Should head injuries lead to compulsory withdrawal from competitions?

[concorde]

If I understand correctly, both Hanyu and Han were evaluated by on-site medical professionals and those professionals they passed (i.e, "sideline test"). So the skaters and their coaches then decided whether or not to return to the ice. Not sure if I agree with their decisions.

Maybe the real issue is what should be "sideline test" be?

 

[noskates]

In contact sports there is definitely a period of time where the athlete cannot compete. I realize figure skating shouldn't be a contact sport.......:hopelessness: but in this case it was. I don't think either Han or Hanyu should have been allowed back on the ice regardless of what the on-site medical team decided. As has been stated before, oftentimes head injuries take awhile to manifest symptoms. I think both men were in a state of shock from the collision and neither should have had a say in whether they took the ice again. You would hope that this incident would be discussed by the ISU and something would be put in place should it occur (God forbid!) again. It's always amazing to me that more collisions don't take place in warm-ups, especially with the men as they go flying around the ice.

 

[gravy]

If I understand correctly, both Hanyu and Han were evaluated by on-site medical professionals and those professionals they passed (i.e, "sideline test"). So the skaters and their coaches then decided whether or not to return to the ice. Not sure if I agree with their decisions.

Maybe the real issue is what should be "sideline test" be?

No, they wouldn't have passed that "sideline test" because there was no "baseline" at the beginning of the season set when they were healthy.

How could the medics (who were specifically brought to treat the US/Canadian skaters) know Hanyu/Han (Japan/China) were fine and their usual self if they don't have a "normal healthy" result to compare against after their collision? Especially since those doctors had never personally attended to Hanyu or Han in the past.

It really was just a guessing game at CoC, which was very scary.

 

[el henry]

Not only does the NFL have a baseline for its players, the players are evaluated by neurologists, not simply MDs, before being returned to play. The NY Times had a good article about the protocol and how it is working (and how some players think they are fine, and they are not, and the medical staff has the last word. (Story from the article: player lies motionless for six seconds before rising to his feet. Doctor: "You're out of the game" Player: "On whose authority?" Doctor: "Mine". ).


http://www.nytimes.com/2014/11/30/s...e-under-a-concussion-management-protocol.html


Figure Skating does not have enough money to implement these protocols at each competition, but at some point common sense needs to reign. Even that did not happen at CoC.

 

[Meoima]

No, they wouldn't have passed that "sideline test" because there was no "baseline" at the beginning of the season set when they were healthy.
How could the medics (who were specifically brought to treat the US/Canadian skaters) know Hanyu/Han (Japan/China) were fine and their usual self if they don't have a "normal healthy" result to compare against after their collision? Especially since those doctors had never personally attended to Hanyu or Han in the past.
It really was just a guessing game at CoC, which was very scary.

Yeah, I am on the same boat "they shouldn't have skated" here. But well what's done is done. I am quite sad that these 2 young men are still dealing with post collision trauma as they both admitted in the recent interviews (that they don't feel safe and secure on the ice and have to constantly check the rink to see if there's other people behind). I don't know when and how they will be able to overcome the fear of collision.

 

[penguin]

The tricky thing about a rule like this is defining that line. I think a crash of Hanyu/Han's magnitude is enough that you could justify pulling them both, but as has been pointed out above, what about the less severe injuries and how do you determine where the limit is? Also, head injuries don't always present symptoms right away; I hit my head on the ice while skating once, and felt fine to finish practice for the day. It wasn't until Day 2 that I started feeling dizzy and went to a doctor, who confirmed I had probably sustained a brain contusion. Of course, if I knew I had one at the time I would have gotten off the ice right away.

 

[Krunchii]

I can't say all head collisions should be an automatic withdrawal because there could be different levels of severity but I do want some sort of procedure in place for all injuries. There needs to be some sort of consistent system across competitions ready in case of another incident, whether head, leg or whatever injury that can possibly prevent them from competing, have a medical team on stand by, be able to delay the event to check if someone is okay, have skaters submit medical history etc etc

 

[gkelly]

I think it's reasonable to have a medical team at each competition who are available and competent to give quick rinkside evaluation of injuries and have the authority to determine that occasional rare injuries are too potentially dangerous to allow the skater to compete. At most competitions they would not be called upon to make such determinations

Referees usually aren't medical professionals (although since this is a volunteer sport, occasionally they do happen to be), so they can't make the medical decisions. But it's their job to keep the competition running both safely and on time with fairness to all the competitors, so they would be making decisions about when or whether a skater may resume skating if there's an interruption in a program or warmup, when additional warmups or additional resurfaces are necessary, etc.

For injuries that happen mid-program, there should be a written guideline on when the ref should stop the music/stop the program.

There are already rules about scoring penalties for interruptions if a skater has to stop and restart, depending whether it is the skater's fault (which falls usually are) or the venue's fault.

These could be expanded to allow for quick medical evaluation before the skater is allowed to resume and to skate the rest of the program at the end of the group.

But the circumstances for stopping the program or for requiring medical evaluation and clearance (rather than just having it available) should be a pretty high bar: e.g., The skater loses consciousness or is unable to get up from a fall within 30 seconds, or they're clearly dazed and not resuming the program, again for more than a handful of seconds.

If an injury takes place during the warmup, there could be provisions to insist on a spot medical check if similar circumstances occurred during the warmup. And to allow the skater to move to the end of the skating order for that group if cleared to skate.

What we don't want is skaters who take a hard fall near the beginning or in the middle of their program to stop themselves (or pretend to be dazed so the ref will stop them) so they can get a nice rest before starting again. That would just be ripe for abuse. Scoring penalties would be a disincentive.

But for injuries sustained earlier that day, the previous day, several days earlier at home, etc., I don't know how refusing to let skaters compete could be enforced. They will usually seek medical treatment themselves. Someone who wasn't present when an injury occurred and doesn't know the skater personally can't really come in after the fact and say "I heard you hit your head in practice yesterday (or got mugged or had a car accident last week). We won't let you skate unless you show us XYZ tests and written authorization from a physician that you're cleared to compete."

Education to coaches about delayed dangers of certain kind of injuries could be more useful.

I've hit my head on the ice a handful of times over 20+ years of adult skating -- don't remember if I ever did as a kid. I may have been too shaken to continue with that day's practice, but never badly enough that I couldn't have skated full out the next day. Fortunately for me.

And there will be more of those kinds of falls than really dangerous ones. It is tricky to know where to draw the line. I just don't see it being either practical or desirable for the ISU to try to keep track of and evaluate every out-of-competition fall.

 

[SoundtracksOnIce]

My response is definitely withdraw them without question. I attended a seminar on concussions and brain injuries a couple of years ago and it's just too iffy and dangerous. Concussion symptoms can show up later and we keep getting new information that we don't know. When I was eight years old (1990 in case anyone is wondering for reference sakes), I was in a car accident and hit my head on the dashboard. (I wasn't wearing my shoulder belt - yeah, I know, not smart). The doctors said I had no concussion. I had nausea and headaches for months and they said the nausea was due to a "damaged nerve in my stomach." Today, I would have been diagnosed with a concussion, but medical research was simply different back then.

Another example is the late actress Natasha Richardson, who died because her head injury was misdiagnosed.

I can see letting someone keep going during a program because it is hard to tell and that's in the heat of the moment (although I would have yanked Jeremy Abbott off the ice in a heartbeat) but if it's warm-up, there's no excuse to not pull them and have them examined properly. What got me in this case was that Hanyu for sure (I can't remember about Han) lost consciousness. This isn't a murder mystery from the seventies, where the detective gets whacked in the head and knocked out, and gets back up in two seconds. What was Orser doing?

 

[peg]

What was Orser doing?

He was telling Hanyu it was no time to be a hero and that his health was the most important thing.

 

[phaeljones]

No way those two skaters should have been allowed back onto the ice. They are even an extreme example. Start with the easy cases with whatever rule you want, and it should not be that hard to draft one to have stopped those two. Just do that and it will be a better world for skaters. Work on the difficult nuances later to expand the rule.

If the NFL and the NCAA can put a reasonable protocol in place, so can everyone else. There is no excuse.

 

[MIM]

Some head injuries take time to develop symptoms, so a skater could theoretically not feel any symptoms until after a competition has concluded. Not much you can do in that case. However, when a skater s laying on the ice for more than a minute and it's debatable if they're even conscious and if they're as dazed and confused as Hanyu and Han Yan were, then it's obvious there's something wrong and no way should they skate.

Yes! Yes! Yes! I was with my sister who is a child neurologist when I was checking the result of COC men's event. Watching the clip, she said there is no way the skaters are allowed back to the rink that soon after the crash which had knocked them unconscious. If someone is unconscious just for a few seconds after crash/fall, that is a very bad sign. He/she should be immediately sent to a hospital to take further examinations and a full rest.

I just wished there had been a leadership/authority to pull them both in order to keep them from even further injuries. ISU should be the one to put safety rules, but until it is systemically implemented, I guess it is up to the individual coaches.