Friday, January 21, 2011

Crosby’s Injury Renews Focus On Hits to Head in the N.H.L.

By JEFF Z. KLEIN
The New York Times
http://www.nytimes.com
January 20, 2011

PITTSBURGH, PA - JANUARY 01: Sidney Crosby looks on while playing against the Washington Capitals during the 2011 NHL Bridgestone Winter Classic at Heinz Field on January 1, 2011 in Pittsburgh, Pennsylvania. (Photo by Jamie Squire/Getty Images)

While Sidney Crosby, one of the N.H.L.’s biggest stars, is recuperating from a concussion that may prevent him from playing in the All-Star Game, some team executives are willing to widen the scope of a rule that bans blindside hits to the head.

Jim Rutherford of the Carolina Hurricanes, one of the 30 general managers who voted unanimously for the rule last season, said, “Based on the discussion we had when we were putting in the rule we have now, I would suspect that I would not be the only person willing to discuss how we are handling blows to the head.” Rule 48, which went into effect this season, penalizes “a lateral or blindside hit to an opponent where the head is targeted and/or the principal point of contact.”

However, it is legal to hit someone in the head with a shoulder as long as the hit is delivered from straight ahead. That falls short of the ban on contact to the head in the Ontario Hockey League, the top incubator for N.H.L. talent, or the International Ice Hockey Federation, which prohibits contact above the collarbone.

“This rule is a step in the right direction,” Rutherford said this week. “But the purpose of the rule, and ultimately what we have to get to, is the safety of the players. This was a first step, and to this point it’s working. We have to continue to look at hits to the head as to how we can eliminate them from the game.”

Ray Shero, the general manager of Crosby’s Pittsburgh Penguins, said it was necessary to revisit the rule because players were still being injured by blows to the head.

“Every hit, every concussion, every suspension contributes to the discussion,” Shero said. “When Sidney Crosby gets hit, it gets put in the spotlight, but that’s where it needs to be.”

Crosby said this week that he might sit out the All-Star Game in Raleigh, N.C., on Jan. 30, but not to protest the league’s failure to suspend players for the two blindside hits that have sidelined him. Crosby has been out since Jan. 6 with what the Penguins termed a mild concussion, the first of his N.H.L. career. His symptoms are improving, he told reporters, but he still had headaches and there was only a slight chance he would play in the All-Star Game.

Last week, Crosby criticized the league for not disciplining David Steckel of Washington, whose incidental blindside hit against him went unpenalized during the Winter Classic on Jan. 1, or Victor Hedman of Tampa Bay, who received a two-minute minor for checking Crosby into the boards from behind on Jan. 5.

The N.H.L. decided that Crosby’s head was not the target in either case and was not the principal point of contact.

Through Monday’s games, according to reports by teams and the news media, 47 players have been sidelined by concussions this season, including four with carryover injuries from last season. (Marc Savard of Boston and Pierre-Marc Bouchard of Minnesota have since returned; Ian Laperriere of Philadelphia has not; and Paul Kariya, a free agent, is sitting out this season in an effort to recover.)

The 43 concussions sustained since the exhibition season began in September puts the league on pace for about 77 in the regular season, near the average of 75 in recent seasons and below the 82 last season, according to Dr. Ruben Echemendia, a neuropsychologist who directs the joint N.H.L.-N.H.L. Players’ Association concussion working group.

The league has suspended several players under Rule 48, the latest a four-game ban issued Tuesday to San Jose’s Scott Nichol for a check to the head of Phoenix’s David Schlemko. It has also released a video showing instances in which players have pulled up to avoid throwing a blindside check.

“We are very pleased with the operation of Rule 48 through this point in the season,” said Bill Daly, the N.H.L. deputy commissioner. “And, in particular, we are pleased with how we believe the players have adjusted their conduct to the new rule.”

Most but not all concussions are the result of body checks. Laperriere’s came after being struck hard in the face by the puck twice; Atlanta goalie Ondrej Pavelec’s was the result of striking his head on the ice.

“Players are still getting hit in the head, whether it’s laterally or north/south,” Shero said. “We’ve got the majority of our players coming into the N.H.L. from the I.I.H.F., O.H.L., college hockey — and in all those leagues it’s illegal to hit someone in the head.”

John Davidson, the president of the St. Louis Blues, who have lost four players to concussions this season, praised the new rule as “a bold step.” He said that a player’s post-career health had to be considered.

“If we have to take another step, it wouldn’t bother me at all,” Davidson said. “Concussions are the great unknown. Sometimes the concussion symptoms don’t show up for a day or two. I don’t know, maybe a player who is unconscious momentarily should be pulled from the game immediately.”

If that were part of the rule, Crosby would have left the Winter Classic. After an initial bout of wooziness — discernible to viewers of the final episode of HBO’s “24/7” series on the Winter Classic — Crosby reported being symptom-free and finished the game.

But he reported feeling foggy before he played Jan. 5 and received a concussion diagnosis the morning after Hedman’s check.

“It’s not uncommon for symptoms to develop or worsen a day or more after the initial hit that causes brain trauma,” said Dr. Michael Stuart of the Mayo Clinic, the chief medical officer for USA Hockey, referring to Crosby’s symptoms. “That’s why we teach trainers and physicians that follow-up is important.”

Dr. Paul Echlin, a concussion specialist from London, Ontario, who monitored two junior teams for head trauma in a 2009-10 study, noted that Crosby exhibited all the signs of a potential concussion after being hit by Steckel.

“He’s slumped over, can’t get up, his coordination is gone, all the red flags are up to evaluate him,” Echlin said. “If there’s any doubt, you take him out. To have a player concussed a second time is completely irresponsible.”

One difficulty in determining the extent of the N.H.L. concussion problem is the absence of a leaguewide protocol. All players who sustain possible concussions are evaluated by trainers and doctors. Some teams list injuries as concussions. Others, like the Calgary Flames and the Colorado Avalanche, list them as head injuries.

“It’s a serious brain injury — that’s what they should be saying instead of mild concussion,” Echlin said. “There’s no such thing as a mild brain injury. The brain is microhemorrhaging; it’s tissue that bleeds.”

The general managers will have a chance to revisit the rule when they meet in March. None who were interviewed, however, advocated a blanket ban on hits to the head.

“It’s a discussion worth having,” Steve Yzerman of Tampa Bay said, “but how can you penalize accidental or incidental contact with the head? And what if one guy is 6-foot-6 and the other guy is 5-foot-9?”

If the executives recommend toughening the rule, it will have to be approved by a joint committee of players and league officials before going to team owners and their deputies for final approval.

“If further adjustment to the rule is thought necessary or appropriate, it will be considered and processed in the normal course,” Daly said.

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