Daniel Alfredsson's angry outburst in the Ottawa Senators' Game 6 battle with the New York Rangers Monday left at least a few observers wondering: was he still feeling the effects of a concussion?
The normally genial Swede had been out for the three previous games with a head injury and some thought the uncharacteristic flare-up might be a sign that he had returned to play too early.
Alfredsson himself dismissed that suggestion when asked by reporters.
But Dr. Philippe Souvestre, a Vancouver sports medicine specialist, says such outbursts are a "warning sign" that a concussion has lingered and a player could be putting himself at risk by hitting the ice before healing fully.
"In my clinical experience, people suffering from a concussion often exhibit various forms of loss of cognitive control, including outbursts of anger, anxiety and even depression," he said.
It's possible for a person to compensate enough that there are no obvious signs of a concussion, then become inexplicably upset, he said, adding that typical emotional signs of a concussion include restlessness or panic attacks.
Concussion expert Dr. James Kissick, however, says it's unusual for someone to have a concussion and show only anger without exhibiting other symptoms, like dizziness or a headache.
"While we see emotional symptoms in concussions – depression, nervousness, anxiety, irritability – it would be hard to attribute [Alfredsson's outburst]to that, especially given all the other stuff going on in Game 6," he said.
Alfredsson, after all, had been benched earlier in the game during a power play and, just before he snapped, took a hit from Rangers forward John Mitchell. Not to mention the stress of the game itself, in which the Senators failed to finish off their top seeded opponents.
Dr. Kissick also cautioned that it is difficult to assess someone without knowing all the factors. Alfredsson would also have been put through a regimen with his team to ensure he was feeling better before he came back to play, he said.
Alfredsson and his teammates, for their part, suggested he got mad simply because, right after getting past a concussion, he had allowed Mitchell to hit him.
"I had pretty good control of everything until I got hit and then I just lost it. I can't explain it in any other way," he said.
After the hit, he skated to the bench and slammed his stick on the boards. Later, he stomped on water bottles and had sharp words with his coach.