Head Contact and Concussions

Author: pivotalphysio

Concussion awareness has increased over the past few years from amateur to professional hockey players. Prevention, diagnosis and treatment protocols have been implemented in order to protect athletes but compliance with these programs is vital. Rules have also been changed within hockey Canada at all levels to help reduce the occurrence of incidental or intentional contact above the shoulders.  In my experience, the new head contact rules are effective but only when they enforced properly and consistently by referees. As a trainer I find it important to know your athletes and to be paying attention during the game in case a player “gets their bell rung” and doesn’t tell anyone. The guidelines I follow when working with a concussion include immediate removal from activity followed by a SCAT 2 assessment and the hockey Canada guidelines for post-concussion return to play.

Return to Play Protocol
1. No activity, complete rest. Once asymptomatic for 24 hrs, proceed to level 2
2. Light aerobic exercise such as walking or stationary cycling (no resistance training).
-If still asymptomatic, progress to step 3.
3. Sport specific exercise, progressive addition of resistance training.
– If still asymptomatic, progress to step 4.
4. Non-contact training drills.
– If still asymptomatic, progress to step 5.

5. Full contact training after medical clearance
-The only person to clear an athlete for full return to play after a concussion is their medical Doctor.
– If still asymptomatic, progress to step 6.
6. Game play, monitor performance.

– If during any of the steps the athlete has concussion related symptoms start over with step 1.

I believe coaches, parents and players are starting to realize the serious nature of concussions now that professional athletes such as NHL players Sydney Crosby, Nick Kypreos and Keith Primeau have spoken out. The old fashion saying of “when in doubt, sit them out” is exactly what should be happening with all suspected concussions.

To learn more about the current research and the crash test analysis depicted above follow the link:


Emma Van Ulden, BPE

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