Crosby, Concussions and hockey

With Canadians across the country rubbing their hands together in anticipation of the 2011-

Khatija Westbrook

2012 NHL season, which starts this week (Oct. 6), Face Time chatted with Mount Royal University's Dr. Khatija Westbrook, an associate professor in the Department of Physical Education and Recreation Studies, about head traumas and hockey.

It's a topic that has a lot of misconceptions and seems to be in the media frequently during the past year in particular with the deaths of several NHLers who were dealing with issues that may have been aggravated by post-concussion symptoms.

Not to mention, the greatest hockey player in the world according to multiple sources including TFT's recent top-50 player rankings (link), Sidney Crosby hasn't played an NHL game since Jan. 2011 and won't be suiting up for the start of this season either as he continues to recover from a concussion.

Westbrook is currently working on a research project (Long Term Athletic Development program), which hopes to discover and clarify ways to preempt athletic injury by looking at how society trains athletes when they're young.

FT: What makes the consequences of concussions, so unpredictable and volatile?

Westbrook: It's actually quite interesting, there are people in the United States that do a huge amount of research on this area right now. They have things in football helmets that are measuring the force and the direction so they film all the practices and games in the States for football.

So, as soon as someone thinks that they have a concussion, they have this information about force and how much came through and the impact and where it came from, they have the symptoms and stuff like that. And even with all of that they can't necessarily predict if you get hit this way, with this much force, and that much torque, it's going to be this much force that's imported to the body.

So part of it is, it's really hard to measure the force that goes through in any given situation and every situation is different in that you might get hit with more rotation in one or you might have what they call double crush, where they hit both sides of the brain, because it's basically like a sponge in the bucket, so it will slosh back and forth on both sides and that is incredibly hard to measure.

What the researchers are finding is that it's the unexpected hits and sometimes it's these really mild hits (such as the one that many suspect initially caused Crosby's concussion LINK) that create the issue.

Part of it is the inability to be able to control the variables that go into the injury in the first place. Second it's the fact that everyone just has different physiology. Then you're looking at, 'have they had a concussion before or haven't they and how is the body reacting to that.'

FT: Will Crosby be more susceptible to another concussion when he returns?

Westbrook: There is no set guarantee that if you have had a concussion previously, you're going to be that much worse.

You do tend to see that if you've had one concussion and then you get a second one, depending on how close together they are, you might not recover as quickly.

FT: How is it possible that Crosby got such a severe concussion from what appears to be a mere bump?

Westbrook: So this is what they are finding: if the person sees the hit coming, then they tend to tense up the muscles so they control the way their head moves a little bit. If they don't see it coming, they don't have that bracing mechanism and it's not always the hits you would expect to give a concussion that do the most damage.

Because they aren't expecting it, more force goes to the brain.

FT: Is there anything that they can really do to prevent and protect?

Westbrook: They look at different helmets and so it used to be you could get these great concussion helmets with extra padding but what they're finding now is that they actually add more weight to the head.

So now they are actually finding that they are not stopping the concussion, in fact, they can be more problematic because what they have is more mass that you are trying to control. So the helmet is not necessarily the answer.

Technique is hugely important, so how to tackle correctly for spinal injury and head injury, how to absorb shock, how to park shock. So technique can make a difference and being prepared, being aware of where your opponents are on the playing surface and where they're coming from is the best way to preempt these injuries.

FT: How much trauma are "fighters" in the NHL exposing themselves to by punching each other in the head?

Westbrook: There is actually a brain bank study going on right now, but it started off in football and they were finding that NFL players, usually the linemen were dying early, usually in their 40 and 50's.

Many of them committing suicide or having high violence instances with their kids.

A former football player who went into professional wrestling, Chris Benoit killed his family and committed suicide out of the blue, a few years back (LINK).

He had suffered a series of concussions through his career and ended up killing his family and then himself. So this raised a lot of interest in the neurological community and started this brain bank and collecting brain samples and what they've discovered is there's a repetitive concussion brain damage that occurs over time.

They are seeing the degeneration of the brain, that's going along with that. Now, they have done it mostly with football players, but they are starting to do it with hockey players, and my understanding is they are finding that there is this syndrome, but I don't think they have found the same kinds of patterns that they have found with football.

Obviously they don't have enough information yet to know. So it's quite possible, but they can't say with certainty yet.

FT: What don't most people realize about this area of discussion?

Westbrook: What they're finding now is that when someone is concussed, it's not so much damage to the neurons as the function pace. It impacts how neurons work and interact. Processes can be scrambled. There are people who can never read a book again. There are students here who can't study as well as they used to be able to because they've got learning disabilities from concussions.

I have a friend who has emotional memory loss from a concussion. If she sees a friend or family member every couple of days, then she'll have an emotional connection to you but if she doesn't see her father for a week, she'll have the knowledge that he's her father but she won't have any emotional connection to him.

There can be so many cognitive deficits that can come from concussions. I remember one girl that had to retire from the national field hockey team because she had memory loss. She literally couldn't remember set plays when she was on the field.