There was an odd incident in the NHL this week during a game between the Los Angeles Kings and Toronto Maple Leafs where potential concussion signs were spotted by the league’s designated concussion spotter. Their role is to flag incidents that have led to players on the ice showing visible signs of a possible concussion.
Kings’ goaltender, Jonathan Quick, was accidentally hit in the head by teammate Derek Forbot, who was jostling in front of the net with Maple Leafs’ forward Zach Hyman.
There were two clear potential concussion signs:
1) Quick was hit in the head, which caused his head to move in a jerking motion
2) While Quick was falling to the ice, he appeared to clutch and grab his head with his glove hand
Check out the incident in the video below.
After being told by the referee that he needed to be assessed, Quick hesitantly went to the bench and was replaced by his back-up goalie. At the next stoppage in play, he returned to the Kings’ net less than a minute after being removed.
Given the visible signs, the player was correctly removed from play by the concussion spotter who did an excellent job in identifying a potential concussion. Whether or not the NHL concussion protocol was properly followed once he got off the ice has developed into an ongoing debate. We won’t get into that here.
Concussion is mainly diagnosed through the symptoms that an athlete may report or through comparison with objective baseline testing measures, if available. If an athlete doesn’t report any symptoms, there are very few visual signs that spotters can look for that may indicate concussion.
Here are some of the common signs that spotters should look out for. As a parent, coach, or teammate you can watch for these too. Everyone should be a concussion spotter.
Ways to be a concussion spotter
1. Significant impact to the head or body
A concussion is caused by a hit to the head or elsewhere on the body (due to the force transmitted to the head). This could also include secondary contact with the ice or field. If you see a significant impact then you should suspect a concussion.
2. Loss of consciousness
If an athlete loses consciousness following an impact then it’s definitely a concussion. If they are unconscious for an extended period – more than 60 seconds – then they should be taken to an emergency department immediately as this may mean a more severe injury.
3. Lying motionless
You should suspect a concussion if a player is down on the field or ice, and does not move following an impact; they may be unconscious. This is sometimes accompanied by a fencing reflex or posturing. This is when a player’s arm is flexed or extended into the air for several seconds after a hit. The fencing response is a clear indication that the player is unconscious. Check out the examples in the video below.
4. Clutching the head or helmet
Grabbing the head or helmet following an impact can be an indication of a concussion.
5. Difficulty getting up, stumbling, incoordination, slowed movement or disorientation
In the example, you’ll notice that Chicago Blackhawks captain, Jonathan Toews, shows these symptoms following a huge hit. Keep in mind, any one of these signs after a hit could mean that the player suffered a concussion.
6. Blank or vacant stare
Does the athlete seem to be staring into space after the hit? Are they looking at you or right through you? Do they seem dazed and confused? A blank stare may tell you that they have a concussion.
7. Inability to communicate, unable to respond to questions or slurred speech
Listen to how they talk. If an athlete cannot respond to simple questions or you don’t understand them following an impact, it’s likely they have a concussion.
If an individual is sick and vomiting following a big hit or impact, then this is another possible sign of concussion. In fact, vomiting after head trauma may be a sign of a more severe head injury and the athlete should be taken to the hospital immediately.
Recognize and remove!
The culture of sport and toughness is much more apparent at the professional level where the stakes are higher for the athletes. However, at all levels, we need to continue to take a stand and strive to improve the health and safety of athletes through proper concussion recognition and management. Remember, when in doubt, sit them out!
Understanding all the signs and symptoms of concussion is often the first step to proper concussion management. Early recognition and intervention by a licensed healthcare professional with concussion training has been shown to improve recovery time and patient outcomes. All those involved in sports – teammates, opposing players, coaches, teachers, referees and more – should be a concussion spotter.