Concussion Prevention for your athlete! A preventative plan.
This article is worth reading if you have a son or daughter involved in contact sports
The concussion problem in sports has reached epidemic proportions.
It was the third period of a wild west shootout. The CNHA Canucks had come from a 3-0 deficit and roared ahead scoring 5 goals in the second period. Clearly, the visiting Royals were on their heels. The third took on a more physical tone led by the larger Royals team. The teams traded goals and hits with the Royals coming out slightly on top. Royals score again and momentum begins to build. They make a nice play out of the neutral zone, clean fore check, things are looking up.......until a crushing mid-ice hit on the Royals 6'1" forward brings the momentum to a screeching halt. Momentarily, the player appeared unconscious but thankfully was up and around after a few minutes. Although the hit may have been helmet on helmet, it didn't look to be a dirty play and no penalty was called. As most players will tell you, when playing the "fastest game,” it’s hard to position yourself perfectly when moving in access of 18 mph (top NHL players have been clocked over 30 mph).
So what exactly happened when the Royals player took that hit?
Let’s assume he was skating below his maximum speed (he had the puck) at 16mph. He is 6'1" and weighs 180lbs. The Canucks player doesn't have the puck and is skating at close to his maximum speed of 18mph. He is 5'10" and weighs 155lbs. Using a mathematical formula, we can discover how much energy is expended in an open ice hit.
In our calculations, we'll assume that the players become entangled and "stick" to each other during the collision. This is called an inelastic collision. Even though the players may not come to a complete stop, we can still calculate the amount of energy that will be dissipated in the collision. We do this by calculating the energy of each player before the collision, and subtract the energy of the combined players after the collision. I won't bore you with the equations but at the end of the hit the amount of energy produced from the collision is equal to 4356 Joules (all things being equal, of course). This collision produces enough energy to shoot a puck 43000 feet. The puck would initially be moving at a speed of 357mph. The stopping force is 514 pounds. This is enough energy to light a 60 watt light bulb for 72 seconds. No matter what measurement you use, it’s a lot of force in a short amount of time. This discussion up to this point has been purely academic. The real question is, what about the brain?
According to Dr. Richard Smayda (scientific American):
" A concussion is an immediate but reversible traumatic paralysis of the nervous function of the brain. It is usually caused by a blow to the head or by striking the head against a stationary object--blunt traumas that are differentiated as either acceleration or deceleration, respectively." He goes on further to explain
".....it is the rotational movements of the brain inside the calvaria (meaning the entire cranium except for the facial bones) and the shearing forces affecting the upper reticular formation that create torque, which leads to the typical loss of consciousness. These forces also cause the brain to move in a swirling fashion and contact the inner prominence of the skull, particularly the petrous and orbital ridges and the wings of the sphenoid"
In plain English, the sudden stop of the body (due to the hit) causes the brain to "bump" into the interior of the skull at the point of impact. It then ricochets off that surface and impacts the opposite side of the skull. This results in bruises that damage two sites on the brain called the coup and contrecoup injuries. According to researchers like Smayda, it’s not the initial hit that does the most damage.
"....a concussion involves a host of effects (secondary injuries) that emerge several hours or days after the trauma. It is critical for physicians to monitor these secondary tissue damages, as they are frequently the origin of significant long-term effects, including brain damage, cognitive deficits, psychosocial/behavioral/emotional changes, bodily damage and biochemical changes at the cellular level.''
So the question becomes, is there any way to mitigate damage from potential massive hits to the head?
Many athletic associations have added new practice rules to reduce the number of blows to which the players are exposed during practices. However, up to this point everything has focused on how to deal with the athlete after the concussion, but there is now a movement to help educate athletes, parents and coaches about sports concussions and what can be done to prevent or avoid them. We’ll never be able to eliminate concussions from sports, but there are certainly things we can do to help reduce the forces our brain encounters.
There are three current components of neck injury and concussion prevention:
- Protective equipment
- Technique (not leading with the head while hitting, or "head" hunting)
- Awareness – It may seem strange but many parents and athletes are still unaware of the potential damage concussions can do to the human brain.
In terms of our Royals forward, however, none of the three would have helped him prevent a possible head injury. What can we learn to keep this type of injury to a minimum?
Sports like boxing and Muay Thai may be brutal, but the coaches learned long ago that a strong neck is paramount absorbing force. In these types of sports it is typical to spend 5% of practice time on strengthening the neck.
This is the least publicized aspect of concussion prevention for several reasons.
According to Jim Kielbaso, Director of Sports Training at TPT Center who has worked with athletes at all levels of competition (youth, high school, national level, collegiate, Olympic, NFL, NBA, MLB and NHL),
"....Firstly, most people don’t know how to safely and effectively train the head and neck musculature. Second (ly), it would be next to impossible to produce scientific evidence to show that training will help prevent concussions because you would have to use real human beings and expose them to potentially life-threatening blows. This would never pass any collegiate ethics committee, so the research probably cannot be done."
If we turn to another industry, the automotive industry, it has been well researched that a stiffer neck reduces the g-forces encountered by crash test dummies. It seems obvious that strengthening the neck would be a good idea. A stiffer neck will simply move less on impact and the brain will move less inside the cranium during this impact, thus reducing possible damage. This plain thinking has not been endorsed from the medical community for several reasons;
- Doctors won’t make any money from the prevention side of this issue.
- Doctors probably have no idea how to train.
- Doctors typically refer to the scientific literature, but we’ve already established that this evidence will probably never be published in any scientific journal.
Now, it’s important to grasp that no amount of training will stop all injuries, but that’s not the point. The point is, things like ACL injury prevention programs didn't exist 10 years ago, but now virtually all University strength programs have protocols in place.
The same goes for properly training the neck & head to reduce the risk of concussions and serious neck injuries. The training does not eliminate the injuries, but it can help to lessen the risk or severity of neck and head injuries.
The leading researcher on neck training, Ph.D. candidate Ralph Cornwell, put it best when he said “If we know that it might help, and it’s not going to hurt, why wouldn’t you want to do this kind of training? People do ACL prevention programs all the time. This is like an ACL prevention program for your brain and neck. You can replace your ACL, but as far as I know, you only have one brain. It just makes sense to protect it.”
Major sports organizations like USA Hockey and the NFL are recognizing that something must be done, so rules are changing quickly. However, that may not be enough to help our hockey training youth.
With the knowledge that training can help prevent injuries and, when done properly, can cause no harm, why would we NOT strengthen the muscles surrounding the head and neck?
In keeping with one of the Jungle Strength and Performance’s main tenets of Keep things as simple as possible, below is a simple neck strengthening program that everyone can do from the comfort of their own home and NEED to become a part of each players preparation for playing hockey.
Do each exercise for 30 seconds for 1 set. Initially three times per week will lead to strength benefits as the athlete has not previously been exposed to this type of stress. Movement should be done slowly and under control. All movements can and should be performed face down (prone position) as well.
Month 1. Perform program as above
Month 2. Add time up to 60 seconds per movement and up to 2-3 sets
Month 3. Add in addition loading (manuel resistance) and reduce the sets and time under tension to month 1 levels.
Month 4. Increase volume as needed (always slowly!)
For access to article pictures please go to https://junglestrength.wordpress.com/2014/11/09/concussion-prevention-for-your-athlete-a-preventative-plan/