Post-concussion syndrome keeping NHL star, Sidney Crosby, off ice

Sidney Crosby recently reported having suffered his third concussion to the Pittsburgh Penguins medical staff. As a result, he missed the first game of the season and remains on injured reserve. His admission has raised many questions regarding his future in the NHL.

Concussion was first described in writings by the ancient Greeks. It is best described as a group of neurologic symptoms that result from a biomechanical force applied to the brain. Although a great deal has been learned regarding the recognition of a concussion, there is no specific diagnostic test and no definitive treatment.

Millions of sports-related concussions are reported each year, the vast majority of which resolve over a period of days. The persistence of symptoms has been described as post-concussion syndrome (PCS).

Among the symptoms for PCS are headache, depression, fatigue, disordered sleep and poor memory. These symptoms are often considered part of the original injury and delay a return to athletics. In fact, specifically treating these conditions can allow for a safe return and avoid an extended absence from academics and sports.

Chronic Traumatic Encephalopathy (CTE) has recently become a fear among athletes who have suffered multiple concussions. The potential for developing violent behavior, depression and suicide has prompted early retirement from contact sports. It is important to note that CTE is only diagnosed post-mortem.

In their recently published book, “Back In The Game: Why Concussion Doesn’t Have to End Your Athletic Career,” Dr. Jeffrey Kutcher and Ms. Joanne Gerstner clarify much of the confusion surrounding the diagnosis and treatment of concussion. This is an authoritative text written in understandable terms. It is highly recommended for parents, athletes and coaches.

Sid Crosby’s potential return will be determined by his ability to increase activity without disabling symptoms. Most importantly, his injury was self-reported and that reflects some success in the area of education and awareness of concussion.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at

Careful judgment key when dealing with opiates

Opiate medications have been the basis for pain relief over thousands of years. Unfortunately, inappropriate use has lead to an addiction crisis affecting many people, including high-level athletes.

Opium is an extract from the seedpods of the poppy plant most commonly grown in middle and far eastern countries. The most active substance in opium is morphine. Currently, a variety of oral opiates have successfully alleviated pain but in some cases lead to lifelong addiction.

Opiates work by binding to receptors on nerve cell membranes in the brain. This action blocks the proliferation of neurotransmitters that cause pain. Over time, increasing doses of opiates are required to achieve pain relief. Unfortunately, this can lead to addiction and the search for alternative illegal narcotics.

There are very few industries where one hundred percent of your employees will suffer a work-related injury. Professional sports are among those industries. High-velocity collision sports and combat sports athletes are particularly vulnerable.

Injuries move through acute and chronic phases. Acute injuries last days to weeks while chronic injuries last months to years. Many of the injuries seen in sports also require surgical intervention necessitating post-operative pain relief.

“Opiates play a helpful role in pain control immediately following acute injury and postoperatively,” states Dr. Jeffrey Anderson, Medical Director of UConn Student Health Services. “They don’t have a legitimate role in the management of chronic pain in the competitive athlete.”

Fortunately, there are many effective, non-addicting, medications designed for chronic pain. Many of these medications typically act on the brain for other conditions including epilepsy and depression. 

The use of opiate analgesic medications must be offset by careful judgment and consideration of alternative medications.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at