Originally posted on Fox Sports Arizona  |  Last updated 1/27/12
When New York Rangers forward Wojtek Wolski elbowed Ottawa captain Daniel Alfredsson in the head earlier this season, causing a concussion, NHL disciplinarian Brendan Shanahan declined to suspend Wolski. Shanahan cited Wolskis clean track record and the specifics of the play, arguing that Wolski didnt see Alfredsson until the last minute, then tensed up to protect himself. When then-Calgary forward Rene Bourque elbowed Washington center Nicklas Backstrom in the head on Jan. 3, causing a concussion, Bourques reputation for dirty play and the clear evidence that he went out of his way to throw the elbow led to a five-game suspension. Did the NHL get either of those calls right? Alfredsson, an All-Star Game captain this weekend, doesnt think so. When you get guys sticking out an elbow, youve got to get away from that, Alfredsson said. There should be severe punishments when that happens. Some thought Bourques punishment was severe. NBCs NHL analyst, Ed Olczyk, thought it was a joke. Brendan dropped the ball on that one, Olczyk said of Shanahan. When a guy is not making a hockey play and throws an elbow in, looking to separate somebody from their helmet, you have to give him a big suspension. I would have given him 10 to 15 games, and if he does it again, it will be 30. Youve got to whack guys hard who do not have respect for the game. Shanahan declined an interview request. There is no doubt the NHL is taking steps to curb the incidence of concussions in its game. The league is exploring new ways and has already implemented other measures intended to improve equipment, rules, awareness and education regarding what is perhaps the most dangerous yet least understood injury in the game. Critics would contend that high-profile concussions (such as Penguins star Sidney Crosbys lingering injury), rampant media coverage and a 2009 Congressional hearing on NFL concussions have cast a bright spotlight on the topic that makes it impossible for the NHL to ignore it any longer. Yet in spite of recent efforts, the NHL board of governors received a detailed report during 2011 All-Star weekend that showed the number of concussions was trending upward (Commissioner Gary Bettman is expected to address the issue again this weekend in Ottawa). So is the NHL truly doing enough to curtail concussions? Until the number of incidents sustains a downward trend, the answer must be an emphatic no. "I know it is an emotional, intense subject -- especially for our fans, Bettman said during last year's All-Star break. We understand it, we get it, but dealing with this issue is not something you can just do whimsically or emotionally. You really have to understand what is going on. That understanding begins with the science of concussions and their causes. Dr. Dean Karahalios is a neurosurgeon at the NorthShore Neurological Institute in suburban Chicago. While granting that we know much more than we did five years ago regarding concussions, Karahalios said there is much to learn in the areas of understanding, prevention and treatment. At one point not too long ago, concussions werent thought to be responsible for any significant brain damage or long-term effects once a player or patient had recovered, Karahalios said. Now we know from certain arenas such as football or hockey that there are probably more sinister ramifications. Well-publicized autopsy studies on several former NFL players who died before the age of 50 have revealed that they were suffering from chronic traumatic encephalopathy (CTE), brain damage caused by repeated head trauma. The research, Karahalios said, shows changes occurred in the brain at a microscopic level. The images look very much like they do in patients who suffer from Parkinsons disease and Alzheimers, he said. While there is no direct link with head injuries and these problems, these individuals who had repetitive injuries are getting these diseases at an earlier age than the normal population. This caused us to rethink our concept of concussions being a temporary disruption. We now believe there are probably some lasting effects. Theres bad news and good news associated with that finding. A study funded by the Department of Defense on soldiers who had been concussed in combat found they released a chemical called UCH-L1 into the blood stream. You can do a blood test and find the same substance in patients with Parkinsons disease, Karahalios said. Thats the bad news. The good news is if theres a common pathway, we may be able to focus our research and treat it. The NHL was the first league to implement baseline testing for all athletes, a process in which athletes are tested before a season to measure normal cognitive function, which is the baseline. When an athlete suffers a head injury they take the same test again with their cognitive function measured against the normal results to highlight potential head trauma. No player can return to play without passing this test. Karahalios said the methodology and rigorous research behind the test make it a very good measuring tool. But he also noted that its all weve got right now. In the future, well have much better ways of determining if someone has sustained injuries and the severity of those injuries. Equally important is widespread evidence that once a player suffers one concussion, he is more susceptible to additional concussions. We dont know whether they are made more susceptible through their injuries or whether theyre genetically predisposed to concussions, but the evidence is certainly there, Karahalios said. To highlight how limited our knowledge of concussions is, Karahalios noted that the only current treatment is rest that allows the body to heal itself naturally. There are promising drugs and treatments being studied, but none is ready for use. The same can be said of better equipment, specifically helmets that reduce the incidence of concussions. As director of the Neurotrauma Impact Science Laboratory at the University of Ottawa, Dr. Blaine Hoshizaki simulates the blows NHL players absorb with their helmets and heads. Hoshizaki was a vice president at two of the major helmet and hockey equipment manufacturers, Bauer and CCM, before his present post. In replicating injuries such as Crosbys, Hoshizaki found that while current helmets do a good job protecting players against linear hits, most concussions occur through whats called angular acceleration, where a player suddenly turns into a big hit. Thats what happened to Crosby, who took a shoulder to the side of the head in the Winter Classic last year at Heinz Field. We were trying to improve the performance of certified NHL helmets a long time ago, but we werent really having a great deal of effect on concussive injuries. Their frequency wasnt being affected by what we believed were better-designed helmets, Hoshizaki said. The truth is, no helmet in any sport has ever done a good job of protecting players from concussions. It really comes down to the transfer of energy to the head, and thats what were experts at. Using crash-test dummies as victims, metal poles to deliver the blows and video of numerous NHL hits to the head as a guide, Hoshizaki has replicated the details of those hits in his lab to gain a better understanding of how that energy and trauma transfers to the head and the brain. One hope is for a better-constructed helmet. Hoshizaki said there are a couple promising models in the research stage, and the M11 helmet, funded by former NHL star Mark Messier and designed to absorb more impact from high linear forces, is being tested by several current NHL players, including Colorados Peter Mueller, who missed an entire season due to a concussion. But Hoshizaki cautions that helmets can only go so far to protect players. You could have a helmet an inch think and youd still be hard-pressed to manage that energy transfer, he said. Perhaps prompted by Crosbys injury, the NHL is now at an understanding that you also have to use the rules to manage that. If I was a bit bitter over my 12 years of fruitless campaigning on this topic, I would say, 'Jesus, why didnt they do this 12 years ago?' But at least theyre doing it now. Among the rules changes the NHL has adapted to combat hits to the head was a broadening of the range of contact that is forbidden. Amendments to Rules 41 and 48, which cover boarding and illegal checks to the head, respectively, went into effect this season. Rule 48, enacted in its original form last year, now bans all hits "where the head is targeted and the principal point of contact," although it is up to the referees to determine whether the victim of such a hit "put himself in a vulnerable position immediately prior to or simultaneously with the hit or the head contact on an otherwise legal body check." The rules are a good start, but with concussions still on the rise, perhaps partly due to better reporting mechanisms, Olczyk said those rules dont accomplish enough. Among the rule changes Olczyk would like to see implemented are: 1. A hyrbrid form of icing used currently by the USHL that gives a linesman the discretion to blow his whistle and stop the play if he believes a defending player will reach the puck first. If the linesman believes the attacking player has a chance to reach the puck first, he keeps his whistle in his pocket and lets the race to the puck play out. The linesman always will side with the defending player and blow his whistle if he feels the race is a tie by the time the players reach the faceoff dots. The idea is to cut down on the number of injuries that result from big collisions behind the net when both players are racing at top speed with only the boards, glass and each others bodies to stop them. 2. A rule that abolishes checking when the arms, stick or elbows are raised above the chest. Olczyk calls for "better technique" and cites Phoenix Coyotes forward Martin Hanzal as the classic example of a guy who skates with his arms high all the time, thus putting opponents at potential risk. We need to implement it at the minor levels, too, because guys are skating around like theyre carrying tomahawks, he said. The rule would be simple. If a guy hits somebody and his stick or elbows are chest high or higher, its a penalty. 3. A way of padding the hard plastic caps on players elbow and shoulder pads, which have become formidable weapons in the checking game. "Equipment has gotten better, and guys are just fearless as a result, Olczyk said. "Maybe we could experiment with some sort of bubble wrap over those plastic caps. 4. The last of the changes is one Olczyk isnt even sure he supports -- bringing the red line back into play. When the NHL emerged from the lockout in 2005, the league adopted a number of rules intended to open up and speed up the game. One of those was the elimination of the red line for two-line passes. The league had been bogged down by the neutral-zone trap, and removing the center line was an attempt to combat the trap by allowing more puck movement. But an unintended consequence was the speed it created through the neutral zone, which created greater collisions in the offensive and defensive zones. Hoshizaki has argued for years that speed was one of the greatest concerns in concussions, yet he laments that the NHL never connected the dots when implementing this rule. Olczyk understands that speed is one of the drawing cards of the game. "That change, to me, is a last resort, but dont you have to look at everything if you want to slow the game down a little and make it a little more controlled? he said. If something is going to protect players better and keep them healthy for their later years, Im all for it. Olczyk predicts these changes would be met with resistance by hockey machos culture, which is present in players, coaches, management and fans. But there is a growing community that believes the current trend toward safety is the correct one. I know I was knocked out in my playing days, but it wasnt under the protocol they have today, so I never had a concussion diagnosed, said Coyotes assistant Jim Playfair, whose last NHL season was 1989. Anybody who played back then probably had one. We used to play without helmets. Thats being stupid, not brave and tough. The way they do it today is right. Theyre trying to take care of these kids now and in the future. Olczyk was also a part of that macho culture in his 16 NHL seasons. I remember getting my bell rung in a game in Dallas when I was with Winnipeg, he said. I was on the bench and I just blacked out. All I saw was black. I got tapped on shoulder by (coach) John Paddock to go back on the ice and I said I just needed a minute. They sent the trainer down to talk to me and I lied. I told him I was fine, and I went back on the ice and was just awful. How many concussions did I have in my career? I have no idea. A couple for sure where I missed time, but I know there were other times where it probably happened. Olczyk is glad that the reporting of concussions is far more prevalent. He also believes physical play is a vital and exciting part of the game, but ultimately, he believes there must be educated limits. Injuries are going to happen in this game. Thats just the reality. What makes our game so great is its fast, its hard and youve got to be willing to pay a price, he said. So if a guy injures someone making a hockey play, you have to live with that. But you cant accept the cheap stuff. Youve got to have respect for other plays. Is it going to have to come to, God forbid, a death in our game before we reach that conclusion?
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