RALEIGH -- Paul Strand estimates he had as many as 12 concussions playing hockey, the first as a junior.
"I was old school," he said. "You got a head injury, and you kept playing."
But Strand, who coaches the Junior Hurricanes' bantam hockey team, said he quickly sat down a player this season after a concussion. After being out a month and a half, the player returned to the ice and suffered a second concussion. Strand said that the player was sidelined the remainder of the season and that he recommended the player sit out next season as well.
"The second time he was hurt, it wasn't even a hard hit," Strand said. "It was a little tap on the head in the back, but close to where the other hit came.
"Players want to keep playing, but there's no reason to risk another injury, and there's always that risk. Paying attention to these injuries is more important than having a full lineup, that's for sure. The culture, when it comes to these injuries, is changing."
Jason Mihalik hopes to help with that change. An assistant professor in Exercise and Sport Science at UNC, he helped direct an exhaustive study this season with Strand's bantam team that produced data about hits to the head in hockey.
Sensors were placed in the helmets of 13- and 14-year-old players to gauge impacts to the head - the G-forces delivered. Game videos from the season were studied. More than 600 collisions, each matched up with the correlating data, were carefully analyzed.
Mihalik, an assistant coach on the Junior Hurricanes U16 team, looked at elbows to the head, hits from behind, high-sticking. He looked at "clean" hits and those not-so-clean.
"We looked at hits where we were the hammer and where we were the nail," he said.
The results of the study will be released today in the online edition of "Pediatrics," the journal of the American Academy of Pediatrics. While there are few startling conclusions in the report, Mihalik hopes it will reinforce the need for better coaching techniques, with more emphasis on teaching how to better anticipate hits and being in the proper position to best absorb the hit. It also could help alter the macho attitude and playing style often adopted by those younger players who seek to imitate the big bangers they see playing in the NHL.
"It was really the first study to show quantitatively that elbowing and head-contact infractions were more severe than legal collisions," Mihalik said. "That's worth noting as it applies at the youth level. It really promotes the need to really get coaches educated and getting officials on board with calling the infractions and upholding the rules, and teaching the kids to play within the rules.
"If we can keep the game clean, we're going to keep the severity of the head impacts lower and thus reduce concussions."
Mihalik also has been a part of a larger study that involves the Junior Hurricanes, who are sponsored by the Raleigh Youth Hockey Association and the Carolina Hurricanes. Six sensors (accelerometers) were placed in the helmets of 30 players in two age groups - 13- and 14-year-old, and 15- and 16-year old boys - to register the force and location of the impacts in practices and game. The telemetry was collected over the last four seasons.
The data revealed the G-forces sustained from hits averaged about 18 to 22 g's, roughly the same as hits delivered in college football.
"The average magnitude of the hits were almost identical," Kevin Guskiewicz, who runs UNC's Sports Concussion Research Program, said in an interview this year. "Football players have mass, but acceleration is higher in hockey."
Mihalik's report concentrated on 16 players on Strand's bantam team last season. The various body positions during hits were studied. The collisions were divided into categories such as an anticipated hit with good body position or anticipated hit with poor body position.
Of the 666 collisions evaluated from a 54-game season, more than 63 percent took place along the boards. More than 47 percent were anticipated hits with good body position, and only 15 percent were unanticipated. Again, not surprisingly, open-ice hits were found to be more jarring than those along the boards, and unanticipated hits more damaging than anticipated hits.
One conclusion of the report was a recommendation that "hockey coaches spend time during practices educating players on how to deliver and how to receive body collisions safely in all areas of the ice."
Strand, 38, suffered most of his concussions playing in the East Coast Hockey League, including a season with the Raleigh IceCaps. Now youth and amateur hockey coordinator for the Carolina Hurricanes, he called Mihalik's study "a tremendous asset" in building awareness among young players and their parents about concussions and hopefully preventing injuries at an earlier age.
"Changing the culture is probably the biggest thing we can be doing to make sure kids are not suffering these injures that can cause trauma down the road in their lives," he said. "I still have headaches and other problems related to my injuries."
Mihalik said Guskiewicz has held a seminar on the dangers of concussions with the players and their parents associated with the Junior Hurricanes programs, and that it was an eye-opener for many.
"They're hyper-aware of concussions because of our involvement," Mihalik said. "There seems to be a change in mentality that this isn't a sign of weakness; it's a legitimate injury ... that takes time to heal.
"I think the parents have become a bit more aware. I think the players are more cognizant of it."
Mihalik said he had one player approach him and say, "Jimmy's not feeling so great, maybe you need to look at him." Mihalik said "Jimmy" was found to have had a concussion.
"Three years ago, I don't think that happens," Mihalik said. "So we're making small steps. But they're forward steps, which is a good thing."
