Research paints a dire picture for the NHL's concussion victims

Rangers defenseman Marc Staal, who was concussed when hit by brother Eric (left) last February, is still feeling the effects and has been sidelined for three preseason games. (Andy Mead/YCJ/Icon SMI)

By Stu Hackel

The insidious nature of concussions to NHL players continues to make news. Some of that news is good regarding Sidney Crosby, the Canadiens' Max Pacioretty, the Avalanche's Peter Mueller and Pierre-Marc Bouchard of the Wild. Some isn't so good, particularly involving Marc Staal of the Rangers.

The Blueshirts blueliner, who is considered the top man in their young defense corps, will be held out of the team's first three preseason games, the result of a concussion he apparently suffered last February and from which he developed symptoms over the summer.

The hit was delivered by his brother Eric in Carolina on this play:

Marc  missed some games and at the time, the Rangers announced that he had a knee injury. But as Jesse Spector reported in The New York Daily News, Rangers coach John Tortorella said yesterday that Staal "was shaken there, too." Tortorella said the defenseman took a neurological test that he passed before returning to play, but the symptoms returned in March and he sat out two games. The Rangers did not disclose the nature of the injury. Again the symptoms subsided and Staal returned to action. But over the summer, he experienced headaches that persisted as he came to camp, thus the Rangers' current precautions.

Staal is supposedly cleared for contact now, which seems quite odd for a player who has headaches.

The plan that Tortorella outlined yesterday is for Staal to miss games against the Devils and Flyers in North America during the next week, then play in the team's exhibition matches in Europe prior to the season-opener against the Kings in Stockholm. UPDATE: Staal was sent home from Rangers practice on Monday with a recurrence of symptoms.

Of course, Boston's Marc Savard has already been declared out for the season and his career could well be at an end following a series of concussions.

The Penguins, as is widely known, have taken a very conservative approach with Crosby, hockey's best-known concussion victim. He did take part in training camp this past weekend -- although he is not cleared for contact drills -- and displayed no post-concussion symptoms after the fast-paced workout. But in the offseason he did have some effects that lingered from his early January concussion and he backed off working out until they subsided entirely.

Like Crosby, Blackhawks rookie Jeremy Morin is being held out of scrimmages and contact drills as a consequence of concussion he suffered playing in the AHL last season. The Maple Leafs Matthew Lombardi, who missed almost all of last season when he suffered an October concussion as a Predator, is in a similar situation.

Mueller, who missed all of last season, returned to the ice with the Avs over the weekend, absorbed some hits and felt fine following his first action in a year. He was concussed late in April, 2010 and again in a preseason game last fall. "I took a couple hits and I gave some hits, and I didn't really feel anything," Mueller told NHL.com after scrimmaging with his teammates. "I'm extremely happy with today. It's another step in recovering."

As for Bouchard, Minnesota's talented winger, he finally looked like his old self during Sunday's scrimmage, "skating elusively through traffic, stickhandling by defenders and setting up play after play, writes Michael Russo of The Minneapolis Star-Tribune. "Best yet, he showed immediate chemistry with potential linemates Guillaume Latendresse and Matt Cullen." Bouchard missed all but one game due to concussion in 2009-10 and only returned on December 1st last season. "But even then," Russo writes, "Bouchard used the year to rediscover his timing, game and fitness."

Pacioretty, who scored  a goal today in a Canadiens training camp scrimmage, was on the receiving end of last season's most infamous incident when Boston's Zdeno Chara shoved him headfirst into a glass support during a March game in Montreal, not only suffering a concussion but breaking a vertebra and missing the rest of the season. Pacioretty told Tony Marinaro of Montreal Radio Team 990 (audio) that he's made a complete recovery (although he'll need some ongoing maintenance on his neck muscles), was able to train hard over the summer and added 10 pounds of muscle. He's also partnering with Montreal General Hospital to establish a foundation to raise funds for research into brain trauma.

There can never be too much research on this issue. It has become indispensable for the hockey community as it grapples with understanding the consequences of concussion. Some of the latest research was discussed over the weekend in Toronto.

Most of the time, the symptoms we hear about from concussions are physical, like headaches. But increasingly, we are getting news like what came out of a seminar on Saturday at Toronto's St. Michael's Hospital entitled "Outcomes following Concussion in Hockey."

Dr. Shree Bhalerao told attendees, who including James Christie of The Globe and Mail,  “I’ve spent 12 years doing this stuff in an acute setting, but what I haven’t seen is articles from the psychiatric point of view.” He went to detail the psychiatric symptoms he's encountered from concussions, including depression in 30 percent of the patients, as well as diminished motivation, withdrawal, impaired sleep, anxiety and unfounded fears.

“They don’t want to return to the ice," Dr. Bhalerao said. "They have a feeling of panic ... the elements of an acute stress disorder." He added that patients also exhibit personality changes, becoming irritable, increasingly impulsive and sometimes lapsing into substance abuse.

“Eighty-seven per cent have cognitive changes in short-term memory and problems in what have become known as executive functions: problems in sequencing organization, attention and planning,” said Dr. Bhaleroa.

Dr. Michael Hutchison told the group that a videotape study of almost 200 concussions in the NHL between 2007 to 2010 showed most are caused by head shots initiated by an opponents' shoulder, elbow or gloves. Only about one in 10 were the result of fights.

The NHL has also studied what activities lead to concussions and has had a working group looking into the issues for a long time. These studies seem independent of the league's research and data, which differentiates between concussions caused by legal and illegal hits and accidental contact.

But Dr. Bhalerao's research needs to be brought more into the discussion, especially in light of the heightened awareness about depression and addiction to painkillers that resulted from the deaths of Derek Boogaard, Rick Rypien and Wade Belak. After this summer, we shouldn't need any more convincing about the severity of these problems in hockey.