Thursday, March 24, 2011

Concussions, CTE mean it's time for fighting to go

The time has come to rid major junior hockey of fighting.
There. I said it.
And you know what?
It doesn’t feel half bad. In fact, it feels pretty good.
Having been around the WHL for more than 30 years, I have long been a drinker of the Kool-Aid. When hockey people would say that fighting is an integral part of the game, that a fight could swing a game’s momentum one way or the other, that players rarely got injured in a fight, I would nod my head in agreement.
Fighting, the hockey lifers will tell you, has always been part of the game.
And it has been. Just like the centre-ice red line. And goaltenders handling the puck without restrictions. And obstruction. And one referee.
But now it’s time for fighting to go.
Why?
Because the time has come for the WHL to rid its game of headshots. It has to do this because it is imperative that it do more to protect its young players from concussions.
And it would be hypocritical to invoke a ban on headshots and not take fighting out of the game.
How can you ban headshots while saying it’s OK for two players to stand there and punch each other in the face?
My thinking started to change about the time that researchers at the Center for the Study of Traumatic Encephalopathy at the Boston University School of Medicine revealed that an examination of the brain of former NHLer Reggie Fleming, a disturber in the 1960s who died in 2009, showed indications of chronic traumatic encephalopathy (CTE).
Then, in the last while, the same researchers found CTE in the brain of former NHL enforcer Bob Probert.
That, along with some on-ice happenings, has made headshots and concussions the hot-button topic in and around hockey at all levels.
Also influencing my thinking were incidents involving Sidney Crosby and Killian Hutt, Zdeno Chara on Max Pacioretty, Matt Cooke on Marc Savard and on and on.
And then came an email from the mother of a WHL player. She expressed concern over the number of concussions and head injuries in the WHL this season, a figure that now has reached at least 100. This wasn’t your ordinary email, because it came from a professional who provided documentation, some of it frightening, to every statement she made.
It is most obvious that, while the study of concussions and their long-term effects is in its infancy, head injuries no longer can be looked at in the short term. Studies that have been done contain too many words and phrases like “ongoing impairment” and “recurrent or cumulative damage” and “chronic neurocognitive impairment” and “early onset of dementia.”
During the 2009-10 season, a group of medical professionals, including Dr. Charles Tator, who is considered Canada’s pre-eminent expert on sport concussions, put together the Hockey Concussion Education Project, a study involving “67 male fourth-tier ice hockey players from two teams.”
Physicians involved attended 52 regular-season games involving junior-aged players and observed 21 concussions to 17 players. “A concussion was diagnosed in 19 (36.5 per cent) of 52 observed games,” the resulting report reads.
It is interesting, too, that “no concussions that occurred in practices were reported by either team during the study. Previous sport concussion studies demonstrated that concussion predominantly occurs in game situations.”
The professionals involved in this study, however, ran into some problems.
As they reported: “Complaints by coaches, players and parents concerning the inconvenience of multiple physician visits for serial testing and evaluation were common. The reluctance to report concussion symptoms and to follow such protocols likely results from certain cultural factors such as athletes asserting their masculinity by playing through the discomfort of an injury, and the belief that winning is more important than the athlete’s long-term health.”
The report summarized that “the incidence of concussion in fourth-tier junior ice hockey players was significantly greater than has previously been reported in the literature for this age group.”
Another report — this one by Drs. Jeffrey S. Kutcher, Christopher C. Giza and Anthony G. Alessi, titled simply Sports Concussion — concludes with this:
“Increasing animal and human data suggest that the developing brain’s reaction to concussive injury is distinct from the mature brain, and that age-specific clinical guidelines for concussion management be developed, with perhaps a more conservative approach to assessment and recovery.”
You don’t have to look very hard to find warning signs and lots of them.
According to one study involving U.S. college football players, those who suffered one concussion “were 3.4 times more likely than uninjured teammates to sustain a subsequent concussion during the same season.”
And then there is this from a study titled Chronic Traumatic Encephalopathy: A Potential Late Effect of Sport-Related Concussive and Subconcussive Head Trauma:
“A minority of cases with neuropathologically documented CTE developed dementia before death; the relative infrequency of dementia in individuals with CTE may be due in part to many individuals with CTE having committed suicide or died from accidents or drug overdoses at an early age.”
Unfortunately, the only way to diagnose CTE is through the examination of a brain, although efforts are being made, according to this report, “to identify biomarkers to detect the disease and monitor its progression and to develop therapies to slow or reverse its course.”
In the meantime, the WHL, indeed all of hockey, owes it to the athletes to do more to protect them from themselves.
“It is widely accepted that the symptomatic effects of up to 90 per cent of concussions are short-lived, lasting only seven to 10 days,” reads the report titled Sports Concussion. “This viewpoint puts sports concussion in the light of being a transient phenomenon with little or no long-lasting effects. There is increasing concern, however, that this may not be the case.”
It is imperative, then, that the WHL and other junior hockey leagues err on the side of caution and work harder to get headshots — and fighting — out of the game. According to hockeyfights.com, there were more than 800 fights in the WHL’s  792 regular-season games in 2010-11.
The adults charged with the care of these players must do all they can to protect their charges.
It is becoming more and more evident that the cost of not doing so is far too high.

(Gregg Drinnan is sports editor of The Daily News. He is at gdrinnan@kamloopsnews.ca, gdrinnan.blogspot.com and twitter.com/gdrinnan.)

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