Concussions are probably the fastest growing injuries in sports today. With the athletes in all sports becoming bigger, stronger, faster and more powerful, the speed of the game, no matter what sport, is increasing and the contacts are becoming more and more violent.
Another important factor to consider in the growth of the number of concussions diagnosed is that the awareness of this serious injury is better than ever. What I mean is that we are more educated on what the symptoms of a concussions are, and how to identify them. A raise in awareness in clearly a good thing, bu it means that the number of concussions identified versus the number of concussions that go unnoticed is bigger.
In other words, sports are played at a faster pace and contacts are more violent today than ever before, but we are better at identifying concussions, so the numbers will be higher.
In my opinion, the concussion epidemic is a result of both of these factors (better awareness + faster pace sports).
But the big question is: can we prevent concussions?
While I don’t pretend to have the answer to this important questions, there are a number of factors that need to be considered regarding concussions; these could potentially affect the rate of concussions in sports. Let’s take a look at some of them:
1. Although I don’t have any evidence of this, I feel fairly confident in saying that among all sports, ice hockey is probably the one in which the rate of concussions has been growing the fastest. There are probably many reasons for that. One of them is the dimensions of the surface of play. No other sports played at such high speeds has a surface of play surrounded by boards and glass. And we’re not talking about the size of a football field here, we’re talking about a 200 feet by 85 feet playing surface. When there is 10 guys skating at very high speeds (that is not including the 2 goalies, and the 4 referees), high speed contacts are just waiting to happen. Although contacts between 2 players are most frequent against the boards, open-ice hits are not infrequent, and probably the most devastating ones.
Would increasing the size of the playing surface be one way to limit the number of open-ice hits? I would be tempted to say yes since you would have the same number of players on a bigger surface, therefore opening up the traffic. And this wouldn’t be that crazy of an idea since the International Ice Hockey Federation (IIHF) already uses ice surfaces that are wider (98 feet, instead of 85). There are some other logistic problems that this could cause, but that’s a different story.
International Hockey Rink Size
2. Certain rules in sports are favorable to increase the number of concussion within the game. Again taking the example of ice hockey, after the previous lockout in the NHL in 2004, the 2-line pass rule was abandoned to make the game more exciting. For those not familiar with hockey, this rule was basically forbidding passes across the ice (length-wise), and made breakaways a lot less frequent. With the 2-line pass rule abandoned, it made the game faster, with less stoppages of play, and was opening the door for more spectacular plays, and breakaways…but also for more open-ice hits.
Again it’s hard to know with certainty if this rule alone impacts the number of concussions, but it sure does increase the speed of the game and players are more vulnerable for those open-ice type of hits. There are certainly rules in other sports that increase the speed of the sport or the vulnerability of certain players to more dangerous hits. A revision of the rules in sports where concussions are frequent might be a thing to consider if we want to reduce the incidence of this type of injury in sports today.
3. The equipment in sports is like having a full-body armor. Shoulder pads, elbow pads, shin pads, you name it, are at the fine point of technology and are protecting the bodies of the athletes to make them (or at least make them feel) invincible. The players don’t go nice and smooth when they go to make a hit knowing that they have a full-body armor to protect them.
Would these players make those same kind of hits if they didn’t have any protection? I doubt it. I’m not suggesting that players shouldn’t wear equipment because they definitely need the protection playing high speed sports, but maybe there should be a limit to the development of new technology when it comes down to equipment. Or maybe there could be rules for the equipment (size, material, etc). The NHL created a rule to limit the size of goalie equipment a couple years ago to make sure that wasn’t becoming an issue in the number of goals scored per game (imagine how much less entertaining hockey games would be with less than 2 goals scored per game on a consistent basis). I don’t see why a rule in equipment restriction for players could not be an option.
4. The strength of the anterior neck muscles and the deep stabilizers of the cervical spine are important to minimize the whiplash effect when getting hit. With most hits that result in a concussion there are 2 distinct impacts that occur that can cause or amplify the concussion. The first one is the initial hit during which there usually is a whiplash effect (violent head movement) that makes the brain move inside the cranium.
The second one is the contact of the head to the ground when the athlete falls down after the hit. Often times when the hit is violent, everything happens so fast the player doesn’t have time to react and brace himself, and his head violently hit the ground. In both situations, if the anterior neck muscles and deep stabilizers don’t react fast enough or aren’t strong enough, the whiplash effect can be worse, and therefore increases the chances of the brain injury. Appropriate neck work is very important for athletes who play contact sports to limit the whiplash effect and the brain movement in the cranium when hit hard. Again, I’m not saying that strengthening the appropriate muscle will save you from a concussion, but it is helpful in trying to minimize the risk factors.
5. Posture. With a forward head posture, the anterior neck muscles become inhibited, and this can cause further problems (see #4), but the upper cervical spine muscles also get very stiff and overactive. The rectus capitis minor is one of these muscles. It also blends into the dura, which is the lining that encapsulate the brain. This muscle is known to be a potential cause of headaches. Now it sounds like this muscle could really be a trouble maker when you mix forward head posture and concussion, doesn’t it?
There are a host of factors that contribute to concussions, and as you can see not all of them have to do with the athlete’s body itself. The good thing about concussion is that we are slowly becoming more educated about this epidemic in sports today. Understanding the physiological process is one piece of the puzzle in our fight against concussion, but it’s important to realize that the nature of the game also is one.
Hopefully I opened your eyes on some of the contributing factors of concussions. Your comments or questions are more than welcome!
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