Will Power is to resume track action next Tuesday, following the illness that prevented him racing at St. Petersburg last weekend.
Earlier today, the 2014 champion was revealed to have not suffered concussion in his Friday crash during practice and was cleared to drive again.
In a follow up media teleconference, along with Team Penske president Tim Cindric, and Doctors Terry Trammell and Steve Olvey, Power said he would be back behind the wheel of the #12 Team Penske car on Tuesday, having recovered from the neck pains and vomiting that had afflicted his weekend.
“I don't have headaches or nausea now,” said Power, who despite his illness, set a new track record on his way to his 43rd pole position. “I'll be testing at Barber [Motorsports Park] next Tuesday to make up for missing yesterday’s test. It will be good to get back in the car.”
Power said he was not concerned about the G force effects on his inner ear when the series goes to Phoenix International Raceway for its second round on April 2.
He said: “I actually had the infection at the Phoenix test [Feb. 26-27] and it didn't seem to be a problem. So yeah, I'm not worried about that.
Added Cindric: “He's had a tough off-season in terms of being healthy. This whole inner ear thing isn't a new thing, which is why for us it wasn't so alarming that he wasn't feeling so well over the weekend – until we got to the nausea part.
“We need to get him over this totally and back to where he's feeling himself again. I think some of that's getting some rest and listening to the docs here. I don't see any reason why things shouldn't be business as usual, but we've got to get him over the hump.”
Power said that giving up 50 points to teammate Juan Montoya, who won last Sunday’s race, was concerning but he said he would be continuing his post-2013 policy of ignoring the championship standings.
“I don't look at the points anyway, just go for race wins, but that's definitely the case here,” he remarked. “You know, the double points races [Indy 500 and season finale at Sonoma Raceway] are going to be big for us, so this year I’m real happy they have them…as much as I would have been complaining about them otherwise!
"Yeah, double points could definitely turn things around."
Cindric, who has also served as race strategist for Power since mid-2011, said he shared his driver’s outlook. He declared: “Any time there's a chance for a win, I feel like we go for it. So I don't think it'll change that much.
“You know, certainly it was a lot different racing from the back after working with Will for so long,” he said, referring to strategizing for Power’s late stand-in, Oriol Servia, who had to start from 22nd. "To start last, you kind of had to sharpen your pencil. Fortunately for the other three cars, it was a pretty straightforward race.
“There have been a couple races where Will has started back there and they turned out alright. I think you still deal with it 'on the day,' and I guess I anticipate Will qualifying up front and the race strategy being pretty circumstantial as far as what we do or how we do it.”
False positive explained
Dr. Trammell, IndyCar’s renowned safety consultant for some three decades, and the doctor who treated Power’s broken back in September 2009 and October 2011, explained that none of the data from Power’s crash on Friday had suggested a concussion-inducing shunt, hence the tests.
He said: “Will had, as you know, an impact with a wall on the driver's right. It compressed the right side of the car but at relatively low G's for that style of racing. I think the maximum right-side Gs were 56.9 on the chassis.
“His ear accelerometer data average result was 30G, which is low and below our threshold. He was being evaluated at the scene of the crash by the IndyCar medical team with Dr. Billows present, had no symptoms at that point of any kind, and was released from the scene.
“Later that evening, Will began to develop some neck soreness and stiffness, and developed the symptoms of nausea, headache and dizziness.
The presumption is that when a driver has had an impact, anything that's wrong with him was a result of that impact. And the next step is to go to a concussion assessment tool or clinical evaluation tool of which there are several. We use one called the SCAT test – sports concussion assessment test. That test is based on the premise that the cause of your symptoms is a concussion. It therefore quantitates the symptoms and gives a probability that you've had a concussion based on the numerical score for the symptoms.
“If you have some abnormality to start with, what we would call compounding factors or variables, those are not taken into by the test. It simply assumes that all of your symptoms are from a concussion.
“Well, if you have an inner ear infection with fluid in the inner ear like Will did, that by itself can cause you to have a sense of balance disturbance, vertigo, and can cause you then to be nauseated. It can produce a headache. As Saturday went on, Will’s neck stiffness and soreness seemed to respond badly to loads under braking. That causes increasing muscle tension, which also causes a headache.
“So now you have a driver who’s nauseated, has a balance disturbance, vertigo, headache, can't concentrate very well, and you have him take the SCAT test, which he'll now fail. It's part of our concussion protocol to say that if you fail a concussion assessment test, whatever kind we're using – and SCAT is the one we're using now – that you have to be evaluated by a more definitive diagnostic test such as the impact test before you can return to competition. We take the possibility of concussion very seriously and want to err on the side of caution rather than the other way around.
“The other side of this is we depend and are increasingly dependent on our actual accelerometer data, both ear and chassis, and we found that they relate very well one to the other and help us determine the forces involved and the probability that those forces can cause injury.
“Dr. Olvey researched it for us, and found that our threshold for concussion is somewhere greater than 50G resultant, and probably closer to 80G or above for a concussion, and has a Head Injury Criteria [HIC] value that approaches 1,000. Will's head injury criteria was 44. So nothing correlated very well. His crash was not sufficient to really cause a concussion under most circumstances, and he had a mix of symptoms for a variety of reasons.
“So that's how he could have a positive SCAT test and trigger the concussion evaluation that he subsequently had.”
Cervical muscle tension caused headaches
Dr. Olvey, retired former director of the Neurocritical Care Unit at Jackson Memorial Hospital in Miami, stated: “You have to err toward being conservative, and Will was sent to our Concussion Center at UM, and we've had a lot of experience with high-end athletes as well as some motorsports. Felipe Massa was there and Dario Franchitti.
“We looked at every conceivable area of detecting concussion and what was really important was that Will’s impact test on Monday was actually a bit better than his baseline test that he had back in January of 2015!
“Following that, we looked at balance and coordination, which is all a part of your vestibular function, which can be affected by concussion, and then in the course of the day, we had him undergo a sophisticated type of MRI called diffusion tensor MRI which delineates areas of the brain that are white matter areas that are affected with concussion and with, actually, repeated concussions, and also other white matter diseases like multiple sclerosis and so on.
"We were unable to detect any evidence of acute concussion, and in fact, his DTI was perfectly normal, indicating that there were no residual effects from any past concussions.
"We were aware of his ear infection, which had been adequately treated and was much improved, but we also found that he had marked cervical muscle tension, which Terry referred to, which can cause a pretty debilitating type of headache. It's usually bi-frontal, goes down the back of your neck, and you get into a vicious cycle unless you break it.
“So Will is on some medication to relax the muscles of his neck and to get the cycle broken so that when he steps back into the car the whole thing won’t repeat itself as far as his neck muscle spasm goes.
“We'd like him to sit out this week, but it's related to the cervical muscle tension problem, not a concussion, and he will be able to go back in the car on Tuesday and have no further problem.”