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Chris Pronger's 'Concussion Symptoms'

Yesterday, Chris Pronger was announced to be out for an indefinite amount of time with ‘concussion symptoms.’

This follows the heels of a time when he was out with a ‘virus’ that became a knee injury that required surgery.

While it may seem fishy to some, it actually isn’t. In fact, this progression of symptoms makes perfect sense given the events of the last couple of seasons with Pronger’s health.

By putting together a mini-timeline from the Stanley Cup run in 2010 to the present, it becomes possible to make sense of what is happening to the Flyers Captain.

June 2010: After the Flyers loss in the Cup Finals to Chicago, Pronger has knee surgery and misses the first two games of the 2010-11 season.

December 2010: Pronger breaks a foot after blocking a shot, he misses a month.

March 2011: Pronger breaks a wrist, maybe re-breaks it, misses the end of the regular season and only plays a few playoff games as the Flyers bow out in the second round.

November 2011: Pronger takes a stick to his right eye on the follow-through from a Mikhail Grabovski shot during a game against Toronto.

The last incident is probably the most important one. The stick to the eye could very well be the whole cause of his current non-knee related problems.

To show this, first the knee problems will be explained, then the concussion symptoms.

Chris Pronger is now 37 years old, and like many 37-year old athletes, he is beginning to show his age. Because of that, it’s not surprising that his knees are giving him trouble.

Pronger is also a big man, standing at 6'6" and weighing 220 pounds; he’s a physically imposing player.

However, there are consequences to being that large for athletes.

While Pronger may throw his body around to inflict punishment on his opponents, his knees take a lot of punishment moving the rest of his body around. It should come as no surprise that things would begin to go awry for them.

On top of that, the broken foot would change how Pronger skates in that the foot would alter the balance of weight on his legs. This shift in balance would lead to strains on different muscles in his legs which would put pressure on different parts of his knees causing the current problem. It is not a far jump in logic to assume all these problems are related.

Now the virus, which actually now seems to be a concussion. In all probability, this is connected to the stick that caught Pronger’s eye last month against the Maple Leafs.

Viruses, eye injuries, and concussions actually share a few common symptoms. All three could result in weakness, fatigue, headaches and nausea. The Flyers medical staff that treated Pronger’s eye injury most likely screened him for a concussion, but probably saw test results that indicated eye damage was the cause of his symptoms.

Flyers General Manager Paul Holmgren described the symptoms Pronger had to the media.

"I think over the last few days, he's had some difficulties," Holmgren told reporters. "Fairly persistent headache, just a sluggish feeling.".

These symptoms, while being symptoms of a concussion, are also symptoms of an eye injury.

Anyone who wears glasses or contacts will probably easily understand the explanation without a detailed lesson in ophthalmological and neurological anatomy. The pupil of the eye regulates the flow of light into the lens of the eye so the rods and cones can be stimulated into transmitting a signal through the optic nerve to the brain to be translated into an image that is seen.

If you are someone who wears glasses, imagine being forced off them for a long amount of time while needing to read something at a distance and having to strain. For anyone else, imagine the feeling you get while your eyes have to adjust from a dark room to a brightly lit environment. Healthy eyes can make the transition fairly easily, an injured one cannot.

When an eye injury like the one Pronger suffered against Toronto occurs, the flow of light into the eye is no longer properly regulated. This improper regulation of light can cause headaches and, in turn, the sluggish feeling.

The inability to focus on an object because of concussion or eye damage can cause the dizziness and nausea. Those symptoms could have easily been diagnosed as a virus, especially if others in the locker room had the flu.

There’s also a chance Pronger legitimately caught a cold or virus on top of all these symptoms, as all three explanations, eye-injury, virus, and concussion, share symptoms.

It is a logical assumption that Pronger passed all cognitive tests for a concussion, and due to the damage to the eye, the fMRI test was probably inconclusive since the stick damage to his eye/face would have clouded any obvious brain trauma for a concussion test.

On top of that, sometimes concussion symptoms can take days or weeks to build to an intolerable level.  It is possible that these headaches have plagued Pronger since the incident. It would fit, given the timeline of events.

With that, the Flyers have done the right thing by shutting Pronger down for the short term and sending him to see concussion specialists. When looking at the damage done to Marc Savard and Ian Laperriere as a result of returning too early from concussions, this course of action makes the most sense.

Especially since Pronger’s contract is a 35+ contract until 2017, which means, under the current NHL CBA, the Flyers are on the hook for his salary regardless of whether or not Pronger is actually playing hockey or not.

6 Comments

George Prax's picture

Really interesting insight and good to see some of the science behind it, but I hate how we have to resort to speculation and guessing when it comes to these injury situations. Pronger's season, possibly even his career would be in jeopardy and Holmgrem and the Flyers are playing games with the media. Obviously as you explained it could be more complicated than it seems, but in a day where concussions are such a serious problem and such a mysterious type of injury we should be sharing information, not trying to hide it for inexplainable reasons.

Matt Bernot's picture

I, honestly, want to give the Flyers the benefit of the doubt on this one. The overlap of possible symptoms could fool anyone and because of the eye damage, any kind of MRI or fMRI of the brain would already be clouded.

Plus; I'm completely convinced Pronger would not have been honest about how he felt after the stick to the face.

Really though, nothing can be completely proven...yet.

George Prax's picture

I definitely understand that the situation is relatively unique, but it doesn't seem like the Flyers were doing anyone any favors in terms of how they were handling it either. If there's a concussion test administered than I believe the information should be made public. And what kind of "concussion tests" are they administering anyway? Like the one Kris Letang got after he was hit by Pacioretty, in ten minutes between the hit and overtime, only to return at the end of the game? I'm not sure he's played a game since. There are some inconsistencies in how these things are handled and I bet it's adding to the problems.

Matt Bernot's picture

No one knows, the team didn't say.

There's a baseline test, IMPACT test, fMRI and several other cognitive tests that doctors use with concussions.

The baseline test takes about 8 minutes to perform and is usually done in the quiet room of the arena.

fMRI's can take 40-45 minutes and must be performed in a hospital, so we know that's only done when a player physically misses time to go to hospital to have them done.

As for the Impact test; that measures specific brain functions such as memory and reaction time, it's a longer version of the above baseline test

as for the other cognitive tests, they are just the smaller parts of the impact test.

George Prax's picture

Good info, thanks. Seems like they need to apply a more specific policy for these things.

Matt Bernot's picture

The thing is, concussions are so varied in that they present that a specific policy would do more harm than good. Unless the rule is "any suspected concussion shall be treated in hospital by an league appointed doctor and this player shall not play until cleared by said NHL appointed doctor"

The other thing is, sometimes symptoms can take a week to appear; how many guys (Crosby, Pronger, others) would play through the concussion before the symptoms appear.

That is the most dangerous option.