On concussions in hockey

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The NHL All-Concussion Team would win a lot of games – Puck Daddy:

You’re probably well aware that concussions have become something of an epidemic in the NHL over the past few years. It’s not like nobody’s talking about it. But just recently, the epidemic has taken a nasty turn, targeting star players with sudden aplomb. It’s almost as though the brains of NHL superstars need a tough guy. It’s not just Sidney Crosby anymore. The injury list is littered with big names.

Suddenly, it seems, concussion talk is everywhere around hockey. I’ve been having multiple discussions with people I know about it.

Crosby works his butt off to come back, takes another hit, and is out again. Suddenly, nobody really knows when or how he’ll be back. Or what’ll happen after the next hit. The ghost of Eric Lindros hovers over the league’s move visible player.

And now Pronger goes down. And stays down. Pronger, whether you love him or hate him (probably, both), never stays down.

Out for the season, is Pronger’s career over? – The Globe and Mail:

This is mid-December. NHL playoffs generally stretch until nearly the end of June. So in the opinion of the two specialists who examined Pronger this week — and diagnosed him with “severe” post-concussion symptoms — they do not believe his condition will appreciably improve enough in the next six months to permit him to play again this season.

This is not a new problem. Just ask Eric Lindros. Or Brett. Or Nick Kypreos. Or Jay More. Pat LaFontaine. Paul Kariya. Wanye Primeau. Fenando Prisani. Adam Deadmarsh. Scott Stevens. The list goes on, and on and on. I first wrote about concussions back in 2003. I’ve written about it on and off since (2005,20072009, 20092011 ). I remember going all the way back to the Cow Palace years and talking to the Sharks medical staff about concussions, back when everyone was first trying to get a handle on all of this.

We’re going to continue to write about it into the future, because injuries are part of the game, and given that the core of the game of hockey is the physical (and violent) collision, injuries are not going to stop unless we fundamentally change the game. Which means to fix this, it has to stop being hockey.

But what’s happening now is I’m having conversations with other fans that are some variation of “I’m uncomfortable being a fan of a sport where player’s health and life are damaged for my enjoyment”. It’s a question I’ve struggled with myself. Along with the uncomfortable question of just how you stop injuries to the head when you allow two players to drop gloves and pound each other in the face. Fighting is an elephant in this particular sitting room, and one that has to be grappled with as part of the solution — and I say that as someone who enjoys a good fight during a game.

KuklasKorner:

Even the most passionate hockey fan would be hard-pressed to remember a time when so many stars were out with concussions.  It’s almost as if the scrambled brain epidemic is getting worse, even though body checking is seemingly at an all-time low.

I’ve always been of the opinion that virtually nothing can be done to combat concussions.  Nothing, that is, outside of banning body-checking altogether.  It’s simply impossible to avoid violent collisions in a game played at such a high speed.

And this has become a hot button within the media, bringing it a lot of visibility and commentary.

That is, in fact, part of the problem.

Let me rephrase that.

This is a complex issue. There is no “concussion problem”. There are lots of problems that end up causing or caused by concussions. And there  are “problems” that get raised as part of this that actually make it a lot harder to see the real problems.

One of those “problems” is simply the media making this a high profile issue. It creates a perception that things are a lot worse now than they have been in the past. It gives something Mike Milbury to rant about. It generates headlines. Sometimes, those headlines get in the way of seeing what’s really happening.

Roy Macgregor, I think, gets to a core part of the current “problem” with the media frenzy going on:

NHL’s all-concussion team would be lock for Stanley Cup – The Globe and Mail:

 

It matters not how concussions are happening – head shots, fights, accidents with sticks and pucks, running into one’s own teammate – they have become an increasingly polarizing issue in today’s hockey. There are as many sick of the issue as there are those wanting the issue addressed – even the media has started sniping among themselves – with the only sure truth being that concussions aren’t going to go away even if they cease to be mentioned. They are, sadly, increasing – or, at the very least, the recording of them has.

 

“Maybe now it’s everybody is more careful with the head injuries,” suggests Boston captain Zdeno Chara, himself out with a knee injury.

“It’s more serious and nobody wants to risk it, so everybody is taking time to make sure they are good before they play again.”

It’s unclear that there are more concussions in hockey today than there were last year or three years ago.

But a lot of things have changed. Our understanding of concussions and the long term health implications is increasing. Some of the recent brain studies, including those of Derek Boogard, that show significant brain trauma, is bringing home the fact that there are problems here that in the past were mostly ignored. It’s not a new problem, some of the NFL brain studies are showing this same brain damage in players going back into the 70′s. I expect if you did brain studies of some of the physical players and fighters of the 60′s and 70′s NHL, you’d  find the same.

The NHL has a long history of “shake it off, get back out there”. Hockey players have a high tolerance of pain, and traditionally play though injuries almost beyond comprehension. Even five years ago there was still a culture of “just got my bell rung” and players got back out there.

The league has made huge changes in the last two or three years. The rules for checking players for concussion have become a lot more stringent. Our understanding of concussions in general has gone up massively. Players have been educated on concussions, and, frankly, probably scared by what’s going on enough to stop doing the macho thing and playing through these “bell ringing” incidents that even a couple of years ago they would have ignored.

So the number of RECOGNIZED and REPORTED concussions is going way up. This isn’t necessarily that there are more concussions, but they’re being more reliably diagnosed, and the league is more careful about tracking them, and giving players less leeway to come back from them early or ignore them and play through them.

So some of the spike is better diagnosis, and better treatment, and better understanding. And the media looks at raw numbers and turns that into a crisis, which makes it harder to see the real problem behind it.

Because, don’t for a second think I’m using this as a way of saying there’s no problem here.

It’s a problem without simple solutions. I think the league has gotten serious about understanding it and solving it to the degree it can. I wish it’d hit this point of urgency five years ago, but I have no issue with the league’s response now (and honestly, five years ago, I don’t think concussions were well enough understood to do some of the things that are being done today — but I do think we could be farther along the path towards solutions than we are).

There’s been work done on improving the safety of the arena — such as the rounded glass installed this year to deal with hits like those that injured Max Pacioretty. The arenas that had the immobile seamless glass have been upgraded to use more flexible (and much safer) boards and glass — anyone remember when that glass was first installed and Mike Modano had his head smushed into it, going out for a significant time with a concussion?

Research has shown hockey helmets actually don’t help much with concussions, and work has been going on to improve head protection. New style helmets are coming onto the market that improve on this problem. Other hockey gear has evolved over the years from being protective to being an effective weapon against other players, especially changes to elbow and shoulder pads, which have added hard shells and rubber knobs that can be used against a player in a check (I once saw Marty McSorley with his shirt off; his shoulder pads were little more than a couple of slabs of leather — he had traps to die for. Today’s shoulder pads look like something stolen from a bad japanese Manga movie).  The league has been working to replace this gear with less damaging hardware, elbow pads without hard caps and less — offensive — shoulder pads. Those safety changes have to get the approval of the players union as well; let’s not forget the players union is the group that has stonewalled mandatory visors choosing “personal choice” over “let’s try not to lose too many eyes” — right, mattias Ohlund and Brian McCabe and Jamal Mayers? — so getting safer gear into the game takes longer than we might hope).

And the rule changes. Rule 48. The OHL just banned hits to the head. There were calls for the NHL to do the same. It didn’t — and they were right to take a more specific approach (but I’ll leave arguing this point to a different article, later); the players are getting it; retraining them takes time (and some will never learn, and as they become problems for the team, they’ll find their careers ending — but if Matt Cooke can figure it out, pretty much anyone can). It’ll take some time to see just how effective these changes are in reducing concussions. It seems to me that it is — but the problem right now is that this real reduction is obscured by the increased recognition and reporting, so it’s hard to see what the difference is. We’re judging numbers based on two very different standards, and trying to make comparisons.

My gut tells me the league is on the right track and making progress; I do think there’s a lot of work to do. I disagree with the view above that nothing can be done here. Lots has been done, is being done, and there’s lots more to do. That’s a defeatist attitude, and probably the most important change being made right now is educating the players and helping them really understand concussions, both to get it through their occasionally thick skulls that making hits that cause concussions is a stupid and dangerous thing — but even more so teaching players that ignoring concussions or playing through them is even MORE stupid. Retraining the league and players that it’s okay to say “I can’t go” isn’t sissifying the game, it’s protecting the future health of the player.

The league can only do so much to stop concussions if the players don’t take them seriously. The big change going on in the league now is that education process; getting the players to understand and accept that they don’t have to “skate it off” when “they got their bell rung”. As this change in attitude gets ingrained in the players, when the players really learn it’s not okay to headhunt — that’s when concussion numbers will realy go down. That process is ongoing, and I think we’re starting to see the effects — the early effect is MORE concussions being reported and MORE man-days lost to them and MORE headlines bemoaning the concussion crisis. But players moving into a situation where they’re safer, and where they’ll be healthier in the future for understanding this now.

Right now, there’s a lot of noise about concussions. That’s good — that’s driving awareness, and that is, if nothing else, motivation to the league to keep looking for ways to make this problem better and the game safer for the players. the tradeoff there is that hockey is inherently a physical and violent sport, and injuries are inevitable — the only way to take injuries out of the game is to ruin it.

That is not, under any circumstance, an excuse to ignore injuries or to think you don’t NEED to find ways to make the game safer. The league has a difficult set of compromises to make on this, and right now, I think they’re doing an overall good job.

We also need to remember that some of this noise is because we’re making progress – because lots of what used to be swept under the rug is now visible for all to see. And that’s the first step in removing move of it to the dust bin of history where it belongs. And this process is not something solved by snap decisions; it’s going to take time, and research, and commitment. which right now, the league seems to be committed to.

And ultimately, I think it means the end of fighting in the game, because at some point we are going to have to come to grips with the reality that we can’t say it’s unacceptable to target the head of a hockey player — unless you take your gloves off for a fight.

But that’s an argument for another article at another time….

 

This entry was posted in Sports - Hockey.