NHL still on wrong side of brain injury debate
League needs to address, acknowledge brain injury, writes Adam Kassam.
With the Stanley Cup final well underway, the NHL is celebrating one of the most intriguing storylines in its history.
The Las Vegas Golden Knights have a chance to become the only expansion team in major professional sports, excluding MLS, to win a championship in its inaugural season. This collection of misfits and throwaways has taken the sports world by storm, despite many hockey fans’ desire to see Alexander Ovechkin finally win a Cup.
Most believe that this series will be the kind of exciting, back-and-forth hockey that the league has been trying to promote for years. It will also represent a victory lap for commissioner Gary Bettman — the most hated man in hockey.
Given the wildly successful year that Vegas has had, it is unsurprising that Bettman used the opportunity at the state of the league press conference to highlight how positive a story this has been for the league. It is hard to argue with his assertion that “Las Vegas would actually give hockey a greater presence,” especially given how the team has supported the city after a mass shooting before the start of the season.
While Bettman’s quartercentury legacy as commissioner will include overseeing expansion franchises and an increase in league revenue, history will judge him harshly on how he has handled the growing concerns about chronic traumatic encephalopathy (CTE).
The NHL is currently engaged in a lawsuit from more than 100 former players, who claim the NHL had not done enough to educate its players to prevent head trauma. In a 2015 deposition, Bettman claimed that “there’s no medical or scientific certainty that concussion lead to CTE.” He reiterated the league’s position recently by callously dismissing the issue, stating, “I’m not going to start another news cycle … there’s nothing new on the subject.”
This dodge is not only egregiously irresponsible, it is dangerous and patently untrue. CTE is a progressive degenerative disease of the brain found in individuals with a history of repetitive head trauma, including concussion that cause symptoms and sub-concussive events that are asymptomatic. It was actually first described in boxers of the 1920s, when the condition was called dementia pugilistica or “punch drunk syndrome.”
Research has established that CTE is caused by repetitive head injuries that are common in professional and amateur sports, including hockey, football, soccer and rugby. Hockey players are at especially high risk because of speed created by players on the ice, and the rotational shear forces created during impact.
The challenge with CTE is that it can only be definitively diagnosed by neuropathological assessment on autopsy. Additionally, concussions are a clinical diagnosis that often present without findings on imaging or blood work, although new biomarkers may change the game.
This lack of objective measures, therefore, is how a claim can be made that there is no link between a concussion and CTE.
The league should be ashamed. By putting its corporate interests first, the league is sending a clear message that its players are simply disposable entertainment and that their health is secondary.
Ultimately, while the Golden Knights may make history, the NHL is at risk of being on the wrong side of it with CTE.
Adam Kassam is a freelance health writer and chief resident physician in the department of Physical Medicine & Rehabilitation at Western University.