TJ OSHIE Injury – Dr. Wilson Reacts

TJ Oshie is injured in tonight’s game and had to be helped off of the ice.

Welcome back everyone, my name is Dr. Stefan Wilson and this channel is designed to examine the mechanism of sports injuries.

We’ll go to the replay here. TJ Oshie is number 77 who is skating across the blueline and is then met by the Oilers defenseman. Oshie is stopped almost immediately and then falls to the ice. When looking at this play for the first time, it is not dramatic or even exceptionally gruesome. The impact between Oshie and the defenseman is not particularly severe but it’s the after effect that is very noticeable. The thing is when we think about concussions, typically we have this vision built up in our minds about how it needs to be this horrific injury or play and that it is super obvious that the player, or person is practically unconscious. But when we think about the cause of a concussion, then it becomes very consistent.

The mechanism is that Oshie was skating quickly into the offensive zone and then came an abrupt stop when he made impact with the defenseman. That abrupt stop is when his skull stops moving, but inside of his head, his brain is still physically moving at that same speed and what makes it stop moving is when it slams into the inside of his head. That abrupt stoppage of movement with his brain hitting the inside of his head is what begins the process of a concussion. And once you have sustained one concussion, your brain is more sensitive or susceptible to having it occur again in the future. So you don’t have to have a massive impact in order to induce a concussion, you just have to have the sudden movement of your head stopping very quickly in order to cause that force to inevitably be transferred through the mass of your brain. When we continue through the replay here we see his team mate motion towards the bench for the athletic trainer to come out and help Oshie.

Oshie is the able to roll over onto his back but you can see how he is not comfortable. If you look at how his chest is moving here you can see how his breathing is also quite rapid. With the trainer over top of him on the ice, he is talking to Oshie and he will be trying to assess Oshie and his level of consciousness and awareness. He will do this with verbal questions while listening to his responses and visually observing Oshie’s movements. When Oshie turns to get up off of the ice this is a positive sign because the trainer did not motion for additional medical help on the ice, he did not attempt to immobilize Oshie’s neck so this is certainly positive. This means Oshie was capable of participating in the trainers assessment in answering questions and following his commands. This is also a very positive sign indicating his alertness is at a level in which his answers had appropriate enough information for the trainer to make the decision to help him off of the ice. When Oshie does stand up here, we can see the unsteadiness of his legs.

Granted he is on skates on ice, but still you can see his balance is off and his ataxic stance of leaning forward with his feet fairly wide apart in order to gain more control. He is then helped off of the ice with a team mate holding his right arm and the team trainer holding his left arm for support. Oshie then went straight into the dressing room. Shortly afterwards it was announced that Oshie would not return to the game and will also not be travelling with the team on their next road trip.

The positives here is that his head impact was not severe as there was no end range of motion for his neck or any pressure to the top of his head that would cause an axial load. The likeliness of a significant neck injury for him is minimal but he certainly will need some valuable recovery time.
As always, be well.