The Hit on Brooks Orpik

By Dr. Wyatt Kupperman

Credit: Keith Allison.

They finally did it! The Washington Capitals have advanced to the Stanley Cup Finals.  Twenty long agonizing years for Caps fans filled with immense promise and expectation (full disclosure: die-hard Caps fan). The realization has yet to sink in for me, but come Monday night, the Capitals will play their first Stanley Cup game since 1998 (Editor’s note: die-hard Red Wings fan here.  Sorry we beat you in ’98 and caused your lifelong misery).  Storylines abound for this Cup Final: Ovechkin and Backstrom finally getting to the Finals.  GMGM somehow getting an expansion Vegas Golden Knights team to the ultimate stage for a chance at Lord Stanley, something he failed to do with a loaded Washington Capitals roster for years.  And “The Flower”, Marc-Andre Fleury, getting to showcase the huge mistake the Penguins made by letting him go.

Capitals players last night sacrificed their bodies blocking shots, delivering body checks, and taking some devastating blows.  One such blow was questionably delivered to Brooks Orpik in the second period. This piece isn’t intended to debate the legality of the hit.  But you can guess where I side.

If you saw the hit, it appears that Orpik’s forehead and face are driven into the end boards.  He remains down on the ice for sometime.  On the video in that link, around 1:33 he skates off with assistance appearing “dazed”.  Interestingly, according to NHL.com, this hit may have been analyzed by a centralized spotter in New York, and an in-arena spotter.

Brooks Orpik and Alexander Ovechkin. (Credit: Sarah A. Photography).

The centralized spotter will communicate with the player’s club if he should be taken out of the game and evaluated under protocol.  Not sure if communication was necessary, as Orpik was taken off the ice immediately.  One would imagine that he went through a concussion protocol in the locker room based on the mechanism and aftermath.  So I’m guessing he passed and hopefully was symptom-free.

But with our knowledge and awareness of head injuries, this hit reminds us of a very rare and potentially catastrophic event surrounding repeat head trauma if one plays while symptomatic: the “second impact syndrome”.  Check out this link and take a moment to study the diagram there at the top.

Still debated in the scientific and medical communities and lacking epidemiological data, second impact syndrome is the result of a second blow to the head of a player still dealing with the symptoms of the first blow.  After a first blow, the brain may be in a hypermetabolic state and vulnerable.  With a second, and sometimes even less intense, traumatic strike, the brain loses its ability to regulate pressure, which in extreme cases can lead to worsening swelling, herniation, and death.

We will see if Orpik deals with any symptoms over the next few days related to this hit.  Maybe it “looked worse than it was”.  But for his sake, hopefully he is good to go for game one.  But it certainly is a reminder that all head injuries are serious, and not just in the long-term.

 

Thanks to NHL.com, American Academy of Neurology, and National Center for Biotechnology Information.