Sunday, December 23, 2007

On concussions

Often referred to as the "invisible injury," concussions remain mostly a mystery, even to the doctors who spend their lives studying them. But the human lab that is the NHL has made this much clear – the human brain can only absorb so much pounding.
Simply put, if you love hockey and you're honest about the game and the toll it takes on the men who play it, you ought to be reading this story.
The Star's put together a terrific package on concussions in hockey, including all kinds of multimedia in what is Part 1 of a two-part series.

Starkman even provides transcripts of a lot of his interviews (including Eric Lindros, Stu Grimson, etc.) and there's a lengthy list of players whose careers were ended due to blows to the head.

While I wouldn't call concussions hockey's dirty secret, it is fair to say we don't often hear of the true, human impact on players — especially those who retire and fade from view. Lindros's description of his battle with them makes it sound like a nightmare, something you wouldn't wish on anyone.

It's an important package for several reasons, but the main one in my view is that too often these injuries are still being misrepresented, played down or ignored entirely:
"A friend of mine who was a team doctor on one of the other NHL teams said, `Well, we don't have any concussions,'" said Dr. Jamie Kissick, former Ottawa Senators team physician. "He said this facetiously because the coach didn't believe in them, so there were no concussions."
"I think some you might find aren't legitimate. ... I think there's a small percentage, not a great percentage, of players who use it as an excuse, `Oh yeah, I've got a concussion.' They can milk it. It's a hard thing to really say that you haven't, you know, if you're trying to get some extra insurance money out of it to get paid an extra year or something."
— Colin Campbell, NHL executive vice-president
You know, it was interesting during the Hockey Hall of Fame induction press conference last month in Toronto, listening to luminaries like Mark Messier and Scott Stevens talk about what was then the issue of the day (head hits) and offer an explanation of the fine line between what constitutes legal and illegal hits in hockey. Both spoke of a need to keep the power element — the "danger," I believe Messier called it — in the game, to keep it fierce and, well, hard-hitting.

Eliminating head hits, they said, would water down that integral part of hockey, and make hitting, in many cases, something punishable instead of laudable.

It's a difficult issue, really, because on one hand, you'd like to protect players from these types of injuries, but on the other, "danger" is definitely part of what these men are paid to work with. There are plenty of hazardous occupations out there that you rarely hear about, jobs where deaths can occur on a regular basis, and it's worth acknowledging that — at least in the minds of most of those playing in and running the NHL — concussions are simply one of the on-the-job hazards in professional hockey.

Can you have a sport where 700 grown men pound each other for 1,300+ games every year and not have casualties?

UPDATE Part 2 of the series is right here.


At 5:28 p.m., December 23, 2007, Anonymous Phillie said...

Keep in the mind the whole principle of boxing: Hitting an opponent in the head so his brain bounces to the other side of the brain cavity and induces sickness or damage. It's a horrible injury and it's why helmets are never going to prevent concussions.

At 6:29 p.m., December 23, 2007, Blogger Baroque said...

This article from yesterday's New York Times isn't about hockey, but it is about concussions. It's an injury that is an issue in all sports - and the major concern many doctors have is for younger athletes, as more and more teenagers are getting concussions and even less is known about how they affect a developing brain than an adult brain.

At 10:24 p.m., December 23, 2007, Blogger Adam C said...

Both spoke of a need to keep the power element — the "danger," I believe Messier called it — in the game, to keep it fierce and, well, hard-hitting.

I don't disagree with this opinion, necessarily; but perhaps we should keep in mind that these were two players from whom head hits were a regularity. It would be only human for them to defend their own actions.

At the very least, the league needs to crack down on head injuries. I thought they'd managed that a couple of years ago with minimum rest periods for players diagnosed with concussions, but recent events (including but not restricted to Gange) indicate that the right diagnoses are simply not being made.

I would like to think, too, that hits could still be powerful and "dangerous" without headhunting.

At 12:30 a.m., December 24, 2007, Anonymous ken said...

One thing that ought to be changed is the equipment, particularly shoulder and elbow pads.

In the last 15 years or so, both have so hard that even incidental contact is like getting hit with a brick. The old pads, of the kind worn between 1890-1990, weren't so hard. While the new kind do prevent injury to the wearer, they also cause injury to anyone hit by them.

And so an unintended consequence enters into view: in the past, if you checked a guy, you'd feel it almost as much as he did. Also, if you missed him, you'd be crashing into the boards. Both points forced players NOT to fly in full speed, and to basically hit with the intention of knocking a player down, but not to kill him.

With the new, harder, pads, you can fly in at full speed. If you get him, he absorbs 100% of the force and gets a concussion. If he moves, and you smash into the boards, well, no big deal. You don't even feel it.

That's another reason why: players are hitting harder, with harder equipment.

Obviously there will be pre-1990 exceptions of guys getting labelled, but I think overall my point stands. I played hockey while wearing both kinds of pads, and playing against guys wearing both kinds of pads, and this is what my experience has taught me at any rate.

At 3:26 a.m., December 24, 2007, Anonymous beingbobbyorr said...

Well, we don't have any concussions .... the coach didn't believe in them, so there were no concussions.

.... recent events ... indicate that the right diagnoses are simply not being made.

I'm starting to wonder whether team physicians shouldn't be hired and fired by the NHLPA, not the clubs. There shouldn't be any ulterior interests standing in between the patient and the doctor (are you listening Hilary Clinton?).

I recently went around interviewing Ophthamologists (eye doctors) in Southern California, looking for the best guy to do my Lasik surgery. Out of the 14 guys I saw (and graded on CRSQA's 50-question criteria), the worst one was the "official Ophthamologist to the LA Kings" (please, no jokes linking this to their current position in the cellar). Makes me wonder what criteria teams use when selecting their "official _______". With greater player movement, will teams have less incentive to treat the player's health issues preoperly?

At 10:05 a.m., December 24, 2007, Blogger Baroque said...

I'm starting to wonder whether team physicians shouldn't be hired and fired by the NHLPA, not the clubs.

I'd like to see every sport do something like that. A physician who's job is to get players back on the field or court or ice as soon as possible is going to give in to a player who claims he's fine, even if he shouldn't be playing but just wants to avoid a reputation as soft or a malingerer.

At 12:09 p.m., December 24, 2007, Anonymous Anonymous said...

Thanks to Dave Babych lawsuit NHL team docs are finally treating injured players as patients.

At 3:47 p.m., December 24, 2007, Blogger HockeyTownTodd said...

The good thing is they are talking about doing something about the problem.

The bad thing is they have been talking about it for 10 yrs and they have done squat.

The argument about wearing that gladiator armor under the sweaters is the players need it for protection.

The catch 22 in that argument is if they eliminated the hard pads is no one would need them for protection.

There is someone in Vegas right now probably laying odds that nothing will be done this time, either.

At 10:33 p.m., December 24, 2007, Anonymous beingbobbyorr said...

I didn't see anything mentioned in that article about the new more concussion-resistant helmet design that came out about 5 or 6 years ago. I think I've seen Martin Straka wearing one, and Adam Deadmarsh was trying it during his comeback attempts circa 2002-04, but they seem to be fairly rare. I'll defintely be looking for these in some of the near-future games I'll be attending. They're a little geeky-looking, but if it helps the boys remember their kids' names ....

At 12:46 a.m., December 25, 2007, Blogger HockeyTownTodd said...

"They're a little geeky-looking,"
I was not aware of those. Lilja that plays for Detroit wears something that looks like it has ear protectors on it. I wonder if that is the one you are talking about.

At 7:34 a.m., December 25, 2007, Blogger FAUX RUMORS said...

1) We find Colin Campbell's statement that there are players who are "milking" it to get money from the system disgusting!
2) Colin, either name names, or shut the hell up! Its that kind of attitude that is hindering the proper diagnosis and treatment of these potentially devestating(long term) injuries

At 5:53 p.m., December 28, 2007, Blogger MikeP said...


"The catch 22 in that argument is if they eliminated the hard pads is no one would need them for protection."

In 1890, nobody shot the puck 100mph. Not even close. Even in 1990, I think it was fairly rare.

Nowadays, every team has at least one guy that can crank it up over 90mph. (My team, the Oilers, have Sheldon Souray and Jarret Stoll, f'rinstance. The team they played last night has a pair in Beauchemin and Pronger.)

Still think protection is only needed as defence against other peoples' protection?

At 6:59 p.m., December 28, 2007, Blogger HockeyTownTodd said...

Mike P:
You failed to mention how many concussions were caused by 100 mph shots.

At 12:20 p.m., January 01, 2008, Anonymous MikeP said...

HTT: that's because you were talking about the padding causing concussions, so get rid of the padding. It's there, in part, to protect from the puck. I'm surprised I should have to point that out.

At 12:35 p.m., January 01, 2008, Blogger HockeyTownTodd said...

"I'm surprised I should have to point that out."

I am surprised I have to point out that the post was about concussions.

If you want to turn it around and make it about 100 MPH pucks, just back it up with some numbers.

At 12:17 a.m., January 19, 2008, Anonymous Anonymous said...

Soooo...when is an intentional elbow wrapped in hard plastic to the head going to constitute assault rather than a "minor"? or is it going to take video reviews in a court of law to answer that question?


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