[greenfrog]

Sidney Crosby is returning to NHL play on Monday (10.5 months after his concussions in early January):

http://www.theglobeandmail.com/sport...rticle2242738/

I'm honestly up in the air about this one. I respect his decision, and am confident that he's now symptom-free playing at 100%, but also feel that it comes with significant risk. In any case, I wish him luck and hope that he never, ever sustains another concussion.

[Mark in Idaho]

I am waiting to see how good the recommendations and treatments of a Neuro-Psychologist and a Chiropractor with a Ph.D. in Neuro-Physiology hold up. The press keeps referring to them as Crosby's doctors or team of doctors. There does not appear to be an MD in the mix.

I agree with what greenfrog says, <but also feel that it comes with significant risk. In any case, I wish him luck and hope that he never, ever sustains another concussion.>

I do not agree < that he's now symptom-free playing at 100%>

The current tests used, such as the iMPACT test, fall far short of determining the ability of his brain to sustain another impact of any level.

I am still eager to see some more thorough research into the ability of the Post Concussed brain to tolerate stresses of any kind.

History shows that athletes who return to play after such a concussion struggle to play at the same intense levels as prior to their injury.

It will be interesting to see how many NHL players get ejected or suspended with the tighter rules regarding hits to the head.

[greenfrog]

Mark, what I meant was that I understand Crosby has been exerting himself 100% in practice without subjectively experiencing any symptoms. The reports from his practice sessions are reportedly very positive.

Further, I believe that Collins and Carrick are being ultra-cautious with Crosby (their reputations are on the line, for one thing). I do not believe they would be clearing him to play had he reported experiencing *any* symptoms in recent weeks. I imagine that Crosby has been consulting medical doctors as well, though probably not the Penguins doctors that idiotically cleared him to play almost immediately after his first concussion in January.

However, I am not saying that I believe Crosby's brain is fully recovered, that he has the same resilience as before, or that he will be able to play at 100% of his former ability. All of this remains to be seen. The evidence certainly suggests that he is now at greater risk of injury from a further concussion (and possibly sub-concussive impacts).

Patrice Bergeron comes to mind as one hockey player who was out for a lengthy period with a concussion (almost a year, I believe) and is back in action playing at a high level. Other athletes have tried to come back from lengthy concussions but have encountered difficulties, and some have had to retire (eg, Corey Koskie, Mike Matheny, Paul Kariya).

[rick92]

i definitely respect his decision to continue playing. you only live once so might as well try to enjoy it. also with that being said, he is taking a big risk, but he is obviously aware of the risk because im sure he has suffered a whole lot this past year and knows what its like to have pcs. if he can stay symptom free and not have any more concussions then its a good decision for him, thats probably hard to do in the NHL though

just my 2 cents.

[Mark in Idaho]

The problem Crosby faces is not getting another concussion. It is sustaining sub-concussive impacts. He will suffer many sub-concussive impacts in each game once he returns to the ice. His ability to skate at 100% intensity or effort has little to do with his ability to return to the game.

As Collins has stated directly, his Buffalo protocol only prepare the athlete to return to the game "physical symptom free." The iMPACT test only tests at a surface level. Even a full Neuro-Psych Assessment battery falls short of giving adequate information.

I doubt Crosby has any medical doctors overseeing his condition "who have a reasonable understanding of how to test him for return to play condition." There are no standard tests for use by any professional that fully test for recovery condition.

I suggest that Crosby has been released to return to play based on a few criteria.
1. He is no longer experiencing head aches, even during or after physical exertion.
2. He has regained his vestibular functions to an acceptable level.
3. He has regained his reaction times to an acceptable level.
4. He has regained an acceptable level of his baseline cognitive skills.

What he has likely not been tested for are:
1. His reaction times when he is at the end of his on-ice shift.
2. His judgment skills when he is at the end of his on-ice shift.
3. His cognitive skills when he is at the end of his on-ice shift.
4. The above when he is oxygen deprived due the cumulative effect of exertion from a period of play.
5. The above (1-3) when his blood/body is flush with the waste from muscle efforts and the related pounding of play.

So, I would hope that he can keep track of how he feels and how he is thinking and is willing to pull himself from the game if he notices any deterioration of 1-3 skills above. Unfortunately, a deterioration of judgment skills often prevents making sound judgments to end play.

The days and weeks after returning to aggressive play will tell.

[greenfrog]

Crosby scored two goals and two assists in his return tonight. He looked very, very happy. Let's keep our fingers crossed for Sid the Kid.

http://www.nytimes.com/2011/11/22/sp...tml?ref=sports

[greenfrog]

Here's the game recap:

http://sports.espn.go.com/nhl/recap?gameId=400047520