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May 17th, 2010
10:05 AM ET

Bracing for blow may ward off brain injury

By Stephanie Smith
CNN Medical Producer

On the ice at a youth hockey game, players hurl and slam into one another - and that's on a good night. That makes it the perfect venue to study how all those collisions - and a player's preparedness for them - can impact the severity of a head injury.

According to a new study in the journal Pediatrics, the better a player anticipated a collision with another player, the less jarring the impact to the head. Makes sense, but perhaps more important is the converse of this finding: The less prepared an athlete was for that jarring collision, the worse the blow to the head.

"If players anticipate collisions they can better absorb the forces related to impact," said Jason Mihalik, lead study author and assistant professor in the Department of Exercise and Sport Science at the University of North Carolina at Chapel Hill. "[Athletes] who don't expect to get body checked are not able to tense the neck muscles to absorb force, and that can lead to a more severe impact to the head."

Mihalik and colleagues conducted their study by tracking clashes between players at youth hockey games. During a full season, a team of 16 players between 13-14 years old wore special helmets outfitted with devices called accelerometers. The devices measured the acceleration of players' heads as they bumped into one another, while radio frequency devices on the helmets communicated the force of those blows to a computer outside the rink.

When a player's head was struck, the data were recorded on the sideline computer. That data were compared to game videos to determine whether players had anticipated the hits or if they were caught unaware, and the number of head injuries among team members during the season. It may seem like an obvious point, but as Mihalik and colleagues point out in the study, preparedness - and providing technical skills for players to recognize an imminent hit - really matter.

"Players don't anticipate on their own. they need training in it," said Mihalik. "Coaches need to prepare athletes to be aware on the ice and officials are also responsible for helping out."
When players are unprepared, the result, according to Mihalik, can be calamitous.

According to the National Center for Injury Protection and Control, 15- to 19-year-olds are at the highest risk for suffering a TBI. Among children up to 14 years old, 37,000 are hospitalized and 435,000 visit the emergency room as a result of TBI.

Study authors recommend that, "...coaches...promote the skills necessary to keep the safety of participants at the forefront…” - advice that coaches of any youth sport may wish to adopt.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


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soundoff (64 Responses)
  1. Dan Mouritsen

    Twenty years ago I had brain surgery where they removed part of my right temporal lobe and five years ago a had a baseball sized tumor removed from my neck. Since my surgeries I have gained 65 pounds and can't seem to drop any of the pounds. I now weigh 245. Could this be a side effect of the surgery? Both tumors were benign. 6 years ago I was told I was borderline diabetic by one doctor. My blood sugar generally hovers around 122. I drink only water and 2% milk. But I am the son of a baker and I cook most of my own meals.

    May 17, 2010 at 16:37 | Report abuse | Reply
  2. Lincoln Brigham

    Am I the only one that finds it odd that the authors did not recommend against 15-19 year-olds participating in sports known to result in traumatic brain injuries?

    Is there any evidence whatsoever that, "promot[ing] the skills necessary to keep the safety of participants at the forefront" actually works? In practical terms what does that mean anyway? "Hey kid, don't get hit from your blindside" Wow, stellar advice.

    May 17, 2010 at 17:55 | Report abuse | Reply
    • Dee

      exactly! who are these parents that let their kids do this? there are other ways to learn the purported skills this sport teaches

      June 29, 2010 at 03:42 | Report abuse |
  3. John Worthington

    Yes – the reflex action of bracing is for self-preservation, an instinctive basic survival response. When conscious of an impending fall or blow, the instinctive response is to protect one's head, even at the peril of one's extremities, such as a broken wrist, etc. This is certainly worth mentioning, but should definitely not be a surprise.

    May 17, 2010 at 23:31 | Report abuse | Reply
  4. Sktanky D

    Kinda goes without saying, although I've always heard of people avoiding injury because they weren't tensed up. But I think the most devastating hits in hockey are open-ice when you catch somebody with their head down. Did you ever see one of those guys try and get up? It's scary. As far as the research goes I think they first should have, and maybe they did, is predict from the data which players "braced" and which didn't, then watch the game video and see if their was a direct relationship. As far as teaching technical skills to improve a players ability to brace, I don't know much about that, but isn't "bracing" a reflex?

    May 18, 2010 at 10:03 | Report abuse | Reply
  5. Milosz

    It amazes me how people need to complicate the obvious. If you receive a blow to your head, of course it is going to hurt. And the stronger the blow, the more potential for damage to the head, brain and neck. It is not rocket science – it is common sense, and it is known by everybody with an IQ above 25.

    Then come some genius, with a high-tech helmet, full of space-age sensors and whatnot, and comes to the conclusion that "a sudden movement in your head can, potentially, hurt your brain". Well, duh! It doesn't take much to learn that, and all the sophistication is only there to distract from the fact that the "study" is empty.

    Unfortunately, there seems to be a lot of those so-called "studies", which are more of a silly show than actual research. And it is a pity that there is a consumer audience for that kind of thing.

    May 18, 2010 at 19:22 | Report abuse | Reply
    • mike

      Uh, dude, they are saying that magnitude of the force determines level of shock to the brain, it is whether you see it coming or not, right? Like, if you see it coming, then you use your body muscle to absorb the shock waves and dissapate them, but if you don't see it coming then you are more subject to "whiplash".

      I mean, it is still jsut as completely obvious, and I hope my tax dollars didn't go to yet anouther study of the obvious.

      Here's a study that needs to be performed – that " Sitting down regularly can rest your legs." Okay, Monty Python mocked stupid studies like this one with that line 40 years ago.

      June 28, 2010 at 23:12 | Report abuse |
  6. JR

    Here's an idea, steer your kid away from 'youth hockey'. Oh wait, I already did.

    May 20, 2010 at 09:28 | Report abuse | Reply
  7. George S

    In high school soccer, one of the first thing our coach did was lightly throw the ball at all our foreheads, so we realized it hurt a little, then did it again but had us snap out head forwards to bounce the ball back to him, so we realized it didn't hurt. So, nice to know that it actually protected us as well. (Of course, heading a soccer ball is less impact than a check to the boards, but it (hopefully) happens a lot more often during a season.)

    May 20, 2010 at 09:46 | Report abuse | Reply
  8. mike

    In high school soccer, one of the first things our coach did was THROW A BALL AT OUR HEADS REPEATEDLY SO WE'D LEARN THAT IT HURTS TO HAVE A BALL THROWN AT YOUR HEAD. And it never did me any harm, except for blurred vision, migraine headaches, and fits of rage...

    Okay, this is what playing sports does to people. Sports is touted as the anti-drug, but it is the worst drug of all. It infatuates people who go on in life to think of nothing else. All education comes to a stop, people fight each other, they squander family wealth betting on which team will win "this time". It is sooo pathetic.

    People who play sports in high school shoudl be put to death in the 9th grade. We wouldn't have all these bullying problems, and we'd probably have settled Mars by now, too.

    June 28, 2010 at 23:17 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.