Hits to the head: Scientists explain Sidney Crosby’s concussion

What crash-test analyses reveal about hits, helmets, and the game of hockey

by Cathy Gulli and Charlie Gillis on Thursday, February 17, 2011 4:00am - 20 Comments
The aftershocks

Neurotrauma impact lab: University of Ottawa scientists reconstruct hits to the head, including ones from pro hockey, to better understand concussions. Photographs By Blair Gable.

Inside a white cement-block science lab at the University of Ottawa, two young researchers cover a beige crash-test dummy head with a black nylon stocking. It’s supposed to mimic the tousled hair of Pittsburgh Penguins superstar Sidney Crosby, who’s been knocked out of the game since early January because of two massive, back-to-back blows to the head. Here, at the elite Neurotrauma Impact Science Laboratory, researchers led by Blaine Hoshizaki are reconstructing a hit similar to Crosby’s first one to establish the relationship between helmet performance and how concussions occur. That nylon stocking, however out of place it seems, makes sliding a helmet on and off the sticky urethane and aluminum head form easier.

Guided by a laser, they position the dummy inside a Plexiglas cage so that a thick metal rod with a hard, white plastic nib is aimed at its left side—precisely the spot where the cold shoulder of David Steckel of the Washington Capitals hit Crosby during a game on New Year’s Day. Everyone nearby in the hangar-like space puts on heavy-duty earphones and steps behind yellow and black danger tape on the floor. With one press of a red button, a calculated reconstruction of the hit similar to the now infamous Crosby-Steckel one is under way.

Beep! Beep! Beep! A shrill, pulsating tone precedes a bursting whoosh as an air compressor drives the rod into the head form at the exact same speed (27 km/h) and angle as when Steckel’s 217-lb. body collided with Crosby’s head. The crash hurls the head form along a monorail track while it flops back and forth on a dummy neck. However hard the hit looked on the ice, seeing it in the isolation of the lab is disturbing—much like the unsettling feeling one gets from watching footage of crash-test dummies flailing in car accident re-enactments. It’s the distinct surprise that anyone survives these events.

The aftershocks

David Denoma/Reuters

During the five-millisecond flash of impact, nine sensors inside the head form each pick up data at 20,000 times per second. That generates a 3-D computerized brain model depicting where brain tissue stress has occurred. Tissue stress reflects injury. Whereas a computerized image of an unaffected brain would be coloured all blue, the image representing a head side-swiped like Crosby’s shows a rainbow of stress emanating from the left hemisphere—green, yellow, orange, red, grey. There is hardly any blue on that side of the brain.

To Hoshizaki, director of the lab, the dramatic results are frustratingly similar to what he’s discovered in doing thousands of reconstructions of brain injuries, including many NHL and NFL concussions, over the last few years: that no matter what make or model of helmet Crosby was wearing, and no matter how much it met or exceeded safety standards, the current equipment isn’t built to protect players specifically from concussions. And, just as troubling, the rules of the game and the way players are managed don’t adequately help either. Hoshizaki wants to change that.

He and his team of young scientists who run this lab are in a good position to make that happen. No one else in the world is doing exactly this type and extent of research. To be sure, nowhere else in the world does it matter more than in a country whose undisputed sports hero has gone from bionic golden boy to one more broken pro athlete. Ever since Crosby’s last game on Jan. 5, when a crushing check into the boards by Victor Hedman of the Tampa Bay Lightning gave him a concussion that he’s still battling, hockey league officials and fans alike have been hand-wringing about how this could have happened to one of the greatest players since Wayne Gretzky—one who’d been on a 25-game scoring streak, a feat so amazing that it last happened nearly 20 years ago.

RELATED ARTICLE: The damage done by concussions—Sidney Crosby as a case study

Hoshizaki will have plenty of answers when, on Feb. 23, he speaks at the first-ever hockey safety summit devoted solely to concussions. The event has been in the works for almost a year and will be attended by representatives from the NHL, the American Hockey League, Hockey Canada, USA Hockey, as well as the standards organizations and minor and amateur leagues. As part of his presentation, Hoshizaki will be using the brain model from the reconstruction to demonstrate the disconnect that currently exists between what his lab indicates about hits to the head and what actually happens on the ice.

The summit will be hosted by Reebok-CCM, which has a $10-million deal with Crosby, the richest endorsement in NHL history. That this hockey icon is currently out of the game, says Olivier Camet, the company’s senior product manager, “makes it even more clear that we need to take this seriously and do everything we can to prevent concussions in the future.” The summit is all the more pressing given the recent admission by Crosby that he might not be back for the rest of the season because of the brain injury. “That could happen,” he conceded uncomfortably. “Am I sitting here packing it in? No, I hope I’m back, and geez, I hope I play this year. But that is the thing, you don’t know. There’s no time frame.”

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  • http://fitnessyour.com/ shujaat meer

    there are many games in the world ,where players must protect their head,like in the hockey,cricket and other games,

    • M_A_D_world

      Your right, many sports require that we respect the potential of head injury. However since hockey is at the forefront in Canada, it's natural it would be our case study.
      The difference is that in hockey and football, player contact is the norm. Without respecting your opponent, you likely will hit them aggressively. Sometimes with the intent of putting them on the bench.
      In the States, the NFL and it's players are faced with similar concerns. Can players be spared life changing trauma without sacrificing the game?

      • harebell

        I think it has alot to do with the type of hits and the approach of the tackling player. Blindside hits and hits from behind are commonplace in hockey and NFL/CFL. Sports like Rugby and to some extent cricket/baseball the impact is largely from the front so there is an element of preparedness that you don't get in hockey.
        Association football (soccer) has worked hard to try and outlaw tackles from behind because of the vulnerability of the player to serious career ending injury.
        Another aspect of hockey that does not occur in other sports is the acceptance of fighting. It is bad enough with guys feeding each other blow after blow to the head face on. But when you consider the Bertuzzi affair and the terribly cowardly sucker punch that happened in the Penguins/Islanders game the other night it surprises me that there aren't more serious cases of brain injury on a regular basis. A good way to reduce a lot of the head impacts would be to deal more harshly with fighting. Otherwise accept your are going to damage some very good players.

        • Other guy

          Don't forget the speeds of the impacts make a huge difference. Hockey players are moving much faster than someone running on a rugby pitch or football field.

  • Tys

    Is the only way they can get people interested to read it to include Crosby's name on it? Players have been having concussions and having their careers ended by concussions long before he came along.
    If they decide to make some drastic change to the rules because this happened to a single player, what is that telling all the players previous? "Sorry about your luck, but we just didn't think you were important enough to change the rules for you."
    They should have been looking into concussions as soon as the first player had to quit because of them, not because Crosby got one. Either way though, the game will continue on without him.

    • jim gllup

      tys give your head a shake, but not a drastic shake because I think you are already concussed, making a stupid comment like that.

    • Healthcare Insider

      Tys, the truth of the matter is that the medical community – neurologists in particular – have been busy gathering more and more information about the seriousness of concussions and that is what has brought about the use of helmets in sports like skiing. When the best player in a sport experiences what could be a career-ending injury, it is only normal that there is a wider public interest and journalists respond by writing about it. The NHL has already been looking at these blindside hits and head hits. More pressure has been put upon them now because it is their number one player who is out with the injury but there is no doubt that a change in policy will be beneficial for everyone in the game. Had Wayne Gretzky had a career-ending concussion or Gordie Howe – yes, we probably would have discussed this alot sooner.

    • player

      You Crosby haters are such dinosaurs.

  • june conway beeby

    Incomplete scientific knowledge about the brain had led to cruel tragedies for these poor young people–and who knows how many others have suffered equally over the years.

    At least ,we now realize the importance of brain research, and should make it one of the priorities in scientific research funding. There are many other brain solutions waiting to be discovered.

  • Ariadne

    Hits to the head should not only be their main concern. Whiplash itself causes more damage from head to toe and it is more a widespread occurrence.

  • Joe Dickenson

    As a concussion victim (2 treated hockey concussions and 1 work related concussion), this article was refreshing. It's time that we gave this injury the respect it deserves. As a farmer and lobbyist, I was effectively confined to the couch in my home for 5 weeks dealing with a relatively minor concussion because too much (read hardly any) activity or concentration wore me out or left me with head pain that would put me down for the rest of the day. The biggest problem is these are invisible injuries and those not suffering from them, can't see what's being felt by the victim. Thank you again Macleans, let's hope the research will continue to move along so that we see an end to these horrible injuries.

  • http://www.amazon.ca/Man-Who-Lost-Himself/dp/0771018649 momof2

    If this subject interests you, you should check out June Callwood's book about a CFL player, Terry Evanshen's brain injury– fascinating and heartbreaking. http://www.amazon.ca/Man-Who-Lost-Himself/dp/0771…

  • Little Coach

    The hope, and the anticipated outcome, is that this discussion will also lead to changes in youth sports. Basketball in Alberta and across Canada, for instance, is a "smash-mouth" sport. Extensive contact has become the norm. High impact collisions, hard fouls, submarinings, are becoming common-place, with referees opting to judge calls based on whether or not an advantage was gained, rather than whether or not a rule-infraction occurred. Even in hockey, rules are in place to maintain safety, to foster respect between athletes, to ensure that the drive is to, as Vince Lombardi promoted, "Win. Fairly, squarely, by the rules, but to win!" In many sports, we have drifted away from the rules in favor of the higher intensity, survival of the toughest approach and the apparent excitement it brings.

    In some leagues, basketball is a sport of speed, coordination, power, amazing skill, and finesse. Not so much in Alberta. We could do better, and our kids deserve a safer playing environment. Highly competitive? I hope so. Fast? Winner take all? I hope so. But not at the expense of safety and respect.

  • http://www.facebook.com/people/Tom-Hennessy/100000148200376 Tom Hennessy

    Look at this simply. When you take a ‘hit’ say in the hand. You get a ‘bruise’ / spilled blood / broken red blood cells. This blood is NORMALLY ‘mined up’. This blood contains the metal iron. When the body doesn’t remove this iron it is deposited in a long term storage form known as hemosiderin to be used when needed. Normally it would be removed. This iron is what is causing the problem as in Parkinson’s , Alzheimer’s and tardive dykinesia and other neurodegenerative diseases like Multiple Sclerosis. Very low iron diet and targeting of the iron in the brain is what is being tested in neurodegenerative disease.
    “Increasing evidence indicates that iron deposition in the brain might play a role in cognitive dysfunction associated with neurodegenerative disorders and aging.”
    “Cognitive declines therapy by iron burden reduction” 
    “Cognitive impairment is associated with subcortical magnetic resonanceimaging grey matter T2 hypointensity in multiple sclerosis”
    “Iron chelators that can cross the blood-brain barrier may have thepotential to treat cases where abnormal iron accumulation in the brainis associated with the degenerative processes”

  • http://www.facebook.com/people/Tom-Hennessy/100000148200376 Tom Hennessy

    Look at this simply. When you take a ‘hit’ say in the hand. You get a ‘bruise’ / spilled blood / broken red blood cells. This blood is NORMALLY ‘mined up’. This blood contains the metal iron. When the body doesn’t remove this iron it is deposited in a long term storage form known as hemosiderin to be used when needed. Normally it would be removed. This iron is what is causing the problem as in Parkinson’s , Alzheimer’s and tardive dykinesia and other neurodegenerative diseases like Multiple Sclerosis. Very low iron diet and targeting of the iron in the brain is what is being tested in neurodegenerative disease.
    “Increasing evidence indicates that iron deposition in the brain might play a role in cognitive dysfunction associated with neurodegenerative disorders and aging.”
    “Cognitive declines therapy by iron burden reduction” 
    “Cognitive impairment is associated with subcortical magnetic resonanceimaging grey matter T2 hypointensity in multiple sclerosis”
    “Iron chelators that can cross the blood-brain barrier may have thepotential to treat cases where abnormal iron accumulation in the brainis associated with the degenerative processes”

  • http://www.facebook.com/people/Tom-Hennessy/100000148200376 Tom Hennessy

    Look at this simply. When you take a ‘hit’ say in the hand. You get a ‘bruise’ / spilled blood / broken red blood cells. This blood is NORMALLY ‘mined up’. This blood contains the metal iron. When the body doesn’t remove this iron it is deposited in a long term storage form known as hemosiderin to be used when needed. Normally it would be removed. This iron is what is causing the problem as in Parkinson’s , Alzheimer’s and tardive dykinesia and other neurodegenerative diseases like Multiple Sclerosis. Very low iron diet and targeting of the iron in the brain is what is being tested in neurodegenerative disease.
    “Increasing evidence indicates that iron deposition in the brain might play a role in cognitive dysfunction associated with neurodegenerative disorders and aging.”
    “Cognitive declines therapy by iron burden reduction” 
    “Cognitive impairment is associated with subcortical magnetic resonanceimaging grey matter T2 hypointensity in multiple sclerosis”
    “Iron chelators that can cross the blood-brain barrier may have thepotential to treat cases where abnormal iron accumulation in the brainis associated with the degenerative processes”

  • martin visokey

    i took a hit from a car going 55mph on my motorcycle head on head. no ones fussing about my head injury. i cant even get ssi

  • Vroseboom

    I totally agree, I put my kids in basketball because it used to be speed finesse skill team play and “no contact”  - not any more .My daughter has suffered 2 concussions now and has to quit a game she loved.  Many of her team mates have had concussions too and should not be playing because they continue to have symptoms still a year after the injury.  

    they need to clean up the sports so that they return to skill speed finesse and not this ridiculously dangerous thing they have become.  We also play bball in Alberta and I am not happy with the way the sport has gone.  Especially at the post secondary level it gets even worse.  Why shouldn’t we be able to play in a safe environment.  YOu can still play very competitive and fast and exciting sports without allowing the contact.   Clean it up, keep it safe.

  • Jewelscoles

    It just figures the medical profession is skeptical. They always are it seems if a cure doesn’t involve expensive drugs/longterm treatments. Kudos to the Canadian-born Carrick & his motto …”seek wisdom” … “because it is something (he) has always ascribed to.”

  • http://twitter.com/MSIDOC @MSIDOC

    Great article, compelling video. I recommend that interested parties review a recent comparison of helmet pad technology performed by the Lawrence Livermore National Laboratory. They compared the padding systems of the NFL and the U.S. army in a model of linear acceleration. They determined that the current NFL helmet pads do not provide the same level of protection as the authorized U.S. Army pads. Suffice it to say, rotational accelerations are at issue, however, lets make sure we are using the best protection in our helmets as possible while we continue to work through the research and standard setting on rotational injury prevention. The U.S. army has done great work in this area and can offer significant insight into this issue. I posted a link to the helmet pad comparison on my website at http://www.medsecintl.com. Dr. Matt Evenhouse.

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