Additional convergent evidence for the under-reporting of concussions in Canadian youth hockey

Mot people recognize that concussions are a risk of playing minor hockey. This is because of (a) the contact nature of the sport, such as the use bodychecks strategically in the game, (b) the fast speed at which the young players move on the ice, and (c) the hard surface and enclosed nature of the rink. Surprisingly, the actual incidence of concussion in youth hockey is not well established. This is mainly due to the lack of accurate, if any surveillance in minor hockey. Unlike the NHL and OHL, which have systems in place to monitor the occurrence of concussion during play, no such surveillance exists in minor hockey leagues.

In yesterday’s Globe & Mail, Alan Maki reports on the results of an alarming Canadian study conducted as part of the Hockey Concussion Education Project (HCEP). The study found that the 2011-2012 concussion rate was three times greater in interuniversity male hockey players and 5.5 times greater in female players than what researchers had reported a few years ago. The study was unique in that it had physicians physically present at rinks watching players and looking for behavioural signs of concussions. They also included MRI brain imaging on those athletes who were flagged as having had a possible concussion. According to the analyses of Harvard Medical School experts, there were signs of changes to the white matter of the brain even in those athletes who were not diagnosed with concussion.

This provides us with more evidence that concussions are not being reported as often as they should. Moreover, it presents converging evidence that concussions or “getting your bell rung” can cause a measurable impact to the brain.

For an overview of the science of concussion and repetitive head injury, please see Journal of Neurosurgery which has a listing of several current free full text scientific articles that provide up-to-date information such as on the pathophysiology, sequelae including neuropsychological changes, and of particular interest for athletes, the season-ending or possibly career-ending consequences that concussion or its mismanagement can have.