Mild Concussion-Day to Day

What exactly is a “mild concussion?” When a player has one and it’s “day-to-day” at what point should fans become concerned about said player not returning to the lineup?

Ales Hemsky last played December 28th against Nashville. That’s over a week ago and I don’t know that he’s been on skates since then. I’m not suggesting we’re looking at a Patrice Bergeron situation here but this is clearly something more than “mild concussion-day to day.”

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30 Responses to "Mild Concussion-Day to Day"

  1. mc79hockey says:

    Hopefully it doesn’t mean that the same fellow responsible for Stoll’s post-concussion care is involved.

  2. Lord Bob says:

    Well, better that Hemsky wait too long than not long enough, that’s for sure. Hopefully, after the Stoll experience, the Oilers are playing it really safe with the Franchise.

  3. HBomb says:

    February 1st, vs. Nashville.

    I’d dress MacIntyre in a full cage with “seek and destroy” orders for Jordin Tootoo. We’re talking full-on Federal League goonery here.

    This is bullshit. With Horcoff playing hurt and Hemsky flat-out not playing….blech.

  4. Unleaded says:

    God, this is just what I don’t want to see right now – the Oilers best player being out of the lineup with an injury that is about as well understood by the medical community as a nuclear reactor is to a english major.

    I’m going to do my part and just let this one go. Worrying is not going to help anyone, especially not me.

  5. Bruce says:

    I’d dress MacIntyre in a full cage with “seek and destroy” orders for Jordin Tootoo. We’re talking full-on Federal League goonery here.

    HBomb: Maybe we should just trade for Bertuzzi.

    Careful what you wish for.

  6. Rod says:

    You’d think by now the Oilers would be extra cautious about the possibility of nose injuries being more than just the nose. Sadly, evidence suggests they haven’t learned a thing about protecting their assets.

  7. HBomb says:

    HBomb: Maybe we should just trade for Bertuzzi.

    Careful what you wish for.

    Bertuzzi? I’m not suggesting a sneak attack – make sure he knows what’s coming.

    But make him answer the bell against someone significantly larger than him.

    It burns me that a no-talent 4th liner like Tootoo takes out one of the elite players in the league with what I thought was a dirty hit (watch the replay – in typical Tootoo fashion, he left his feet and targeted Hemsky’s head).

    If the NHL won’t punish that shit, the Oilers need to respond.

  8. stubby says:

    Concussions are very tricky and complex. Post-concussion symptoms may not show up intially but may 48 hours later.
    It is very difficult to determine return to sport timelines for this injury.
    Factors that effect return to sport are the number of previous concussions (any previous knocks not just this season), the severity of the concussion and the way the person’s brain heals.
    There is more than one classification to choose from when diagnosing severity and I don’t know which one the Oilers staff uses but generally the severity levels are mild, moderate and severe.
    So Hemsky is mild, but is it his 1st this year, how many over his career??? I don’t know.

    So for 1st mild concussion, day-to-day….
    means testing daily for key symptoms, when he reports none for a week than back to the ice.
    2nd concussion is time off, about 2 weeks than daily testing for symptoms, symptom free for a week than return to sport.
    The time off increases with each one.
    This explanation is way to simplified for the actual complexity of managing this injury, but I wanted to give the best idea for timelines I could.
    I feel a need to put a disclaimer “Do not take this brief summary from a guy on the internet and use as replacement for actual medical treatment. Seek advice from your physician”. :)

  9. mc79hockey says:

    Too late!

  10. Fake Craig McTavish says:

    Ha ha . I’m thinking that’s an upgrade.

  11. Dennis says:

    I’ll only say this now because HB said it first and I’m always cognizant of leaving Some things for other people to criticize;)

    There was no reason for 83 to play out the remainder of that game vs Nsh.

    From the way the brass are tip-toeing around this there doesn’t seem to be any chance that 83 will re-appear anytime soon.

    You’re talking an org that had Mike York playing the PP point with a broken wrist and one that let 94 come back way early so he could be ready for the Olys.

    Whenever in doubt, you’ll never go wrong doubting this team.

  12. stubby says:

    I’ll play devil’s advocate.

    I’m not convinced the timeline on Smyth’s return in ’02 was too early. He was back playing at 10-11 weeks and I know that he was put through the proper paces with his rehab. He was on the early side of returning but I don’t remember it being re-injured or he missed games because of it. this was an ankle with a plate and screws put in, pretty stable.

    As far as Hemsky in the NSH game, let’s look at this scenario…..
    if the trainer asks Hemsky the screening questions and he answers with no problems, how can they keep him out of the game. Those concussion symptoms are not always immediately there.

    Hemsky left himself in a bad position, he needs that head on a swivel….. I think I read that he knew he put himself in a bad spot and should have known better. Moreau also didn’t feel it was cheap, but rather a hard hit and he felt Tootoo made a tough play and than stepped up and took him on like he was supposed to. Moreau also commented he was just the first guy to get to Tootoo. During intermission I think.

  13. jon k says:

    The team isn’t bleeding out too badly with him out of the lineup so why rush it?

    With Hemsky the team has a known commodity under a good contract for long term so why bother damaging it by returning him early?

    If the days turn to months there might be reason for concern, but one week out after getting your bell rung isn’t smoke and a hot door knob yet.

  14. dubya says:

    I miss Hot Doorknob. My favorite ‘sphere nickname EVAR.

  15. raventalon40 says:

    Jordin Tootoo deserves to get a beat down.

  16. docweb says:

    Back from my OT game and obviously my comments from the previous post show some sort of ESP or…

    Anyway since I’m not computer savvy enough to copy and paste I’ll just retype my previous post from yesterday (with a few more tidbits)..impossible to sleep until 1:00 AM now anyway.

    A comment and a concern…

    Up until a few years ago concussions were graded 1-3. Grade one with symptoms less than 15 minutes, Grade 2 with symptoms more than 15 minutes, Grade 3 with any loss of conciousness. Along with them went the usual guidelines for return to play ,etc.

    Now there are only two categories. “Simple” concussion is any concussion lasting less than 10 days and “Complex” concussion with symptoms lasting more than 10 days. (See

    By this definition “Poo” had a simple concussion and Hemsky has a complex concussion. If you were a Family Doc and Hemsky was your patient you would be sending him to see some sort of specialist.

    Hemsky and Gagner both played after they were concussed and both later said they “just didn’t feel right”. Poo looked bad right from the hit but here he is within a week back playing and feeling well. He did not play at all after the hit.

    Without a doubt there are individual differences within symptoms, length of recovery,etc.

    But…if you don’t “feel right” don’t play! Honestly, sitting out one game in the big picture means nothing but recurring concussion problems can lead to career ending issues.

    K.Lowe(the other one) and/or the players need to be clear…

    If in doubt,sit it out. It can’t be any simpler.

  17. Rod says:

    Thanks for that post docweb.

    Your last line sums up the reason I’m knocking the Oilers for not protecting their assets. I have no problem with their cautious approach since the Preds game. Problem was, they weren’t cautious enough or aware enough right after the hit. Unless I’m completely mistaken, there’s a real chance Hemsky’s injury was “just” a simple concussion, and that his speedy return that night exacerbated it to the level of a complex concussion. Not good. One of these days they’ll learn that head injuries might be more than just bent cartilage. That’s twice now a nose has “obscured” a concussion.

    I realize an athlete has the mindset that he has to return to action…but the organization has to get their priorities straight. If the medical staff encounters a head injury from a hit along the boards–and there was clearly a head injury–don’t let him return. At a minimum, check all the camera angles to determine what happened before letting him return. Especially if it’s The Franchise. A bloody nose from a high stick is completely different than one from an elbow.

    Better to be without their best player for a period or two than a week or two or…

  18. hunter1909 says:

    Tank for Tavares already.

  19. Ssseth says:

    Like everyone else, I’m keeping my fingers crossed on a quick and speedy recovery for Ales.

    But the way he plays, frankly I’m surprised he hasn’t been hurt like this earlier in his career. Unfortunately it was only a matter of time. Hopefully upon his return he’ll still play physical, but he needs to watch out for himself a bit more.

  20. LMHF#1 says:

    Get the elbows up Ales; no one will fault you for it.

    And guys who take runs deserve to get a face full of elbow pad. You want to hurt me; I’m going to defend myself.

  21. Master Lok says:

    Screw elbows. Get your damned stick up Ales!

  22. dstaples says:

    It means: end of January.

  23. PunjabiOil says:

    Apparently, Dan Tencer thinks he’ll be out until the ASG (January 24-25)


  24. docweb says:

    Rod: I agree. I’m positive the med staff,players and training staff are all on the same page once the diagnosis is made. There are clear guidelines that they follow.

    The problem that I see, as do you, is making the initial diagnosis, erring on the safe side, and protecting the players.

    Finally…why is shooting the puck over the glass a penalty and drilling someone in the head with a “clean” check not?? You’d think the Player’s Union would be all over that.

  25. CrazyCoach says:

    Not that my comments in here are ever considered of any value to anyone but here goes….

    The difficulty in treating/diagnosing concussions is that each person reacts to them differently. It has to do with the chemistry of the brain. As the brain operates, it releases certain chemicals that are crucial in body function. The tricky part of a concussion is that the brain releases these chemicals in a timed sequence, much like an engine in a car. When you are concussed, what essentially happens is that the brain basically purges all chemicals at once. The tough part is that the entire timing sequence is messed up, much like crossing the spark plug leads on an engine. This is what causes the detached feeling one has when suffering a concussion. It seems in certain cases (ala Pat Lafontaine) the timing is really messed up and for whatever reason the brain cannot find its proper sequence. At this point, medicine hasn’t been able to speed up this process or even truly understand it.

    The NHL has done a horrendous job in protecting its players. I think part of this was the short-sightedness of Hockey Canada back in the late 70′s. When the CAHA instituted mandatory face protection in the form or full cages, they made the error of not including rules about high sticks or hits to the head. What it spawned was an erroneous belief among young players of invincibility regarding the head. While there has been much education on the dangers of hits from behind, the hockey community has done a poor job of educating players about the dangers of concussions and hits to the head. While HOckey Canada has tried to reverse this trend of hitting the head through strict rules, the effectiveness won’t be know for many years.

    Just my understanding on this subject. Hopefully it adds to the discussion.

  26. Bruce says:

    Not that my comments in here are ever considered of any value to anyone but here goes….

    CrazyCoach: Don’t sell yourself short. Your comments are well-founded, I would only add a word about mouthpieces. Rules about bloiws to the head are beginning to reach 21st Century standards everywhere but the NHL, and the groundswell is growing there too.

    At least these days concussions are better diagnosed than they once were. They may have been more rare in the past, but they certainly did happen. I recall a poignant chapter in Jean Beliveau’s “My Life in Hockey” about his sluggish play (and life) in the fall of 1961, where every sentence and symptom just screamed “post concussion syndrome”.

  27. Lowetide says:

    Coach: Not so. We may not agree but I really enjoy your posts. You have a unique view and experience (coaching) that lends a different pov. Plus you’re older and can relate to obscure references. :-)

    Keep posting. That’s an order. :-)

  28. CrazyCoach says:

    Ok LT and Bruce thanks. I know my rants about MacT are tiresome at the best.

    Bruce you are very correct. I was told by a trainer once that the reason boxers, and now contact sports players, wear mouth guards, is to prevent from being knocked out or suffer a concussion. The reson being so is that if you take a blow to your jaw while your teeth are clenched any movement backwards from the lower jar affects the nerves on the TM joint (temporomandibular) which causes blackouts and concussions.

    Mouth guards force open the TM joint just enough to prevent this.

    I guess another question to ask would be that if blackouts are prevented, does it lead one to take a harder hit to the head than what is conservatively possible?

    All I know is that when I coach, if a kid on my team takes a penalty for a hit to the head (2 minutes, plus a 10 minute misconduct), they go get changed. I tell my players and their parents at the start of the season that is a non-negotiable rule with me, accidental or not. When parents whine and complain and say it doesn’t account for tall kids who accidently hit a smaller kid with a shoulder hit to the head, I remind them that they guy who hit Brad Hornung did what was accepted at that level to.

    Hits to the head need to be eliminated at all levels.

  29. Ribs says:

    I sure wish I had played against more teams with coaches like you, Crazy. I was one of the smaller kids for most of my minor hockey days and my head sure took a beating because of it.

    The equipment started to get more dangerous as well. Bigger kids looked like Eric Lindros with the size of shoulder pads they started making. Some of the elbow pads made back then were ridiculously dangerous as well.

    I feel kind of ripped off not having the mouthguards that are mandatory today. I’m not sure that my concussion problems could have been prevented by one but it sure couldn’t hurt!

  30. CrazyCoach says:

    Hey Ribs,

    Hard to believe now because I weigh 224 pounds and stand 6 feet tall, but like you Ribs, I was a small kid for my age and instead of learning actual technical skills like skating, shooting, passing, stickhandling and checking, I was learning the game of survival.

    I remember some of that old gear in the 90′s. Thank god someone had the brains to outlaw the elbows pads with plastic caps on the elbows.

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