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Another NHL Player Gone Too Soon

Another NHL enforcer was found dead in what should be the prime of his life. Wade Belak was found dead in his Toronto apartment today, apparently due to suicide. He joins Derek Boogaard and Rick Rypien in hockey heaven. the causes of death were two suicides and one overdose on alcohol and pain killers.  This is very tragic especially for the families and friends of these players. I believe the culprit here is multiple traumatic brain injuries.  Moreover,  I suspect there are many more of these guys who struggle with pain, irritability, and depression as a result of multiple blows to the head over the course of a hockey career.

In the old days, when someone suffered a concussion on the playing field, court, or rink, it was said that that player, “got his bell rung” .  As soon as he could get back out there, perhaps with the help of some smelling salts, he was encouraged to do so.  However, it is now known that the effects of brain injuries last well beyond the sense of feeling better physically.  Cognitively, they last much longer because the brain has not completely recovered.  The effects of multiple head injuries are cumulative and the effects worsen as the brain ages.

Sports rely heavily on previous motor programming.  In fact, if an athlete is accused of “thinking too much”, it is likely that he is relying too heavily on his prefrontal cortex rather than his finely honed motor skills that are a result of hours of practice. An athlete that is performing in the zone is hardly aware of what he actually did to achieve that level of excellence.  If he thought about it too much, he would lose the flow.  It’s similar to when a golfer suddenly realizes he’s having a personal best round then loses it because he has brought it into awareness.  In my mind, a player could actually appear quite well when his motor functions returned after a concussion, but his executive functions could still be significantly below his pre-injury baseline.

The executive functions are located in the prefrontal cortex of the brain.  They are involved in higher level thinking tasks such as planning, initiating, inhibiting, attention, and decision making. Moreover, the prefrontal cortex is the most vulnerable part of the brain so any concussion would likely involve this area and these functions.  In fact the prefrontal cortex is likely to be the most affected. Is it any wonder why someone who has had repeated blows to the head with little time for full recovery might experience problems in these areas outside of the sports arena?   What happens when they retire and they aren’t earning money using their well-practiced motor skills and having to rely on executive functions?   The worst scenario here is the poor decision to end one’s life.

Now, I am a huge hockey fan.  I love the Detroit Red Wings and have been to 2 Stanley Cup Final games. A close second is football, another head bashing sport. I like these sports very much. However, there are many changes that can happen that will make these sports safer.

1. Enforce the rules that penalize cheap shots that result in head injuries.  No exceptions.

2. Make sure executive functioning of the brain returns to baseline before allowing a return to the game.

3. Provide support and coping skills for individuals who played years before new rules would be in place.  These players are the most vulnerable and need the most help.

 

Note: Last year’s Minnesota Brain Injury Walk for Thought focused on increasing awareness about sports concussions.  Properly treating traumatic brain injury is important at all levels of competition from youth to professionals.

 

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