The Impact of Concussions: An Interview with David Koncan, MSc

By Dr. Brent Smale

It’s been estimated that 20% of ice hockey players per team experience a concussion each year (Tator, 2009) and scarily, this number is likely under-reported, especially in youth hockey (Williamson and Goodman, 2006). Therefore, it’s crucial that players, parents, and coaches are aware of how concussions occur and what precautions can be taken to avoid them. Working hard to provide this information, Researchers at the University of Ottawa have established themselves as world-leaders in concussion research. An integral member of this lab is David Koncan who holds a Masters Degree in Sports Engineering and is currently finishing his PhD at UOttawa, where his research focuses on modelling concussions in young athletes. David was kind enough to sit down with Apex Hockey to discuss concussions in youth hockey and what actions we can take to protect ourselves while playing the game we love.

Thanks for sitting down with us David. Do you mind giving a little background on yourself and how you ended up in concussion research?

For sure. My interest in sports started when I was very young, having played hockey since I was 6 years old but it wasn’t until my Master’s that I had figured out I wanted to work in sports-related research. I was accepted into the Sports Engineering program at Sheffield Hallam University in Sheffield, UK, and immediately enjoyed conducting physical tests on sports equipment as well as performance measures with athletes. Having suffered several concussions as a youth hockey player, I was always interested in helmet technology, and following my Master’s Degree I decided to come back to Ottawa to pursue further studies in concussions and head injuries.

So, let’s get into it. Most people know that concussions are brain injuries but what specifically is happening to the brain during an impact that is causing the injury?

See, the brain behaves for the most part like jello. If you place it on a plate, then move the plate sharply, the jello will wiggle around. This is pretty much how forces are transmitted to the brain in head impacts, with the brain jiggling around inside the skull, causing some internal stresses and strains that can ultimately result in the symptoms we identify as a concussion.

Speaking of symptoms, what are some signs that someone has suffered a concussion?

Naturally, any head impact has the potential for some form of injury; however, certainly not all head impacts will result in a concussive injury. The more visible signs that someone has suffered a concussion would be balance problems, nausea, disorientation or confusion, headaches, or sensitivity to light or sound. These are easier to spot, however there can be many more manifestations, some of which are very subtle and may only show up some time after the event.

If we have an idea of how they are caused, what methods do concussion researchers use in their experiments?

This video is a recording during helmet testing where in-game scenarios are re-created within the lab to get the most accurate simulations.

Experiments are commonly conducted using dummy head forms and different impact apparatus. For hockey, common events that can lead to concussions are falls or collisions, with a monorail drop tower being used to reconstruct fall events, and a linear impactor used for collisions. These pieces of equipment allow for the research team to precisely recreate real-world head impact events and measure how the impact forces get transmitted to the brain.

Fascinating. So what excites you most about concussion research? Any cool and innovative techniques on the horizon?

One of the great things about concussion right now is the growing awareness, and people being invested in finding better solutions for making sports safer. It’s great when the research you do can be used. There have been a lot of improvements made in brain simulations, something I work at personally. I think it offers a promising way to look into how impact forces are transmitted to the brain causing concussion, looking closer at what happens on a tissue level.

This video demonstrates the stresses and strains occurring to the brain during an impact. The blue represents normal values whereas the orange and red represent stresses and strains associated with concussions.

Are all helmets built the same? How often should a player replace their helmet?

All helmets are not created equal; however, they are all tested and pass certification standards. Determining the best helmet is a complex task, but my recommendation would be to use a helmet that has some form of rotational energy management. Rotational energy management is important, since rotational forces can be more damaging to the brain. The CCM Resistance helmets employ rotational energy management so these are good options.

Like any piece of equipment, helmets do suffer from wear and tear and so it is good practice to replace them every so often. In fact, NHL teams replace away helmets more often than home helmets because of the wear they receive during travel. In general though, you can check the date on the certification stickers on the rear of the helmet and make sure to replace it before that date. Other than this date, the most important thing to look at is signs of damage. Replace the helmet if there is any damage to the shell or liner caused by wear and tear, extreme temperatures, or severe impacts. Damaged materials in the helmet will not provide the same level of protection, and so the helmet should be replaced.

What are your thoughts on the future of contact hockey with respect to concussion rates? Is it realistic to think contact hockey can exist without the fear of traumatic brain injuries?

Like all sports, there are risks of injury when you participate, and hockey is no different. As we’ve learned more about concussions and brain injuries, we’ve seen shifts in how the game is played. Hockey is a fast-paced game and always will be, so the risk of head injuries is unlikely to be completely eliminated, but coaching strategies can be revised, perhaps eliminating the emphasis on “finishing your check”. For players in leagues that include body contact, always be aware of your surroundings and the most important thing is to get your head out of the way of any potential head impact when possible.

I completely agree. Being aware out of the ice and playing with your head on a swivel might just be the most important piece of advice. Thanks for your time, David. We appreciate you sitting down with us.

References:

Tator, C.H., 2009. Concussions are Brain Injuries and Should be Taken Seriously. Can. J. Neurol. Sci. 36, 269–270. https://doi.org/10.1017/S0317167100006922

Williamson, I.J.S., Goodman, D., 2006. Converging evidence for the under-reporting of concussions in youth ice hockey. Br. J. Sports Med. 40, 128–132. https://doi.org/10.1136/bjsm.2005.021832