Concussions

[dblacklock]

There has been some discussions on our FIL Officiating and Rules Committees about Concussions and whether there needs to be some more emphasis in this area.

The NCAA has made it a point of emphasis this year and have implemented rules to try and better deal with checks up and around the head.

In the US they are seeing a lot more concussions in the Men’s Field Lacrosse game then we have seen in the past. There are a number of reasons. I think we are seeing more violent body-checks many of which are illegal, but are being taught or allowed. I think we are learning more about concussions and so more are being properly diagnosed. I also note that in reason years the helmets being used are designed differently and for different risks.
One way the increased concussion issue is being address is by new somewhat similar rules in both the NCAA rule book and the NFHS rule books.

The NCAA language is:
Targeting the Head/Neck
SECTION 14. A player shall not deliberately initiate contact to an opponent’s head or neck with a cross-check, or any part of his body (head, elbow, shoulder, etc.) or stick. Any follow-through that contacts the head or neck shall also be considered a violation of this rule.
PENALTY—One, two or three minute nonreleasable foul, at the referee’s discretion. Excessive violation of this rule may result in an ejection from the game.

Do we have the same problems in the English game? Do we have the infrastructure to not allow a player to return until they receive appropriate medical clearance? Thoughts on this would be appreciated.

[LAXLoofer]

viewtopic.php?f=6&t=14466

Will give an example of a hit in the BUCS/ELA which ran the risk of concussion ("Just sharing a great hit" thread.)

I don't think all clubs have the infrastructure/funding to include a qualified medic on the pitch for each match (I believe the rule is "first aid kit"). I don't know how much this might cost to implement.

St. John's Ambulance might be able to help with that http://www.sja.org.uk/sja/what-we-do/event-first-aid-cover.aspx (just an example, other alternatives may be available).

Maybe we could focus on head/neck hits in the same way as NCAA (immediate start to include all spring/summer tournaments and summer leagues, as a trial period).

Possible insist on mouth guard (1 minute non-releasable "self-endangerment, aka: berserker nut-job" penalty). I realise they aren't very comfortable, but if it helps prevent a concussion I for one am happy to cough up 7 or so quid, even the basic ones provide some form of protection.

http://www.amazon.co.uk/OPRO-Silver-Protection-Gum-Shield/dp/B000V9M76K (example, others brands/sizes/strengths are available).

To be fair, having now refereed and watched a season's worth of matches, I've only ever seen 3 deliberately high checks to head/neck level. All of which were penalised with 2 minutes or more after which the game calmed down significantly. I only saw one heavy, through the numbers bull-dodge (and that one was clean and magnificent , the defender bounced back up Bruce Lee style "look ma, no hands") .
I think the general consensus would be that most of the time we don't hit each other quite as hard or frequently as the NCAA/MLL players, at least in SEMLA D1.

[Moaning Git]

The NCAA language is:
Targeting the Head/Neck
SECTION 14. A player shall not deliberately initiate contact to an opponent’s head or neck with a cross-check, or any part of his body (head, elbow, shoulder, etc.) or stick. Any follow-through that contacts the head or neck shall also be considered a violation of this rule.
PENALTY—One, two or three minute nonreleasable foul, at the referee’s discretion. Excessive violation of this rule may result in an ejection from the game.

Do we have the same problems in the English game? Do we have the infrastructure to not allow a player to return until they receive appropriate medical clearance? Thoughts on this would be appreciated.

On Don's points. I agree deliberate targeting of the neck and head should be severely penalised, possibly with an instant expulsion when the hit is a violent one to the neck. I do not agree that a follow through from a shot should be penalised in the same way even if this result in injury, which I think would be unlikely to the head but possible to the neck.

I do not believe that we have the infrastructure suggested. A player who is ko'd or knocked senseless from a collision deliberate or not should end up in A and E. That will put him out of the game for the day. It is not a first aiders call, and any coach should put safety first. If a player were injured on the Saturday and then turned up to play on the sunday saying that he had received the ok to play, or had signed himself out of treatment then the responsibility lies with the individual and the coach.

I also believe gum shields should be made compulsory for all players not only will they provide extra protection but they might also shut some of them up!

[webby]

An example of how dangerous head shots can be - NHL Stanley Cup Finals - Aaron Rome (Cannucks) with a late high hit on Nathan Horton (Bruins).

Horton is out for the remainder of the season with concussion.

Rome was given an interference major (5mins) and a game misconduct. Upon review, Rome was given a 4 game suspension.

After the hit, the Bruins outscored the Canucks 12-1 (8-1 in the rest of game 3, 4-0 in game 4).

http://www.youtube.com/watch?v=pUYqTE3cnuQ

[young_trig]

An example of how dangerous head shots can be - NHL Stanley Cup Finals - Aaron Rome (Cannucks) with a late high hit on Nathan Horton (Bruins).

Horton is out for the remainder of the season with concussion.

Rome was given an interference major (5mins) and a game misconduct. Upon review, Rome was given a 4 game suspension.

After the hit, the Bruins outscored the Canucks 12-1 (8-1 in the rest of game 3, 4-0 in game 4).

http://www.youtube.com/watch?v=pUYqTE3cnuQ

Also in the rugby this week.........

http://www.youtube.com/watch?v=CjnPnQCB6vI

[the pom]

1 week ban a bit unfair I don’t think that was an intentional high hit.

[Sour37]

1 week ban a bit unfair I don’t think that was an intentional high hit.

completely agree

i'd bet there were at least a dozen other tackles in the game that developed the same way i think Ioane has a glass jaw

[davewilliams]

1 week ban a bit unfair I don’t think that was an intentional high hit

The first tackler tapped his ankle, so he dipped and therefore caught the second tackler's swinging chin-high right arm. Maybe the game was moving too fast for Mr Vaea, or he'd shut his eyes in anticipation of impact, but a week suspension's OK by me.

[DanSawyer]

If you choose to go in at shoulder height you take the risk of hitting him high if he's hit just before. You run the risk of injuring him so you accept the risk of a penalty.

Tackle the legs and these things won't happen to you...

[Mmk]

a hit to the neck or throat can be very dangerous especially cos theyre exposed. high, deliberate hits should be penalised very heavily to discourage players from doing something stupid. by deliberate i mean if the defender is lining the man up for a hit/ has a second to think before making contact or tries that behind the back stick check which you know some noob will do and get wrong.

that "just sharing a great hit" wasnt deliberate in my opinion. neither player was watching the other till the last moment. it was an unfortunate incident and nothing more. on the other hand (going off topic) what would be the rules against the sidelines behaving as despicably as they did in that incident? what can the refs do (even on home turf) in that situation?

i dont think a mouth guard would stop a concussion. the energy dissipated by a mouth guard from an upward hit to the jaw would not be sufficient to prevent such an injury. if helmets cant stop them, it seems less likely that a mouth guard could. the evidence for the theory is quite thin.

[Mort rotu]

i dont think a mouth guard would stop a concussion. the energy dissipated by a mouth guard from an upward hit to the jaw would not be sufficient to prevent such an injury. if helmets cant stop them, it seems less likely that a mouth guard could. the evidence for the theory is quite thin.

I dont think its to do with the amount of force applied, its how quickly its applied thats the problem. You have to get the brain to move independently of the skull, causing it to bash against the inside of it. A mouth guard spreads out the force by displacing(being squished) then rebounding much slower, not absorbing the force outright. This means you don't build up the required pressure to move the spinal fluid out of the way as easily so your brain is less likely to smack into your skull. Also a helmet isn't going to stop a hit from that direction (upwards) from giving you concussion, as its not in the way.

I used to wear one for Rugby, I wouldn't object to wearing one for LaX as long as somebody can get the decent fitting ones (shock doctor ones like this or this for example) with helmet straps.

[Mmk]

i dont think a mouth guard would stop a concussion. the energy dissipated by a mouth guard from an upward hit to the jaw would not be sufficient to prevent such an injury. if helmets cant stop them, it seems less likely that a mouth guard could. the evidence for the theory is quite thin.

I dont think its to do with the amount of force applied, its how quickly its applied thats the problem. You have to get the brain to move independently of the skull, causing it to bash against the inside of it. A mouth guard spreads out the force by displacing(being squished) then rebounding much slower, not absorbing the force outright. This means you don't build up the required pressure to move the spinal fluid out of the way as easily so your brain is less likely to smack into your skull. Also a helmet isn't going to stop a hit from that direction (upwards) from giving you concussion, as its not in the way.

I used to wear one for Rugby, I wouldn't object to wearing one for LaX as long as somebody can get the decent fitting ones (shock doctor ones like this or this for example) with helmet straps.

it probably depends on how elastic or inelastic the mouth guard is. i wear one for mixed and i dont think that it would do anything to prevent a concussion (i hate wearing it). i understand what you meant about cushioning the blow. by spreading out the time taken for the force to reach the brain you would reduce the impulse. theoretically this is a hard thing to test because if it does prevent concussion and the wearer knows it does then they are more likely to get into bigger hits and cause concussion. if it doesnt then the wearer will still get into bigger hits and still get concussion.

there are a few medical journals/articles which have reviewed the evidence and some of the more recent ones state that there is little fact in the theory. wearing a mouth guard doesnt (statistically speaking) prevent any concussions. these were a neurologist's findings on the matter.

id say its down to preference. im not going to wear one if there is no rule on the subject.

[Steely Dan]

just to chime in - I recnetly got hit quite hard on a side impact helmet to helmet contact. This didn't result in concussion but did result in a nice clean break to the jaw and a few chipped teeth from lower to upper jaw contact. If I can find a mouth guard that lets me breath easily enough then its a definite upgrade for next season but I accept this is down to personal preference and is also a little bit of "shutting the stable door..."

[wildcat]

Currently , I think there is no strong evidence to say that mouth guards prevent concussion. (that doesn't mean that they dont, but just that no one has proven it scientifically).

It is difficult to prove it, because they are relatively few and far between and there is such a wide range of symptoms that could be classified as concussion. A team mate recently got diagnosed as concussion, and told he shouldn't play for a couple of months. That figure is a made up one by the doctor he saw!

[Mort rotu]

There is probably a bio-mechanical engineering PhD in this somewhere, but couldn't you test it with a mock skull, a balloon(maybe the bladder from inside a football) and a hand full of accelerometers?

coat the inside of the 'skull' with paint, fill the bladder with jelly/cauliflower cheese to represent brain tissue and fill around the balloon with mock 'cerebral fluid' (I assume water and electrolytes), apply force to the rig, measure the acceleration and see how much acceleration you need to get paint on the balloon?

an extension should mount a jaw to the skull and repeat, applying the force through the jaw. It's probably already been done somewhere.

[LAXLoofer]

a hit to the neck or throat can be very dangerous especially cos theyre exposed. high, deliberate hits should be penalised very heavily to discourage players from doing something stupid. by deliberate i mean if the defender is lining the man up for a hit/ has a second to think before making contact or tries that behind the back stick check which you know some noob will do and get wrong.

that "just sharing a great hit" wasnt deliberate in my opinion. neither player was watching the other till the last moment. it was an unfortunate incident and nothing more. on the other hand (going off topic) what would be the rules against the sidelines behaving as despicably as they did in that incident? what can the refs do (even on home turf) in that situation?

The sideline supporters/team bench are the responsibility of the coach/security staff of the team they are supporting. The referee has some extra special powers for these situations. Ranging from 30 second technical fouls to match abandonment and disciplinary committees for disrepute.

[LAXLoofer]

An example of how dangerous head shots can be - NHL Stanley Cup Finals - Aaron Rome (Cannucks) with a late high hit on Nathan Horton (Bruins).

Horton is out for the remainder of the season with concussion.

Rome was given an interference major (5mins) and a game misconduct. Upon review, Rome was given a 4 game suspension.

After the hit, the Bruins outscored the Canucks 12-1 (8-1 in the rest of game 3, 4-0 in game 4).

http://www.youtube.com/watch?v=pUYqTE3cnuQ

Rome got off light. People have been suspended for longer for a less lethal transgression.

[webby]

An example of how dangerous head shots can be - NHL Stanley Cup Finals - Aaron Rome (Cannucks) with a late high hit on Nathan Horton (Bruins).

Horton is out for the remainder of the season with concussion.

Rome was given an interference major (5mins) and a game misconduct. Upon review, Rome was given a 4 game suspension.

After the hit, the Bruins outscored the Canucks 12-1 (8-1 in the rest of game 3, 4-0 in game 4).

http://www.youtube.com/watch?v=pUYqTE3cnuQ

Rome got off light. People have been suspended for longer for a less lethal transgression.

But Chara got nothing for this...

http://www.youtube.com/watch?v=jimZ1tSdPY0

[LAXLoofer]

An example of how dangerous head shots can be - NHL Stanley Cup Finals - Aaron Rome (Cannucks) with a late high hit on Nathan Horton (Bruins).

Horton is out for the remainder of the season with concussion.

Rome was given an interference major (5mins) and a game misconduct. Upon review, Rome was given a 4 game suspension.

After the hit, the Bruins outscored the Canucks 12-1 (8-1 in the rest of game 3, 4-0 in game 4).

http://www.youtube.com/watch?v=pUYqTE3cnuQ

Rome got off light. People have been suspended for longer for a less lethal transgression.

But Chara got nothing for this...

http://www.youtube.com/watch?v=jimZ1tSdPY0

Agreed, a less than subtle sucky check! And even suckier review by the Toronto commission. Odds are they judged "lack of intent to injure". And it goes to show the human falability of the NHL disciplinary committee, they don't get it right all of the time.

In the old times that would be a bench clearance, without doubt and Chara would be lucky to get off the ice alive!!!

http://prohockeytalk.nbcsports.com/2011/03/09/nhl-has-awkward-decision-to-make-after-zdeno-charas-wicked-hit-on-max-pacioretty/

Nice to see that Pacioretty had his priorities straight about the spirit of the game though. This is the message all hockey and lacrosse players need to take note of:
>>"I am upset and disgusted that the league didn’t think enough of (the hit) to suspend him," Pacioretty told TSN. "I’m not mad for myself, I’m mad because if other players see a hit like that and think it’s okay, they won’t be suspended, then other players will get hurt like I got hurt<<

http://www.montrealgazette.com/sports/Pacioretty+disgusted+ruling+Chara/4413203/story.html

[the pom]

There is a difference between the two
Romes was intentional no doubt

But with chara could you prove he did it on purpose?
I have not played hockey but just to put a big hit in on a pro must be hard to time it to the micro second so there head hits the post??
Is it possible chara was just putting in a big hit.

I would consider this a rink design issue if there was a tapper in to the rink or say a large radius on the post he would probably glanced off still ended up on his ass but being able to skate away