Hockey Night in Canada

Sidney Crosby's long-term health at stake: neurosurgeons

The road back on to the ice for Sidney Crosby after suffering another concussion is an uncertain one, according to two neurosurgeons who deal with sports injuries.

'It's never a good idea to play when you are symptomatic,' Dr. Neilank Jha says

CBC Sports contributor Tim Wharnsby discusses the ramifications of Sidney Crosby's injury to the Pittsburgh Penguins playoff hopes. 4:47

The road back on to the ice for Sidney Crosby after suffering another concussion is an uncertain one, according to two neurosurgeons who deal with sports injuries.

On Monday night, the Pittsburgh Penguins' superstar suffered the fourth diagnosed concussion of his career after taking a cross-check to the head from Washington Capitals defenceman Matt Niskanen.

The Penguins say their captain will not play in Game 4 of the Eastern Conference semifinals Wednesday night (CBC, CBCSports.ca, 7:30 p.m. ET). When or if he will play again this season is unknown.

Sidney Crosby went down hard after taking a cross-check to the head from Capital's Matt Niskanen in the first period of Game 3. 0:38

That's the frustrating thing about concussions, doctors say. There is no universal diagnosis or a prescribed road to recovery. Each case is different.

"In some cases people do recover within a few days and their symptoms resolve," says Toronto neurosurgeon Dr. Neilank Jha. "It doesn't necessarily mean because he's had four documented concussions previously that he will not be able to return. From a fan perspective, from a Penguins' perspective, if they win [this playoff round] it's very possible he could be back for the Eastern Conference finals."

Jha says in the coming days it will be important for Crosby and the Penguins' medical staff to monitor the star's concussion symptoms.

"Would it be a good idea for him to return if he still has symptoms? I don't think so, because he would be putting himself at a high level of risk," Jha says. "But if he does resolve the symptoms that are currently going on and it's his desire to win another Stanley Cup again, then that decision is left up to him and his medical staff."

Dr. Charles Tator, the project director of the Canadian Sports Concussion Project for the Krembil Neuroscience Centre at Toronto Western Hospital, says the number of initial concussion symptoms a player has is tied to how long it can take to recover.

"So for example, if you have headaches, nausea, sensitivity to light, fatigue, etcetera, the likelihood is that you may never recover," Tator says. "But if you have three or four, the recovery is likely much shorter."

Tator says it's imperative Crosby allows full recovery from any concussion symptoms or he could be risking long-term damage.

"That is one of the frustrations of advising people of what to do during the recovery process. Some people recover promptly like within a day or two, and some people it can take a year or two. He has already experienced a prolonged recovery.

"It's never a good idea to play when you are symptomatic," Jha adds. "We advise both professionals and kids [to] sit out when in doubt."

Severity of latest concussion unknown

It's not known how serious Crosby's latest concussion is. 

He was seen greeting and chatting with teammates around the Penguins' dressing room Tuesday. 

But both Tator and Jha say Crosby's concussion history in the context of his current recovery can't be ignored.

In the 2011 Winter Classic, also against Washington, Crosby suffered a concussion that kept him out of action for nearly two years. He also sat out the first few weeks of the current NHL season but returned in top form to lead the league in goals with 44.

"Concussion history is important," Tator says. "You are more likely to recover after one concussion than after 10 concussions."

Jha says that even if athletes do everything they are told to do, there could still be long-term implications.

"You are more susceptible to having another concussion in the future even if the symptoms resolve," Jha says. "However, if you still have symptoms and you have another concussion before recovering that's even more concerning."

About the Author

Jamie Strashin

Reporter

Jamie Strashin is a native Torontonian whose latest stop is the CBC Sports department. Before, he spent 15 years covering everything from city hall to courts and breaking news as a reporter for CBC News. He has also worked in Brandon, Man., and Calgary. Follow him on Twitter @StrashinCBC

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