What Every Hockey Parent Needs to Know About Concussions

Hello hockey friends and families around the world, and welcome back to another edition of Our Kids Play Hockey.I'm Lee Elias, joined by Mike Bonelli and Christie Casciano Burns, and today's episode is about something every hockey family needs to understand, concussions.Now, don't turn the episode off.We've gotta talk about this, not in a fear-based way, not in a dramatic way, but in a responsible, practical, best practices way that you can all apply.That's the goal for today.Bringing in our guest, it's Dr. Robert Baric, founder of myconcussiondoctor.com.Again, it's myconcussion D-R dot com if you wanna check it out.And he focuses on concussion recovery education and helping families better understand how to manage brain health in youth sports.Our goal today is that you're gonna leave this episode with takeaways that you can apply for your teams and your kids moving forward.It's one of those listens, you listen one time, you might remember this, might help save a kid in the future.So with that said, Dr. Baric, welcome to Our Kids Play Hockey.Thanks, Lee, Christie, and Mike.Thanks for having me.Dr. Baric, yeah, we're so grateful to have you on because we have so many questions for you.Beginning question, just what is the definition of a concussion? What's really happening in the brain if you suffer from one?Okay.So a concussion diagnosis is as squishy as can be, and we have the extreme ones where there's actually bleeding in the brain.It's called a subdural hematoma.And again, f- extremely rare, fortunately.Extremely serious.You gotta get to the ER immediately.But now you're in this entire squishy zone from that down to 0.And then, Christie, the most important thing of concussions are it's, it's a head injury, it's a head bump, and head bumps are cumulative.So you mighta had your first one, 80% of kids by year one fall from 3 feet on the floor.Check one.Right?And, and now you're playing hockey or any other sport or just living life in the backyard, and it might be your 50th head or your 90th, or your 900th.So, so really it's, i- as much as I'd love to have this binary, you know, blue, pink, I'm pregnant or I'm not, it's not like that.I'm wondering, so when we grew up, when I grew up, much older than these 2 guys.Not really.So at one, when I, when, when I grew up, the, the, the adage basically was, you know, you got your bell rung, and there was no diagnosis of a concussion, right?When, and, and, and we knew and we didn't know.What most, you know, I, I, I know if you got your bell rung, it's like get up, get going, you know?Shake it off.And I think what you're talking about, and we define concussions, can you just explain, you know, the kids, actually, you know, our, our, the kids that listen to our show might understand concussions even better than our adults that listen to the show because we, we, we're in, they've been in the world of listen, if it, when it doubt, sit it out.You know, when you're, when you, when, when you get hit in a way, speak up and let people know.Me, I, I, I could guarantee you that I wasn't speaking up if I had my, you know, if I got injured in a game.I was just like, "Oh my, I gotta find a way to keep playing here," and this is on me, not on somebody else to diagnose me, right?So could you just talk a little bit about, you know, knowing that what a concussion is clinically, what, what is it exactly, uh, uh, like what, why the reason for the cumulative piece of this?Like, and why aren't we, I guess, why aren't we understanding it better and communicating th- what concussions are when, when we only talk about it happening in the, in the sport, right?In, on the ice.But it, but in actuality, it could be happening in all these other aspects of life we don't even, we're not even aware of, right?As coaches and even parents.Okay, so you asked huge points.Of all the concussions in the United States, 15% are sports related.85% are in the bedroom, you know, you bumped your head on the corner.You, you, you bend down in the kitchen and you stand up into a door.You, you get in an auto accident.You, I mean, this is, this is just called life.But, you know, the heads, what, so 3 things happen quickly in the brain.Let me, I'll give you real quick physiology, and I think this is gonna answer your, question.Your brain weighs 1% of your body, consumes 25% of your calories.The energy systems just fail.Oh, I can't be around lights, I can't be around school, I can't process data.Number 2, the brain has very specific cells called glial cells, more than you wanna know, but just like in our body we have the lymphatics, in the brain we have our glymphatics.And a u- a University of Rochester researcher basically came out in the last several years and said you have, your brain has its own whole super toxic detoxification systems, and all that fails.And then number 3, you actually get swelling inside the brain.The, um, the astrocytes, which are cells in there, they actually create a scar.So you actually have scarring at the, at the microcellular level in the brain.And of course, we, we can see this in the CTE in the, in the post, you know, I donate my brain to science where I was just at a conference pre-Super Bowl, and they open up their brain and it's just a catastrophe, but we can't do that in a live person.Hey, let's open up your brain and try to find scars.Um, are there better on-field pre- and post-diagnostic tests?100%.But the industry is still running on 1980s technology.Oh, Mike, you have left, left shoulder pain hypothetically.Oh, go home for 2 days, stay in the dark.And you're gonna say, "No way, man.I'm having a heart attack, potentially.I want an EKG.I want I, I wanna, I wanna do things.I wanna chew on my aspirin to do as much as possible."But concussion care is still stuck 50 years ago, but the, the micro, the neuro microbiology, the, the neuro imaging has, has propelled us to 2030 data, but everybody's running on an old algorithm.That's a good way to put it.I think we see that all the time.Um, a lot of misconceptions, then, out there, Dr. Baric, about concussions.Maybe you can dispel a few of them.Well, again, it's, it'sSo, so people look at bi- kind of concussions as binary.Were you knocked out?No, I wasn't knocked out.Okay, then you don't have a concussion.That's crap.So if, if a, if a person did a good eye tracking exam or a neurological exam, a simple neuro ex- exam of walk right foot and left foot right in front and then ask, give them numbers and they have to say odd or even, that could, that is aThat could be an amazing sideline exam.Like, uh, and, and, and you're like, well, yeah, 3, 3, 3 is even, but they can't do, put 2 things at once.That simple.So, so the on-field exams, um, nobody's even doing the cur- the, the Amsterdam documents, the Berlin working documents.So, so sadly there's a lot of people with a lot of titles that are still using older technology 'cause that's the way my daddy did it.Well, I, I love that you just gave that example.Let's- Yeahlet's revisit that for the parents and the coaches real quick of, you said left foot in front of the right foot while also sayingSay that one more time.Like, this is- Yessomething coaches can do, right?Mm-hmm.Ah, huge.So, so- Yeahgive, give them 2 tasks.Right.Right?2 tasks.Go, um, um, you know, close your eye, touch your nose and I'll, and I'll auditorily tell you numbers and you just tell me even or odd.That simple.And they'll be like, "Uh, yeah, uh, 3, uh, uh, odd.Wait a second."Right.Right.Yeah.I don't read myThat, that should be an easy answer.Right.But when you, when you multitask, it's quickly able to see that, that, that, um, that failure.Now, here's the question.Could they do it before the helmet?It depends.Well, it depends on the age.I, I would say it depends on the age, but I know, ILi- listen, we're bringing this up, Dr. Barrett, because like you said, that's a huge takeaway for the audience, right?The, the small things.'Cause I think what happens is, you know, a lot, a lot of volunteer coaches, especially at the youth level, don't necessarily know what to do, right?And, um, one of the things that, that, um, what's the right word here, uh, scares me a little bit is sometimes coaches will be, "Are you okay?Are you okay?Let's get you back in the game."Right.And it's like, whoa, whoa, whoa, whoa.0 uh, you know, especially with a head injury, um, or a head contact of any type, you've gotta slow your roll in that situation, all right, and really focus on the kid.The game honestly does not matter at that point.And, and if you're not doing that in youth hockey, uh, you probably should not be coaching.I'm not gonna lie to you.If you can't make that distinction between winning the game and the health of your athlete, um, that's a problem.And hope- look, hopefully you have someone there that can take them aside and do this.I know you gotta manage the game, coaches, but their health is number one.You know, we talked in the pre-show a little bit, doctor, about Sidney Crosby and, uh, you know, I'm gonna connectMike, Mike is not as old as he thinks he is.But I'm gonna connect, like, well, how we talked about this before.You know, when we were growing up it was, it was maybe a day-to-day injury.Sometimes get back out there the next shift.Um, I remember, uh, in college I received a big concussion.I got cross-checked in the back of the head, um, and all I could think about was getting back in the game, and that's how it was back then.We didn't even consider that something would be wrong with my brain, and I'll tell- it was, I had a bad concussion after that.Um, now luckily, luckily my coach did not put me back in the game.I remember being so angry in that moment."I'm fine.I'm fi-" I was not fine.All right?And then I felt it.I didn't play for, uh, at, at that time, 2 weeks after that, which was considered a long time then.Yeah.Right?Um, now you spin it around, I, I forgot what year.Sometime in, like, the 2007-8 time period, Sidney Crosby, uh, received a concussion in the NHL, actually in the Winter Classic, and he sat out an entire season.And, uh, for the younger audience, he was ridiculed for this.Now, I wanna say this too.This, this'll add some spice onto it.I'm a Philadelphia Flyers fan growing up, okay?So there's no love for the Pittsburgh Penguins or the team that he plays for, okay?And I'm supporting Sidney Crosby here 'cause he's obviously one of the greatest hockey players who's ever lived.He sat out for a year, was ridiculed, was called a wuss, um, every name under the sun.And I'll tell you what, the bravery of him to not play that entire year and let his brain heal, to have a full career, after we have seen multiple athletes, Eric Lindros comes to mind, top of mind, um, oth- other NHL athletes, other professional athletes, not sit out and, uh, you know, have horrendous concussion problems after or worse, right?You know, you see the CTE come in in football and other sports.This kid sat out for a year and really educated the hockey audience of concussion awareness, and that you must do this.I feel like ever since that moment, we- we've changed the discussion.Not far enough, but we've changed the discussion of okay, this is not a minor thing, right?So I would love your thoughts on that, 'cause y- you had mentioned it to me before as well, about how he really led the way.But he took a year to come back.I can't imagine all the tests he was having, and things like that.So, so, 30-second story.So I am a Pittsburgh fan growing up there.And- Love itand he goes out on a concussion, and I'm in North Carolina, and I says, "Oh, Sidney Crosby needs to go to see this guy."And my kids are looking at me like, "Who's this guy?"And then few months later, I read in Los- in, uh, Sports Illustrated, Sidney Gos- Crosby goes to see this guy.Um, that is the extreme case, right?And, and there are people that were able to get him back to his level.Interesting all behind the scenes, uh, when he's, when he was c- when he was rehabbing, s- skating counterclockwise, he could shoot the puck perfect.Clockwise, he couldn't.Interesting.So I mean, that's the level of refinement, that there are people and expertises to get these individuals back at that level.It's- Rightbut the goal is to never get there.Right.I, I don't- RightI don't need a whole house fire.I need a fire extinguisher in my house.So like- If I have a fire extinguisher in my house, I got a little bit of a mess, but I put it out in the kitchen.It's minor.It's little.But if, if I have to, you know, I don't have that fire extinguisher, I call 911, the fire people come, my house is half burnt down.Here's the problem.In the real world, you and I move out, but that's our body.We can't move out of our body.We gotta live in this thing-the rest of our life.So here's a data point scared, scared the heck out of me last year.Finland has socialized medicine.Good or bad, but this is good in this case.They're able to track you your entire life.Mm.If somebody has a mild head injury before they graduate high school, they have a 15% less likelihood of going to college.Oh, wow.Wow.Look at the incarnation, uh, inc- incarceration, sorry, incarceration rates of people in jail, male and female.95-plus percent have all had head injuries.Huh.Wow, interesting.So this is, like, mind-blowing, 'cause- That isy- your, your brain, and to me, it's not if they're gonna have a head injury.Is it gonna be a one out of 100?A five out of 100?Huh.Uh, or you know, a 90 out of 100 that we got the stretcher board, and we're taking youYou know, I, I'm, I'm thinking about, like, you just mentioned Sidney Crosby.You're talking about the, you know, obviously professionals, uh, in the field, right?People, like, you know, you see the sideline, uh, uh, doctors at NFL games, and, and, uh, hockey, and the concussion protocols.What can we do as parents?Like, so, so now, now, and, and I don't know, and to Lee's point, like, I don't know if we can depend on our coaches to be the arbiter of whether my kid can play or not, right?I mean, 'cause the coach is worrying about their worries, watching 15, 20 players.Let's face it, the parent is watching one player.That's all they're watching.They don't care about anybody else.Right?So they see that player go into the corner, they hit their head off the ice.You know, what are some thingsAnd it maybe, maybe it wasn't dramatic.Maybe it wasn't the big hit, the kid crashed into the boards, you know, everybody comes out on a knee, and, and, and it, all that stuff.It's just, this is just, you know your kid, right?You see your kid gets hit.What can a parent do, and what should they look for, you know, behavioral, physical?You know, how can I determine and say, "Oh, you know what?I, I, I think my kid might have a concussion.I should really look into this more"?Okay, so y- you hit it, you hit it, it's the straw that broke the camel's back, right?You, this might be the 45th to the 46th, and this was the one where he gets a, a, an innocuous head bump.He's down, and a knee hits him in the head.Or, or, or, and he gets up, and he finishes his shift, and he's, comes back.Um, parents, parents know this child the best, right?They know this, they know their child the best.Is, is there changes in attitude?Is there changes in sleep?Is there changes in, um, uh, being able to multitask?And multitasking is a g- great, very simple, on-sideline test that you can do.Could you put them in goggles and have them eye tracking exercises?Yes.Could you prevent a, or, uh, preemptively do a QEEG and do pre, post-assess at the beginning of the season?Yes.Those are 2 tests that could be done pre, post that, um, beginning of the season and then any time you think you have one, that you can't consciously throw.The impact test, everybody was throwing.They're gaming the test, right?Uh, 2 +2 equals 6.Well then, when you get your head, you really does, do think it's 6.So they're, they're throwing those tests.But the, the eye tracking and the actual brain tests and the, and the balance, those are good.You know, you get your baseline, and then if you have an injury, you can redo those tests, 'cause they're non-invasive.We're not taking brain biopsies out.Right, and that- NoI'm, I'm wondering too, sorry Lee, I just- No, go for itI'm, I'm, just a follow-up to that, you know, because we've seen this, you know, time and time again, and you hear about it.Like, what, um, like the symptoms, 'cause they can show up, right?They don't necessarily have to just show up like, okay, after the game, and your son, you know, you go out, and you have lunch, and everything seems fine.All of a sudden the next morning, they're like, "Oh, I don't feel so good," or, or, "I didn't sleep all night," or, like, so, you know, what are, what are some of those symptoms we can look for?And then, and then really, what is the, like, what's the window?Of when we can kind of say, okay, we just kind of out of theYou know, there's no, there's nothing I'm really worrying about.'Cause to your point, like you see some kids get hit and you're like, "That kid definitely got a concussion.There's no doubt."And maybe as a doctor you say, "No, he really, he didn't, he didn't, like he didn't damage his head."And maybe it was the f- you know, like, you know, maybe it wasn't the 74th hit to his head.It was, uh, just it happened and it really, it looked worse than it was.But then the kid, you know, another kid hits him with a stick coming out of the locker room by mistake, and maybe that's the thing that set him off.Correct.So I'm just wondering like, what, like what's the window and the timeframe that we should be looking at?Okay.So you asked sev- several good points.The, the- I'm good at thatat the end ofYou wanna look, of course, as quickly after that injury, you watch it for a week or so, a week or 2.So TBI, everybody says, oh, a traumatic brain injury.I have renamed that.It's a traumatic body injury.Within 30 minutes, your microbiome in your gut is screwed up.Your heart output goes, goes backwards, or goes mo- is modified.Uh, your test- testosterone starts reducing.Your pi- pituitary, hypothyroid.Uh, your sleep is disrupted.Your, your calm hormones, your sero- serotonin, dopamine, GABA are all affected my- through the microbiome in theSo when you hit this, it affects everything.TBI, a, a traumatic body injury.And then I've even made a new acronym, it's called a TFI.And what is a TFI?What happens with that kid that gets his head bumped and has to be out of school for 2 weeks that's 12 years old?Can't leave him home by himself, it's a traumatic family injury.Yeah.It's a TFI.Mom, dad, aunt, uncle, somebody, that whole family's affected.I mean, what happens if there's a long-term inj- event here?You, you have to take care of your wounded.So mom and dad are committing their time to their wounded, as they should be, but others are suffering, right?So it's truly, it's a, it's a traumatic family injury and a traumatic body injury.Yeah, especially in, in the youth sports space.You know, one of the things I'm, I'm reminded of, we, we did an episode a while back with, uh, Bryce Salvador, he's former captain of the New Jersey Devils, and I remember, you know, he was talking about injuries in youth hockey versus pro hockey, and he made the very good point that, look, in pro hockey, we've got all the doctors there, right?And they know that.They know if there's a serious injury, they're gonna be checked out in the building, in their gear, right?And that also, they're paid millions of dollars to play a sport, right?So, so that's their job, right?So the parameters surrounding pro hockey are drastically different than youth hockey.Now, I, I know people go, "Oh yeah, of course, we know that."Well, we don't necessarily treat the concussion the same way in youth hockey- Mm-hmmor, or, um, differently in youth hockey.We just go, "Well, the pros get back out there."Well, they've got 10 doctors looking at them over the course of 24 hours, right?So when it comes to youth hockey, uh, in my opinion, you always take extreme caution- Yeahno matter what.All right?Uh, a- and again, it may not look that bad.Like, one of the things we want to talk about, doctor, is that, like, you know, a concussion, sometimes it does look super obvious, right?You got hit in the head and you flung around, uh, it's probably a concussion.Sometimes concussion hits don't look like they're head hits.In fact, if I remember correctly, I remember when Sidney Crosby got hit, at the time, you know, weI remember it, itHe did get hit in the head, you could see that.Right.But none of us thought like, oh, that was a major- Right.head injury.No body board here.We're not taking him out on the body board and everybody on their knee for the ice for a week.Right.You know, you know, an hour.Right.Right.So, so my question to you here, too, is that there is no concussion hit.They can look a lot of different ways.It could be on the fall on the ice, it could be against the boards.Could be contact body to body.It could be incidental contact.Kid could fall down.Like, there's, there's a lot of different ways a concussion could happen, correct?C- yeah, correct.And Mike, you hit it right on the head.There, thereThe brain could have no negative effect on the ice, but you're walking in, you're walking down and, you know, you just turn into a stick.Right.And again, that's the little bitAnd that's really why I have spent 5 years looking at the cellular changes that happen in any head bump.And is this hockey or s- or whatever.And they're all the same.The 3 systems fail.The energy system fails, the detox, the drains fail- Yeahyou get swelling.And, and I went out and I developed a product called Concussion 911 that is natural, and you're able to protect your brain.You're able to keep all those 3 flowing.Right.So, you know, we have some teams, different levels, that do it proactively before the game.They say, "I want my brain in the best metabolic state before I go out there."Right.But if they do get it, then if they do get their, that head bump or that's suspected, it's all natural stuff.And it says, wow, I want to kick the brain into en- energy, the backup system, ketosis.I want to give the brain ketones, exogenous ketones.I want to get the brain's, uh, drains working optimum, and I want to get through the blood-brain barrier and get that inflammation down.And if there isn't any, so what?It doesn't hurt you.Right.Mm-hmm.have a question too for, and we're gonna get into return to play protocol, and, uh, fortunately, I've, I've seen it get better, especially with high school hockey teams.But a lot of parents ask me all the time, is there any equipment that can help prevent or at least lessen the blow to the head to help lessen the chance of a concussion?Mm-hmm.Mouth guards.They say you have to wear your mouth guard.What about helmets?Is there any kind of technology out there now that parents can turn to?So there isI, I, I apologize because I just came from the NFL, the Super Bowl, and worked with all those individuals.There areYou, you, you go, you, you're watching TV and there's a helmet, and then there's a helmet, right?It's, it, it's- The guardian helmet?Yeah.Yeah, there, there's, well, the guardians actually are really thin.Yeah.So there's, I mean, fortunately, helmet technology has gotten much better, right?And ideally, as a head grows, you get one that fits your head.And so the, the, you know, what's the most, uh, valuable part of your body?It's your brain, right?It's your brain and your head.That's gonna, the thing that's gonna propel you and employ you the rest of your life.So yes, to get, technology in the world of helmets is better.I do not know of an overlay to put over that helmet.Every NFL team and, and even high or high s- really college, wears those big puff helmets off the, off camera.That's amazing.You know, I know in hockey too- Mm-hmmwe always say, Dr. Barrick, to the audience that you don't go cheap on your helmet, don't go cheap on your skates.Yeah.Because, um, I, I do know for a fact that the major manufacturers in hockey do a lot of research into their helmets.There's a reason that your helmet has an expiration date.Mm-hmm.Because they know that the technology is going to advance.So, um, especially with younger kids, make sure that thing fits correctly.Parents, I'm gonna say this very bluntly, you do not know how to fit a helmet.Unless you work at a- Thank you for saying that.Yeah.It, it- We all think we do, right?If you- Yeah, I, I mean, yeah, if you don't work in a pro shop- It's good to knowuh, you do not know how to fit that helmet.I, I also- People in the pro shop shouldGo ahead, Mike.Yeah.I also think it's so important too to understand that that's why some of the rules have changed in, in other sports and sp- and certainly hockey.Like the emphasis on, you know, body contact and body position and understanding how to get hit and when to get hit and what's, you know, what's legal and not.You know, the game is changing because I think, uh, uh, to, to the doctor's point, like there is no really fail safe equipment- Rightthat can, that can protect the inside of your brain.Like, you know, so it's like, well, what, what's one of the ways we can do that?Well, we can, we can, we can develop the game around the fact that you can't protect the brain like we all think we can, right?Right.So if we're, if we're trying to train players at a very early age, I know in USA Hockey, you know, and a, a lot of people, uh, you know, talk about the fact that there's no body contact until the k- kids are 13 years old.And in fact, that's not true.It's, it, there's body contact from the day the kids get on the ice.Right.It's about how you teach that body contact and how to protect yourself as a player.But also the rules of the game have evolved where, I mean, if you watch a game from the '70s, it's like, my God.Like, I think- Sureevery single person had a concussion every shift.Well, that's 'cause every shift had, uh- Like-aggravated assaults back then.Yeah.Yeah.Right.Yeah.Exactly.So, you know, I mean- The McKenzie Brothers.You know, so I think, I, uh, uh, so I think there's a, there's a definitely a, a, an understanding that if we teach our kids the rules the correct way, and we enforce those rules, we can help reduce the need for all the protective gear over and above what we have now.And, and- Yeahbut I think it's really important to understand like why those rules are in place.It's because there really isn't a tool, 'cause if there was, wouldn't everybodyIf there was a helmet out there that, that, that kept concussions from happening, wouldn't every single athlete get that helmet?Right.100%.Well, and, and, yeah.I, I, I will say this- You have too many variablesoh, go ahead, doctor.My bad.You have too many variables.You hit a edge on a ice and, and you going down and somebody's coming by and hits you in the knee, that's not a, that's not a cheap hit.That's just called life.Right.There's just too, just too many variables.Well, yeah.L- let's talk about ice hockey for a minute.Fir- first off, I mean, Mike, the helmets you and I wore buckets.I mean, I mean that.Literally were buckets with some foam in it.It, it, it's, I mean, it was more than they had in the '70s, I'll say that.But I mean, the technology today is, is pretty amazing.But as Dr. Barrick just said, there's too many things.I'll tell you the scariest, um, head thing that I see in youth hockey, and we're talking probably the younger ages, and this is with coaches too.It's not even the hit, it's the kid who falls back- Oh Yeah, absolutelyand hits the back of their head on the ice.Huge.All right?And, and here's the thing, for those of you who have not, like just parents listening, who've not been on the ice, um, when that kid hits the back of their head on the ice, I mean, there's a face that they make and it's scary.All right?It's usually shock and then what just happened.Um, you know, another one too is with coaches, I gotta say this, I haveWhen I see coaches out there, Mike and I'll laugh about this.We all hate wearing helmets on the ice as coaches.It doesn't look cool.We'd rather have a baseball cap on.You know, you never know who's watching.But looks aside, we have to wear helmets on the ice.The amount of coaches I see without their chin straps on, all right?And I'll tell you right now- Of courseif you fall back like I'm talking, that helmet's flying off if that chin strap's- Yeahnot on.And I have seen a coach- Yeahhit the back of their head with no helmet on, and they had- Mm-hmmstopped, they had to stop coaching, all right?All because they didn't wanna buckle their chin strap, or the helmet was not on tight, all right?Like, this safety is not just for players, right?And also, I, I, I gotta, I gotta be on the, the soapbox here, what kind of, like, lesson are we teaching our kids if we're out there with a loose helmet with the chin strap off?Like, we're telling them that it's stupid.Exactly.Right?So, so b- Yeahit's buckle your chin strap, coaches, put the helmet on.And I'm gonna remind everybody again, I gotta say this again, Krista, you, you're notYou do not know how to fit your kid's helmet.You don't.All right?Go to the pro shop.They will actually do a good job.Mm-hmm.Especially if you have the cage on, the chin strap needs to be there.Get it fitted properly.If it's too big or too small, get them a new helmet.Right.Okay?Again, don't- And what about mouth guards?cheap on your skates or your brain.Go ahead, Mike.What about mouth guard, mouth guards?Mouth guards are important too, yeah.We've always heard that that helps prevent concussions.Is that true?So there is, thereI, I think it's all radiated.There is now technology, there's a, a, a dentist out of, I wanna say Iowa, that's done some really neat technology to get the jaw in the rightA- and everything's not tested in the real world,So, yes, if you hit the jaw perfectly and you're, you're blah, blah, blah.But, yes, you, you need a high quality mou- helmet and mouth guard.Yeah.Right?Yeah.You get what you pay for.Yes.I'm glad you mentioned that.Let's talk about return to play protocol, because really this is where emotions can get high.What does a proper return to play protocol look like?Um, and some parents, you know, I've, I've seen it, they'll shop around for doctors until a doctor says, "Okay, they can play."So dangerous, but that's where the emotions come into play, and I think parents sort of lose sight of how important it is to make sure your kid is ready before they get back on the ice, healthy before they get back on the ice, out of the danger zone.And again, so youTh- this is on a case by case basis.And, m- you know, if I'm a parent, I'm looking for providers that areWhat w- I, I'm gonna ask them and say, "What guidelines are you following?Are you using the Berlin Working Papers?"Right?"Are you using" What happens every few years, COVID screwed it up a little bit, is they get all the smartest people in the world, from neurologists to orthopedic surgeons, chiropractors, physical therapists, athletic trainers, blah, blah, blah, and they say, "What do we know, people?Are you following that?"Um, the second is, is it, it's on a case by case basis.So there's no magical Buffalo treadmill test that you, everybody grade G back on or, you know, recovers back onto.And that is where the technology of do, do, do, do you have a pre/post qEEG?Do you have a pre/post, um, eye tracking ex-Uh, you know, you put a, basically a VR goggle on and you do eye tracking, and you're seeing.And, and just like for instance, okay, somebody's walking.Okay, my eyes are tracking.What sh- what happens in a concussion is this one goes and the, this one says, "Oh, there you are."It's like-wait a second here.You're supposed to be moving together.So, but they're, they're, they're not even using today's l- la- latest research technology.So, i.e. it's the opposite.There's, there's one thing to be, never put 'em back on the ice, that's wrong.There's one thing to put 'em back on the ice because they have a pulse, that's wrong.Right?And, and they have, it's the other of saying, okay, is this person, is this person using the best technology in today's world?And, and I always ask them.I say, "It's my kid, but if it's your kid, are they going out on the ice?"And I, when I get this, the answer is, okay, I got my answer.Right?Um, uh, I, I want, I want every person to play to their fullest potential, but I don't want them to go out, because what happens if their brain's compromised?Their likelihood of injury, way higher.Yeah.Way, way higher.That's a good point.And, and, and let's- Very good pointbe very clear, all of us will agree.There's just no game, I don't care if it's a championship game.There's just no game worth your kid's- Yeahbrain getting injured.Yeah.Um, 'cause it, it's, even if you win the game, it's, their future is in jeopardy, all right?And again, I think the 4 of us, I know the 4 of us have all met someone who's had too many concussions.Um, and it's life affecting in a negative way.The stats you gave earlier about incarceration- Mm-hmmum, and college acceptance, I mean, that's insane.But it shows you how, how, how, like it's there.That stat is there.It's like it exists.Right.You know, you don't wanna ignore that kind of information.So I really love that you're, you're, you're shining light on that.Yeah.And, and just remind parents, yeah, look, look, I know it's hard.As a coach, I want my best players on the ice, but it's just not at the expense of their health.I, I had a college teammate, I'll never forget this, he was a goalie.Um, pre-med, right?And, um, biology major.Uh, in net, he got ran into the net and the back of his head hit the post.Oof.And he had a major concussion.He was in the hospital that night.And uh, I remember we were all thinking, oh, well, how long till he's back, right?This is around 2000, 2004, 5 period.Never played again.And it was a choice he made 'cause he wanted, he, he, happy ending, he became a doctor.All right?Mm-hmm.But I remember him telling me, he's a friend of mine, like, "I can't jeopardize my dream of being a doctor for this."Right.Um, and a younger me kind of didn't understand that as a hockey person, but I also didn't have the information that we have today, of that they probably told him, "You're done.""If this is what you wanna do, you're done playing."Yeah.Uh, and it, to me, that was courageous now looking back, of to stop doing something he loved for something better at later on.And, and I'll say this too before we get to our, to our last question.Um, you know, we talked in the pre-show a little bit, doctor, about kids' dreams, and we always say it, you don't have to support your kid's dream, but you have to support their right to have a dream.I want your kids to have big dreams, but you have to be realistic with them, that nothing is guaranteed.That you, it's okay to tell them the odds, but it's okay to pursue your dreams.But you also have to understand the risk-reward factor of things like concussions, right?And that, that if your head has been injured multiple times, you need to sit down as a family, you said it like traumatic family injury, and have a real discussion, because there is no game.I, I mean, re- I, I mean, I'm, I'm even, maybe going up to the pro level here.There, there's no game worth your brain, all right?It's just, it's just not.All right?And keeping in mind at the pro level, you're an adult and you have every advisor and everything to make a good decision there.We don't have that in youth hockey all the time.Sorry, I went on a soapbox again.That's why I do that sometimes, doc.No, but it was so necessary.Because I think a lot of families still wanna hold on to the, "Well- Yeahhe'll be okay.She'll be all right."Yeah."You gotta play that championship game."Yeah.How about this, Christie?And, yeah.Your kid's not weak if you don't play 'cause you're injured.That's exactly it.All right?That's not weakness.Exactly.I, I know we viewed it that way- Sure30 years ago.Yeah.All right?Mm-hmm.Um, and you know what?If I was raised by the, the, the World War II generation, I'd probably have a different, different, you know- SureGod bless every one of them.Yeah.Right.But, but it's, like we have the information, we have the technology.We have the information now.Go ahead, doctor.So, so let's do, let's jump into the positive.Okay, what can I do as a parent to minimize my kid's likelihood of injury?Okay.Number one is neck, neck strengthening exercises.Yeah.Oh.Huge.So this is go home.You go on YouTube, there's great neck, neck, neck, both flexors and extensors.Mm.These need to be built up.You don't need to be a tree trunk, virtually everybody that I test in my clinics are weaker.Mm.Right?So- Wowthat is a great at home exercise to do.That reduces head injuries.Huh.Right?Number 2, we have to fight inflammation.So, so how do we proactively or reactively give those people going out on the ice the right natural stuff so their brain's energy detoxification and inflammatory systems are in their best shape?So when they do get that head bump, it's a little head bump.It's not magnified because they're eating, they're eating junk food, crappy oil foods- Oh, great pointon their way to the thing.So there's a lot of stuff that the parent can do that I wanna get this brain and neck in the best shape that I can so then, not if, but when, it's a, it's a nothing, right?It's a nothing.So the things that I have all mine is this deep neck, work with the neck, flexors, extensors.Go on YouTube, there's, there's hundreds of them, chiropractors, physical therapists.But you wanna get specific, exercises because this is a, you know, a sport specific.Yeah.Number 2, again, that was going back to that Concussion 911.It is, it is a natural powder.It has 10 active ingredients, and the whole purpose is we have people saying, "I'm, I'm taking it before"So hypothetically, somebody gets a concussion.They take it 3 times a day for 10 to 14 days.Why?Because that's when the brain is healing.That is that critical window.But we have parents coming to us and saying, "Hey, I'm taking a much smaller dose, scoops.I'm doing one scoop," in their protein shake on the way to the thing.Why?This is all the natural stuff that gets their brain in the best anti-infl-naturally anti-inflammatory process.So when that bump, that head bump hits, there's far less residuals.And then, um, and then the last is, is going back to the parent side, follow your gut voice.Follow your gut voice.You know your child the absolute right?I can't make this call through video.You know your child.Are theyIs their sleep patterns different?Is their attitude different?Is their affect different, meaning how they're interacting with people?Is there, is there appetite difference?Are there changes?If there's changes, that's telling us that all this stuff's going sideways, and they need to recover.There'sI mean, that's, that's the, that's the best thing.I have 3, uh, 3 of my children's, uh, concussions came at a swimming pool.I mean, like, what?Yeah.I mean, it's a- Wowit's, it's, it's such a hardmean, concussions, and the, and the reason I think these conversations are so important is because it's not like a, it's not a broken bone.If my, you know, if my kid breaks- Righthis pinky, I can say, "Well, he can probably play.We'll tape it up- Yeahand we'll make it work," and although, you know, I think a- as, as I've gone through with players and seeing them now as adults, and I'm like, "Oh, I really wish, I really wish I wouldn't have had that player play through that type of injury-" Mm-hmmbecause it really affected them later on down the line.I think we have to be aware, and maybe you could just give us, you know, kind of a final, not, not so much of a warning, but just a discussion around, you know, the culture of hockey and sport, and just this, you know, this shake it off, you'll be okay, you're, nothing's broken mentality, which, you know, again, it is, it'sI, I don't wanna say it's not normal, it's just that's j- that's just the way it is.You getIt's, you know, hockey and sports are very competitive.They're, they're, uh, they're, they'reYou're, you're at a, a heightened, uh, you, you know, p- you know, area where you just say, "Listen, I can, I can barrel through a lot, whether it's mentally or physically or emotionally.Like, I can put things and compartmentalize them."Uh, but what can we do as a parent to say, "Okay, how can we, how can we understand this?We understand the culture, but we can make a difference here, and, and, and what can we do to make sure that I don't put my son or daughter back on the ice that's gonna make, that's gonna affect them down the road?"So, so it's several, it's several things, and basically we have to think.They have no frontal lobe, right?And, and you go back to the Civil War, Pickett's Charge.You want me to run up the grass a mile and a quarter, they're shooting cannons at me, and I'm in the grass.I think that's a good idea.No.You know?So I think that'sI, I'm up for it.What could go wrong?I love this clip.The par- the parent has to be the parent, and the parent has to have the big picture.And again, Lee and Mike and Christie have all said, "I want them to be and win the next gold medal for our country.I want that to happen."In the real world, I want them to play hard, I want them to, but I have to keep that perspective of, is this kid, am I compromising this kid's future-entire life from this one injury to win this game that's 17 years later from now means nothing, right?So do we want them to play hard?Yes.But it's, it's, here's what you're doing, you're doing, you're trying to get as many baselines as possible, and that could be simple, that could be simple balance tests.That's could be simple eye tracking tests.That, that, those don't cost any money.Could you do a QEG on their heads?Yeah, we do pre-QEGs on our, on our, uh, athletes.Can you do, uh, eye tracking exams?Yeah.Or the right, the right optometrist, the right, uh, neuro rehab person can get a baseline.But again, it's all how do you getThat's part of it, to get baseline so you can do a pre/post.But it's also how do you get that brain in the best nutritional state, and that's where you can proactively, either through the grocery store or through, like, Concussion 911, to be able to get that brain in the best nu- uh, s- state, so then when that injury occurs, then you don't have that, right?What's the, what's the best issue?The one that we prevented, right?What'sSo then we don't have that decision of, "Well, we think you're kind of okay.Go try."Um, does that answer your question?Yeah.No, no, no doubt.Yeah.I think it's, I think prevented a, you know, being, being, being theWe say this all the time even when, when kids go through tryouts and when kids go through other aspects of sport, right?Be your child's biggest advocate, number one.Absolutely.And if that's like, "I'm sitting him out.I'm gonna, I'm, I"Yes, I know everybody thinks I'm soft, and everybody thinks that I don't wanna win.I get all that, but my, my number one priority is my child, and I see him.I see the way he reacting today.I see the way his, his demeanor is.It's my obligation to make sure that I protect him."And I think that's allAnd, and as, as coaches, uh, we need to respect that and understand that.And, and again, I think it's just, it's so hard because it's not a, it's not a, it's not a gash that can be stitched.It's not a broken bone that can be healed.It's something none of us can see.Maybe a doctor can, right?A doctor's like, "This, this player's clearly concussed."And I might be like, "Ah, he's fine."But it's just, it's, it's really just, it's so hard, and I think that's why this conversation and educating yourself around this is so important.Because there's no definitive, "You have a concussion today, and, and now you're cured."And it's, it's- Rightreally, really difficult.So thank you, uh, for at least- Of courseputting us down the path of- Yeahresearch and, and, and, and understanding and recognizing a lot of the things we should be doing now.Yeah.Hey, listen, the goal today was to give some, A, actionable items, some information, and make sure that you're leaving this, uh, show with more information than when you started.I think we absolutely accomplished that, doctor.So thank you so much for your time and expertise on this.Um, it's an important topic.And again, we, we talk a lot about this, on this show tactics to win and tactics- Mm-hmmto, to succeed, and that the ROI of hockey is the life lessons.But we have to have these conversations, too, because the ROI is that your kid gets past hockey and does professional life- Rightor something else.So, Dr. Barrick- Yeahthank you so much for being here today.Oh, I'll be happy to be he-Uh, thank you for interviewing me, and hopefully we got some good innova- Yeahin- information to these parents so they can be their best, you know, their, their child can live to their fullest potential.Very enlightening.I think you gave a lot of parents a new way of thinking about concussions.Love it.Thank you again.Well, that's gonna do it for this edition of Our Kids Play Hockey Safely and Healthfully.That's not a word, but I just made it up.If you have any questions, feel free to email us at team@ourkidsplayhockey.com.Uh, make sure you check out My Concussion Doctor.Again, that's myconcussiondr.co- dot-com.Uh, it's also that on social media.Uh, check out Dr. Barrick's research and his team.I mean, again, parents, we, we all owe it to our kids to take a few minutes to just learn about this.Uh, and you've done that today, obviously, on this show.But that's gonna do it for this edition of Our Kids Play Hockey.Remember, we'll see you next time.Have fun.Skate hard.Stay safe.Learn something.Take care, everybody.