Crosby’s possible fast return from concussion not unusual, doctors say
Penguins star might play tonight in D.C.
It is not a miracle of modern medicine. Nor is it a professional sports franchise prioritizing wins and championships over the health of one of its players.
If captain Sidney Crosby does return to the Penguins’ lineup for Game 5 of the Eastern Conference semifinals on Saturday in Washington, it will actually be relatively normal.
Although some might be quick to accuse the Penguins of rushing Crosby back — or allowing the NHL’s best player to rush himself back — that’s not the opinion shared by several concussion experts.
“I don’t have a problem with what they’re doing at all,” said Anthony Alessi, an associate clinical professor of neurology and orthopedics at the University of Connecticut and director of UConn’s NeuroSport Program.
Dr. Alessi, of course, did not treat Crosby, but he does know plenty about concussions and what it takes to recover from one. The same goes for Viet Nguyen, an assistant professor of neurology and neurological sciences at the Stanford University Medical Center.
Presented with a hypothetical scenario in which a patient was concussed Monday and returned Saturday and asked whether that would set off any alarm bells, Dr. Nguyen said it would not.
“Let’s say [the patient] had a concussion,” Dr. Nguyen said. “They had 15 minutes worth of dizziness and confusion during the game. You take them out of the game. The rest of the night they’re fine. The next day they’re totally fine. They test normally on all the metrics. They have no symptoms when you exercise them. Then, yeah, I don’t think there’s any problem adding that player back into practice and back into competition [within the same week] if they remain asymptomatic.”
Capitals defenseman Matt
Niskanen cross-checked Crosby in the head during Monday’s game. Crosby left the ice with help from head athletic trainer Chris Stewart but was seen walking around PPG Paints Arena later that night. He did not play Wednesday in Game 4. His symptoms have been minimal.
Crosby revealed after Friday’s practice that it was actually his third day skating, meaning he started on Wednesday.
That’s also normal, to start skating again so soon, the doctors said. The Penguins have done similar things with Crosby at the beginning of the year and with Conor Sheary, who was also concussed Monday then skated Tuesday.
“Think about it,” Dr. Alessi said. “We take a highly trained athlete who’s willing to work out at high levels every day and suddenly shut them down to nothing? That has tremendous, detrimental impact on their system. We have good measurements of the factors that help the brain heal, and these healing factors go up with exercise shortly after a concussion.”
Another misconception regarding Crosby’s concussion and the return from it seems to be the length of time that symptoms take to present or show.
“If the person is getting better over those first 24 to 48 hours, to the point where they don’t have symptoms, their recovery is going to be fairly quick,” Dr. Alessi said. “People don’t typically — and it’s almost unheard of — start having symptoms three days after a concussion.”
There’s a counter to every opinion or theory, and concussions are no different.
William Barr, the NYU Langone Medical Center’s director of neurophysiology, would prefer for all sports to have a seven- or 10-day noplay window that was either mandated or recommended for those who suffered concussions.
He also acknowledges that it might be a little unrealistic to expect that, especially with hockey’s schedule.
Presented with the same scenario as Dr. Nguyen, Dr. Meeryo Choe, associate director of the UCLA Steve Tisch BrainSPORT Program, said a Monday-toSaturday timeline would be “right at the borderline of what the recommendations are.”
Although acknowledging that Crosby and the Penguins weren’t necessarily doing anything wrong, Dr. Barr prefers the seven- to 10day period as a safer alternative. “We just don’t know,” Dr. Barr said. “Being safe and based on research that I’ve been part of, I feel more comfortable when people pass through that 10-day window. That’s all I can say.”
Anybody who followed the Crosby situation unfold via Twitter might’ve read that he was in the press box for Wednesday’s Game 4, the one he missed.
A player with a concussion around all those lights and sounds? What gives?
“This old attitude of rest in a dark room and don’t do anything, take away all their social interactions and their screens, may actually be harmful,” Dr. Nguyen said. “And while rest is important, complete sensory and social deprivation is probably a little too far to the extreme.”
Penguins coach Mike Sullivan fielded 10 questions in his daily media briefing Friday, five of them about Crosby and the possibility the Penguins were rushing him back. “We rely on our medical staff to advise us and help us make the best decision,” Sullivan said. “The priority has always been on the health of our players, first and foremost, and that will never change.”
An additional factor with Crosby involves his history with concussions. This is the fourth that has been reported. On one hand, he’s more susceptible. On the other, he’s more familiar with the process, more communicative with his symptoms and more descriptive of them.
“I think having gone through this, I like to think I’m pretty aware of my body at this point,” Crosby said. “I understand the importance of making sure you’re good before you come back, and I have a lot of belief in our staff here that they’re going to do everything in their power to make sure I’m good when I come back.”
Ultimately, how the brain heals is outside of any human’s control — which can be a blessing or a curse.
In this case, according to the experts, it seems that Crosby has not experienced many major symptoms after Niskanen’s hit, has progressed appropriately and, as such, likely could be good to go Saturday in D.C.
“They had him on the ice [Friday], seeing if he could tolerate some contact,” Dr. Alessi said. “That’s the right thing to do. If he could tolerate that without any symptoms, he could be ready to go fairly soon.”