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Breaking: head injuries are bad

I feel like I’ve been ranting about head injuries from day one.  And again on day 365.  And again on day… call it a pet peeve.  I always come back to the notion that we’re going to have to talk about this, and talk some more, and then discuss it again and have a few more chats and shouting matches until the noise becomes so unbearable that the NHL does something about it just to shut us up.  I want to start this time by saying I believe they have done something, they need to keep it up.

Today I read a piece that begins with the irony that the NHL could put together quite the All Star team made up of players currently out with concussions.  It goes on to say people are getting uncomfortable with all this concussion talk:

“It matters not how concussions are happening – head shots, fights, accidents with sticks and pucks, running into one’s own teammate – they have become an increasingly polarizing issue in today’s hockey. “ -Globe and Mail

Bullshit. It absolutely matters how they are happening. You can see how it matters, once you get over the “oh my god, you mean their BRAINS get damaged? Even Crosby’s? Even young Skinner’s? HOW CAN THAT BE IT IS INTOLLERABLEAAAAAAHHH!”

Get over that, move the conversation forward. Concussions have been happening in contact sports for a very very long time. The contact sports exception was not invented to prevent law suits over bum knees. It was for permanently disabling injuries, the kind you sue over.  Those usually involve the head and spine.  That little rule says basically “hey, you knew it was dangerous, you can’t blame us or me.”  Old as the idea is, it still gets repeated like news:

There’s no reason for Larry Brooks to worry about blame.  It won’t cost the NHL or Bettman a penny in legal damages.  The earliest mention of the rule I found through a quick google search was 1975.  That means we, and the NHL, and the NFL and everybody else has known for a long time that you can get hurt in contact sports, and getting hit in the head is really bad for you.

Concussions happen differently in different sports, by accident, as part of the game, they happen more to some than to others. Consider that many (not most, but many) soccer players sustain long term brain damage due to hitting soccer balls with their heads. How in the HELL do you take that out of the game? And we think the NHL has a challenge? Where did I get that bit of soccer player injury information? That  obscure factoid I had to dig really hard for… wait, no.  I watched it on HBO in Bryant Gumbel’s special Real Sports episode about concussion.  It’s no secret.

What sport leads in the concussion race?  Not football, not hockey, but equestrian sports. Those people need to wear their helmets and stop falling off.  As sports go, hockey’s in pretty good shape here.

So, does it matter how they happen? Absolutely. The NHL even gave us some numbers last season about what percentage of concussions resulted from legal (last season) hits (44%), illegal hits (17%), accidents (26%) and fights (8%).  If you can’t prevent all of those, does that mean you shouldn’t prevent the ones you can?

“WE CAN’T PREVENT CONCUSSIONS, SO PLEASE STOP TELLING US ABOUT THEM IT MAKES US SAD.”

You can prevent some of them right now, just like you can prevent lung cancer: eliminate some of the causes. Does this mean taking hits out of the game? No. Take out the illegal ones, take out the fights, and bang, you’ve knocked out 25%.  Right now.

Not enough? Get the players in the habit of keeping their heads up, cut out some accidents. Maybe advise players not to jump over each other. Sure, there’s that cool photo of Leighton jumping over Byfuglien, but Byfuglien saw him coming and kept his head down. Not everyone is that lucky. You might eliminate another 10% by encouraging self-protective play.

You will shorten recovery time and reduce long term damage by treating suspected head injuries immediately and dumping the asinine “as soon as my head clears I’m good to play” philosophy.  No idea what percent of man games you gain there, but I would guess a bunch, even with the admittedly limited understanding we have of concussion treatment.

I know of at least one person who died of lung cancer though he never smoked, never worked in an office where they smoked, did not live in a house with a smoker. So clearly not smoking doesn’t prevent ALL lung cancer, but it prevents a lot. I don’t hear anyone saying “if you can still die of lung cancer without smoking or hanging with smokers, might as well smoke.”  That is the logic being used when we say you can’t stop concussions so stop talking about it:

There are as many sick of the issue as there are those wanting the issue addressed – even the media has started sniping among themselves – with the only sure truth being that concussions aren’t going to go away even if they cease to be mentioned. They are, sadly, increasing – or, at the very least, the recording of them has.  -Globe and Mail

That last line negates the whole idea that there are more concussions now than before. I started writing down my crazy ideas about hockey less than two years ago. I could tell that concussions were being swept under the carpet, even as they became more talked about. They were being discussed as the new rule identifying head shots came into being. I had a problem with the timing:

“Some say it is because only recently we have discovered that blows to the head cause brain damage. Um… I am pretty sure that from the first time someone was kicked in the head by a mule, folks were able to put 2 and 2 together to make, well, “bad”.” -March 2010

I hoped that this was only for publicity purposes, not treatment. Then I witnessed the handling of David Perron’s case. Everyone screamed bloody murder about how dirty the hit was and bickered over whether Perron stayed down too long on purpose and who should have done what to avoid the collision… But they threw Perron back in that game, aggravating the injury and ensuring that for at least a few days people would call him a diver.   We know now and should have known then that this is exactly the wrong thing to do with a suspected head trauma. So much for the hope that NHL team personnel know more than they tell the public.

Now I assume any and every “upper body injury” is a concussion until told otherwise. I wonder if that wouldn’t be a good policy for NHL trainers and medical personnel too?

See how Claude Giroux’s case has been handled. I don’t for a minute think this is just a matter of which team is handling it. I think the protocols have change dramatically even from last season. I also think that news of Pronger’s concussion made the Flyers quicker to act in Giroux’s case. That Pronger’s concussion was not diagnosed sooner may or may not be a case of medical incompetence, but because it wasn’t identified right away, the odds are very long that he will play again. I do mean again, not just this season.  Is Giroux coming back any time soon?  We don’t know, but I think his odds are much better than Pronger’s or Crosby’s.  Perron is back, seems to be doing well.

So, sometimes they get it right, sometimes they still get it wrong, but just because we are talking about it doesn’t mean the situation is worse. It just means we are talking about it. You cannot fix it until you look at it and talk about it, in public, between teams, across medical facility boundaries. Including your audience in the discussion isn’t such a bad idea either. It isn’t as if the NHL did a bang up job on their own, in secret, is it?

Can you eliminate concussions? No. Can you prevent more of them each year? Absolutely, but you have to come up with a plan, you have to keep your eyes, ears, and medical records open.

Here’s a list of names to consider in the ongoing discussion: who’s out now.

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