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This article was published 10/1/2017 (1109 days ago), so information in it may no longer be current.
Patrik Laine’s roughly 27,000 Twitter followers likely noted with great interest the injured hockey star’s mention Monday of a recent visit to a Fort Garry spa.
A Winnipeg concussion expert figures that’s a positive sign.
Dr. Glen Bergeron, director of Heads Up Concussion Institute, a University of Winnipeg research centre, said the Winnipeg Jets right-winger is doing exactly what he should be doing a few days after suffering a concussion.
"I saw he tweeted out that he went to Thermëa spa and that’s OK to do that," Bergeron said Tuesday. "The newest thought process on (concussions) is that this period of saying you need absolute rest, put yourself in a dark room, with no TV, no texting, that kind of thing, is not the norm anymore.
"It’s OK for two or three days to rest because you’ve had this trauma to you. But very shortly you need to be up and moving, so even activities like walking or getting on a treadmill, with some very light aerobic activity.
"We’re saying after two or three days, start to become a little more integrated."
Laine, 18, found himself on the receiving end of a crushing hit from Buffalo defenceman Jake McCabe on Saturday afternoon against the host Sabres. The NHL rookie had just taken a pass from centre Mark Scheifele and didn’t see McCabe coming from his right.
Video replays show the players knocking heads. Laine fell back, his head appearing to hit the ice. He lay motionless for a time and then looked woozy as he was helped to the dressing room by the team’s training staff.
Winnipeg has offered no time frame on a return to active duty for the league’s leading rookie point-getter (37), who is being monitored closely by the Jets’ medical team.
Bergeron said the effects of trauma to the brain are difficult to predict.
"I think it’s always concerning when you’re talking about the potential for a brain injury — which this is — and the potential for subsequent injuries if he’s not fully rehabilitated. I think (the Jets) would be very concerned about that," he said.
"The brain, in a concussion state, it’s a functional injury, which means the efficiency of the brain to communicate with itself, from one nerve to another, has been altered. It’s a process of time, where the brain re-calibrates itself, to a certain degree. That’s one way of looking at it."
Since the diagnosis, the club is following NHL protocol, which indicates a player can resume playing once he’s successfully completed a series of six steps, with no ill effects.
Bergeron said one day is usually associated with each step in the recovery, meaning the Jets will likely be without their deadly shooter for another three days, at minimum.
"The international standard is you move one day at a time. You challenge, you evaluate 24 hours later before you challenge at a higher level. And if you show any symptoms at all, you go back to the previous level. In that scenario, it takes a minimum of seven days to get back once you are symptom-free," he said.
"The majority of concussions will resolve themselves in seven to 10 days, and that’s where we talk about this whole notion of being symptom-free. Upwards of 80 per cent of people will be better within six weeks."
Following a brief period of rest, Laine’s recovery begins with mild exercise, such as walking or a light cycle on a stationary bike. Then, on the next step, he will be challenged to jog or cycle at a quicker pace. The next phase is a return to the ice.
"When (the team is) comfortable the person can tolerate the cardio-vascular exertion, then they put them on the ice where they’ve taken away all of these visual distractions, so he’s on the ice by himself," Bergeron said.
"When they’re comfortable he can do that and he can exert himself properly, then they will put him in a controlled practice, where there will be others around him. He will have to be able to tolerate others in his peripheral vision, coming back and forth, the sounds and the movement. That’s a practice with no contact.
"Then, he’s put into a situation where he has to start making some quick decisions, so that’s a scrimmage and he gets jostled around again so he gets a sense of confidence that, ‘Yes, it’s OK for me to get that contact, and I can get into a game situation.’"
When he returns, the concern, of course, for Laine, his family, the Jets and their fans is the young all-star’s susceptibility to future head injuries.
Dr. Erin Manning, assistant attending neurologist at the Hospital for Special Surgery in New York, specializes in the treatment of neuromuscular disorders, including the treatment of acute and chronic neurologic disease in athletes.
She said for hockey players, the risk is always there. But devoting enough time to recovery is key to the prevention of recurring concussion problems.
"We know that a previous history of concussion can make it harder to recover from future concussions," Manning said.
"We really have to ensure people get the time to heal before they return to playing the full sport, to hopefully prevent them from having these prolonged symptoms down the road if they get another head injury.
"It’s not that they get extra time, it’s everyone working together to ensure they get the appropriate time."
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