WESTBOROUGH, MA March 15, 2016 High schools across New England and across the United States are writing injury protocols for athletes who sustain a concussion during interscholastic competition. Many schools are limiting the number of days when full contact drills may be undertaken to limit hits to the head. These protocols are not limited to football. In hockey there is always a mix of body types on the ice at any given time. I played college hockey as a natural freshman and was thrown around the ice by men who were 25 pounds heavier. That was a different time.
In 2016 the majority college ice hockey player spend one to two years in junior hockey (ages 17-21) allowing them to continue their physical development prior to entering college hockey. This includes not only Division I scholarship programs but Division II and Division III programs as well. Very few natural freshmen play college hockey at 18 years of age unless they are highly gifted athletes. Even these players are coached and managed by trainers with ongoing development programs, weight training, and nutritional support to enhance upper body size and strength.
Sometimes a younger athlete will be skating against someone who is 3 years older and more fully developed. The height and weight differential may be dramatic as shown in the attached video. The video was attached to an published article in the January 2016 issue of the Journal of Pediatrics. The study identified lighter weight and early puberty as adding to vulnerability for
concussion in male high school athletes. Among females, it was found that heavier weight added to the girls concussion risk in high school ice hockey. The study was conducted at three hospitals in the Providence, RI area and cited a recovery time of over 54 days in smaller, prepubertal athletes who sustain a hit on the ice. I have been able to provide both preseason testing of high school and middle school athletes for several years and am available for post-injury neuropsychological assessment and return to school consultation.
Rhode Island was the first state in New England to require concussion education and physician protocols for athletes and family members who are playing high school sports. It was a Rhode Island ice hockey player and his driven, motivated mother who got the bill onto the governor’s desk in RI a few years ago. I have taken care of players who have been injured playing hockey but the recovery time is significantly longer for the young, smaller athlete. This is consistent with the findings published recently from the Hasbro Children’s Hospital study.
Postconcussion syndrome results in 10-15 percent of athletes. It is diagnosed when symptoms persist after 28 days of recovery. Most athletes report a decrease in symptoms after 7-10 days but most have measurable neurocognitive changes after 10 days. As students return to school they require support and often a specialized school re-entry plan to accommodate their needs during the recovery. It is my practice to see athletes who have been injured within 72 hours of their injury. Long delays in receiving care is a problem in many areas of the country and consultation with school personnel is recommended.
“Sport-related concussion. A dangerous hit to the head involving a study participant (varsity ice hockey player, wing, freshman, 128 lbs, 63 inches, early-pubertal stage). Study participant experienced concussive symptoms for 76 days, missed several weeks of school, and the remainder of his high school ice hockey season. The aggressor received a 5-minute major penalty and a game misconduct.” Kriz et. al. 2016
Peter K. Kriz, Cynthia Stein, Janet Kent, Danielle Ruggieri, Emilie Dolan, Michael O’Brien, William P. Meehan III.Physical Maturity and Concussion Symptom Duration among Adolescent Ice Hockey Players. The Journal of Pediatrics, January 2016 DOI: 10.1016/j.jpeds.2015.12.006