Wednesday, March 23, 2011

Mark Recchi has something to say about concussions

Check out the audio from this Boston sports radio show with Mark Recchi being brought in to comment about the Habs/Bruins game Wednesday Thursday night as well as the welcome news that Max Pacioretty may be able to return for the start of the playoffs.

Actually, fast forward to about four minutes in, when it starts to get real good. This is concussion doctor Mark Recchi:

"Well he obviously does have a fractured vertebrae, but the concussion was obviously really a non-factor."

"Maybe a day he felt it, and then he was fine."

"I believe yeah, they were trying to get Zdeno suspended and they embellished it a little bit."

"They [concussion doctors? The Canadiens?] were trying to do what they could to get him suspended."

The idea that the Habs medical staff would take Pacioretty off the ice on a stretcher and check him into the hospital and have him sit out for five weeks in the off chance that Zdeno Chara gets suspended is the stupidest idea I've ever heard since I heard Canucks fans make that point about Steve Moore seven years ago.

You know how there's some talk about recruiting a bunch of former players and putting them on a 'Player Safety' committee? Yeah, don't bother with that anymore.


  1. Good sir,

    When our players, Marc Savard and Patrice Bergeron, suffered their own severe concussions, they could not even be in a room with the lights on or around loud noises for WEEKS, if not months.

    Pacioretty went and saw "Hall Pass" in a theater four days after he got hurt. You know, with its bright lights and loud noises.

    Guess what? If he was hurt anywhere NEAR as bad as those guys, he wouldn't have been there - or appeared at the arena.

    Let's face facts. He wasn't concussed as bad as they said he was. The neck injury is on another plane entirely; we're not debating that. The concussion, though? Embellished as fuck, sir. That was NOT "severe" like it was initially claimed, I'm sorry.

  2. Yeah! Anything with a faster recovery than two of the most handicapping injuries any player has ever returned from is obviously not "severe." That's definitely where the bar is set. Come on!

  3. Dear Ghadin,
    I've had 2 concussions. One of them was so severe I had a hairline fracture on my skull. It took about 5 hours to get my vision back (I had double vision) I threw up about every 20 minutes for roughly 5 hours. Bright lights never bothered me at all during recovery.

    I was in a hospital so I didn't hear loud noise for the first 24 hours. But after that I don't remember any noises bothering me.

    I could watch a movie. In fact all I did was watch TV and movies to pass the time since I wasn't allowed to sleep more than 1/2 an hour for not one day but 2 days.

    I hate to break it to you but it sounds like Bergeron and Savard had migraines not concussions. Either that or - shockingly - symptoms are different for every person.

    Imagine that.

  4. The problem with concussions is, there are a number of symptoms that different severity symptoms use that may or may not correlate to actual severity of injury or recovery time. Loss of consciousness (LOC) and amnesia are good examples. LOC, in and of itself, doesn't really have much bearing on severity, but length of LOC (>1 min) could be considered a factor that affects concussion management. Amnesia, meanwhile, tends to vary with time and severity of injury.

    The real problem with concussion is, there's a ton we don't know, and that we know we don't know. The biggest problem is, current imaging techniques are unable to detect structural damage, which makes it very difficult to get a primary measure of severity, instead using secondary measures that present themselves at the time of injury and during the rehabilitation period. Therefore, it's difficult to predict when a concussion is going to be among the 10-20% that require more than a week or two to clear up. Two players could present with the same symptoms, and one will be out ten days, and the other ten weeks. It's unfortunately not an exact science, so to use this as some sort of evidence that the Habs trumped up the severity of Pacioretty's injury betrays an ignorance on the part of both Recchi and Gahden.

    Pacioretty presented with, among other things, prolonged LOC, and the mechanism of injury (MOI) was high-velocity impact with an immovable object. Under the circumstances, and considering he also had a broken neck, I think it's perfectly sensible to move him right up the scale (especially since we don't know about any possible balance, neuropsychological, or nausea-related symptoms). At worst, they were overly cautious, and at best, he presented with every indication that he would be out for a damned long time and is recovering more quickly than expected. No shenanigans or conspiracy here, just a bunch of experienced guys doing what they can with our incomplete understanding of the data available.

    For more information, see the following paper, which represents the current consensus on concussion:

    McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, Cantu R. Consensus statement on concussion in sport--the 3rd International Conference on concussion in sport, held in Zurich, November 2008. J Clin Neurosci. 2009 Jun;16(6):755-63.

    You may note Robert Cantu's name at the end of the authors list: he's the guy who's been doing a lot of the work on chronic traumatic encephalopathy (CTE) in deceased athletes, most notably NFLers. The paper is published in several other journals, too: if you can't get a hold of J Clin Neurosci, a quick PubMed/Google Scholar search should turn up the others; I counted nine on my PubMed search.

  5. Aaaand I realized I started two paragraphs with the same phrase. Shit. That's what I get for slamming out a comment in ten minutes.