The ISU's concussion protocol or lack thereof

wickedwitch

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For those don't know what this is in reference to, Liu/O'Shea had a horrific fall during their program [ADMIN EDIT: at Warsaw Cup], one of the very worst I've seen. Both skaters hit their heads and appeared badly injured. Chelsea was particularly badly injured. After:
  • music continued playing for a bit, indicating the referee did not immediately stop the program
  • their coach came out
  • they are helped -- not carried on a backboard -- off the ice
It's pairs skating. Bad falls will happen. (Although, maybe there should also be a rule that competitions can not go past a certain time, because this was very late at night.) But how was the response not better?!? I have zero medical training, and even I know that with a bad head injury, you support the person with a backboard. Why were medical staff at the rink either not there, not ready, or incompetent?

This is not the first time this has happened. The ISU needs to do better.

Genuine question: how are injuries like this still being handled so poorly?
 
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Karen-W

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This isn't the first time this season this has been discussed. I know it was brought up after Keegan Messing whacked his chin on the ice falling on a jump during Skate Canada - he was bleeding when he got off the ice and looked disoriented. IIRC, it was also discussed during Kevin Aymoz's horrific SP at SkAm. There have been multiple instances where those following events live have noticed skaters looking disoriented after a bad fall where their head hits the ice.

I just don't understand why the ISU doesn't mandate that a program MUST stop when a skater's head hits the ice and concussion protocol followed. No result is worth the lifelong damage that could be caused by an undiagnosed concussion.
 

Immortelle

Rejected by Krasnopolski
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I’ve thought this for a while, especially since Keegan a couple of weeks ago and one of Krylova’s ice dance teams at a Russian Cup event last year.
Maybe some of the past skaters who are medical professionals need to really bring it to the ISU’s notice that tacitly encouraging skaters to continue after a head knock with no medical assessment and with seemingly no medical staff present is just not on anymore…
 

Kateri

void beast
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It's been terrible for a long time, with many incidents. And in some cases, while I still think it's negligent, I get that things are moving fast, it was hard to see what happened, the skater is zooming off again, and they don't get stopped.

In this case, where a skater was clearly unconscious on the ice for several seconds after falling from height onto her head, and they, even after everything has been stopped, and they have time to consider, STAND HER UP AND WALK HER OFF?

Absolute medical negligence.
 

Panja

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83
I wish I knew. I saw it happen (on the live stream) and it was horrifying. No other word that fits. I don't think Danny has a concussion (but definitely some bad bruises, he needed to be helped off the ice too) but Chelsea? I think she was unconscious for a while.

The competition took rather long (with 20 couples, starting at 9 PM is a recipe for disaster) and ended really late. It does seem it was handled poorly...and there's been alas so many more of this kind of accident (remember Ashley and Timothy at Golden spin?). I would expect there to be some kind of proper protocol by now. The only good thing was that the Camera turned away so we didn't have to continue seeing them lying there and what the helpers were doing. But I'm still worried sick about them.
 

Willin

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TBH I just don't think concussions are taken seriously enough worldwide. While the US has higher awareness of concussions due to Football and CTE, we still have parents and skaters who put the skater right back to training after a concussion and coaches who allow that - despite mandatory training for coaches about how to handle concussions. I think it will take a skater dying or being paralyzed from a neck injury or something similar for the ISU to do anything. No one takes them seriously enough. I know Ashley Wagner has spoken out about it, but there are still plenty of skaters who don't care about it as we've seen with Keegan and Kevin this year.

I think the most important thing would be to do something like the NFL/NBA/NCAA's concussion protocol: any hit to the head means an athlete is immediately taken out of the event, escorted off by medical personnel, evaluated by a qualified medical team, and not allowed to practice or compete for minimum 24-48 hours (how long it can take symptoms to show). If a concussion is found they are not allowed to practice or compete until cleared by a qualified doctor. So, in skating:
1. Stop music and ref blows the whistle with any head hit
2. The athlete must be escorted off the ice to prevent further falls
3. The athlete is disqualified from the competition and gala (forcing them to not train for at least 24 hours)
4. The skater must be evaluated by a qualified doctor - and it cannot be their federation's person (as it was when Yuzu got cleared to skate at CoC after a likely concussion)
5. The skater must have a letter of clearance from a doctor before competing at their next ISU event - and feds should ban them from skating at domestic events without a clearance letter
 

rfisher

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I wish I knew. I saw it happen (on the live stream) and it was horrifying. No other word that fits. I don't think Danny has a concussion (but definitely some bad bruises, he needed to be helped off the ice too) but Chelsea? I think she was unconscious for a while.

The competition took rather long (with 20 couples, starting at 9 PM is a recipe for disaster) and ended really late. It does seem it was handled poorly...and there's been alas so many more of this kind of accident (remember Ashley and Timothy at Golden spin?). I would expect there to be some kind of proper protocol by now. The only good thing was that the Camera turned away so we didn't have to continue seeing them lying there and what the helpers were doing. But I'm still worried sick about them.
The fact Danny was able to move on his own, doesn't mean he won't fit concussion criteria. It really doesn't take that hard of a hit. He needs a neurological assessment. ASAP.

There should be a protocol in place that all ISU sanctioned events have to follow. Even high school football teams have this. To not have it in place in a sport that risks head injuries is ridiculous. Treating competitive figure skating as primarily a pretty, musical entertainment is a core issue IMO. It's a high level sport. Any other sport where there is an elevated risk of head injuries has concussion protocols in place.
 

Coco

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I'm so sorry to hear about their accident, that's horrible. It is long past time for a concussion protocol and also an injured skater protocol. At worlds last year MBM had to get herself off the ice when she tore her achilles.
 

overedge

Mayor of Carrot City
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If gymnastics has a protocol for when an athlete falls off an apparatus - not too different from a pairs skater being dropped by their partner, or a skater falling on a jump landing - then skating should have one too.

IIRC several national skating federations have concussion protocols for their clubs and sanctioned events. Also a lot of ice rinks have their own concussion protocols that clubs or organizations have to follow if they want to use the rink. It's absurd that there isn't a protocol at the international level. I would also question the judgement of medical staff who would let a skater walk off the ice after an accident that serious.
 
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Orm Irian

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The fact Danny was able to move on his own, doesn't mean he won't fit concussion criteria. It really doesn't take that hard of a hit. He needs a neurological assessment. ASAP.
You're exactly right , it does not take much at all. Remember when Gabriella Papadakis was out of competition for six months and had to retrain her brain to work normally before she could even start to skate again? She tripped on a choctaw and skated away from it thinking everything was fine. But that was all it took.

I am so angry right now. This stuff is basic. Anyone with a standard first aid certificate knows better than to move a person with potential neck and spinal injuries unless they are in danger of further serious injury where they are, and then to do it by picking up their heels and dragging them very slowly and carefully to keep tension on the spine. Why in the blue burning blazes did anyone at that rink think it was okay to get Liu on her feet and semi-drag her off the ice? It's utterly unconscionable. She should have been in a neck brace and stretchered off the ice. Period.

So. These are the changes I want to see the ISU implement before the start of next season.

1. A blood rule. If there's blood on the ice, the skater is off the ice with an automatic medical withdrawal and goes to hospital for care and stitches if necessary. The ice is cleaned and resurfaced before the next skater/s go out. Actually, let's go all out and make this a visible injury rule. No more skaters shoving dislocated shoulders back into place halfway through their programs!
2. A head-strike rule. If a skater's head hits the ice, the referee must blow their whistle to stop the program immediately and the skater is given an automatic medical withdrawal and sent to hospital for a full concussion check-up.
3. A loss of mobility/consciousness rule. If a skater becomes unable to move or loses consciousness on the ice, the referee must blow their whistle to stop the program immediately and the skater must be placed in a neck brace and stretchered off the ice, and taken to hospital for a full check-up.
4. The establishment of a universal call-for-aid signal such as striking the ice three times with the palm of the hand. If a skater on the ice gives this signal the referee must blow their whistle to stop the program immediately and medical assistance must be rendered to the skater on the ice. The skater is given an automatic medical withdrawal.

But the ISU loves its power and control and is too invested in shoving its 'perfection' image of the sport forward at all costs to do anything like that. When are they going to accept that despite all the pretty dresses figure skating is an extreme sport and needs the safety protocols of an extreme sport?
 

Karen-W

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overedge

Mayor of Carrot City
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I see the rule says "should", not "must", which gives the event organizers some leeway. But I suspect the rule was worded that way so that if competitions ran late because of Zamboni problems, power outages, etc., then the organizers wouldn't be forced to stop in the middle of an event and start again the next morning. I don't think it was intended to let organizers schedule events for when it was convenient, or for whatever reason this event started at noon.
 

Vagabond

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A head-strike rule. If a skater's head hits the ice, the referee must blow their whistle to stop the program immediately and the skater is given an automatic medical withdrawal and sent to hospital for a full concussion check-up.
Eys.

Apparently, Aymoz, Liu, and O'Shea all hit their head on the ice today. They should not have been allowed (or forced) to continue. I think the same rule should apply to striking one's head on the boards. Federations and coaching associations should have similar rules for head strikes during training sessions.

This site says:
Studies now show that complete rest lasting longer than 2 days can actually lead to worse outcomes. Moderate physical activity within the first week of a concussion, even on the first or second day, actually speeds recovery time and lessens the chances of developing post-concussion syndrome. Mild, sensible exercise will produce those chemicals that your brain needs to begin the healing process, and staying connected to people will help your mental health and attitude.
I am not a medical professional, but, to me "moderate physical" activities in this context should not include ice skating.
 

Braulio

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Rukia

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At Nebelhorn Trophy, the OLYMPIC qualifier they didn't manage accordingly the even worst looking accident from the polish couple

That was a bad fall, and someone should have stepped in, but she was conscious the whole time and popped back up. Chelsea pretty clearly was knocked unconscious. She wasn't moving at all and didn't even look like she was responding to Danny (it looked like he was trying to talk to her). She should never have walked off the ice after that.
 

Karen-W

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At Nebelhorn Trophy, the OLYMPIC qualifier they didn't manage accordingly the even worst looking accident from the polish couple

Thank you! Is there any way we can start compiling a list of the falls this season that resulted in a skater's head hitting the ice? I feel like one way to get the point across is to create a video showing each and every incident where the concussion protocol was completely ignored by the ISU and event organizers at major senior and junior events (ie - any event that is listed on the ISU Events page, plus National Championships and National qualifying competitions such as the USFS NQS, SC Sectionals & Challenge, Russian Cup, Japanese Regionals/Sectionals). My belief is there are a lot more of these incidents than anyone realizes.
 

Vash01

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Any type of blow to the head needs to be taken very, very seriously.
I will never forget what happened to actress Natasha Richardson after a Skiing accident. She had a head injury but she didn't go to the hospital until later (1-2 days?). She lost her life. :(

The NFL and NBA are taking concussions and other injuries seriously. It is time the ISU did too.
 

overedge

Mayor of Carrot City
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I will never forget what happened to actress Natasha Richardson after a Skiing accident. She had a head injury but she didn't go to the hospital until later (1-2 days?). She lost her life. :(

IIRC she refused help on the ski hill, but then said she had a bad headache about two hours later, and was taken to the hospital then. She died two days after the accident, but she didn't go without medical care for two days.
 

Orm Irian

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There's a union saying I always remember, that every occupational health and safety protocol in the world is written in someone's blood - or someone's life. If the ISU doesn't get its act together soon, the eventual safety protocols in figure skating are going to be written in a skater's life too.
 

rink_mom

Member
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Absolutely disgusting -
  • how long it took medical to step on the ice
  • how they didn't come on with equipment when clearly there were 2 serious head (and possible neck) injuries
  • that they walked them off Liu in particular couldn't even keep her feet underneath her with 2 people holding her up. Stretchers/neck immobilization should have taken place. They should have been assessed in place to minimize any further injury then when stabilized moved properly - not walked off.

    I truly hope they both make full and speedy recoveries and somehow protocols are changes - URGENTLY!

    Side note I was totally confused at Skate Canada why Keegan was allowed to continue because they broke all the protocols we have to follow - when I asked was told it is because it is an ISU event not a Canadian event so they follow ISU protocols not ours.
 

MsZem

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When I saw the thread title I thought it was about Aymoz's fall yesterday, which looked bad. This (which I don't want to watch) sounds even worse. I just hope the skaters involved will be okay.

So. These are the changes I want to see the ISU implement before the start of next season.

1. A blood rule. If there's blood on the ice, the skater is off the ice with an automatic medical withdrawal and goes to hospital for care and stitches if necessary. The ice is cleaned and resurfaced before the next skater/s go out. Actually, let's go all out and make this a visible injury rule. No more skaters shoving dislocated shoulders back into place halfway through their programs!
Yes to everything you suggested, except this which is too broad. There have been multiple instances over the years of skaters getting cuts on their palms/fingers from grabbing their blades doing spins. There are other types of injuries that do not endanger skaters' health but may be visible, so you'd want a more specific definition.

I think it will take a skater dying or being paralyzed from a neck injury or something similar for the ISU to do anything. No one takes them seriously enough.
I really, really hope not. It's a horrifying thought. I see two other options: 1. as @Immortelle wrote, if skaters who are medical professionals advocate for better protocols, it might help. Dr. Joannie Rochette, for example, has the skating and medical qualifications that could carry a lot of weight. 2. If someone sufficiently high profile follows the lead of Simone Biles in Tokyo, WDs in the middle of a high profile event, and explains it's due to the effects from a prior concussion or something to that effect. That would get a lot of attention, of the kind the ISU couldn't ignore.
 

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