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Bourque mystery concussion a troubling sign

Rene Bourque hasn't played since Feb. 21. (Andre Ringuette/NHLI via Getty Images)

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Rene Bourque hasn't played since Feb. 21. (Andre Ringuette/NHLI via Getty Images)

As the dreaded ‘C’ word, and by that we mean concussions, begins to rear its ugly head in a prominent way, the Montreal Canadiens and left winger Rene Bourque received two bits of very disturbing news Tuesday.

One of them is that Bourque, who had a concussion two and a half years ago with the Calgary Flames, has a concussion and is out of the lineup indefinitely. But the worse news is that neither Bourque nor the Canadiens has any idea when and how it happened. In fact, until learning the diagnosis Tuesday morning, the Canadiens thought Bourque was suffering from a cold.

“I was shocked this morning when I heard the news,” said Canadiens coach Michel Therrien after a workout in Toronto. “We heard this weekend that he was not feeling right, but we thought it was a cold or something like that. Tough news for us.”

If this doesn’t raise red flags for everyone in hockey, it should. The Montreal Canadiens are an elite organization with some of the best medical personnel in the league at its disposal. If an outfit like that can’t even determine that one of its players has a concussion, how can the rest of us do it with any certainty? It once again brings to light that when it comes to concussions and the hockey and medical communities, the amount of knowledge out of their grasp on this subject far outweighs what they know.

One of Canada’s leaders in concussion research said it’s not terribly surprising that situations such as Bourque’s crop up from time to time. That’s because there are so many misconceptions around concussions, including one that there has to be a direct blow to the head in order for there to be a concussion.

“Shoulder-to-shoulder contact can do it,” said Dr. Lauren Sergio of York University. “It’s possible there could have been some incidental contact that brought it on.”

Particularly when it comes to a player such as Bourque, who has had at least one documented concussion during his NHL career. Sergio said that her research indicates that regardless of the time lapse between concussions, the probability of a subsequent concussion is higher when there has been a previous one. It also highlights the fact that no two players, nor two concussions, are the same. All of the uncertainty continues to make the whole issue rather unsettling.

Bourque has not played since Feb. 21, but what if he had done so without having a baseline test done? After all, there was no single incident that anyone could identify that led to the concussion. It’s very possible Bourque could have surmised he was not feeling well and attempted to play through it, as many players do at all levels of hockey. Playing under those circumstances and suffering another concussion could have been devastating.

And remember, these are NHL players with access to the best care in the world. What about a minor hockey player in a weekend tournament who suffers a concussion due to innocuous contact, then sucks it up to play another game just hours later thinking he has a slight case of the flu? It’s even more serious for those players because young people who suffer a subsequent concussion before the first one heals are exposed to something called second-impact syndrome. When that happens, the brain loses control of its auto regulation of blood flow, which in turn results in swelling that can bring on respiratory problems, permanent brain damage and death. Virtually all cases of second-impact syndrome have occurred in athletes 20 and younger.

Bourque’s is just one in a spate of concussions in the NHL that have occurred of late. Canadiens rookie Brendan Gallagher recently returned to the lineup after suffering a concussion and it has hit everyone from stars - Rick Nash, Evgeni Malkin and Jeff Skinner - to rookies - Gallagher and Vladimir Tarasenko - to role players - Artem Anisimov and Ryan Carter - of late. (Bourque had not been placed on injury reserve as of Tuesday afternoon, but it’s expected he will be.)

As has been the case for the past couple of years, it seems the more we learn about concussions, the more we realize we don’t know.

“It’s still science and we’re still trying to figure it out,” Dr. Sergio said. “The good news is I just got a big grant to study it.”
 

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