Your brain, your brain on hockey

Photo: George Parros / Youtube screenshot Photo: George Parros / Youtube screenshot

A concussion, from the Latin concutere ("to shake violently") is the most common type of traumatic brain injury. Often causing temporary disorientation, memory loss, or unconsciousness, concussions are cause by severe blows to the head, or in this case, by playing a game. The human brain is surrounded by cerebrospinal fluid, which protects it from light trauma. Severe impacts caused by forces which provide more acceleration, may not be absorbed by this cushion and can cause the brain to volatility collide with the skull, resulting in a concussion.

If you think this is more likely to happen when two objects, going at 20 miles (32 km/h) per hour on the ice collide with one another, you're probably on to something. In a game of hockey, those objects, traveling at that precise speed aren't objects, but players.

Steve Montador is definitely a player. Moreover, he is definitely a gamer. A well respected NHL veteran was a leader in most dressing rooms and a well respected voice on any team he played with. Most coaches loved him along with his gritty style as he was always counted on to play important minutes and was used in any game situation. Most of all, he loved playing a physical brand of hockey. Unfortunately, the twilight of his career could offer a grim impact going beyond the usual meaning of the term.

After yet another in a series of concussions that plagued Montador at the end of his hockey-playing career, the defenseman decided to temporarily retire from the game.

''This morning, the club and Montador have, after brief consultations with medical team, decided that the player will retire for some time due to the health issues. Namely, because of the injury in one of the home games, Montador has not been feeling well recently. Considering his previous serious injury, the medical team's recommendation and Montador's own decision resulted with an agreement on a necessary recovery. The recovery will take place in Montador's home in Canada'', said the club's chief spokesman Ranko Vucinic.

Physical side effects of concussions that can include dizziness, headache and nausea. There may also be a ringing in the ears and increased sensitivity to sound and lights. Frequent concussions, such as those experienced by football and hockey players, can cause sleeping problems, mental disorders and even depression. In those two sports, the problem had become so severe that medical institutions felt a public outcry was needed.

Beginning in 2010, the American Academy of Neurology (AAN) was calling for any athlete who is suspected of having a concussion to be removed from play until the athlete is evaluated by a physician with training in the evaluation and management of sports concussions.

"While the majority of concussions are self-limited injuries, catastrophic results can occur and we do not yet know the long-term effects of multiple concussions. We owe it to athletes to advocate for policy measures that promote high quality, safe care for those participating in contact sports." then said Jeffrey Kutcher, MD, MPH, chair of the AAN's Sports Neurology Section.

Still, the governing bodies of the NFL and the NHL wouldn't budge. Part of it stems from the culture of both leagues and their respective sports. When I spoke to The Hockey News' columnist Adam Proteau in 2012, he underlined some of the reasons why concussions occur more frequently on NHL ice:

"The removal of the red line and crackdown on obstruction made the game much faster and I think that plays a huge role. There's also the hyper-aggression and predatory nature of the North American game that adds to it. And the lack of proper fines and suspensions here fails to make players accountable."

He also added his opinion on why the NHL seems to finally be re-examining the issue at hand:

"First of all, Crosby's saga has drastically raised awareness of the issue, but I still think the NHL hasn't recognized the severity of the epidemic enough to take the rapid and wide-ranging steps that need to happen. The league remains in denial to a large degree and that isn't likely to change until there's a death on the ice, or until players launch a lawsuit against the league the way a group of retired NFLers have done recently."

There are many options to cutting down on concussions, including taking some of the increased speed out of the game, streamlining over-protective equipment and a total ban on head shots at the NHL level. I'd be ok with any and all of them, but the league is moving too slowly and cautiously to make a real difference right now."

The NFL players Adam is talking about are the 4,500 former athletes suffering from depression, dementia and Alzheimer's disease blamed on frequent blows to the head, that sued the league, accusing it of concealing the concussion dangers and rushing injured players back into play while glorifying and profiting from crushing, devastating hits that made for exciting highlight-reel footage.
Stop me if this sounds familiar. If what you're reading describes every hockey highlight pack ever fed to a hungry audience, you'd be right.

In recent years, a string of former NFL players and other concussed athletes have been diagnosed after their deaths with chronic traumatic encephalopathy, or CTE. It is believed to be caused by repeated blows to the head. It can be diagnosed only posthumously, but scientists say it's showcased in symptoms like memory loss, impulsiveness, mood swings and addiction. More than 20 dead NFL players were diagnosed with CTE after their untimely deaths.

In 2013, the NFL reached a settlement with its former players, agreeing to compensate victims, pay for medical exams and further research but also denying any wrongdoing in the matter. 765 million dollars was paid out as a result. After neglecting the problem for years, so much so that the league was called the "League in denial", NFL Commissioner Roger Goodell was quoted saying to NFL lawyers: "Do the right thing for the game and the men who played it."

North American hockey is still escaping blame. Not only because of injuries that happen/ed on hits once glorified by the league, much like the career-ending ones thrown by Devils' Scott Stevens. A different era perhaps, a predatory time. Today, we're all more hypocritical, viewing Stevens as a hockey hero and Matt Cooke as a villain on skates. Perhaps being good at hockey has something to do with it, perhaps we're quite intent to keep hold the past, keeping its glory intact in our heads. And it shows.

Suspending Raffi Torres for more than four games for elbowing Edmonton's Jordan Eberle in the head would actually add validity to the change in perspective. Perhaps, suspending superstar players for doing the same thing (Mike Richards for the hit on David Booth) would add much needed credibility to that claim.

The current concussion policy for the NHL went into effect March 16, 2011. Before, an NHL player suspected of having a concussion was examined right on the bench. Now, the athlete is examined in a quiet area around the dressing room, away from the ice. The team doctor makes the final call on if player can return on the ice. If a player is diagnosed with a concussion and sidelined, he must be symptom free, and concussion tests must return proper results before he can return to action.

During the 2011-2012 season, there were 90 registered player concussions and 1 779 man games lost to concussions. When calculated differently, 21.7 players would have missed an entire season due to concussion effects.

CTE is often referred to as Dementia pugilistica (DP) and is described as a neurodegenerative disease or dementia usually affecting amateur or professional boxers. Hockey enforcer Derek Boogaard died from the same disease on May 13th, 2011, 2 months after the NHL passed it's "quiet room" concussion protection. Rick Rypien and Wade Belak were also lost in recent years. Both were men who fought frequently and suffered blows to the head, although unlike Boogaard's, their brain was never analyzed. Derek's brother Aaron commented that, due to his size, Boogaard usually had to take extra amounts of painkillers for them to have any effect.

"He'd go through 30 pills in a couple of days. He'd need 8 to 10 at a time just to feel OK."

In addition to taking pills, Boogaard drank a lot and was often seen at bars being bought drinks by men who admired his pugilistic skills. He developed an addiction, and missed training camp prior to the 2009–10 season due to drug rehabilitation masked as a concussion issue by the team. Even with all the warning signs, the enforcer role is still alive in the modern NHL. On May 13th, 2013 Derek Boogaard's family had filed a wrongful-death lawsuit against the National Hockey League. On October 1st, 2013, after a devastating injury to enforcer George Parros, sustained in a fight with Colton Orr, the NHL re-examines its state on fighting.

Although North America is the birthplace of hockey toughness, there was never any doubt that hockey was a man's game, no matter where it was played. American football might be as close as you can get to hockey's twin brother in terms of physicality and dominant masculinity. In the past, players like Bobby Holik would never dream of telling their coach they couldn't play because "they felt dizzy". Sure enough, that would get them benched.

In 2012, the New York Jets' coaching staff didn't know that quarterback Greg McElroy was experiencing concussion symptoms. According to several players he confided in, he had been wrestling with the decision to tell the Jets' medical staff. "He definitely has that warrior mentality, but it got to the point where it was scaring him." his teammates were quoted saying. Even with all the evidence presented from 2010, the quarterback still struggled with the decision. Philadelphia Flyers defenseman turned scout Chris Pronger still doesn't regret wearing a visor in 2011 when he caught a puck in the right eye in a game against the Leafs. Multiple hits resulting in post-concussion syndrome limited Pronger to only 13 games during the 2011-12 season and, despite him never officially retiring, ended his hockey-playing career.

"I don't have any regrets. I played the game to the best of my abilities and the best I knew how." said Pronger. The hockey culture was certainly well learned, but will that matter in the long run?

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