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Honesty indeed best policy for concussions

Friday, 12.03.2010 / 4:30 PM / NHL Insider

By Dan Rosen - NHL.com Senior Writer

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Honesty indeed best policy for concussions
The number of concussions NHL players have suffered at this point of this season is exactly the same as reported the same point last season, according to Dr. Ruben Echemendia, who oversees the League's concussion testing program.
The number of concussions NHL players have suffered at this point of this season is exactly the same as reported the same point last season, according to Dr. Ruben Echemendia, who oversees the League's concussion testing program and is the chairman of the NHL/NHLPA Concussion Working Group.

Echemendia said Friday on a conference call with several media members that 33 concussions have been reported as of Dec. 1. Fewer concussions were reported as of Dec. 1 two season ago, but Echemendia said he is hopeful the uptick in concussions is a result of NHL players being more honest when discussing their symptoms with team doctors and trainers. Echemendia also said it is too early for any data to be viewed as a reflection of the effectiveness of a new rule enacted last March -- and reinforced with an on-ice penalty this season -- that bans blind side or lateral hits where the principal point of contact is the head.

Echemendia said the only way for teams to accurately assess and treat a concussion is for the player to be open and honest. He said he believes players are paying more attention to brain symptoms now, due to increased education and awareness about concussions among NHL athletes compared to a decade ago.

"No matter how many tests we give, we're never going to be able to proceed with 100-percent clarity [about a player's status] unless the player can tell us what's going on with them," said Echemendia, who spent 15 years as the director of the Psychological Clinic at Penn State University before pursuing a full-time independent practice. "We have to rely on the players to honestly report their symptoms. We do know from our data that even those players who report their symptoms and say they're feeling symptom-free, we're able to from our data pick up an additional 30 percent that have concussions through the neuropsych testing showing they're still not ready to return to play. But in the end it's a complicated injury. We absolutely have to rely on the player to tell us what is going on with them.

"The earlier they tell us what is going on with them, the less time lost and the better off they're going to be down the road."

Echemendia suggested research findings on concussions have motivated upper management -- including owners, general managers and coaches -- to be more understanding when it comes to a concussed player.

"I think it's happening in a pretty significant way with respect to the support that we've received as a concussion working group," Echemendia said. "There is always that tension of having a healthy player and wanting to promote healthy play while at the same time needing to have players on the ice. One of the things that we're finding in our work is that if we identify these injuries early and we manage them early and appropriately, there is going to be less time lost overall. If we get them off the ice early and evaluate them, those players are going to spend more time on the ice overall than that player who has symptoms, continues to play, feels pressure to play and then consequently is out for a much longer period of time."

Based on video analysis done by the Concussion Working Group, the League took a pro-active step in curbing concussions this past summer with the new rule banning blindside hits in which the head is the principal area of target. Echemendia said the rule change developed because the group's data suggested a significant portion of the concussions were being caused by those blindside hits. The proof was in the "video data," said Echemendia.

Echemendia also said he thinks the culture of hitting can change without having an effect on the integrity of the game. He pointed to how players are looking at concussions differently.

"What we've noticed is there have been changes in terms of player culture with respect to this injury and with respect to understanding how important this injury can be or how serious the consequences can be," explained Echemendia. "Along those lines, I think players will begin to understand that hitting is an important part of the game, but it is also one of the causes of concussion. As we modify that we maintain the integrity of the game while reducing the amount of concussions."

Echemendia was asked if the NHL is doing enough about concussions.

"The NHL is doing more than anyone else at the professional level in this area," he said. "Whether we're doing enough, that remains to be seen. I think we can always do more and I think we can always do better. That is part of what our group aims to do. We're carefully evaluating where we are at any given point and changing as we go on to make recommendations about possible directions where we can go."

Follow Dan Rosen on Twitter at: @drosennhl

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