches and I suffer from concentration problems, which is a bit irritating. Additionally I seem to have memory lapses. Like the other week I successfully tied one bow on a sofa bed and went to do the next and did not know how to do it. I’ve been referred to a neurologist for further exams and hopefully a CT scan. I’m not worried that the scans or exams would reveal anything major, but you know, it’s more for my own peace of mind than anything and I guess to my family’s peace of mind as well.

I’ve also started hammering pucks at the net in our back-yard. The only trouble is that I don’t dare shoot top shelf after a few pucks pinged off the cross bar and ricocheted to our neighbours yard, nearly hitting them as they lay on the lawn tanning.

Needless to say, though it’s only been a month into my off-season training, I’ve been encouraged and I’m hoping I can carry the form throughout the summer.

One of the biggest questions I get asked (relating to the concussion) on Facebook and by friends is that whether the ongoing issues mean that I will be hanging up the skates. The answer is no, I won’t be. Aside from the concussion, I feel great and I think after the few weeks rest and ongoing physio the body is starting to feel good as well. I’ve got an itch to get back out on the ice, which is a good sign and you know what, I enjoy playing so there’s no reason to give it up. As long as I’m having fun with hockey I don’t see a reason why I should consider hanging up the skates.

There’s no denying that this concussion has been worse than any before and recovery has been slow, but it’s another bump in the road that I hope to leave behind soon enough.

P.S. Go Habs Go!