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Dr. Saul Miller

Headshots, Concussions, and the Game

I was driving back from a week of working with the Medicine Hat Tigers of the WHL. Sitting beside me was one of our veteran defensemen who at 19 years of age is retiring from the game after a series of concussions. He is one of 3 players on the team currently concussed. Prior to my week with the Tigers I was in Switzerland for three weeks working with SC Bern of the Swiss A League. We had 2 players out with concussions. A major midget (youth, 15-17 years old) hockey team I was consulting with prior to going over to Europe also had three players out with concussions. 

Something is happening. There seems to be an epidemic of concussions across all contact sports… especially hockey. I’ve been a sport psychologist for over three decades and have worked with approximately 30 different sports and I can’t recall concussions being anything like the issue it is today. 

I think the two primary reasons for the increased incidence are: 1. players are bigger, and faster, and attempts to make the sport more appealing have increased the pace of the game. 2. Second, people are simply much more aware of concussions and it seems like almost any bump to the head is immediately diagnosed as a concussion. That’s not to say I want to play down the significance of having a concussion. The affects of injury to the brain (and that’s what a concussion is) are serious and can be long lasting and even life changing.

However, rather than just commenting on the increased incidence of concussions, I think several things can be done to do to reduce the incidence of brain injury. First, and perhaps most obvious, is to severely penalize blows to the head... whether intentional or otherwise. If the infraction is deemed intentional, the penalties should be very severe. And for those repeat offenders, penalties should be especially and increasingly severe.

Second, players, especially young players, can and should be coached to take responsibility for not putting themselves in harm’s way. A player who turns into the boards protecting the puck and then is hit from behind into the boards has to assume some responsibility for what happens. (and it’s a tough call for the referee). Similarly a player handling the puck with his head down is setting himself up for an injury. There should be more emphasis at the developmental level coaching kids to play “heads up” hockey. 

Third, there should be a change of equipment. Elbow pads can be softened and still be protective without being the hard shell weapons they currently are. Helmet research is ongoing. Also there should be more research on whether the use of certain fitted mouth guards can reduce the incidence of concussion.

Fourth, hockey players, who are exposed to the possibility of receiving blows to the head should incorporate neck muscle strengthening exercises (e.g., neck bridges) into their physical training program just as boxers and football players do. These exercises may help to create a protective effect similar to what is provided by a heavy duty shock absorber. And having heavy duty shocks if you’re playing hockey is protective… and a good idea. Physical trainers should explore what off ice exercises could support the heavy duty shock absorber idea.

Fifth, I believe we should compile statistics on the relationship of fighting to concussions. If it’s found that fighting leads to a significant incidence of concussion…. and if reducing concussion is a really priority, then the rules and penalties relating to fighting should be reexamined.  

Of course one of the things that makes hockey (and football) exciting is the fast, physical nature of the sport. That can’t and shouldn’t be changed. And, concussions will happen.

What former NFL coach and commentator John Madden said about reducing head injuries in football applies equally to the NHL as well. He said, “ Football is a tough game. The NFL is tough. Guys are big and fast and strong and there are violent hits. It’s a violent game. Within that, how can we make it safer?” The brain is precious. The question of what can be done to make hockey safer but not tamer, and to reduce the incidence of head injuries in the game can and should be explored very aggressively. 

Dr. Saul Miller is the author of Performing Under PressureHockey Toughand Why Teams Win

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