By stuhackel
December 22, 2011

Too tough for his own good: Maple Leafs winger Colby Armstrong did not tell team doctors about the concussion symptoms he felt after a playing the Canucks last Saturday. (Gary Angus/

By Stu Hackel

Should the NHL adopt the NFL's newest concussion protocol that's designed to help teams spot injuries and sit players who want to play through head trauma? The only intelligent response has to be, "Why not?"

Effective immediately, a certified athletic trainer who is paid by the NFL and not the teams will be at each game to monitor the action provide the medical staffs with "any relevant information that may assist them in determining the most appropriate evaluation and treatment," the league said in a statement on Wednesday.

The trainers will not diagnose or prescribe treatment and they can't order players to be removed from a game, but they can alert teams to incidents that deserve closer attention when they weren't immediately obvious at field level. The independent trainer's role, the NFL says, "will be to provide information to team medical staffs that might have been missed due to a lack of a clear view of the play or because they were attending to other players or duties."

Those scenarios could certainly apply to the NHL.

NBC and Sports Illustrated's Pierre McGuire read about the new protocol while waiting in a Chicago airport on Wednesday morning and he believes it is something the NHL needs to adopt. "I don't think that's a bad rule for hockey," he said on Montreal's TSN Radio 990's Melnick In The Afternoon program later that day.

The NFL's new protocol was adopted in the wake of a concussion suffered by Cleveland Browns quarterback Colt McCoy, who was injured by a helmet-to-helmet collision with Pittsburgh linebacker James Harrison on Dec. 8. It was an illegal hit and Harrison was suspended for one game. But McCoy returned two plays later after saying that he was fine, or at least well enough to play. He was not checked for a concussion by the Browns' trainers who maintain that they didn't see the severity of Harrison's hit nor did they detect any concussion symptoms. McCoy promptly threw an interception that ended Cleveland's hopes of winning that game. He hasn't played since.

The NFL's new protocol can also help teams respond to players like McCoy, whose desire to return to the field overrode any other consideration he had about himself. McGuire sees parallels with the NHL. "We sometimes have to save (the players) from themselves," he said. "They're just so darn tough."

McGuire added that only one team, the Chicago Blackhawks, sends a doctor to all road games. It costs the team $200,000 a year. "I think the league needs to send a doctor from the team on the road with every team," he said. "I think it would protect a lot more of the interests of the players."

In our post on Sidney Crosby's most recent concussion last week, we noted that one aspect of the NHL's ongoing problem arises because injured players who want to stay in the lineup can deceive their team’s medical and training personnel by not disclosing that they are hurt. For example, Brayden Schenn of the Flyers did just that for two days while suffering concussion symptoms, and his case is not unique. Additionally, on Nov. 26, after Penguins defenseman Kris Letang suffered a broken nose from a third-period hit by the Canadiens' Max Pacioretty, he returned to play and even scored the winning goal in overtime. It was later determined that Letang had suffered a concussion. He has yet to return to action.

Last Saturday,  Colby Armstrong of the Maple Leafs checked Ryan Kesler of the Canucks and later experienced blurry vision and nausea, but he didn't tell Toronto's medical staff. He merely reported his broken toe, which occurred during the same play. Armstrong told reporters that he said he was ready to play in the Leafs' next game, on Monday against the Kings, but was forced to admit that his symptoms had started earlier when he vomited after riding an exercise bike the day of the game.

These three examples, and many others, exhibit the hockey player's credo when confronted by injury. It was articulated well on Wednesday night's episode of HBO's 24/7 by Mike Rupp of the New York Rangers. "It's never fun to miss time, especially extended time," he said. "I don't always agree with staying out of the lineup until you're 100 percent. You stay out until you can get by and do what you need to do without being a liability on the ice."

We all greatly prize the unsurpassed courage that NHL players have always displayed, but playing with a head injury, as we know now, is markedly different than playing with a broken toe. The consequences of an already concussed or not fully recovered player sustaining another head injury can be disastrous.

Interviewed for the CBC nightly news program, The National (video), Dr. Julia Alleyne of Women's College Hospital in Toronto said of athletes who try to play through head injuries, "You perpetuate the symptoms and delay recovery. You also may mask more serious symptoms, potential hemorrhage, potential bleeding."

In each of these cases, the NHL's protocol that mandates a "quiet room" or ImPACT test was not used to determine the extent of the player's injury or even reveal it. So another layer of protection -- an independent trainer on site to watch from above -- is hardly a bad idea.

After being concussed late in the second period of last January's Winter Classic, Sidney Crosby didn't get a proper diagnosis and returned to play the rest of the game. He was hit again a few days later, which led to his extended absence. Playing while his brain was already traumatized may have worsened his condition. The return of his symptoms earlier this month after what looked like inconsequential contact could indicate that he's more vulnerable to concussion-related problems as a result of playing hurt.

These are all situations that could benefit from the NFL's new protocol because an independent voice can neutralize an NHLer's desire to keep playing and not get the testing or sufficient rest he may need.

Paul Echlin, a London, Ontario, sports medicine specialist who studies concussions, told David Shoalts of The Globe and Mail that he sees that attitude even among pre-teen hockey players. Echlin calls it one of the chief obstacles to the proper diagnosis and treatment of concussions, adding that it's an  attitude that threatens any player’s well-being, both in the short- and long-term.

“It’s got to stop,” Echlin told Shoalts. “People have to realize it’s not bad to report symptoms or to say you don’t feel right after a hit. If you get the diagnosis sooner, you can allow people to rest.

"You can also not allow them to go back in a game and risk another hit to the head, one that could end a career," he added.

Given the recent sharp increase in NHL concussions, anything the league can do to, as McGuire says, save the players from themselves is well worth doing.

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