NHL Injury Report: Notable Injuries And Not-So-Notables [video]

In our previous installment of the NHL Injury Report, Bleedin’ Blue editor Kate Cimini spoke with biomechanics expert Justin Price, about general drawbacks athletes can encounter when they do not follow a proper recovery plan or give themselves enough time to come back slowly.

For the next chapter in the series, I sat down with Dr. Orr Limpisvasti, Orthopedic Surgeon at the Kerlan-Jobe Orthopaedic Clinic in Los Angeles and Anaheim Ducks physician to discuss specific questions we had about player injury and recovery time.

It is difficult to talk generalities of injury, as, as Dr. Limpisvasti pointed out, there are so many factors that determine how an injury is handled. Is the player invaluable to the team, or can they muddle along without them? The player’s age, fitness level, and previous injuries all go into how each new one is handled. As such, we dug in deep and got very specific. We talked Kariya, Crosby, Backes and more, as almost all players in the NHL have or will suffer injury that affects their game negatively.

However as we saw in the case of Daniel Carcillo, the NHL doesn’t always take precautions to protect their players. They have tightened up since the retirement of Ducks captain and forward Paul Kariya, which he credited to too many hits to the head, such as the one below.

But how do the medical experts deal with the players? Dr. Limpisvasti has the answers.

KC: For our background knowledge, can you explain your duties as a team physician as they relate to players coming back from injury? Are you the first responder, so to speak, or do you deal with their injury from start to finish, outside consultations aside?

Dr. Limpisvasti: Team physicians assess and treat injuries on-site along with the team’s athletic trainers. Start to finish. We also regularly serve as outside consultants for other teams [and] sports.

KC: Can you talk about the process for clearance to get back on the ice? I understand it’s gotten more stringent over the past decade, though maybe that relates solely to concussions.

Dr. Limpisvasti: The process is the same for all pro sports: accurately assess the injury, evaluate and utilize all of the treatment options that can optimize the best recovery, assess risk of return to play. The ‘clearance’ is a discussion of risk including the player, physician, and team.

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KC: Have you treated athletes who were more concerned about getting back on the ice as quickly as possible, rather than the long-term effects not rehabbing properly could have? How did that attitude affect their recovery and/or careers?

Dr. Limpisvasti: All hockey players care more about quick return to the ice. It usually takes serious concerns with significant discussion before a player backs off of the push to return to play with the injury.

KC: Common knowledge tells us that number and severity of injuries can certainly impact a player’s career — I’m thinking specifically about Paul Kariya’s multiple severe concussions, here. But what about multiple minor injuries suffered throughout a career? A broken finger here, frequent small sprains there, such as Penguins player Beau Bennett has suffered. At what point do you, as a physician, step back and say that these continued injuries are going to speed up this players’ retirement?

I say this because on the opposite end of the spectrum, we have Jaromir Jagr, who has had an incredibly long, productive career. He suffered only one major injury on the ice, a dislocated shoulder during playoffs with the Rangers in 2006. The two are clearly related to a certain degree, but what degree is that?

Dr. Limpisvasti: All injuries are taken seriously. Loss of game time and opportunities to progress or continue a hockey career are of utmost importance to players. They consider nothing that threatens immediate participation ‘minor.’ Again, the singular injury, as much as the cumulative trauma, is treated with extensive disclosure to the player about their risks. Only rare injuries ever place us in a position to tell teams that a player is not ‘cleared.’

Dec 19, 2014; Newark, NJ, USA; New Jersey Devils center Scott Gomez (21) plays the puck while Devils right wing Jaromir Jagr (68) and Tampa Bay Lightning defenseman Jason Garrison (5) battle during the second period at Prudential Center. Mandatory Credit: Ed Mulholland-USA TODAY Sports

KC: Sidney Crosby’s return to the ice after a puck broke his jaw and several teeth in the spring of 2013 was relatively quick, as well. He took approximately one month off and returned to the ice with a cage on his jaw to prevent further incidents. What kind of stress does that place on the body, both continuing to heal a relatively serious injury and play a very physically taxing, tough game?

Dr. Limpisvasti: A broken jaw is a serious injury and often occurs with a concussion. It is very taxing to try to recover and jump back into intense sports competition. Many players as they get closer to the end of their career take more time to get back.

What About The Blues?

Nov 23, 2014; Winnipeg, Manitoba, CAN; St. Louis Blues forward David Backes (42) is injured during the third period against Winnipeg Jets at MTS Centre. St. Louis Blues wins 4-2. Mandatory Credit: Bruce Fedyck-USA TODAY Sports

KC: Blues captain David Backes, in particular, has had a rough year. He had a concussion in October from a hit by Trevor Daley of the Dallas Stars, took a puck to the mouth in December, and all this was on top of his pretty dramatic concussion in April from a hit by Chicago Blackhawks defender Brent Seabrook. He’s on a hot streak right now, and is a pretty senior player, having played in over 600 NHL games, so he’s likelier than not to be more careful with his recovery. However, the past two years have been pretty bad to him.

Even if he doesn’t re-injure himself, can constant injuries such as these have an effect on the length of his career?

Dr. Limpisvasti: All injuries add up. Just playing NHL hockey without a ‘noted’ injury is tough on their bodies. The only saving grace is that they are on skates so that their knees are relatively spared compared to running sports. Many can continue to play with significant arthritis.

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