Concussions spark hockey debate

Officials, doctors and players all face a changing sport.

By Connor Dalton

The hockey world, suddenly reeling, is looking for an answer.

By Connor Dalton 

A QMJHL game between Halifax and St. John. Some sportwriters, like Chris Cochrane, have called for change at this level of hockey. (Photo: Connor Dalton)

 Escaping a bitter January night, Ronald Kelly arrived home. It was 11:30 p.m. and he had been to dinner with a teammate, but could only drink water. Kelly’s head was pounding; whether from the punch or the fall, he couldn’t tell.

“There were a couple of seconds,” Kelly says, “where I didn’t quite remember what happened.”

The 23-year-old Dalhousie University hockey player had been hit in the back of the head and fell to the ice. Sitting in the dressing room after the game he felt some nausea. Now at home Kelly watched TV until 1 a.m. He headed to his bedroom, and lay on his bed in the dark with “screaming headaches.”

Finally he got up and went to the kitchen, still with no appetite; he just kept gulping water. It felt better to rest in a chair. The throbbing, raw headache refused to let up. Kelly fell asleep sitting up, alone and still in the dark.

The next morning he called the team trainer and his coach. On Jan. 22, 2011, Kelly learned he had a concussion. Five days later, even some light exercise left him dizzy and he was off the ice for two weeks.

Seven years ago, neurologist Kevin Gordon also had to deal with a concussion—though it wasn’t his own.  He sat in the stands at Exhibition Park outside Halifax, cheering on his teenage son during an indoor soccer game. Something went terribly wrong.

“It’s watching your kid go head-to-head, obviously concussed, and not knowing a freaking clue what to do about it,” says Gordon. “Everyone in the stand said ‘You’re a neurologist, you should know what to do here’.”

But he didn’t.

As Gordon talks in his sunny office at the IWK Health Centre, he still looks bitter about that day. He says many doctors wouldn’t know know how to treat a concussion.

Since that day, the pediatric neurologist has become a concussion specialist. Gordon started helping concussed players at his children’s games and identifying concussions on the spot. He began taking new patients specifically because of their concussions.

He works in an area that has recently taken the spotlight. Sidney Crosby—perhaps Canada’s best and most popular hockey player—was concussed in January 2011 and has barely played since.

Media coverage on concussions has exploded. Barely a side note before, concussion stories were featured in the biggest newspapers in the past nine months.  An Oct. 1 Globe and Mail editorial called for the end of head shots, followed a day later by a New York Times feature on Crosby’s injury.

Hockey Canada (a governing organization for amateur hockey in Canada) has told minor hockey leagues to follow new rules, designed to eliminate head contact. These rules are nationwide and apply to many; more than half a million Canadians registered in Hockey Canada’s programs last year. More than 18,000 were registered in Nova Scotia alone.

[pullquote] “Teenagers fighting—as a sport or as a spectacle—to appease adults, I just think it’s simply wrong,”

               -Chris Cochrane, sports columnist at the Chronicle Herald [/pullquote]

Concussions are a hot topic—both in news and sports—because there is more evidence than ever about the severity of the problem. Concussions are a form of brain injury, common in and outside of sports. Falls are the most frequent cause of concussions outside of sport. Typical concussion symptoms are headaches, tiredness and nausea.

One concussion study, conducted in 2010 by a neurologist from Ontario, followed two junior hockey teams for a season. More than a quarter of the players suffered at least one concussion over the course of the season, and a doctor observed a concussion in a third of the games they played.

Chris Cochrane is a sports columnist at the Chronicle Herald who has called for change in hockey. He has suggested that fighting in the Quebec Major Junior Hockey League (QMJHL) should be banned. “Instead of the 17-year-olds going out, let’s have two of the most boisterous 50-year-old adults in the crowd—that scream every time the kids fight—go down at intermission at centre ice and they can fight,” he says.

Cochrane has received criticism from some hockey fans he calls “the fighting squads”, who fear the game is changing too fast. They see hockey at a crossroads: there is a dichotomy between old hockey customs, and the encouragement for more player safety. “Hockey is a very traditional world,”he says, “and it doesn’t like to change much.”

The columnist believes some fans in the stands want a different game than the young players on the ice. He uses fighting as an example. “Teenagers fighting, as a sport or as a spectacle, to appease adults, I just think it’s simply wrong,” says Cochrane.

Cochrane feels his columns have had a positive impact; by striking up debate and opening a forum that drives change forward. 

“You’re not going to find many things in the area of safety evolution that don’t come from increased coverage, [and] reporters who are doing their job and bringing up problem areas,” says Cochrane.

Crosby forcing hockey to deal with concussions

Right at the centre of the concussion debate has been Sidney Crosby.

The Cole Harbour, NS native was hit in the head on Jan.1, 2011 and suffered a concussion. He played another game afterwards and got hit; what neurologist Dr. Kevin Gordon calls “doubling-up”. He uses this term to describe when a player gets a concussion quickly on top of another concussion.

“That’s probably what Sidney did,” says Gordon. “He was not feeling well during that second game, so he was probably concussed at the time and then took the second impact.”

The Pittsburgh Penguins centre player has not played an NHL game since that second hit. This has made the Atlantic Canadian audience more open to concussion stories. Sports reporters like Glenn MacDonald, who writes for the Chronicle Herald, have become aware of this, and are making decisions based on that.

“I think it’s put it to the forefront,” says MacDonald.

Hockey officials have seen their efforts to reduce concussions gaining speed as a result.

Although his health took a toll to give concussions attention, Crosby is making his way back to the game. On Oct. 13 he was cleared for contact in practice and looks like he will soon be returning to the NHL.

Cochrane’s view of concussions is backed up by more and more studies. A study of hockey in Alberta released last year looked at peewee hockey, where players aged 11 or 12 can body check. Eight other provinces follow this guideline. In Ontario and Saskatchewan, some leagues allow checking from the age of nine.

The study found that checking tripled the risk of concussion in the province compared to Quebec, where players at that age cannot check.

Gordon feels this mounting evidence is making a difference. He is constantly dealing with concussed players and their families. He has seen paranoia and panic over the most minor concussions. “We’ve gone from not paying attention to them at all and a small subset of people having trouble, to paying attention to every single one of them.”

Concussion awareness has led to a bigger appetite for changes to hockey. Effective this season, new rules will be used in minor hockey across the country. Rule 6.5 was announced by Hockey Canada in May.  It makes the issue black and white: no head contact is allowed, even if it’s accidental. The rule states “a minor penalty shall be assessed to any player who accidentally contacts an opponent in the head.”

Todd Robinson is the referee-in-chief at Hockey Nova Scotia (an organization that governs amateur hockey in the province). His job is to make sure these new rules are put into place properly and quickly. He is realistic about what they can achieve.

“These rules are not solely intended to eliminate concussions,” says Robinson. “Because concussions are still going to happen. Concussions can happen off a clean body check when a player falls to the ice.”

Robinson has a silver Hockey Nova Scotia plaque proudly decorating his wall. He remembers watching a minor hockey game this past September, where several head contact penalties were called in the first period. After that, players got used to the rules; the rest of the game was physical but with no hits to the head.

Robinson has spent the last few months travelling the province. He is trying to teach this new rule to players, and thinks this will pay off. “The biggest obstacle is going to be the education part,” he says. “In Nova Scotia, I believe we’re ahead of the game, we’re working really hard to get that message out.”

Robinson says players and teams have been firmly behind these changes. He has also heard criticism, some from parents misunderstanding the rules.

“They’re all different stakeholders in the game. The parent… is maybe less educated about the formalities of the game and more on the emotional part of the game. Our job is just to be consistent.”

The Canadian Centre for Ethics in Sport, in Ottawa, has heard this concern. This group works for player safety—and wants to end hockey hits outside the rules. They were pleased to hear about the new rules but were stunned by the reaction outside of the players.

“We’re talking about quite the culture shift here,” says Paul Melia, their president and CEO. “I’m just surprised at the lack of understanding and tolerance from coaches and parents already about the implementation of this rule.”

Melia hopes hockey fans can change the way they look at the game. He feels this is underway already, propelled by the concussion debate. “We’re looking at [concussions] very differently than we did even 10 years ago,” says Melia. “Getting your bell rung even 20 years ago was seen as part of the football or hockey experience.”

Darren Cossar has also heard reaction to the new rules. The Executive Director of Hockey Nova Scotia is looking at this long-term—hoping the changes will become hockey tradition. “The rule is not going to correct or eliminate contact to the head in one year,” says Cossar. “It’s going to eliminate that over a generation.”

As a neurologist, Gordon has formed a firm opinion after seeing concussed hockey players. “Every country has their tough sport, but they’re going to have to modify something,” he says. Otherwise people are going to be damaged because of head injuries.”

Concussions have become known as a potentially devastating injury, something many in the hockey world fear. Glenn MacDonald, who covers sports at the Chronicle Herald, notices this injury is one players fear. They are secretive about concussions because they are unsure what they are dealing with, he says. 

Gordon jumps onto his laptop, where he has a YouTube video showing some of the worst hits from the NHL last year .It has the chilling voice of Sidney Crosby talking over it, taken from another commercial where he talks about Canada’s love for the game.

Sometimes the neurologist has to tell teenagers they should retire from hockey. He asks them whether they’re an athlete or a hockey player. He’ll recommend less physical sports or other roles, like being a referee or a coach.

 “When the symptoms start getting too overwhelming, then the question is:  ‘Is it really worth it?’ ”says Gordon.

For most players, it isn’t. Only one teenager kept playing after Gordon told him to retire.

Players like Ronald Kelly know how dangerous concussions are, still he is not thinking of retiring. He eventually returned to the game, but with caution.

“I was a little out of shape, and a little timid. I didn’t want to get cranked again,” says Kelly.

His experience made him realize the intensity of a concussion. Still, he came back to hockey. He wants to play the game he loves– a sport changing because of concussions just like his.

 

 

Sidney Crosby –Worst Hits

 

Concussions in hockey: a timeline 

 

Related Links:

Hockey Canada head contact rule website

Cochrane calls for end of junior hockey fighting 

Head shots/fighting debate on The National

Hockey concussion stories in the New York Times—A timeline