Almost 3 weeks later and I still can’t watch the replay of Boston Bruins’ captain Zdeno Chara’s check on Montreal Canadiens’ forward Max Pacioretty without holding my breath.
It was a violent hit and one that will stay fresh in my memory for a while. Pacioretty lost consciousness on impact and in the few seconds that he lay motionless on the ice after impact, I’m sure a few thousand fans (at least) were hoping that they didn’t just see a man die on the ice.
Medical personnel were efficient and careful as they immobilized his neck and secured him to the backboard before lifting him onto the stretcher and taking him off the ice. He was kept in the hospital overnight for observation, most likely due to his loss of consciousness after the hit.
The Canadiens organization later announced that Pacioretty was diagnosed with a severe concussion and a fractured 4th cervical vertebra. The league deemed that the hit warranted no supplemental discipline and the league and players moved on, or so I thought.
Fast forward to Mark Recchi’s appearance on a Boston radio show last Wednesday where Recchi and the show’s hosts, Felger and Massarotti, speculated that the extent of Pacioretty’s injuries were embellished in order to garner sympathy from league officials that would perhaps cause them to slap Chara with a suspension.
“He does obviously have a fractured vertebra, but the concussion is obviously really a non-factor,” Recchi told the Boston radio station. “In maybe a day or two — maybe a day he felt it — but he was fine a couple days later. They were trying to get Zdeno suspended and they embellished it a little bit. In terms of that side, they’re doing whatever they could to get him suspended.” He also proclaimed that Max’s concussion was ‘embellished’ because Pacioretty attended a movie six days after the hit.
The brain is a soft organ that is protected by the skull. Fluid that surrounds the brain acts like a cushion or shock absorber in normal everyday activities. When there is trauma to the head, whether by a direct blow or by a sudden jarring of the body, there is a risk that the brain may strike the skull and brain function is altered or stopped momentarily.
The old school of thought attempted to grade concussions similar to other sprains and strains based on symptoms and loss of consciousness (LOC) or length of LOC. None of the former grading systems are currently used in formal medical literature. Concussions are not visible to the eye and all concussions, no matter how mild or severe the symptoms, are considered serious.
The old attitudes and former school of thought is what the NHL needs to get away from in order to protect their players.
Diagnosis of a concussion starts with an observation of the injury, trauma or impact. Concussions are a form of mild traumatic brain injury, so loss of consciousness (even for a second or two), is one of the alterations to brain function that constitutes a concussion. When an athlete appears dazed or confused after a hit, there is a chance that they have suffered a concussion and many times, these are the more dangerous concussions since they are often missed by training staff and dismissed by the players themselves.
A good example of this that should be fresh in the memory is Sidney Crosby following the collision with David Steckel in the Winter Classic. What makes this type of injury so dangerous is that they are overlooked and the player remains in competition, which can prolong recovery and cause setbacks, not to mention increased susceptibility to future concussions. Amnesia of the hit, impact or fall is also a hallmark sign of a concussion. Symptoms may resolve in hours, weeks or months after the initial injury.
Pacioretty is also very lucky that there was no displacement involved with his cervical vertebra fracture.
He won’t be the first player to suffer or come back from a vertebral fracture. Erik Cole suffered had a fractured 5th cervical vertebra after being boarded by Penguins defenseman Brooks Orpik on March 4, 2006. Cole also lost consciousness from that particular hit and did return to play that season in Game 6 of the Stanley Cup Finals, so it is not out of the question that Pacioretty might make a return to the Canadiens roster sometime in the playoffs.
Like Cole, Max may not be quite the same as he was before the hit. Some say that Erik Cole has just recently returned to the level of play he had before his injury — 5 years later.
Spinal cord injury at the level of the cervical spine can lead to temporary or permanent paralysis of the entire body from the neck down. Imagine if the medical staff on site not been as careful as they were in immobilizing the head and neck. Imagine that Max was jostled while on the ice hard enough to displace the fracture. Imagine that he had fallen in a slightly different way.
It’s best to assume there is a neck injury in anyone who has an impact, fall or collision-type of injury. When an individual is unconscious after trauma, it is always assumed that there is a neck injury. If a player is conscious, there is usually severe neck pain, pain that radiates to the shoulders or arms. There may be bruising or swelling on the back of the neck. The most common cervical spinal injuries involve C4 or C5. A simple compression fracture that has no displacement is usually treated with a cervical brace worn for 4 to 8 weeks while the bone heals. More severe or complex fractures may or may not cause injury to the spinal cord and may be treated with traction, surgery, and internal fixation, 2 to 3 months in a rigid cast, or a combination of these.
Max’s LOC prevented him from returning to play in that game with a severe concussion. His fractured vertebra has kept him from exerting himself which could keep some side effects and symptoms of the concussion at bay.
Recchi claimed that Pacioretty’s concussion could not be as bad as the organization claimed, because he was at the movies less than a week after the injury. No two people or concussions are alike and one size does not fit all with this injury. Yes, Max Pacioretty was able to sit in a dark movie theater a week after his concussion which means nothing about the extent of his injury. Sidney Crosby was able to continue playing and finish the Winter Classic game and he was able to go on to play another few games before realizing that he needed to shut things down for a while.
Stick to hockey, Mark, and leave the medical stuff to the medical professionals.
I know it is convenient to pretend that the well respected veteran in Recchi was just taking some of the heat off of his teammate, but he is a leader in the league and should be a bit more responsible with what he says. Recchi’s statements show a colossal lack of respect for the injury itself and ingnorance of the worst kind. Concussions aren’t something to be exaggerated or embellished and the mere suggestion of such by a well respected, veteran player in the league should be a point of concern for leagues, officials, and medical personnel at all levels.
His statements and criticisms set a bad example and serve no purpose other than to downplay the very thing that the league is working so hard to prevent.
Thankfully, Max is progressing well and could be back for the playoffs, however I think the Montreal Canadiens should play it safe and keep Pacioretty on the shelf until next season. The league does not need another Marc Savard situation from a player coming back from a head injury too early.
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