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Hockey is a violent game. Players are making contact with each other every shift, including forcefully making contact with the opposition along the boards and in open ice. 

As a result, concussions are a part of the game, and players who have suffered concussions or may have suffered a head injury, are rightfully under the watchful eye of the league in today’s game. There is a much larger emphasis being put on the health and safety of players, considering all of the information we now know about concussions and the long-term effects they may have on the body. 

The NHL’s concussion protocol is a complex process. Being placed in it, as well as being activated from it, require multiple steps.

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The Sporting News takes a look at the NHL concussion protocol, discussing what it is, how players are placed in it and how they are removed from it.

What is the NHL concussion protocol?

The NHL concussion protocol is a system implemented in order to properly evaluate, diagnose and recover from concussions in the league. 

How does the NHL concussion protocol work?

The NHL has implemented protocols in order to minimize head trauma in the league. Part of those regulations involves pulling a player from a game if it is deemed that he could have suffered a concussion. 

Part III of the NHL’s concussion protocol involves the “mandatory removal of a player for an acute evaluation as soon as possible if a concussion is spotted.” 

Here is what the concussion spotter is looking for and what results in the removal of a player. 

  • Lying motionless on the ice
  • Motor incoordination/balance problems
  • Blank or vacant look
  • Slow to get up
    • From a blow to the head or upper torso
    • After the head makes contact with the ice
    • After a player is punched in the head 

Once a spotter identifies one of the above as a possibility, then an evaluation with the club physician and/or athletic trainer takes place.

If the Club Physician verifies that the Player experienced loss of consciousness or ataxia from a direct or indirect blow to the head, this shall result in a diagnosis of concussion. If it is determined that the suspected loss of consciousness or ataxia did not result from a direct or indirect blow to the head, the reason(s) for such determination shall be recorded in the SCAT5 App.

It is during this evaluation that the player is either diagnosed with a concussion or clears protocol and that player can return to the game

How long does the NHL concussion protocol last?

Because concussions and the symptoms vary from person to person, the timeline for a return differs. 

There are two initial steps under the NHL concussion protocol regulations for players diagnosed with concussions. 

First, a player will undergo an initial, brief period of physical and cognitive rest. This takes place 24 to 48 hours after the incident. Players then can gradually become more exposed to activities, as long as they do not provoke or worsen the symptoms of the concussion. 

Here is the outline of the return-to-play progression in the NHL concussion protocol. 

  1. Symptom-limited activity: Daily activities that do not provoke symptoms
  2. Introduction of aerobic exercise: Stationary cycling at slow to medium pace, limiting head movement. Introduction of functional movement patterns in the 3-planer motions; no resistance training
  3. Progression of intensity and duration: Interval training (e.g., stationary bike, treadmill, elliptical, etc.) and light resistance training
  4. On-ice non-contact activity: Begin with skating around the rink, with gradual progression of both intensity of exercise and magnitude of movement, with low risk of head impact
  5. Non-contact drills: Continue with intensity established in the previous stage, but now add additional cognitive, sensory, and visual tracking burdens; this typically includes the involvement of coaches and/or teammates (e.g., puck handling, shooting, positional play). Off-ice activity includes introduction of resistance training and plyometrics
  6. Controlled body contact: On-ice activity shall involve controlled body contact (e.g., with coaches or teammates) and cognitively complex drills simulating game situations

Once a player is determined by the club physician to be free of concussion-related symptoms, then the player is referred to the club’s consulting neuropsychologist for a post-concussion evaluation. This evaluation typically occurs prior to the player engaging in on-ice activity involving controlled body contact, but it is a requirement before returning to live gameplay.



Read the full article here

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