Monday, January 30, 2012

Concussions: Then & Now

Over the weekend, there was breaking news concerning the medical condition of Pittsburgh superstar Sidney Crosby. While many in the hockey world believed his absence was due to concussion-like-symptoms, a new twist was thrown into the mix. According to media reports, Crosby is also suffering from a "vertebrae abnormality in his neck."

This raises some interesting questions. Are the concussion symptoms and neck problem one in the same? Are they two separate medical issues? Was Crosby's injury misdiagnosed with subsequent treatment focusing on the concussion, when in fact, his treatment should have been on his neck?

On Thursday morning while attending the media conference for the Maple Leaf Gardens time capsule, Dr. Hugh Smythe shed some light on the subject of concussions - then and now. Upon reviewing his comments, it was as though he peered into a crystal ball in anticipation of the Crosby related events over the weekend.

"As you may know, I was the team doctor (Maple Leafs) for twenty-five-years," stated Dr. Smythe in his opening remarks.

In his memoir, "If You Can't Beat 'Em in the Alley," Hugh's dad, Conn Smythe, wrote about seeing his son's potential for entering the medical profession. "I thought when he was a child that he would become a doctor. He would dissect things to see how they worked. He was gentle, kind, and precise," observed the Leafs boss. His assessment was bang-on as Hugh went on to become a specialist in Rheumatology.

Prior to joining the Leafs medical staff, Hugh lived the dream of every Canadian youngster. While still attending  school. he would spend his evenings, when the Leafs were in action, at Maple Leaf Gardens tending to his duties as Toronto's stickboy. Smythe has pleasant memories of the Leafs playoff run in 1942. Trailing the Detroit Red Wings by three games in the Final, young Hugh watched as his dad's team stormed back to win the next four contests and lay claim to the Stanley Cup.

Dr. Smythe, looking at the current state of  hockey injuries and how they are assessed, provided an historical perspective based on knowledge gathered during his time in the game.

"Nobody ever had to stay out of the game more than a week with a concussion," said Smythe. In most cases, it was his opinion a neck injury was inflicted upon a player, not a concussion. "Among the symptoms of whiplash and chronic whiplash are headaches, dizziness and being unable to sleep. It took me a long time to learn how to do more than guess to make a proper diagnosis. If you know the diagnosis, the treatments are not difficult," explained the 84-year-old Smythe.

"Imagine a guy like Sidney Crosby being out about a year. They would have killed me if any Leaf player was out over a year," said Dr. Smythe with a smile.

I asked Dr. Smythe if today's game was more violent, thus accounting for the increase in concussions over the past several seasons? "Are you telling me someone was more violent than Gordie Howe? Hundreds of people tried to show they could dominate Howe and everyone of them got bruises for their effort."

When discussing the current concussion problem, many point to the role equipment plays in the equation. Dr. Smythe offered his opinion in this regard. "On the sports pages they recently reported on the Final of the World Rugby Championships. The New Zealand All-Blacks won over France. You saw the pictures of what they were wearing (equipment wise)? None! That's what the Leafs had. When I was growing-up, I had the Saturday Evening Post for shin-pads."

Words of wisdom for all to consider.

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