Post concussed athlete any advice?
 

I have been a jock my entire life. Everything I do and everything I am revolves around sports. I was a very successful lacrosse and football player in high school and went to a d3 school to play both. The first week of football I lowered my head against my better judgement and got knocked backwards. I suffered a pretty bad concussion a few days later I couldn't even remember what month it was.

2 weeks later i was symptom free for 3 days and returned to practice only to slightly bump my head again resulting in the return of my concussion symptoms. That was 7 months ago and ever since then I have been dealing with terrible headaches that get worse with TV, Computer usage, Video games, and drinking, pretty much anything fun you could do as a college student.

To my surprise i have been dealing with it all very well but my quality of life has really suffered. I maintain good grades although the time in which I allow myself to study directly relates to how my head is feeling that day. I am not as social as I used to be in high school.

as i said before I have just put my head down and dealt with all of this disappointment very well, but I just watched my lacrosse team scrimmage yesterday and later that night i pretty much snapped. it is killing me not being able to play and no one around me quite understands what I am going through. I have tried everything. From chiropractor and acupuncturist to massage and medication but the headaches still persist. I feel pretty good right now, I have headaches all day everyday but they are not that debilitating.

If you have any advice or can give me any hope of recovery I would sincerely appreciate it.

Dallasstar1213,

Welcome to NeuroTalk. Sorry to hear of your struggles.

What you are experiencing is quite normal for PCS. Have you had any analysis of your upper neck done? A NUCCA.org or other upper cervical chiropractor may be helpful. PCS head aches are often related to misalignment of the upper cervical vertebra and spasming of the associated muscles.

From you recent concussion history, you put your brain at great risk if you return to any level of play. You need to reduce your anxiety and other stimulations to help your brain heal.

It is impossible to suggest what level of recovery you may attain. Nor is it possible to suggest a time frame for recovery.

Most of us have found great value to nutritional supplementation to help our brains heal and tolerate stress.

You are not the first and won't be the last jock with your questions as a college athlete. I hope you are in college with the intent to train for a life-long career as a non-athlete. I suggest you focus on those career goals and give your brain time to heal. It may take a year or two to become symptoms free. No one knows. And, no one knows if you will be able to tolerate another concussion without putting your entire future in jeopardy.

Try to back away from sports for a while so you can focus on healing. Your brain needs rest and low stress. No caffeine or alcohol or artificial sweeteners. Meat protein is good as is B vitamins.

I am having a slow day so others can fill in the blanks.

My best to you.

I understand. When I go past the soccer pitch I used to play on every week I still gaze wistfully out the window at it. It was my favourite thing to do each week and made me forget about everything else. That this source of stress relief was taken from me at the time I was most stressed was very hard.

You won't want to hear this, but I will never be playing any contact sport ever again. Once you have the sort of susceptibility we have the concussions will only happen more easily and get worse, making your life hell for months or years each time and building up problems for later life. However much I love sport, having a brain that doesn't work properly is too terrifying not to do everything I can to avoid it happening again.

I think I've seen it best put by Scott Stevens, a professional Footballer at the top of his game in Australia's most popular sport:-

Read more: http://www.theage.com.au/afl/afl-new...#ixzz1muu2d9tE

If he can find a life outside sport, then so can we. Good luck!

Thank you for your responses
 

I have had a few different chiropractors examine my neck but never an upper one like you mentioned I will look into that. It is difficult watching all my friends get to experience college life to its fullest as I stay away from sports, drinking ect.

It may be surprising but I have had only one diagnosed concussion but obviously it was bad enough to keep me out of athletics for 7 months and counting. I have heard a few people tell me that I should probably stay away from contact sports forever but I am unwilling to give up hope in that regard, it is who I am.

I will most likely never play football again but lacrosse is a different story. My question is if and when I do fully heal from this concussion, if I do receive another concussion is it guaranteed that I will have PCS with the second concussion too? what are the chances that I heal in 2-3 weeks like a normal concussion?

I sincerely appreciate all of your responses every little bit helps.

Dallasstar,

There was research done long ago that showed that nobody every fully recovers from a concussion. You may recover full function with minimal symptoms but you brain will forever be injured. This injury will show up during periods of stress or minor trauma. A minor jostle of the head or an illness with a high fever or just prolonged stress from a job cab cause a return of severe PCS symptoms.

Any further concussions will likely cause more severe symptoms from an equal or lesser impact force.

I am amazed by how many people define themselves by the sports they play. What would you do if you irreparably injured a knee, or neck vertebra or Achilles tendon? All can easily be permanently injured allowing non-stressful activity but not full stress activities.

There are lots of ways to reinvent oneself.

Further head injury can result in severe personality changes that cause a tendency to irrational outbursts and fits of rage.

What parts of your future are you willing to trade away for a few seasons of lacrosse? How about future relationships? How about future sexual functions? Yes, PCS or the meds to treat the pervasive symptoms can cause sexual dysfunctions. How about the ability to perform in a high stress but high pay career?

There are trade-offs in life. We don't usually get second changes to make some of these trade-off decisions.

Hope you can find the strength to make some good decisions.

My best to you.

I asked that exact question in my first ever post on this forum. If I recall correctly, Mark sounded even more exhasperated with me than he does with you :winky:

Whilst you will certainly be able to find doctors who will tell you that you will make a 'full recovery' and be able to go back to sport, the evidence I have seen, my own experience of worse concussions from ever more minor sports impacts and the experiences of many others that I have read about on this forum lead me to believe that Mark is right. And I'd REALLY love to believe otherwise.

I know it's tough to hear and will make you more down than you already are but it might save you from a lot worse in the future.

so your saying 50 years from now if im in a stressful situation my pcs will come back? thats crap

what about if i make it to college and i have to do a presentation in front of a big class, ill be nervous, which leads to stress, which will lead to full blown pcs symtoms again??

this never ends.....

I'm more optimistic than this myself. I am already back working almost full time in an extremely stressful job, and whilst I'm still not quite doing my 'full duties' I would guess that my average day at work is more stressful than a lot of other people's.

I seem to be coping ok despite not having finished recovering from my PCS, and based on my current progress I expect to be able to handle any sort of stress or whatever that I could before my injury, once I finish recovering.

This is also taking into account that whilst I know I have caused some degree of permanent damage to my brain, I will also not be doing things I did before my injury which put stress on the brain like drinking alcohol, headering soccer balls, eating badly etc.

If I'm wrong then I will deal with it, the most important thing for me is that I've reached a state of health where I feel that I can enjoy life again, even though I'm not quite firing on full cylinders.

I'm sure some people make 'fuller' recoveries than others, and our current stage of scientific knowledge doesn't really allow us to predict this. Best to be hopeful until proven otherwise, I would say!

Would increased weight training be a passable substitute for you? Am considering this myself, feel like it has some of the 'macho' (for want of a better word) elements of contact sport and can be taken to extremes if you want to without too much risk of joggling your head around. There's less of a team ethos though there is a certain amount of bonding/advice etc down the gym. Just a thought.

Hey there!

I was a super jock (female version) throughout my entire life from sports ranging in martial arts to track events to volleyball. I got scholarships but I had to decline due to concussions. Sports were all I knew and like you my world revolved around them.

I did try and go back too early and that made my symptoms worse and last longer. So i would advise to wait and get a doctors approval before even thinking about doing anything physically demanding.

Over the years you do get used to everything and start to consider them your norm and you get comfortable and you stop comparing yourself to others or how you used to be and you think you are ok. That is where I made my biggest mistake. 5 yrs later I went back to volleyball. I was able to perform just as well as before but it was the day after that I was sluggish and my PCS was very apparent. Of course there was the denial that its solely because I'm out of shape and tired, but after a few weeks it was like a slap in the face. Things have changed and Im not the same person and don't have the same capabilities.

The chances of a re-occuring concussion is pretty good and you will be out for longer. Like Mark said further injury can do a lot more damage and you really do have to start thinking about what in life you are willing to give up in order to play sports again. One of the hardest things you will do is watch your team go on without you, but you need to realise sports are for fun and for many of us not our career.

Another thing you need to remember is it isnt just sports that will cause a concussion anymore. As I recently learned, a dogs knee to the head is just as dangerous. The more blows to your head the more fragile it gets and the less it takes to injure it.

My only advice is be careful and take your time. Don't give up entirely on what you love but find alternatives instead. Biking and swimming are faily low impact but still keep you in shape and can be done alone or with people if you are looking for more of a team feeling. Coaching, which is what i did, will keep you in the game and with the team, just not on the field.

You only live once so live your life to its fullest potential and have fun but be smart about it.

Good luck with everything!!

Significance of my specific injury
 

Although risking the quality of the rest of my life for a few seasons of lacrosse is not to smart of a decision, I do think the severity of my injury comes into play. The ONLY pcs symptom i have dealt with is headaches, there have been points in time where I could not leave my bed because of how bad they were, and then there are times when I can barely even tell if I have one or not.

My mental capacity is as good as it was before, I have taken tests which determine your memory and thinking skills and I have performed very well. The suffering i have been through have been less pain oriented, but more so just from the lack of proving myself as an athlete. If it was not for the missing sports, I would not even bother avoiding TV, videogames, alcohol. The physical pain I am dealing with is managable, the emotional let down is what is most debilitating.

I guess what I am trying to say is that the PCS i am dealing with from a pain standpoint is not that serious, but what it is preventing me from doing is as bad as it gets.

The severity of your injury has no bearing on your risk of debilitating injury from further play. The intensity of your head aches is the only criteria that counts plus your history of years of full contact sports. When one injury causes such severe head aches or any other intense symptoms, that injury was a critical mass injury that needs to be taken very seriously.

Throughout sports, there are many situations where one critical mass injury has ended a career or other pursuit.

The big question is: Was this last injury your critical mass injury or will the next one be the one that you never recover from enough to live a full life.

If the mental task tests you have done so well on are the ImPACT Test or others like it, they are meaningless at determining your mental condition. They only test at a very surface level.

It is like getting a cast off a broken leg. Sure you can walk on the leg but the leg is not as strong as it was prior. Fortunately, a broken bone will eventually achieve full strength as the bone continues to strengthen as it is subjected to stress. The brain never even gets close to its prior condition.

Update on my condition.
 

So I am not sure if I will get a reply to this post, the thread has been dead for a few months now, but I am going to go for it anyway. It has been 13 months since the first concussion. I have been through several different treatments and medicines, some successful, some not.

I was on Depakote and Topamax, both of which I thoroughly despised and stopped. One thing that has been very effective is nerve blocks. I was a little scared at first getting a needle put into my head, but it made me feel normal, something I havent felt in awhile, for about a month. I was very encouraged by this and beginning to think i was totally healed. I was wrong, shortly after a vacation the headaches came back and hit me hard. I am still not sure if it was due to the travel or the stress my girlfriend had been putting me through at the time. I got another nerve block to deal with these headaches and once again it made a world of difference.

My fall ball lacrosse was beginning at college and I was anxious to prove to my teammates what I could do. The first scrimmage I participated in I played terribly, but made it through unharmed. I intelligently skipped the next scrimmage just to limit the chance of injury but played in the next one. In this scrimmage I once again played pretty poorly (after not playing for a year and a half, dont judge me.) and decided to take as many runs as possible to get back into it. I took a hit to the body and fell to the ground but felt fine. After the scrimmage though concussion symptoms set in, mainly a mental fog but I knew what was going on I have been through it before.

I have yet to meet with doctors about it yet but my trainer knows and I know that I probably had another concussion. I am suffering through HEAVY headaches. My future as an athlete is in serious doubt as well, I am about to lose something that I have built my entire life around. I cannot even internalize the emotional pain I am feeling about potentially losing sports because of the physical pain I am currently enduring.

It took me over a year to heal from the last concussion and I was not even 100%. I know that I now have a long and painful road to recovery from this latest concussion. I am at probably the lowest point of my young life in the sense that I am probably losing what I love most and it is going to be hard to adapt to life without it. I am very mentally tough though and I will find a way through it.

what I guess I am looking for through this post is some sort of hope or inspiration or anything. Or maybe I just needed to do this to vent, however any reply is greatly appreciated.

Dallas,

Welcome back. So, are you asking if there is a chance that you can return to sports? The simpler answer is Yes, you can. The complete answer is, You will continue this roller coaster with every little jar to your head. Eventually, you may end up like me. I can't even shake my head 'No' without concussion symptoms.

There is plenty of life without sports. While you are still young, you should look for other things to do. Maybe you need to find a spinal cord injury support group. You will find some very inspiring people there. There are plenty of people who have lost vast amounts of their previous life. The best find ways to go on.

It sounds like you are a competitor. Take that drive and move forward. If head aches are your worst problem, you are very fortunate. Losing memory and cognitive skills are far worse. My head aches are minor distractions. My inability to remember simple things is daily misery. But, I go on. I have a new grand daughter being born as we speak.

Seeing my kids grow up and have kids is worth far more than losing my opportunity to play soccer in high school. I switched to distance running and was determined to train for the 80 Moscow Olympics until I wrecked my knee cartilage and shoulder from the constant training.

Each time I have had to let go of something, I found something new to replace it. It can be done.

There are some good books about finding the job you will love. They discuss how to find a new passion in life. Read all those books you can find until you find your new passion. They say, Find a job you love and you will never work a day in your life. Then, go for a full life with this knowledge.

My best to you.

btw, I think Jim Cook of Samuel Adams Beer talks about finding a job you love.

Scared
 

Ive been reading things on this site about concussions. And im extremely anxious to get back in to my favorite hobby-weight lifting. Im in high school right now, got a concussion 2 months ago playing football. I feel completely fine. Im talking about heading back to the weightroom after my neurology appointment. I already have a couple friends who will want to come with me after school to the weightroom. But the things im reading here have scared me. Im going to go quite slow at getting back into full blown lifting. Its killing me just sitting around and watching other people workout, and I just want to go back to doing it as hard as I can. But im going to stay slow. Take it easy. Watch myself, and have others watch me. And take time with my recovery.

jmt

Welcome to NeuroTalk. I suggest you take it very slow. Focus on reps rather than max weights. Max lifting causes much more muscle breakdown. The toxins from muscle breakdown will be very bad for your recovering brain. Once you can do a good rep circuit over and over without ANY symptoms, you can start adding max lifts slowly.

Avoid body building supplements until you have returned to a symptom free with max exertion condition. Go easy on energy drinks too, especially if they have caffeine or stimulants.

You will be surprised at how easy it is to get back to your worst condition. Just one day of overdoing it and you can be back to square one.

Think of cardio conditioning before anything else.

Lifting and my current status
 

So I also was in your spot and just wanted to get back to normalcy and start exorcising again. Running and lifting actually made my symptoms feel better for whatever reason (bloodflow, optimism, who knows). My advice to you is avoid lifts that require heavy breathing such as squatting and even benching. You can eventually work up to that when you are feeling comfortable, I was able to with no problems.

Back to my situation, I recently visited with a neurologist who told me no sports for now but that the eventual decision to stop completely will be on me. I HATE that, I personally have to be responsible to say I quit. No one quite understands what I have gone through and it will appear to them as if I just gave up, when in reality I have been fighting through severe headaches for 13 months and counting just to give myself a chance to come back. I honestly wish the doctor would just tell me I cannot play.

On a sidenote, she prescribed me with depakote. It has me scared. I tried to take it awhile ago and I did not like it. I feel as if it messes with my emotions. I am a very reserved and tough person mentally. But with my short term expieriance with depakote I feel way more emotional then I usually do and even anxious. Does anybody know about this drug that can tell me more?

Even though Its a bad situation with taking heavy drugs, Id rather take them then feel how I have been feeling. Thank you for any responses

thanks for response
 

Im gonna take it very slow. ill be accompanied by my girlfriend who is getting back from a knee surgery. guess ill just do what she can. stay with that till i feel as good as new and symptoms stop. still get headaches all the time just from sitting around. but theyre starting to go away. and ive heard from friends and family that emotionally im ok again. and my memory is A LOT better than it was. so yeah....im not even going to put weight on the bar until i feel no more symptoms. Thanks for the advice. saved me from what i thought i was goin to do.

Depakote
 

I take it for mood swings. It helps with my anger issues but leaves me open to feeling emphatic sometimes. What I mean is if I am watching a sad movie I feel sad. If it is exciting... If it is happy... I grew up being encouraged to hide my feelings so this can at times make me feel vunerable.

On a different note if I miss a dose it really whacks me out. I get very angry, frighteningly so. Be careful about dosing as this drug is hard on the liver. If you start suffering from pain in the abdomen go to your Dr or ER.

Avoiding re-injury
 

As a general comment on repeat head injuries, it seems to me very hard (impossible?) to foretell how much harm can come from repeating TBIs/PCS.

The first one or main one in your life (if you're here reading this) was probably much worse then you could have expected.

Now you're partly wiser, (if you're reading these postings and you'll have had loads of other experiences to put you in the picture to some extent), but I reckon these things are certainly true --

-- Contact sports (and some others) have a high risk of TBI/PCS
-- If you've already had a significant TBI/PCS, your brain is more sensitive to and more easily more harmed by physical trauma
-- Repeat injuries are often much worse, and/or happen more easily (=with smaller impacts).

It seems EXTREMELY hard at first to sacrifice sports or activities you love and are accustomed to, in order to keep safe, to avoid a mere chance in the future, but the hardships of re-injury are awful.

I had my injury from a head-first fall off a rearing horse (unhelmeted) onto farmyard concrete. A complete life-changer, to put it ridiculously mildly. That was 21 years ago. Slowly, slowly, I've got a new positive life focus, but the relevant things to pass on are --

-- I had just one probably small impact seven years ago, which immediately sent me into coma, (and with pre-traumatic amnesia, which just means your mind can't access exactly what happened leading up to the impact) ... that was VERY cautionary and set me back

-- over the years, I've known several TBI people with re-impacts, two in particular are always in my mind, because I know the specifics of their re-injuries more closely -- each one, from just a "modest" re-impact, lost very much quality of life, permanently

-- lastly, being "in the know", knowing that your brain is vulnerable, has got to be an inhibition when you're playing a contact sport with an injury risk. It will hold you back a bit, unless you choose denial or a sense of oblivion.

Keeping out of contact sports after having had a TBI is necessary, and gets a whole easier when you've taken a new direction. I hope that anybody reading this for whom it's relevant, can really find their own mechanisms to be safe. Re-injury just gets worse and worse. Maybe it's a bit like the Richter Scale for earthquakes, going up just one point is ten times worse -- but the one extra point with re-injuries comes even with less impact force.

Mind your head -- it holds your mind, and all that.
Have lots of luck, but arguably nearly all luck is pre-arranged (particularly "bad luck"?) ... ultimately it's up to ourselves.

Paul B,

Welcome to NeuroTalk. It sounds like you have some good life experiences to talk about, not that a head injury is good but you are making good use of your experiences.

Please feel free to introduce yourself. There are lots of good people here.

My worst injury was in 1965 and my life changing very minor injury was in 2001 with a myriad of injuries between even though I did not participate in risky activities. Sounds like we have a lot in common.

My best to you.

... In self-intro then
 

Thanks for your welcome, Mark.
I feel I almost know you, for my part, because of the frequency of your excellent postings, which are a mainstay of this web-board, as regular readers (and occasional visitors, like me) will know well.

In self-intro, I've mentioned already my original TBI, from a horse onto farmyard concrete in 1991. I had most of a week's coma (and a large subdural haematoma, but was not operated-on). I'm living in Ireland now -- I sometimes liked to say that my blood is Irish, my voice is English and my brain is from an interplanetary visitor. I'm not fixed in Ireland and feel it's likely I will move again soon.

After my TBI, I had zero access to any rehab (in England at that time) and, without any self-awareness, I tried to go back to work immediately, which was a successful small business. My colleagues had difficulties with me, although I would still believe that their real and imagined difficulties were partly from their own lives, not only mine (but that is not at all to say all was well in my mind).

From that time I wandered. I lived in the US for a while, in CA. I had money, from which I was parted by my own folly sometimes, and by other people's outright deceptions at other times. I then wandered up to Canada and lived in Vancouver for some more years. At that time, Vancouver was terrific -- so beautiful and friendly too. I was in a fairly poorly state, I'd say, altho well enough disguised. In Vancouver I took part in a very good and (for me) re-constructive brain injury support group, and more time passed, with a large amount of stop-go-fail-restart fairly haphazard self-rehab.

After ten years I went back to England in a better state (altho dirt-poor, of course). I went to England because I thought I would seek out some qualification (in the country where I'd had my previous schooling) to do more and be more organised about helping other people with brain injury, who were stuck (being without effective rehab). I had spent some time in Vancouver progressed to where I found I could be helpfully effective in some people's diverse situations (varying widely, from being paralysed, mute and ignored, to being "invisibly" disabled people with constant day-to-day problems but not publicly known as TBI-ers).

So, back in England, I found it VERY straining at the start, (a very different densely populated environment from even big-city Vancouver), but I found I could get on academically, although I truly still cannot really understand how. Boastful-sounding, I managed to do two Masters and then a rehab PhD in London. Strangely, each component task was the immediate hillock just in front. I still alternate between absurd courage-bluster and being overwhelmed by really tiny non-challenges. Getting those degrees should give me confidence, but I know for certain, hour-by-hour, that there's less than a wafer between seeming success and complete nothingness.

However, both much more importantly and much more interestingly, it's a lasting puzzle to find how one can slot in somewhere to produce enough benefit for people (and families) who've had brain injuries. You yourself do very well, I believe, as a main NeuroTalker here. For the last few years I've volunteered in the Irish brain injury association, but I sorrowfully find it ineffectual, or "under-effectual" at least.

It's valuable to have the insider acumen for living as best we can with brain injuries, I hope and believe (and have found too, to sound more positive), because medical and therapeutic outsiders have poor insights still, unfortunately, scandalously and wastefully.

Thank you for what you do, for me and for many others here. It's a pleasure to read you -- and a large benefit too.
Be best.
Paul

Hi there,

I've been away from the forum for awhile but came back and read your story; and I must say I feel like I can really relate. I was a varsity hockey player and have been out with my 1st concussion for over 1.5 yrs now. My only symptoms are headaches and fatigue; and some days it just seems surreal to me that one single concussion can do so much damage. I absolutely loved hockey and working out. It's been driving me crazy that I can't do either. Walking is the best I've got.

Earlier you were struggling with the idea of having to make the call to avoid contact sports. I can tell you my approach. For the longest time my mindset was "I'm not going to call it quits after only 1 concussion; 2 then I will consider hanging up the skates, but not only 1". But then the 1 year mark rolled around, with headaches still every day, and I started having doubts. I have still left it that I will not make the decision until the decision needs to be made (ie I am 100% symptom free and cleared for activity), at this point I realize playing competitively as an elite athlete again is out of the cards; right now I just haven't completely ruled out playing pick-up hockey for fun somewhere down the road.

I'm still "part of" the varsity team- will go and watch practices/games and offer my support. It's tough; but I after much thought I've decided the benefits of being part of the team and the game I love slightly outweigh the pain caused from being on the sidelines and missing out on what I love to do.

comeback,

You need to remember that this was only your first 'diagnosed' concussion. If you have played hockey long and hard enough to make it to an elite level, your brain has taken quite a beating. The many body checks and dings have accumulated to quite a mass of sub-concussive impacts. There are some athletes who have had to stop playing but have never had a diagnosed concussion.

I bet you were into serious body checking before your reached 14. The brain is much more sensitive to impact at the younger ages because the myelin sheath is not fully developed to protect the axons and dendrites.

I spent a year on the sidelines as the soccer team manager keeping the stats. I switched to track and had two fabulous seasons. I was headed for my senior season with expectations to be the likely state champion in the 2 mile run. Then, I tore my medial meniscus during the first track meet. I held a stop watch as I watch the league championship. The lead runner was half a lap from the finish when my coach lean over and said, "Mark, you would have been finished by now." The next week, I watched the state champion finish 20 seconds slower than my best time from the preseason.

Yes, it is painful watching from the sidelines. I still have useful knees because I did not run on an injured knee. The doctor wanted to remove the meniscus so I could recover sooner. That was 1973. I took the conservative approach and rested the knee for the rest of the season. I finally needed that same meniscus trimmed in 2004.

Being able to live for another day or a lifetime is well worth the pain one experiences early on. It may take a decade to fully realize that but you have made a great start.

My best to you.

Hi Mark,

I was wondering if you could explain a little more about "sub-concussive impacts"?? I am not familiar with that; is it a cumulative effect that never completely heals? Is there a way this has been measured at all or is it just a theory?? Thanks!

Sub-concussive impacts (SCI's) have been studied extensively. There are athletes who have never suffered a concussion who have played sports where sub-concussive impacts are common who have developed severe symptoms of PSC, some in their early 20's.

A sub-concussive impact is any impact to the head that does not result in an immediate or even delayed feeling of being concussed.

Football linemen and hockey players are the usual sufferers of sub-concussive impacts. The average football player who plays positions where SCI are common receive between 800 and 1000 per season. They are cumulative.

The article I posted shows what can happen from SCI's

It is often the most damaging head injury because there is not time taken off from play to recover. I can tell you more but the simple truth is any hit to the head cause a risk of damage.

Sorry, if I'm missing it, but where is the SCI article you posted?

Thanks