Winter sports injury prevention

Dr. Beth Snow
23 January 2012

During my hockey playoffs last year, I got a concussion.

It happened in a split section — a body check from an member of the opposing team, which I wasn’t braced for because it happened after the whistle, caused me to go flying backwards and the back of my head hit the ice!

Well, the back of my head hit the inside of my helmet and my helmet hit the ice. Hard.

This happened just days after actress Natasha Richardson died from hitting her head while skiing and my immediate thought was “I don’t want to die!” Probably a bit of an overreaction, but I admit it was my first thought. I skated to the bench and tried to assess the situation — I wasn’t dizzy, my vision wasn’t blurry, and I didn’t have a headache. “I guess I’m fine?” I thought. As it turns out, I did have a mild concussion, characterized by headache, loss of balance, disrupted thinking, which was confirmed by my doctor the next day. Not knowing I had a concussion at the time, though, I did something that, in retrospect, was pretty dangerous. I played the rest of the game. And the next game later that day. Had I received another head injury, even a slight one, there could have been very serious consequences — something known as “second impact syndrome.”

What is a concussion?

Fast Fact: A concussion is a mild traumatic brain injury resulting from impact to the head. Symptoms of concussions include things like loss of consciousness, memory loss, dizziness, nausea, headache, blurry vision, confusion, etc.

Scientists used to think that concussions only resulted in temporary effects, with chemical or electrical changes to brain cells that then return to normal; but we now know that some concussions can actually kill some brain cells and result to damage in the structure of the brain!

Research suggests that having multiple concussions may lead to long-term, permanent brain damage. As well, getting a second concussion before a first concussion has healed is particularly risky — this is because in the time immediately after a concussion injury, brain cells are particular vulnerable to changes in blood flow, pressure inside the skull, and low levels of oxygen in the brain — and all of this makes the brain susceptible to another concussion. This is known as “second impact syndrome”. No one really knows how long this state lasts, which makes it hard to answer the question, “When can I play again?”

What is Second Impact Syndrome?

when a second head injury, even a relatively minor one, occurs before the symptoms of a first head injury are gone results in brain swelling, which can lead to seizures, respiratory failure, coma and death common in youth aged 14-16 years old

Also, the developing brain may be vulnerable to more damage and poorer recovery than adult brain, so concussions are of particular concern to youth.

So what can you do about potential injuries?

Research shows that newer designs in hockey helmets, combined with more people actually wearing their helmets, decrease fatal and serious head injuries, but no study has ever shown helmets to be effective in preventing concussions.

While there is no way to eliminate the risks inherent with sports, learning proper technique and wearing protective equipment can reduce the risk. As well, it’s important not to return to playing a sport where head injuries can occur, like hockey or skiing, after getting a concussion, at least until all symptoms have subsided.

Learn more!

Biasca, N & Maxwell, W.L. (2007). Minor traumatic brain injury in sports: a review in order to prevent neurological sequelae. Progress in Brain Research. 161: 263-291.

Cantu, R.C. (2003). Recurrent athletic head injury: risks and when to retire. Clinics in Sports Medicine. 22(3): 593-603.

Cross, K., & Serenelli, C. (2003). Training and equipment to prevent athletic head and neck injuries. Clinics in Sports Medicine. 22(3): 639-667.

McIntosh, A.S., & McCrory, P. (2005). Preventing head and neck injuries. British Journal of Sports Medicine. 39(6): 314-318.

Article first published on November 16, 2009.

Dr. Beth Snow

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