NHL: It’s Time to Take Concussions Seriously

A pair of ice hockey skates isolated on white background with copy space.

Hockey is thrilling to watch. It’s ridiculously fast (speeds on the ice can reach 30 miles per hour), violent, and sometimes dangerous. Players often get slammed head first into the boards surrounding the hockey rink. They also get whacked on the head with hockey sticks, collide with each other in mid-air, crash onto the ice, and won’t hesitate to drop their gloves in an instant to engage in an all-out fist fight. Most hockey players are missing at least one, if not all, of their front teeth. Hockey is not a sport for the weak, and that’s why fans love it.

  Sarah A. – Flickr @Creative Commons, LA Kings Jeff Carter

But the players pay a price for all the guts and glory that go along with putting the puck in the back of the net. Some of the most well-known and beloved former stars of the game are suffering as a result of too many hits to the head. More than a hundred players have filed a class-action lawsuit against the National Hockey League (NHL) because they claim the league didn’t do enough to protect them from the damaging effects of concussions.

Concussions in hockey can be the worst concussions of all because you can’t change the fact that you are playing on ice. — Chris Nowinski, Ph.D., and co-founder of the CTE Center at Boston University

Pittsburg Penguins’ captain, Sidney Crosby, is arguably the best player in hockey today. He’s won two Stanley Cups, received two Conn Smythe trophies, two Olympic gold medals, leads the league in scoring, and on and on. He’s also had numerous concussions. Crosby famously missed more than a year of the 2011-2012 season battling post-concussion syndrome.

Crosby’s most recent concussion happened last week during Game 3 of the NHL Stanley Cup playoffs against the Washington Capitals. As he lay on the ice, unable to get up, the announcer  said, “This is a scene that nobody in hockey wants to see.” The question is, was the NHL watching?

Crosby missed only one game (Game 4) before he was back on the ice for Game 5. His quick return just five days after suffering a concussion raised more than a few eyebrows.

During Game 6, fans watched in horror as Crosby slammed head first into the boards. Although, he was slow to get up, but that didn’t signal the trained “spotters” failed to pull him from the game and get him evaluated by a doctor, per NHL policy.

The NHL’s new concussion protocol mandates that four independent, certified athletic trainers (or “Central Spotters”) watch games on television and spot players that show signs of a concussion. If a spotter suspects that a player may have suffered a concussion, they have the authority to contact the team and pull the player out of the game. The player must then be taken to a “quiet room” to be evaluated by a doctor.

When Crosby was asked after the game if he was assessed by a doctor, he replied, “Yep. Yeah. Pretty standard.” His coach was asked the same question and his answer was “No.”

When asked why the spotters didn’t pull Crosby out of the game, the NHL’s response was mindboggling: Crosby’s head hit the boards, not the ice. The NHL described it this way:

Depending on the mechanism of injury, “slow to get up” does not trigger mandatory removal,” NHL deputy commissioner Bill Daly told USA Today Sports. The protocol has to be interpreted literally to mandate a removal. “Ice” as compared to “boards” is in there for a reason. It’s the result of a study on our actual experiences over a number of years. “Ice” has been found to be a predictor of concussions — “boards” has not been.

Ridiculous as it sounds, this is the new and improved NHL concussion protocol. The league’s position on the boards versus the ice has some, like Chris Nowinski, co-founder and CEO of the Concussion Legacy Foundation, scratching their heads.

Any head contact is a possible mechanism of injury. I can’t believe I have to say that in 2017.— Chris Nowinski

The NHL’s boards versus ice distinction prompted more than a few critical headlines.

Daily News – “Sidney Crosby’s head-first crash into the boards proves NHL’s concussion policy is a travesty
Washington Post – “Sidney Crosby concussion fears spawn confusion, questions and criticism of NHL process”
Sportsnet —  “T&S: Should Crosby have been pulled from Game 6?” (This article doesa good job of explaining the absurdity of the situation).

The day of reckoning for the NHL’s less-than-stellar concussion policy may be coming to a court room as earlier as this summer. According to their class-action lawsuit, the retired players claim:

The NHL has intentionally created, fostered, and promoted a culture of extreme violence, including violence from fighting. The NHL has known that, due to such violence, head trauma to Plaintiffs and the Class has been and is imminent. The NHL has known that head trauma to Plaintiffs and the Class has and will have devastating and long-term negative health effects. Despite this knowledge and to maintain its revenue stream from its violent construct, the NHL has and does intentionally subject Plaintiffs and the Class to head trauma.

NHL Commissioner Gary Bettman says the lawsuit has “no merit whatsoever.”

If it sounds like a re-run of the players’ suit against the National Football League (NFL), that’s because it is strikingly similar. But one big difference is that the NHL won’t settle with the retired players.

One reason the league won’t settle is it doesn’t accept that multiple concussions can lead to chronic traumatic encephalopathy(CTE), a degenerative brain disease that research at Boston University (BU) shows can lead to dementia, aggression, depression, and suicidal thoughts.

Bettman questions the science connecting concussions to CTE.

The medical consensus is that no causal link between concussions and CTE has been scientifically established.” He cited other medical research that suggests the research on CTE is “inconclusive.” Last year, Bettman said it is “at best, premature” to warn players about the risks of CTE – a stance the lead CTE researchers at BU called “ridiculous.” — 5 Eyewitness News

The NHL has denied any wrongdoing, and the case, just like the sport itself, has gotten rough. Allan Walsh, a prominent NHL agent, is a critic of the league.

The NHL has attacked the retired players in the concussion lawsuit using a multipronged strategy. They have belittled the players’ intellectual capacity to write op-ed articles in newspapers. They have used friendly media to portray the players as greedy and seeking handouts. Most disheartening, the NHL has stated repeatedly that no causation exists between concussions, sub-concussive blows to the head and CTE. —Alan Walsh, The Buffalo News

Walsh says that 90 percent of the former NHL players who have had their brains examined after their death have CTE. There’s no way of knowing which players will get CTE and which won’t.

Medical professionals, reporters, and people around the league have spoken out about the holes in the NHL’s concussion policy. According to the 5 Eyewitness News special series Fighting Back:

Colin Campbell, the NHL’s Director of Hockey Operations, called the team trainer for the Ottawa Senators “an absolute freaking idiot” after the trainer relayed concerns that the league does “not take (the concussion issue) seriously.” Frank Brown, the league’s Vice President of Communications, characterized concerns from the Canadian Medical Association as “imbecilic rants from dumbass doctors.”

There are 4,300 retired NHL players and only 100 have signed their names to the lawsuit. One reason so few have signed on could be fear of retaliation. The NHL wields a lot of power. A former referee accused the NHL in 2011 of not doing enough to protect players from head injuries. According to 5 Eyewitness News, NHL Commissioner Gary Bettman had this reaction:

Are we still paying him anything?” Bettman asked in an email exchange with Bill Daly, the league’s general counsel. “yes (sic), his severance. but i’m (sic) not sure we can stop paying him for expressing views critical of the league,” Daly responded. Undaunted, Bettman asked whether there were any grounds to withhold payments because “maybe he should understand its (sic) not nice to bite the hand that feeds you… Don’t want to hurt him – maybe just get his attention.

The fact that the NHL allowed Crosby to play so quickly after sustaining his fourth “reported” concussion signals to many that the NHL isn’t taking concussions seriously. If Crosby had suffered an ankle, knee, or groin injury, he wouldn’t have been able to play in Game 5. A concussion is invisible and that makes it easier to ignore, but when a player gets back on the ice before their brain has fully healed, the consequences can be life-changing.

Humans have a vulnerable brain after being injured once, and if it gets hit again before recovery, the metabolic consequences are worse and the symptoms can be worse and prolonged. — Dr. John J. Leddy, clinical professor and director of the University at Buffalo’s Concussion Management Clinic

Allow the athlete to recover and return the athlete to play only once he or she is fully recovered and is deemed to be no longer vulnerable. That gives you your best chance of reducing the effects of cumulative brain trauma. — The Buffalo News

The mentality in hockey is to “shake it off” and “get back in the game.” Robin Lehner, the Ottawa Senators goalie, says hockey players have a “warrior mentality.”

I was one of those guys before I got my concussion that could sit there and say, “Come on. It’s just a headache. Let’s go. Let’s get back playing.” That was one of the dumbest things. That’s something I’m embarrassed about being in that position before I got mine because when I got mine, reality hit me, and that reality was not a fun one. — Robert Lehner, The Buffalo News

Keith Primeau was a two-time all-star in the NHL. His career ended in 2005 due to concussions. Primeau felt pressure from the team to get back in the game even after being hospitalized with a concussion. Primeau told Sporting News:

I had four documented (concussions), and the last one was the one that forced me to retire, but I continue to go back to my second documented—in Pittsburgh, in the playoffs, I was taken off the ice in a stretcher, and spent the night in the hospital. A few nights later, I was back on the ice in the Eastern Conference Finals. I knew I wasn’t right, and I still tried to play through it.

Crosby, like many NHL players, feels the pressure to push through the pain and return to the game.

Yeah, you just want to be back out there. I mean, um, I think you, you just kinda go with the flow I think. Trying to, you know, meet expectations as far as you know when you’re going to come back, that kind of thing. But, um, you know playoffs, you want to be in the lineup and not watching.  — Sidney Crosby

Eric Lindros played for the Philadelphia Flyers. He suffered eight concussions from 1998 – 2005. He was NHL MVP in 1995 and won a 2002 Olympic gold medal.

It’s time to understand that we have a problem . . . We just don’t want anyone to go through this again . . . You cannot fix a brain, that’s something I had to learn. It’s not like a shoulder or a knee. . . Hockey in [sic] an old sport. It’s the old-school boys and old way of thinking. We have to change that thinking a little bit. I bought into it, I wanted to be a tough guy. But it didn’t do me any good. That’s what came home to me obviously. . . The lack of response from the hockey community has frustrated me. —  La Couture et al v. National Hockey League

The NHL allowed Crosby to play Russian roulette with his career, and his life. He was lucky, but some players aren’t.

Gary Leeman, Toronto Maple Leafs’ all-star defenseman, had his career cut short thanks to a puck that cracked his skull.

The easiest way to explain it would be, it’s the shot that changed my life.” Leeman told The Washington Post. “It changed my career. It changed a lot of things about me.

Leeman felt pressure to continue playing, so he suited up for two more games despite not being able to hold his head up as he skated. Today, he suffers from memory loss, balance control issues, debilitating fatigue, depression, and panic attacks.

Leeman thinks NHL commissioner Gary Bettman needs to consider how repeated concussions affect the long-term welfare of the players.

I personally believe Gary Bettman has done a great job in putting a good business model together. But I think this is one thing that he needs to take another look at. This game was built on the backs of the retired players. It’s the right thing to do to look after the guys that are reeling from what they should have been warned about. That’s that repetitive hits to the head are going to cause long-term issues. — Gary Leeman told The Washington Post 

According to Statista, the NHL made $4.1 billion in revenue the 2015–2016 season.

One of the biggest impediments to better concussion protocols in the NHL is the lack of transparency about how many there actually are. When a player suffers a concussion, an “upper body injury” is often the official reason given for his absence on the team. It’s common for players in the NHL to have a “reported” or “documented” number of concussions and an actual number.

Keith Primeau had four “reported” concussions, but he tells the Canadian TV program CTV Morning Live Ottawa, the real number was “north of 10.”

If the NHL wants to reduce the number of concussions players experience each year, don’t they need to know how many there actually are?

There probably isn’t a player in the league who hasn’t had a concussion. — former NHL player Paul Kariya

Paul Kariya played in the NHL from 1994 – 2010. Kariya was an NHL all-star. He won the Lady Byng Trophy for the NHL’s most gentlemanly player. His career ended because of head trauma.

The thing I worry about is that you’ll get a guy who is playing with a concussion, and he gets hit, and he dies at centre ice. — Paul Kariya

With so much at stake, why are certified athletic trainers, rather than neurologists, making medical decisions about concussions?

Los Angeles Kings’ star goalie, Jonathan Quick, missed 59 games (4 ½ months) this year due to a groin injury. His GM at the time, Dean Lombardi, told the LA Times what every player with a concussion deserves to hear.

I told him, the reality is you’re looking at a player in his prime and there’s no way we’re going to use a short-term fix. It’s like I told Jon [Jonathan Quick] and the doctors, “It’s up to us to deal with this. And we are not taking a short-term look at this.” The extreme was, I told the trainers and the doctors this, that if he has to sit out a whole year to get to 100 percent, then that’s what we’re going to do, particularly when you’re dealing with an injury like this. — Dean Lombardi, LA Times, “Kings goaltender Jonathan Quick’s return from injury is a slow and tedious process” 

Many of today’s stars have no idea how much brain damage they’ve suffered while playing in the NHL. Nor is there any way they can know how it could affect the rest of their lives.

Boston Bruins center Marc Savard was one of the best players in the NHL. His career was cut short because of post-concussion syndrome. Savard told ESPN he struggles to help coach his son’s hockey team. He suffers from balance issues and his short-term memory is pretty bad.

I took my son to a game the other day and I left the keys in the ignition of the car. Turned it off, at least, but went in to watch the game and I was like, ‘”Geez, where are my keys?” And I went out to the car and they were in the ignition.

Right now the way I’m still feeling and the daily issues I’m having, I mean it’s tough to see a bright future right now, to be honest with you. It’s a day-by-day thing still. I’m still hoping that something happens that I’ll feel a lot better. — Marc Savard, ESPN, “Marc Savard’s life still unsettled” 

Savard is one of the 100 former players suing the NHL.

5 Eyewitness News interviewed New Jersey Devil and Stanley Cup champion Mike Peluso as part of its special series Fighting Back. Peluso is only 51 years old and already suffers from dementia and depression. He described a dark moment in which he thought about killing himself “by mixing all of his prescription medication into a potentially lethal cocktail of pills.”

I’m going to take all this (expletive) right now and be done with it.” That’s when the labrador retriever he once rescued saved him. “I looked at him and said, ‘Jesus, this isn’t right,’” Peluso recalled. “I said, ‘I’ll never do this again to myself, my family, and that dog literally saved my life.”

Peluso is pretty confident he’s going to “die young.”

The symptoms of a concussion can be so profound they can overshadow any fame, fortune, or thrill a player may have experienced from playing hockey, or any sport, including football.

NFL Hall of Fame linebacker Nick Buoniconti was diagnosed with neurodegenerative dementia last year. He can’t read a book or tie his shoes. When asked if he would have continued to play football if he knew then what he knows now . . .

The answer would be no — I would not have played football.

CTE to me is something that the NFL doesn’t recognize until you die — that to me is the biggest criminal act,” he told Sports Illustrated. “I feel forgotten. I just wish they would think of the guys who did pave the way. This is not a game we’re playing — this is life or death.

Many wonder if it’s time for Crosby to hang up his skates. Is the next hit to his head, or the one after that, the one that will end his career, or his life? Will hockey’s greatest player be sacrificed because of the NHL’s failure to take concussions seriously?

How many more studies do we need before we realize significant changes are needed in the way we play the game? – New York Times, “Study Finds Changes in Brains of Hockey Players Who Had Concussion”

Should a star athlete in his prime have to choose between hockey and having normal brain function for the rest of his life? Despite the risks, many NHL players choose to play. This is why we need doctors, not certified athletic trainers making decisions about their health. Players may feel invincible now, but what happens when they finally do face the daily horrors that repeated brain injuries can bring? Will they wish they had made different decisions? Will they wish the NHL had?

Adam Estoclet played for a Swedish hockey team, not in the NHL, but his story says a lot about the hockey culture. Estoclet’s not a fighter or some “dumb goon,” as he puts it. He has an Ivy League degree from Dartmouth. He took a hit to the head in practice and suffered a concussion.

I wish I could tell you that I went straight to the team doctor. But I’m a hockey player. I mean, are you kidding me? What am I going to tell him? “Hey doc, you know what? I feel a little anxious and I hear this weird tone [he heard ringing in his ears]. I think I should sit this one out.” I’m laughing just thing about it.

Estoclet shared his story with the The Players’ Tribune“The Darkness” is about his struggles with post-concussion syndrome.

I am writing this because I know there are probably hundreds of hockey players who will read this who are suffering from the exact same weird feeling that I felt. And they aren’t going to do anything about it.

One hundred percent of them.

One hundred percent will do nothing about it. They will pop some painkillers, keep on playing, and then one day, they will show up to practice and fall into complete darkness.

I know, because I did the exact same thing. When I first got hit in September and was feeling weird, I was sitting in my Swedish apartment reading Bryce Salvador’s Players’ Tribune article about his horrific battle with post-concussion syndrome.

The dizziness.

The weird feeling.

Then the nausea, the feeling like you are floating through space.

Then the regret that he kept playing through it.

Then the feeling like he was turning into a monster.

I read all this, thought damn, then I still kept on playing.

Doesn’t the NHL owe the next generation more?


NHL Concussion Litigation
NHL concussion protocol
Maclean’s – “Handling concussion is a team sport. And we all need to be in the game”
The Washington Post – “Former players are suing the NHL over concussions, but remain loyal to hockey”
ABC Eyewitness News – “Fighting Back: Former Players Say NHL Downplayed Concussion Ignores Science”
RMNB – “Nikita Zaitsev to miss Worlds with reported concussion”
Sports Business Journal – “NHL sees value in Las Vegas”
The Washington Post – “Why did Sidney Crosby keep playing Monday night?”
ESPN – “NFL to study why diagnosed concussion rose significantly in ’15”
New York Post – “The Penguins, NHL, can’t get story straight on Sidney Crosby”Feature image credit: ronlechua – iStock
Former NFL player’s struggles with CTE can be seen in this 2013 PBS Frontline documentary: “League of Denial.”

Feature image of the hockey skates: Ronniechua – iStock

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