NHL concussion protocol needs more clarity

Storylines abound for the third round of the Stanley Cup playoffs. Can the Penguins repeat? Is Erik Karlsson, in fact, a robot? Will P.K. Subban continue to rub Marc Bergevin’s face in it?

And also this: in what way will the National Hockey League’s concussion protocols be shown to be an utter farce this time?

This isn’t just a Sidney Crosby thing, although the incident with the Penguins captain in Game 6 of their series win over Washington was the best example of how the NHL’s concussion rules are a Potemkin village of protocols: tidy on the surface, but a flimsy mess underneath.

A round earlier, late in Game 6 of Toronto’s loss to the Capitals, Toronto Maple Leafs goaltender Frederik Andersen was bumped in the head by the hip of a Washington skater as he passed behind the net. Andersen, who had a head-injury scare at the end of the regular season and also at the end of the 2016 season with Anaheim, bounced back up and finished the third period of what was at the time a tie game.

In the ensuing intermission, the Hockey Night in Canada panel noted the play, and gave specific credit to Andersen for going to his crease immediately and not giving the league’s concussion spotters any reason to believe he was hurt. Even if, you know, he was. Had Andersen remained prone on the ice, or called for a trainer, or shown any ill effects of the collision, the concussion spotters might have swooped in and pulled him from the game at a critical moment. Everyone agreed that it was clever of him to avoid such an outcome.

No one seemed worried that avoiding the concussion protocol also left open the possibility of an undiagnosed concussion. And no one gave any thought to the idea that Toronto’s medical staff might have intervened on their own, just to be safe. These are the playoffs. Such caution would be madness.

The Crosby incident a round later would show just how hockey’s culture, all these years after the dangers of brain injury have become more fully realized, still errs on the side of the bare minimum that the specific rules require, to the point of ridiculousness.

A quick review: Crosby was concussed in a Game 3 loss, and missed Game 4, but just that one game. That was suspicious enough on its own, especially for someone with Crosby’s concussion history, but it’s possible that his symptoms from this one cleared quickly. Concussions are weird.

But in Game 6, he crashed into the boards in a collision that would at the very least have rattled his head, and then got up slowly. There was general bafflement that Crosby was not removed from the game for any length of time by either the inarena concussion spotter or the one watching the game from the league offices. How could this possibly not fall under the requirements for an “acute evaluation” under the league’s concussion guidelines? There are six “signs or symptoms” of a possible concussion outlined under the sevenpage protocol that warrant a mandatory removal from play, and one of them is “slow to get up.”

Deputy commissioner Bill Daly explained to USA Today this week that there is an exception to the slow-to-get-up rule, which is that it only applies under certain “mechanisms of injury’’ such as: player takes shoulder to head, player’s head hits ice, player is punched in head by an (ungloved) fist.

Seriously, that’s what the protocol says.

If someone goes headfirst into the boards, or head-andshoulders-first into the boards, as Crosby appeared to do, then league spotters cannot intervene, and it’s up to team doctors to handle the player as they see fit.

That the protocol exists at all is because teams can’t be trusted to put player safety above team success, so they have written concrete terms that must be followed. And so they are followed to the letter, which is a problem when they are so narrowly defined.

Oddly, the mechanism-of-injury stuff only applies to a player who is slow to get up or who, in the protocol’s phrasing, “clutches his head.” Other possible headinjury signs like a having a vacant look or lying motionless on the ice warrant mandatory removal after a blow to the head, full stop. Same deal for a player who gets up slowly after a shoulder to the head. But if he does so after an elbow to the head, or a stick to the face? Then it’s up to the team to treat him and he doesn’t have to miss a shift.

So while the NHL touts its independent concussion spotters as an important advancement in player safety, it also prevents them from taking action unless in certain circumstances. Zero tolerance it is not. Consider this, under the “clutches his head” section of the protocol: “The clutching must be immediate and related to the blow.”

So if the spotter notices a player on the bench holding his head in his hands, 10 minutes after taking a shoulder to the helmet, they have no cause to intervene. Nor does the policy allow spotters extra leeway in the case of a player with a concussion history; they are only to act based on what is observed on the ice.

If the explanation for what didn’t happen with Crosby is, “Hey, we followed the rules,” then the rules are poorly written. Which is apparent enough, when reading them.