Tag: concussion

15 Oct

Pulling No Punches: The NHL’s Persistent Concussion Problem

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Over the past few years I have written several articles about the incidence of head injuries in professional hockey.  Sid Crosby, Derek Boogaard, Rick Rypien and Wade Belak – these men have all played a role in my education about the perils of the sport.   On Saturday night, I finally made my way into the city to watch my first live hockey game (sidebar: in case you missed it, after three crazy see-saw periods, the Leafs’ centre Dave Bolland eked out the OT winner against the Oilers).   I craved a firsthand immersive experience in hockey culture, and I needed to know: Do dirty hits and fighting have a place in the game?  Is on-ice violence a necessary cog in the greater machine?

Since the start of the 2013/14 season, the media has been saturated with opinion pieces spouting the points and counterpoints in the hockey violence debate, and with good reason.   On October 1st, Habs’ forward George Parros engaged in a fight with the Leafs’ Colton Orr, awkwardly tumbled over his opponent and hit the ice face-first in an unbroken fall.  He lay motionless for several minutes and was ultimately carted off the ice on a stretcher.   Last week, Habs GM Marc Bergevin indicated to the Montreal Gazette that Parros was ‘almost symptom-free’.   Interesting concept, in theory, not unlike being ‘kind of pregnant’, I suppose.   Anyone who has suffered a concussion knows that all it takes is one lingering symptom to shift your life’s pace from 6th gear down to 1st.   You’re either symptomatic, or you’re not.  On October 4th, the Nashville Predators’ defenseman Roman Josi took a huge hit from Colorado’s Steve Downie and sustained what is reportedly his fifth concussion since 2009.  Not only has Josi not returned to the ice, but he has not even been able to work out since his head injury.  On October 8th, the Rangers’ Rick Nash sustained a concussion after taking a first-period headshot from Sharks’ defenseman Brad Stuart.   While Nash is on mandatory IR for 7 days, technically he could return to the ice this Wednesday, although the most recent reports indicate he is still ‘experiencing symptoms’.  This is familiar territory for Nash, as he was already forced to sit out four games in February of this year due to a concussion.

In the midst of these early season head injuries, researchers at a Mayo Clinic conference last week called for a ban on fighting at all levels of the sport.  As the sport is played now, they said, it causes too much trauma.  Scientists are calling for reforms in bodychecking and want to see fighting banned in the NHL, in the minors, as well as at the junior level. Researchers are asking for immediate ejection after a single fight in the NHL, because they firmly believe the NHL needs to serve as the role model for the rest of hockey.  Then just a few days after the conference wrapped up, hockey legend Bobby Orr wrote this in the Globe and Mail:  “But the more I look at the current state of the game, the more I realize a simple truth about it.  The threat of a fight, or the fear of doing something that might trigger retaliation, is a powerful deterrent.  It always has been, and it always will be.”   On the face of it, this seems like a reasonable argument, however a recent study out of the University of Ottawa found that ‘the kind of blow delivered in a hockey fight [particularly a left or right hook to the jaw], is as dangerous to the brain as it gets’.

           

So here we are, just a couple of weeks into the season, and already 3 players are out with concussions.  Head injuries.  Brain injuries.  The back and forth banter about the role of fighting in hockey, of course, continues.  I enjoyed the game on Saturday night. I soaked up the incredible agility of some of the players, their stickhandling skills, the game strategy…  It was, admittedly, a much more organic experience seeing the game played in person.   Then something changed.  Between the second and third periods, the lights dimmed, and bombastic choral action-movie-trailer type music filled the arena.   All eyes were on the Jumbotron, on which commenced a ‘fight reel’ with clips of a series of epic hockey fights through the history of the NHL.  All the ‘great’ enforcers were featured – Semenko, Domi, McSorley.  Nearly everyone rose to their feet, fists pumping, cheering; it was a surreal scene, and it had more than a whiff of Roman Colosseum to it.   In that moment, it was clear that in order for the incidence of brain injuries in hockey to be reduced, not only will NHL culture need to shift, but that of the audience as well.   Bruce Arthur, sports columnist for the National Post summed it up so eloquently, so tidily, in the summer of 2011, just a few days after Wade Belak reportedly hung himself:  “This shouldn’t be a political issue in the sport; it should be a human one.”

Jenn Hartman, Medico-Legal Analyst

16 Apr

The NFL’s Billion Dollar Problem

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A year ago, I wrote about a class-action lawsuit filed by former Redskins quarterback Mark Rypien and 125 other former professional football players. That lawsuit alleged that the NFL “deliberately ignored and actively concealed the dangers and risks of repetitive brain injuries and concussions for decades”. Fast forward to last week when the NFL attempted to have 222 consolidated lawsuits (involving one-third of the league’s 12,000 retired players) dismissed. On Tuesday, Judge Anita Brody of Federal District Court heard arguments on whether lawsuits accusing the NFL of glorifying violence should be governed by the legal system or by the collective bargaining agreement (CBA). The NFL argued that the teams bear primary responsibility for health and safety, along with the players’ union and the players themselves. Simply put, the NFL believes these cases amount to a labour dispute and therefore should be subject to grievance procedures and arbitration.  The lead attorney for the players argued that the NFL glorified and monetized violence through NFL Films, and in doing so, breached its duty of due care. Further, he argued that the league “deliberately and fraudulently” concealed the dangers of head trauma. It will be months before Judge Brody makes a ruling and writes an opinion, and appeals will likely follow. “I will rule when I sort this out for myself” she said after hearing 50 minutes of arguments. And indeed, much sorting lies ahead.  Issues of assumption of risk, contributory negligence and causation are all on the table.

                                                

At the end of the day, one of three outcomes will materialize: i) Judge Brody sides with the players, ii) Judge Brody sides with the league or iii) She takes a divide and conquer approach and divvies up which claims move forward in court, and which are dealt with in arbitration. Such a division would separate those who played under a CBA from those who did not (NFL.com reminds us that there was no CBA prior to 1968, and again from 1987-1993).  Regardless of how Judge Brody rules, the NFL is likely going to pay in spades; monetary damages (whether incurred as a result of a settlement offer or as a result of a liability finding) will exceed a billion dollars and the damage to the institution from a public relations perspective cannot be overstated.  The players are also seeking the establishment of an NFL-funded medical monitoring system for former players who may be suffering long-term effects from concussions.

In a strange twist of timing, on Sunday, a jury in Colorado found Riddell Helmets liable for failure to adequately warn players wearing their football helmets about the dangers of potential concussions.  In 2008, while participating in a "machine gun drill", high school football player Rhett Ridolfi sustained a concussion.  Ridolfi’s coaches ignored his complaints about headaches and allowed him to return to practice later that afternoon.  He subsequently collapsed, required emergency brain surgery, and was left paralyzed on one side of his body.  The verdict found the helmet manufacturer responsible for $3.1 million in damages.  Riddell has already expressed their intent to appeal.

Jennifer Hartman, guest blogger

08 May

The NFL’s Elephant in the Room

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As of last night, the parents of Junior Seau, who are from the island of Aunu’u, American Samoa, were meeting with Samoan elders to discuss how to respond to requests by researchers for the opportunity to study Seau’s brain. Last Wednesday, Seau, former linebacker for the San Diego Chargers, was found dead in his Oceanside, California home. His death was ruled a suicide. The media is saturated this week with discussion of whether Seau’s NFL career played a role in his early death. There are a number of indisputable facts, between which one can interpolate:

• Seau took his own life by shooting himself in the chest. Fifteen months ago, former NFL safety Dave Duerson died of a self-inflicted gunshot wound to the chest, having left a suicide note asking for his brain to be donated for research. The Boston University School of Medicine Center for the Study of Traumatic Encephalopathy determined that Duerson’s brain indeed showed signs of CTE, the progressive, degenerative disease associated with repetitive closed head injuries.

• Up until April 19, 2012, Former Atlanta Falcons safety Ray Easterling was the lead plaintiff in a class action lawsuit against the NFL over concussion-related injuries. Since his death last month, by suicide, his widow has vowed to continue to fight the lawsuit her husband started after 20 years of suffering from symptoms of repetitive head trauma including memory loss, mood changes and depression.

• According to a 2011 study conducted by the Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center at the University of North Carolina, the average life expectancy of a retired NFL player is 55 years. Some insurance providers have indicated that this is actually an overestimation, and that in fact the average age is somewhere closer to 51 years. For comparison purposes, the average male life expectancy in the United States is 78.2 years. [Note: If you played for the San Diego Chargers in 1994’s Super Bowl XXIX, then the odds against you are significantly grimmer. Eight of those teammates are dead, all before reaching the age of 45; a statistical anomaly since the 8 deaths lacked common cause.]

• The same UNC study  suggested that retired NFL players suffer from dementia at a 37% higher rate than average.

• A 2006 report in the St. Petersburg Times found that the more games and practices an NFL player survives, the quicker he dies. In his first 14 pro seasons, Seau missed only 9 games.

If Seau’s parents decide not to donate his brain for research, we may never know with certainty whether he suffered from Chronic Traumatic Encephalopathy. One thing is for sure, there’s something about playing in the NFL that doesn’t bode well for one’s life trajectory. Are repeated head hits causing organic damage to the brain, after which depression is the next domino to fall? Or perhaps, as in Easterling’s case, organic brain damage brings on intolerable shifts in personality and cognitive functioning, but in an unkind twist, leaves one with just enough insight to see what lies ahead. Roger Goodell has made great strides since becoming NFL commissioner in 2006, introducing preseason baseline concussion testing, for example, not to mention the unprecedented smackdown of the Saints players implicated in the bounty scandal earlier this month.  His work is far from finished.

Jennifer Hartman, guest blogger

 

03 Apr

Where Exactly is the NFL’s Tipping Point When it Comes to Concussions?

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Add former Washington Redskins quarterback Mark Rypien and 125 other former professional football players to the list of people now suing the NFL. On March 23, a class-action lawsuit in which Rypien is the lead plaintiff was filed in the U.S. District Court of the Eastern District of Pennsylvania. According to court documents, the lawsuit alleges that the NFL “deliberately ignored and actively concealed” the dangers and risks of “repetitive traumatic brain injuries and concussions for decades”.

Canadian-born Rypien, now 49, quarterbacked for the Redskins from 1986 until 1993. The suit alleges that Rypien suffered multiple concussions and head injuries during his time with the Redskins, and as a result, he now suffers from “various neurological conditions and symptoms”. The plaintiffs are seeking “medical monitoring, as well as compensation and financial recovery” for the long-term and chronic “injuries, financial losses, expenses and intangible losses”.

                                       

This class-action lawsuit is not an aberration; NFLConcussionLitigation.com lists 51 suits against the NFL, representing more than 1,000 former players. Just six weeks ago, the family of former Chicago Bears star Dave Duerson filed a wrongful death suit against the NFL claiming the league did not do enough to prevent or treat the concussions that severely damaged Duerson’s brain. In February 2011, Duerson died of a self-inflicted gunshot wound to the chest, having left a suicide note pleading to have his brain donated to researchers at the Boston University School of Medicine Center for the Study of Traumatic Encephalopathy. The attorney representing Duerson’s family said the NFL should have been a leader in educating current and former players about head injuries.

Rypien’s lawsuit comes on the heels of the NFL’s investigation of allegations that the New Orleans Saints and other teams had ‘bounty programs’ which offered cash bonuses to players for injuring specific opponents. In response, NFL Commissioner Roger Goodell suspended Saints coach Sean Payton for one year, without pay.  General Manager Mickey Loomis was suspended for eight games, assistant coach Joe Vitt was suspended for six games and former defensive coach Gregg Williams (who left the Saints to join the St. Louis Rams) has been suspended indefinitely.  On Friday, Loomis, Vitt and Payton announced that they are appealing their suspensions.  The NFL has indicated that as many as 27 players may have been involved in the bounty scandal, although at the time of publication, none have been sanctioned.

Jennifer Hartman, guest blogger 

26 Jan

The Concussion Discussion: Taking the Longer View

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Worse than watching Sidney Crosby’s head hit  on New Year’s Day, was watching Crosby’s attempt to right himself after the blow and skate off the ice. Dr. Wennberg, a University of Toronto concussion expert and NHLPA consultant, summed it thusly: “To see it was painfully obvious. The telling sign was when he tried to get up. Mr. Crosby’s right foot slipped behind him as he got back on his feet, and his mouth guard slipped out of his mouth – subtle signs that that the hit from Washington Capitals winger David Steckel jarred Mr. Crosby’s brain.” Diagnosis: Concussion.

The word concussion is derived from the latin concutere (“to shake violently”). By definition, a concussion is a traumatic closed-head brain injury caused by a blow to the head and resulting in a temporary loss of normal brain function. The old school of thought was that concussions were considered ‘minor head injuries’ because the effects were seemingly temporary, and indeed, most individuals who suffer from a mild concussion will have no long-term effects. There is increasing evidence, however, that some people who sustain a concussion, and an even larger proportion of those who sustain multiple concussions, will endure long-term consequences. In 2009, the NFL finally conceded that “It’s quite obvious from the medical research that’s been done that concussions can lead to long-term problems.” In fact, a study commissioned by the NFL found that former NFL players were being diagnosed with Alzheimer’s Disease at a rate 19 times greater than the background rate for their non-NFL peers (see last year’s blog by Rick Bickhram on dementia and the NFL).   Long-term neurological effects, which can be permanent, may include memory loss, poor concentration, impaired reasoning, seizures, and depression.  Still not convinced?  The February 2011 issue of National Geographic  includes a graphic photograph of brain deterioration due to repeated hits to the head.

For additional information on concussions, and to access resources on concussion prevention, please visit www.thinkfirst.ca , a national injury prevention charity founded by brain surgeon Dr. Charles H. Tator.

Jennifer Hartman, guest blogger

 

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