Injury News It's official - Giroux has a concussion

[canoli]

pretty much the nightmare scenario we hoped would never happen to Claude Giroux ... and now it's happened. He's got a concussion, nobody knows how bad it is and no one can predict what the next hits will do to him.

One of the articles quoted a doctor saying "there's no such thing as a 'mild' concussion." He went on to say how after you've had one, any hit can trigger concussion symptoms or even cause another concussion. The hit doesn't have to be to the head.

They think that's what happened to Pronger: he didn't take any head shots after the eye injury but of course he got hit. The doc seems to think those hits are responsible for Pronger's symptoms.

How fkd-up can you get? A goddamn stupid freak play takes out our most productive player, a guy the whole league is watching now because he's so damn good. It just sucks beyond belief.

[edit: 2 "positives" (gigantic quotation marks)

1. Couturier. He gets big minutes on a scoring line, one that's been clicking. Of course Giroux is a big reason why they were clicking but I've got a good feeling about Couturier: he's going to be brilliant. I'm sure the coaches have told him many times, "go out play your game; don't try to be Claude Giroux."

2. Homer. He's still batting a thousand...tells us "Giroux is feeling better today" and now he's "out indefinitely" with a concussion.]

Edited December 14, 2011 by Digityman

[terp]

One of the articles quoted a doctor saying "there's no such thing as a 'mild' concussion." He went on to say how after you've had one, any hit can trigger concussion symptoms or even cause another concussion. The hit doesn't have to be to the head.

I think there are a number of perspectives on this injury so I wouldn't be quick to assume any extreme scenarios. Lot's of people make full recovery's from concussions. This is a matter of concern that should not be down played, but shouldn't necessarily rely on the scary comments of this particular doctor.

[Finnfly75]

Thats bad....damn... That really sucks cause there isnt any body to blame ether...accidents happen, but please, Giroux, Schenn and seems like Pronger also...what the hell is happening!!!!! Hope he gets well and will be back sooner than Cindy. If nothing else its great change for the rookies to really step up and also Simmonds to show what he has.

Go Flyers

[phlfly]

yes I read same thing on Twitter it's bad news. But at same time it was a kind rebuilt year so Flyers had a good run for last 35+ games. Let's thank them and hope for playoff spot. It's not a end of the world, it's a just game and intertaiment. Enjoy guys each every moment

[canoli]

you're right Terp, nobody knows the extent of Giroux's injury. But the doctor wasn't describing an "extreme" case, I think his point is, "you either have a concussion or you don't." If you have one there are certain risk factors that follow you afterward and Giroux will have to deal with them.

Edited December 13, 2011 by canoli

[brelic]

At least Schenn is slated to come back on Thursday, and depending on how Couturier does, he'll probably see time on the top line.

This really sucks.

[aziz]

One of the articles quoted a doctor saying "there's no such thing as a 'mild' concussion." He went on to say how after you've had one, any hit can trigger concussion symptoms or even cause another concussion. The hit doesn't have to be to the head.

while i understand that concussions are a serious thing, some doctors (and others) have taken to beating drums on this whole thing that are inappropriate. i'm not a doctor myself, so maybe i can't challenge the guy on whether there are different severities of concussions...but seriously, though, there are, aren't there? isn't it a little disingenuous to say all concussions are the same? my little brother got a concussion while playing on a slip-n-slide once (decided to go down it on his butt, slipped backwards and conked his head), then another while playing high school soccer, then another in a minor car crash. he went on to play rugby in college at william and mary without a reoccurance, and has since completed medical school and is currently an ER doc.

there's a segment of the population that will take any chance they can to be as dramatic as possible. to suggest there is no such thing as a grade I concussion is just something to get his quote in the papers. and it worked.

we'll see how it goes with giroux. hopefully things will be ok in a month or two. as with pronger: no need or basis to jump to conclusions.

[brelic]

I think the larger question is whether or not the NHL is negligent toward its players by allowing these kinds of injuries in the workplace.

Now, don't get me wrong.. I know hockey is a physical sport, just like football. But with the controversy surrounding football players committing suicide, and then the same thing happening in hockey, and then add how common concussions really are when there's contact to the head, one would think that the NHL has an obligation to its 'employees', just like any regular company does. It's not enough for them to say 'well, it's a hazardous work environment.'

They've been trying to eliminate them by imposing heavier penalties for deliberate hits to the head. But you probably can't take those out of the game. What about better helmets? Smaller shoulder pads? Players keep getting bigger and stronger, and so does the gear.

Not really sure what they should do either way, I'm kinda just spitballin' here. But in the end, I do think the NHL needs to protect its most valuable assets. Guys like Crosby and Giroux are infinitely more valuable to the game than guys like Cooke or Steckl.

[Lunatic]

A response to Aziz: I am happy for your brothers' success. However, there is a growing body of evidence that mlld concussions/TBI do have long-term consequences for its' victims. Look at the work of Jeffrey Barth, and or, Ruben Echamendia who have spent their lives investigating the consequences of these injuries. Admittedly we do not know everything about concussion, but what we do know, strongly suggests that we exert caution!

[aziz]

caution, absolutely. but some kind of relativity has to be applied. there are people calling for the retirement of any athlete after a single concussion. if that's what giroux wants to do, then ok, but i'm thinking probably not. rather than these people hyperventilating with what utlimately is hyperbole, i'm more appreciative of those who are trying to find a functional understanding that allows these athletes to work with the issues they have. having some doctor get on a soap box and announce that after ANY concussion ANY physical contact can lead to death and mass starvation doesn't help anyone at all.

[canoli]

I'm glad to hear your brother is doing so well. My sister is a research scientist. She got her PhD in brain trauma and for years worked counseling patients with head injuries. She told me the way the medical community is beginning to think about concussions is basically as a binary state - you either have one or you don't. I say "basically" because she was explaining it to me, not a scientist, and so her explanation was dumbed-down somewhat.

I don't remember all the distinctions she made but her point was that brain injuries are extremely difficult to evaluate. The more we learn about them the more far-reaching the consequences of having one appear to be. I think, if I remember correctly what she said, the displacement of the brain from the brain pan is what's important. If it happens you have a concussion. If it doesn't, you don't. Naturally there will be degrees of movement, or "acceleration" as the doctor called it.

But it's kind of like pregnancy. You can be 3 months pregnant or 8 months pregnant. Is that a grade, as you put it, of pregnancy? Are you more pregnant at 8 months than at 3? You can say that I guess. But at some point you're going to have that baby.

It's similar with concussions. Patients will present with certain symptoms and if certain criteria are met their injury qualifies as a concussion, with all the attendant risk factors associated with them. Naturally there are degrees of injury and the recovery will depend on the extent of the damage but the current thinking is that once the brain is displaced it never fully recovers, if by that you mean "as if it never happened."

Your brother - god bless him - seems to have escaped any chronic symptoms. But then again we'll never know what he could've done, right? Maybe he'd be an ER doc and a world-class pianist, while publishing the next Pulitzer Prize-winning novel in his spare time...

Of course some injuries are worse than others. The point the doctor made doesn't dismiss that notion it expands on the discussion, that's all.

[mojo1917]

@brelic

http://news.harvard....st-concussions/

so when Giroux comes back I hope he's wearing the M11 from cascade sports... endorsement deal or no. this helmet seems to be designed with hockey players in mind , the company and program has mark messier as its hockey adviser.

the NHL would be wise to fund some serious research regarding head injuries and their prevention.

[aziz]

I think, if I remember correctly what she said, the displacement of the brain from the brain pan is what's important. If it happens you have a concussion. If it doesn't, you don't.

my understanding (and i'm no doctor), is that there are still degrees of that displacement, and a large displacement is more likely to be followed by successive displacement. something along the lines of the more the spinal fluid casing your brain is in is violated, the weaker it becomes. your "are you more pregnant at 8 months than 3" point is well taken, but my understanding is more along the lines of a broken bone. it is either broken or it's not....but it can be a greenstick fracture, or it can be a full on compound.

again, sounds like your sister is the expert in this discussion. i just can't get past the reasoning that if it were a binary thing like she says, you wouldn't have situations like simon gagne who had three concussions in one season, but has taken NHL contact for 5 years now with no issue. there has to be more to it than that, there has to be some kind of threshold after which the lindros snowball begins. we don't understand a lot about it, but there has to be more to it than a yes/no.

The point the doctor made doesn't dismiss that notion it expands on the discussion, that's all.

see, i don't know. i feel like it shuts the discussion down. "there is only one kind of concussion, there is no grey area, all concussions are career ending." i don't see how that helps.

Maybe he'd be an ER doc and a world-class pianist, while publishing the next Pulitzer Prize-winning novel in his spare time...

well, thank god for concussions, then. bad enough having my little brother become a doctor. he were a savante, i'd just be the guy who takes the family pictures.

[AJgoal]

The problem with grading concussions is that the brain is such a complex thing that we don't really understand at all - all the research and knowledge we have barely scratch the surface. And everyone who has had one reacts differently to it. As a counterpoint to Aziz's story:

My vehicle was caught in an explosion and I banged my head on an instrument panel (from about 3-4 inches away, with a helmet on). I ended up with what might have been called a "mild" concussion back then (way back in 2004) - few headaches, nothing major (it seemed). A couple years later, I took a stick across the bridge of my nose which resulted in a minor break and likely another "mild" concussion. To this day I still have memory issues to the point where I lose what I was talking about mid-sentence at times. Neither of these incidents caused me to lose consciousness, neither was particularly violent (the stick shot just happened to catch me just right). But here I am, 6 years later, still suffering from some signs of PCS.

All I'm trying to illustrate here is that it's just so hard to know anything about what's going on in the brain, which may be why they're getting away from claassifying concussions based on symptoms. Since every trauma is different, there's no way to be sure how the brain will react in any particular case. At least with increased understanding, we're seeing increased caution after the fact. Hopefully we'll see better head protection and less plastic armor on players.

[Lunatic]

I think that we basically agree, especially on two issues: All things being equal, it should be the players decision as to whether they continue playing or not and second in improving our understanding of functional relationships both as it affects the individual players and the game as a whole. Not every hit results in life-changing consequences. Some do, and with more and more hits, the chances of permanent damage does increase. Until we have a better understanding, it is prudent to be cautious. This means looking at the game itself and how it is played, how we minimize the occurrence of concussions and looking at how we can minimizing the consequences of trauma and improve care for its' victims. The challenge is doing this and maintaining the integrity of the game we love. The two people I mentioned are not thumping for elimination of contact in sports. They are employed by the NFL and NHL respectively.

[Bakanekimiwa]

I think the larger question is whether or not the NHL is negligent toward its players by allowing these kinds of injuries in the workplace.

Now, don't get me wrong.. I know hockey is a physical sport, just like football. But with the controversy surrounding football players committing suicide, and then the same thing happening in hockey, and then add how common concussions really are when there's contact to the head, one would think that the NHL has an obligation to its 'employees', just like any regular company does. It's not enough for them to say 'well, it's a hazardous work environment.'

They've been trying to eliminate them by imposing heavier penalties for deliberate hits to the head. But you probably can't take those out of the game. What about better helmets? Smaller shoulder pads? Players keep getting bigger and stronger, and so does the gear.

Not really sure what they should do either way, I'm kinda just spitballin' here. But in the end, I do think the NHL needs to protect its most valuable assets. Guys like Crosby and Giroux are infinitely more valuable to the game than guys like Cooke or Steckl.

the problem is... there's is nothing more they can do. helmet technology won't do anything. it's the brain sliding into the skull. no helmet can stop that from happening after an impact. they're doing what they can, as far as penalizing plays that result in impacts to the head, but beyond that... i just don't see what they can do.

there is inherent risk in impact sports. do we do away with the impacts? i don't think any player, past or present, would advocate that. so it is what it is... until they figure out how to heal the brain from such injuries.

[aziz]

it's the brain sliding into the skull. no helmet can stop that from happening after an impact.

i was thinking about that....did you ever do the thing in highschool where you made a little box out of balsawood or something and then put an egg in it and the egg had to survive a two story drop? or maybe 10foot drop. or whatever. point is, i think you could make a helmet that would help a lot. problem is, the players would have to decide to wear it. does cool 21 yearold super star wear the gigantor uber-safe helmet, or the sleek bauer one? when we think forcing players to wear visors is a bridge too far....

and gretzky's old ringett helmet is popping into my head now.

plus, that wouldn't do anything about blows to the face or chin that can ultimately have the same effect.

ok, so, you're right. nevermind.

[Phlyer1]

A response to Aziz: I am happy for your brothers' success. However, there is a growing body of evidence that mlld concussions/TBI do have long-term consequences for its' victims. Look at the work of Jeffrey Barth, and or, Ruben Echamendia who have spent their lives investigating the consequences of these injuries. Admittedly we do not know everything about concussion, but what we do know, strongly suggests that we exert cause.*************** Phlyer 1 reply. I have never heard if concussions are cumulative? I am sure like a boxer enough hits to the head will make your head spin even when you are not getting hit. I suffered one in my life(football) and do not remember the game or the rest of the night. Woke up wondering how I got home.

Edited December 13, 2011 by Phlyer1

[Bakanekimiwa]

i was thinking about that....did you ever do the thing in highschool where you made a little box out of balsawood or something and then put an egg in it and the egg had to survive a two story drop? or maybe 10foot drop. or whatever. point is, i think you could make a helmet that would help a lot. problem is, the players would have to decide to wear it. does cool 21 yearold super star wear the gigantor uber-safe helmet, or the sleek bauer one? when we think forcing players to wear visors is a bridge too far....

and gretzky's old ringett helmet is popping into my head now.

plus, that wouldn't do anything about blows to the face or chin that can ultimately have the same effect.

ok, so, you're right. nevermind.

well... i'm sure that if there's anything can be done, someone is looking into it. but, it seems that gone are the days where the guys would just play through it and we'd never be the wiser. i mean... i've probably had a few concussions in my youth, but i don't remember anyone sitting out of high school football with a 'concussion'. i also don't really remember many pro athletes sitting out until lindros. suffice it to say... it just sucks.

[canoli]

see, i don't know. i feel like it shuts the discussion down. "there is only one kind of concussion, there is no grey area, all concussions are career ending." i don't see how that helps.

I think maybe you're putting words into the doctor's mouth here. I didn't re-read the article but I don't think he came close to saying anything like that. All he said was "there's no such things as a 'mild' concussion." Sure we can extrapolate somewhat from that - all concussions are serious, there are no almost-concussions....like that. But IIRC he didn't address athletes in particular and never mentioned consequences of concussions at all.

I like the broken-bone analogy too and I think it applies to concussions. It stands to reason there are degrees of displacement or acceleration of the brain. Add that to the fact that everyone heals differently and you can account for the Gagnes and the Roenicks of the NHL who've suffered multiple concussions but keep (kept) playing at a high level.

[aziz]

i was taking the post in which i saw the quote at face value. it said:

"He went on to say how after you've had one, any hit can trigger concussion symptoms or even cause another concussion. The hit doesn't have to be to the head."

now, if there is no such thing as a mild concussion, and after a concussion any hit -to the head or no- can bring about more concussion symptons...that is to me saying it is not safe for anyone who has had any kind of concussion to expose themself to any type of further impact of any kind. i.e., career as a hockey player over.

as it turns out, i can find the quote about "no such thing as a mild concussion" in an article, but it doesn't mention the rest, with the any hit of any kind stuff. so, you're right, words may have been put in the doctors' mouth. i was basing my take on what i thought the guy said.

[mojo1917]

The team is playing well right now.

there is no rush for Claude to rush back for some meaningless January hockey.

I hope hope hope that jimmy the groin and the skull doctors hold him out of the lineup for an extra week or two so his melon can heal fully and then some.

when he does come back i hope he's wearing the short bus helmet from cascade sports (the m 11) as well as the mouth guard.

seeing what's going on with sidney crosby and the similarities of the contacts that caused the injury have me a little spooked... lets um make sure he's all good and playing in a bubble wrap uniform when returns.

[brelic]

From @davegisaac, Homer says that Giroux hasn't had 2 good days in a row yet.

[canoli]

as it turns out, i can find the quote about "no such thing as a mild concussion" in an article, but it doesn't mention the rest, with the any hit of any kind stuff. so, you're right, words may have been put in the doctors' mouth. i was basing my take on what i thought the guy said.

sorry, yeah, that was me putting words in the doctor's mouth I guess - a different article had the "doesn't have to be to the head" bit, and I can't find it now either. Never mind. If I dig it up I'll post it...