I was eating dinner during Game 5 of the Capitals/Penguins series last night when I heard Elliotte Friedman referencing an academic journal about concussions during the second intermission. You don’t often hear hockey pundits talking about academic research so that got me out of my seat. I walked into the living room and witnessed Friedman tell all the hockey parents and kids watching that new research encourages activity after a concussion rather than rest. His example of why this science might be worth following was based on the excellent play of Sidney Crosby who returned after being diagnosed with a concussion during the game on May 1st. What he said about the research is true. But it is a partial truth, and that’s why what he said was dangerous and irresponsible.

For a number of years now, many researching head trauma have been advising mild to moderate activity as part of post-concussion treatment. MILD to MODERATE activity. Two words that Friedman omitted from his segment and essentially replaced with: participate in playoff-style, high intensity hockey. The Montreal Gazette reported just a few weeks ago, “aerobic exercise is the best option for those early days after being diagnosed with a concussion.” FYI: Hockey is NOT an aerobic activity, especially not playoff hockey. Other popular sources have managed to report on this same research finding and maintain light activity as the central takeaway:

Light exercise after concussion in kids, teens may halt prolonged symptoms: study [Toronto Star, December 2016]

The New Science of Concussion Recovery [Outside Magazine, January 2015]

CHEO concussion study suggests light exercise speeds recovery [Ottawa Sun, December 2016]

Now I’m not a concussion researcher but I do spend my days reading academic research and have access to original articles, which most people are not privy to. So I looked up the article that Friedman was talking about in The British Journal of Sports Medicine (which he tweeted about as well) conducted by the Concussion in Sport Group and it doesn’t say anything about returning to full contact hockey. The premise of the article is about updating a concussion assessment tool and the closest thing that I can find in it about returning to activity is this:

The Return to Sport progression emphasises that the initial period of physical and cognitive rest should typically only last 24-48 hours.

A Return to School progression has been added, including possible academic accommodations.

And, I’m not the only one who caught this “error”:

The article he ends up retweeting from Dr. Jessica Page is from The Journal of the American Medical Association, and then the good Dr. ends up sending him the correct article, “Rest and treatment/rehabilitation following sport-related concussion: a systematic review” from The British Journal of Sports Medicine. That article states, “A brief period (24-48 hours) of cognitive and physical rest is appropriate for most patients. Following this, patients should be encouraged to gradually increase activity. The exact amount and duration of rest are not yet well defined and require further investigation.” Either way you slice it no research team, that isn’t funded by the National Football League, is saying that athletes should return to full contact competition until they are cleared by a doctor.

Here’s more original research that promotes the gradual/light physical activity method:

Exhibit A: Silverberg, N., Iverson, G.L. (2013). Is Rest After Concussion The Best Medicine?: Recommendations for Activity Resumption Following Concussion in Athletes, Civilians, and Military Service Members. Journal of Head Trauma Rehabilitation, 28(4), 250-259.