Tag Archives: concussion

The FIFA World Cup – #SayNoToRacism, #SayYesToConcussion?

June 20, 2014

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Last night’s FIFA World Cup football raised two important duty of care issues, concerning whether, and if so when, athletes have the right to continue playing? The first issue, concerning Uruguayan (and Liverpool FC) striker, Luis Suarez was whether he would be fit to play following minor surgery to the meniscus in his knee in late May. While meniscal injuries can have comparatively quick recovery periods, it is important to differentiate between full match fitness and the graduated stages of functional rehabilitation immediately preceding that. Why is this important? Put simply, if a player returns to play too quickly, or for too long, this will increase the risk of subsequent injury. It is interesting to compare the example of Suarez with that of the French winger, Franck Ribery who refused to allow the French medical team to administer cortisone injections immediately prior to the World Cup (http://bit.ly/1oMsFYx ). Indeed, FIFA themselves argued in 2012 that the ‘”abuse’ of painkillers could put the careers and long-term health of footballers in jeopardy” (http://fifa.to/1jBQpqi – although some of the headline conclusions from this study have been criticised: http://bit.ly/1idT5jb) so whose decision is it to allow athletes like Suarez to play? Ultimately, there are four decision-makers:

  • The athlete themselves – they must have an informed consent as to the risks of participation, or sub-optimal rehabilitation on their long-term health. It has however been argued that this consent could not truly be regarded as wholly voluntary, given the employment pressures that they may (or may not) be under
  • The medical team – in all matters concerning the health of the player, ultimately the responsibility of determining the fitness of an athlete to play must be down to the medical staff. While this may be straightforward in the case of family doctors, the sports medical practitioner may be faced with conflicting duties to ensure the welfare of the player, and obligations towards the team (see http://bit.ly/1nnSqZZ and the Bloodgate incident for discussion of the difficulties in enforcing professional ethics in elite sport environments)
  • The Manager – As the designated responsible person in charge of controlling their players, the final decision as to whether an athlete should be allowed to play will be down to the manager.
  • The rule-making body, FIFA will also retain an element of responsibility through their “agent” (referee’s) control of the match – at present, it seems that there are no explicit FIFA rules governing the rehabilitation of players and the use of pain-killers, beyond a reference to the respective WADA policy. This policy [effectively on the medical best practice of supporting Therapeutic Use Exemptions (TUEs) for Musculoskeletal injuries – http://bit.ly/1lFDcB7] allows medical staff a comparatively wide discretion to prescribe glucocorticosteroids and narcotic analgesics depending on individual clinical need.

So why is this a problem? Eight retired American Football players are currently suing the National Football League (NFL) claiming that the “unethical (substitution) of pain medications for proper health care led to addiction and long-term medical complications.” (http://nydn.us/1gOtbSC) The case is currently ongoing and unsurprisingly is being contested by the NFL, however given FIFA’s own admittance of the problem in their 2012 report, another governing body may be vulnerable to a similar class-action case….

Is it a knock-out round or the group stages?

The second related issue concerns the liability for concussive (or sub-concussive) injuries. Plenty has been written on both the risks of traumatic brain injury in sports and the recent 4th International Conference on Concussion in Sport (held in Zurich, November 2012). Indeed, FIFA was an active participant in this process and contributed to the final consensus statement (http://bjsm.bmj.com/content/47/5/250.full.pdf+html). The FIFA website also clearly lists the Pocket Concussion Recognition tool: http://fifa.to/1m1ypKD which helps to diagnose concussions in athletes.

Why therefore did this process go so badly wrong in last night’s match between Uruguay and England. In the 60th minute, Alvaro Pereira looks to be temporarily unconscious and appears groggy when he is escorted off the pitch a few moments later by the Uruguayan medical staff (http://yhoo.it/1w0zdmg) (see also an excellent analysis of the collision at: http://read.bi/1pOaqBt).  The problem is that when the Uruguayan medical staff clearly signal for a substitution, Pereira is adamant that he should return to the pitch and he subsequently plays out the game. This decision to return to play is clearly wrong. It could be defended if Pereira was assessed and did not exhibit any symptoms, but both lying motionless and an athlete’s subsequent unsteadiness on their feet are visible signs of concussion and the protocol states (in bold) that:

“any athlete with a suspected concussion should be IMMEDIATELY REMOVED FROM PLAY, and should not be returned to activity until they are assessed medically”

Does a cursory pitchside argument with medical staff constitute sufficient assessment? I would argue no. FIFA is supposed to have neutral doctors at every venue to intervene and/or overrule the team doctor, but it appears that no substitution or challenge was made in this case. After the match, ABC News & AP reports that Pereira was checked by team doctors. He is also quoted as saying:

“I said sorry a thousand times to the doctor because I was dizzy. It was that moment your adrenaline flowing in your body, maybe without thinking … what I really wanted to do was to help get the result….What really matters is that everything is OK. Nothing happened. It was just a scare” (http://abcn.ws/1nRUdIm)

Pereira is right to say that nothing happened this time, but sports officials have a duty to protect the athlete from themselves, and if the team cannot, this duty should fall on the referee. The situation echoes the similar ‘Hugo Lloris’ incident in November 2013 (http://bit.ly/1w0ueSx). At the time, Professor Jiri Dvorak (FIFA’s Chief Medical Officer) was quoted as saying:

“The player should have been substituted. The fact the other player needed ice on his knee means it’s obvious the blow was extensive, When he has been knocked unconscious, the player himself may not see the reality. I do not know the details but I know that the Premier League doctors are extremely good and I can imagine that the doctor may have recommended he be replaced. We have a slogan: if there is any doubt, keep the player out.”

Brazil 2014 may have disappearing sprays and goal-line technology, but ultimately these gadgets are sideshows to the main event. Until officials and teams can enforce FIFA’s own medical rules, football seems very vulnerable to a negligence action, given the widely identified and foreseeable risks to health. Sport may have an immunity for ‘playing rules’ but this immunity does not extend to unjustifiable risks, see for example: the English boxing case of Watson v. British Boxing Board of Control (BBBC) [2000] EWCA Civ 2116. In that case, the governing body of boxing (the BBBC) were found liable for failing to implement what were known medical protocols to mitigate the risks of brain damage. Indeed, the Pereira incident only gives greater impetus to the cross-party call for a UK Parliamentary Inquiry into concussion in sport (http://bit.ly/1qjXUaI). Published earlier this week, the document calls for five clear steps to be taken:

  1. A full parliamentary enquiry into concussion in sport
  2. A coherent set of concussion protocols covering all sports
  3. Independent peer-reviewed research into concussion and British sport
  4. Better co-ordination between sports, schools, colleges and doctors
  5. A clear message that concussion can kill.

These sorts of enquiries are much needed, but these recommendations are only a starting point. The media and the public have already shown themselves able to recognise concussive events and there was widespread disapproval on twitter of the decision to allow Pereira to continue  (although admittedly it is interesting to see ow much of this disapproval came from international commentators, medical professionals or from followers of other codes of ‘football’). Without some form of enforcement mechanism though – whether through tighter regulations from FIFA, self-enforcement by the teams themselves, or a fear of lawsuits brought by players – this type of incident will continue unchecked at all levels of the game. Until something fundamental changes, sadly we will be making similar comments in another six months….

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Why Lloris’ head injury was so severe that even the FA and Tottenham lost consciousness…

November 6, 2013

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brain

Although Tottenham’s website thankfully confirms that Hugo Lloris has been given the all-clear following a precautionary CT scan, if the outcome had been more tragic, Tottenham, the FA and the Premier League could all have been sued in negligence law, and most likely would have lost.

This article will review what liability exists, why, and what steps need to urgently be taken in order to manage this risk.

 

WHAT HAPPENED

Tottenham Hotspur played Everton in a Barclays Premier League match on the weekend. Near the end of the game (77th minute according to BBC live text website), the French international goalkeeper, Hugo Lloris suffered a head injury and brief unconsciousness following a collision with Romelu Lukaku’s knee in a challenge.

After a brief delay for treatment, Lloris was not substituted and played out the remaining 15mins of the match.

 

SO WHAT NEGLIGENCE LIABILITY EXISTED?

While the challenge between Lukaku and Lloris was not negligent, the actions by the team and authorities afterwards could create a liability along similar lines to the English boxing case of Watson v. British Boxing Board of Control (BBBC) [2000] EWCA Civ 2116. In that case, the governing body of boxing (the BBBC) were found liable for failing to implement what were known medical protocols to mitigate the risks of brain damage.

What is interesting is that despite the time-gap and the obvious differences between the two sports, there is a striking similarity between the two incidents:

  Watson Lloris
No player liability for the initial blow Eubank punch Lukaku challenge
No referee liability Referee stopped fight correctly Referee stopped game correctly
Rules of the game were followed BBBC rules on medical treatment followed At face value, FA [p.596] & Premier League [O.9] rules on medical treatment of head injuries followed as qualified medical personnel consulted
Medical professionals from outside the industry recommended more stringent rules Neurosurgeons attacked the BBBC rules pre-watson incident Stringent rules on concussion management recommended following NFL concussion suit, and other incidents particularly in Ice Hockey and Rugby

 

If we adopt the same Watson-esque reasoning for Lloris, a number of parties could therefore potentially be liable in negligence for breaching their duty of care towards the goalkeeper:

 

The Medical Professionals from the Club, and/or the Manager

Tottenham have based their media defence on the fact that they followed the FA rule on Head Injuries [6]:

All Clubs shall ensure that any player in a league match having left the field with a head injury shall not be allowed to resume playing or training without the clearance of a qualified medical practitioner.”

Because a qualified medical practitioner from the club assessed Lloris pitch-side, Tottenham argued that they were fully compliant with the relevant rules; and at first glance, this view seems correct. The situation however changes with a closer, more detailed examination of the FA rules on medical treatment. The next page of the FA rules states that:

Any player remaining immobile and unresponsive to verbal commands following a head injury will be regarded as being unconscious and treated in accordance with established principles for extrication and management of the unconscious player. There will be no return to play during that day……”

and further on that:       

“A player may suffer a transient alteration of conscious level following a head injury. It should be noted that under these circumstances, “transient” may coincide with the period of time between the injury and the arrival of the medical attendant at the player’s side. On-pitch assessment will include Maddocks questions as well as demonstration of conjugate gaze, “normal” visual acuity and full visual fields to confrontation. The player will only be allowed to resume play if asymptomatic and with normal co-ordination…..If a deficit is observed the player must be immediately removed from the field of play and regarded as suffering from a concussive head injury. There will be no return to play that day.”

The 4th Consensus statement on concussion in sport (supported and endorsed by FIFA) similarly says,

If any one or more of these [five] components are present [which includes loss of consciousness], a concussion should be suspected and the appropriate management strategy instituted.”

Given that it was widely reported in the media that Andre Villas-Boas (AVB) [the Tottenham Manager] admitted that:

“He [Lloris] doesn’t remember it so he lost consciousness. It was a big knock but he looked composed and ready to continue.”

This would seem to suggest that with either interpretation, by continuing to play Lloris, Tottenham was in violation of the FA rules. Either Lloris was briefly fully unconscious, in which case there should be no return to play, or he had an observable deficit (dizziness, memory loss etc) in which case he should not have returned to play.

The only justification for allowing Lloris continuing to play would be that the injury was transient. This is however a difficult medical decision that should be made solely by medical professionals, ideally in a quiet, non-pressurised environment. In a post-match interview with Sky however, Villas-Boas suggests (at 2m30 in) that:

“The medical department was giving me signs that the player couldn’t carry on, because he couldn’t remember where he was….but he was quite focused and determined to continue, so when you see this kind of assertiveness it means he is able to carry on, and that is why it was my call to delay the substitution.”

Based on the mechanism of injury and his unconsciousness on the pitch, the evidence strongly suggests that Lloris sustained some type of concussion. Indeed his post-match rehabilitation would support this conclusion as it looks to be proceeding along the lines of a concussive injury (CT scan, medical assessment, rest). Given this, the Tottenham decision to allow Lloris to keep playing would seem contrary to the FA rules on Head Injuries and raises serious question marks over the influence of the medical staff in this decision-making process. Were they overruled by AVB? Or did the medical staff make this decision free from any managerial interference?

If the recommended solution was simple [removal of the player], would have comparatively little effect on the game [a substitute keeper was available and ready] and the risks of failing to do this were significant [death, or serious injury from second impact syndrome / Chronic Traumatic Encephalopathy (CTE)], then arguably if an injury had result, it would have been negligent not to have taken these steps.

  

The FA / Premier League Rules.

Even if we take the alternative superficial view of this incident (that Tottenham acted within and implemented the relevant FA / Premier League rules on Head Injuries), this is not sufficient to excuse their duty of care to the player. It could however be used as persuasive evidence that the Club had acted reasonably by taking appropriate advice and relying on the FA scientific experts to lay down appropriate medical rules (outside the competence of the club). Liability would then pass to the governing body / league for negligent rule-making.

Indeed, just as the Court of Appeal held in Watson that:

“The Judge held that it was the duty of the Board, and of those advising it on medical matters, to be prospective in their thinking and to seek competent advice as to how a recognised danger could best be combated. He held that he was left in no doubt that the Board was in breach of its duty in that it did not institute some such system or protocol as that which Mr Hamlyn was later to propose. He held that anyone with the appropriate expertise would have advised the adoption of such a system.” [121]

So this finding is equally instructive to this incident. It would be surprising if anybody in professional sport was not aware of the risks associated with concussion following protracted litigation in North America from both the NFL American Football players association, and NHL ice-hockey players, not to mention recent rugby incidents – most notably George Smith’s infamous return to the field following a heavy collision.

Could or should the FA have done more? Arguably yes. As regulators of the game, there needs to be a clearer stance taken as to how the rules should be applied, and whether in the first instance, they are actually strict enough. While there have recently been some clubs that display admirable restraint, for example Norwich’s substitution and treatment of Robert Snodgrass following a heavy collision with a defender, there have equally been occasions this season where concussed players have continued to play – indeed ironically, Lukaku himself was briefly knocked out during the Everton-West Ham game on September 21st. If the FA and Premier League are aware that players are not being substituted, then their continued tolerance of this practice must surely constitute tacit acceptance?

As Watson shows though, even full adherence to the FA rules may not act as a defence to a negligence claim if other sports or medical professionals implemented more stringent standards.

  • For example, any ice-hockey player suspected of concussion in the NHL is removed from the bench to a quiet place so that a full Sports Concussion Assessment Tool (SCAT2) test can be administered. 
  • Similarly, the NFL test for American footballers based on the SCAT test typically takes 8-12minutes to complete.
  • Perhaps most tellingly though, Dr Barry O’Driscoll (formerly the IRB medical advisor) recently stated that “it’s ferocious out there…there is no test that you can do in five minutes that will show that a player is not concussed….to have this acceptable in rugby, what kind of message are we sending out?”

What is considered reasonable should therefore be judged in the context of safe practice recommended by the medical experts in the field, for example, adopting the 4th Consensus statement on concussion in sport, supported and endorsed by FIFA (amongst other signatories), or reviewing literature and protocols from North America where awareness of concussive injuries seems to be much better understood. It is not sufficient for The FA to argue that their rules on head injuries are the strictest that they have ever been, or that with FIFA F-MARC accreditation the medical facilities at St. George’s Park are world class, instead what is needed is a world-class implementation of safe, effective rule-making and sadly this weekend’s incident exposes the deficiencies in the current system.

 

Recommendations

This article would suggest four actions need to be taken urgently:

  1. The FA or League to impose disciplinary sanctions for clubs acting against the safety of a player – If no sanction exists for ignoring or misapplying the FA rules on Head injuries (or any other medical condition affecting the safety of participants), then medical staff and managers are not incentivised, beyond their own professional values, to make ‘correct’ or ‘safe’ decisions. What is instead needed is for the FA to implement fines or other disciplinary measures for a failure to follow agreed medical protocols. The FA (and clubs) have a duty of care to protect the safety of the players, and much as hard-helmets and ear-protection are mandatory and punishable by health & safety violations in the construction industry, so the FA need to implement a system of enforcement for the (mis)application of their rules.
  2. The FA or League to implement ‘medical suspensions’ akin to yellow and red cards. Just as players might receive suspensions following red cards, so automatic minimum medical suspensions could be triggered followed head injuries. If players, coaches and officials were not just educated about the risks of concussion and return-to-play protocols, but had to abide by minimum suspensions (for example, 5 days), then this would help to reinforce the potential seriousness of the injury. Clubs would of course be free to extend this recuperation as needed, but a minimum mandatory rest-period could also help change public perception that athletes were not being brave by continuing to play and wimps for being substituted, but rather that this decision was taken out of their hands by the governing body. A system of governing body / league ‘medical suspensions’ would also assist with epidemiology as it would make it easier to track repeated concussive injuries or identify particular high-risk athletes.
  3. The FA to review concussion best practice in other sports. Following the clear principle laid down by the Court of Appeal in Watson, the FA as the industry regulator has a duty of care to provide best medical practice, and continuously review these protocols in light of other sports or medical guidelines, with a view to making alterations to the current rules if necessary. [At the time of writing, this recommendation seems to already be in progress]
  4. Consider whether independent medical teams should have ultimate decision-making authority over clubs.  Finally, to avoid any appearance of undue influence, conflict of interest or pressure being exerted on club medical staff (as was observable with Dr Wendy Chapman, the club doctor at the centre of the ‘Blood-gate’ scandal in rugby), it may be advisable for the FA to leave the decision over whether a player sustained a concussive injury, or other medical condition affecting the safety of a player, to an independent doctor available on the side-line. Of the four recommendations, this last point is however more controversial and would add an additional expense to games, particularly since the other three recommendations could equally be applied throughout the Football League structure comparatively easily.

Whether footballers are viewed as human beings, or as multi-million pound club assets, they deserve the protection and safety of the very best medical protocols, whether they want this protection (or in this incident, not). The injury to Lloris represents a warning to the FA that it is not just the professional football clubs that would face negligence liability, but rather the regulator would also be liable for a failure to act in the face of foreseeable injuries. Concussions may be comparatively invisible, but that doesn’t mean the regulator should be as well….

 

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Football Player Sues Canadian University for Brain Injury

September 22, 2013

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By Amy Ulveland – Thompson Rivers University 3L JD Student

According to the Merriam-Webster dictionary, a coach is defined as: a person who teaches and trains the members of a sports team and makes decisions about how the team plays during games [emphasis added]. In many ways, the role of a coach is analogous to that of a parent: just as a coach must respond to an individual’s needs while seizing opportunities to develop character, so too must a parent. While both may use fear to motivate individuals to act in a certain way, this must be tempered with a steady diet of support and encouragement. In other words, they both serve as role models (for better or worse), and exert an observable degree of control. In this role, coaches and parents may be viewed as infallible, all-knowing creatures, but they are not. They are human, and in exercising judgment, mistakes will be made. Indeed, there is no one-size-fits-all manual.

In R v Jobidon, the Supreme Court of Canada was tasked with considering whether an individual could directly or impliedly consent to force causing bodily harm. In taking a contextual approach, the Court paid some attention to sporting activities: “… the policy of the common law will not affect the validity or effectiveness of freely given consent to participate in rough sporting activities, so long as the intentional applications of force to which one consents are within the customary norms and rules of the game. Unlike fist fights, sporting activities and games usually have a significant social value; they are worthwhile.”

The line remains blurry; one can appreciate the difficulty of placing guilt within a sporting context. Players assume a heightened level of risk as part of ‘playing the game.’ With the above in mind, I turn to the recent lawsuit launched by former amateur football player, Kevin Kwasny, against his former coach, and Bishop’s University (see article here).

Kevin was 21-years-old at the time – in his prime – when life as he knew it changed forever. After being hit on the football field and suffering bleeding on the brain, Kevin’s severe brain injury left him and his family with hefty medical bills, and a lifetime of assisted-care. Kevin’s lawsuit essentially argues that his coach and Bishop’s University were negligent in forcing him to go back out to play after showing signs of a concussion from an initial hit on the field.

There are two questions at issue: 1) whether Kevin’s coach was negligent in instructing him to go back out on the field after learning Kevin was feeling dizzy from a hit; and, 2) if so, whether Bishop’s University is vicariously liable for Kevin’s brain injury and damage caused as a result of its member coach’s negligence?

The case will turn on whether or not Kevin’s coach knew or ought to have known that his current state would worsen thereby causing him permanent brain damage, as a result of sending him back out to play. Therein lies the rub: coaches are neither doctors, nor medical specialists. The duty of care is there. The question becomes: what standard of care did Kevin’s coach and university owe him? The court will measure his conduct against that of the ‘reasonable coach’ in similar circumstances. Recognizing coaching styles are as varied as parenting styles, there are certain cues that a ‘reasonable person,’ let alone a ‘reasonable coach,’ ought to recognize and prudently act on.

Showing signs of dizziness after being hit is a telltale sign that an individual is not ready to go back out on the field (where he or she is likely to get hit again).

The court will find some guidance in the CIS Code of Ethics which reads, in part, as follows:

“90.60.2.2 – Responsible leadership is a priority in ensuring the full development of individuals as a whole. Inherent within the implementation of this principle is the notion of competence whereby personnel will maximize benefits and reduce risks to participants by being well prepared and current within the field of sport.”

Issues of causation and proximity will be at the centre of debate, but in my opinion, the court is likely to find that Kevin’s coach was contributorily negligent in pushing him back out on the field after learning of his condition. As the court may be reluctant to place guilt solely on his coach, for public policy reasons cited above, there is a good likelihood it will find Bishop’s University vicariously liable to deter such type of bravado on the field. No individual is expected to be superman – on field or off.

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A (head) shot across the NHL’s bow?

August 9, 2011

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The Globe and Mail – Canada’s national newspaper – just published a piece I wrote relating the NFL lawsuit to the concussion crisis in the National Hockey League (click here for the article). Here are a few excerpts:

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Seventy-five former players sued the National Football League last month, alleging that the league failed to warn and properly protect them from the long-term brain-injury risks associated with football-related concussions. They say the NFL was negligent in failing to exercise its duty to enact rules regulating postconcussion medical treatment and return-to-play protocols and to enact reasonable rules to protect players against the risk of brain trauma.

No doubt the NFL lawsuit will raise eyebrows and blood pressure at the National Hockey League’s head offices in New York. And if it doesn’t, it should. Although hockey and football are different sports governed by different rules, the fact is they’re cut from the same cloth of contact sports. Perhaps the threat of litigation will force the NHL to rethink its approach to head injuries.

Let’s hope the NFL suit will prompt the NHL to get rid of head shots from hockey. Enrolment in youth hockey is declining. The reasons are myriad, but there’s no doubt that hockey violence and its effect on kids’ brains is a factor in their parents’ decisions. The NHL’s influence on youth hockey is unmistakable, and kids will mimic what’s modelled. The league does a disservice by not doing more.

Real change in youth hockey and the pros will only occur after the NHL breathes in the smelling salts, gives its head a shake and eliminates head shots from the game. And if the league continues to skate its way around this issue, perhaps the long reach of the law in the NFL case can knock some sense into the NHL.

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Ripple Effects of Chara’s hit on Pacioretty in the NHL

March 16, 2011

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The ripples from Boston Bruins captain Zdeno Chara’s hit on Montreal Canadiens forward Max Pacioretty last week have begun lapping on the shores of sponsors and big business (click here for a video of the hit).

Chara checked Pacioretty driving his head into a steel (and padded) stanchion resulting in Pacioretty sustaining a non-displaced C4 fracture and a severe concussion. Chara was given a five minute major penalty and game misconduct for interference. The National Hockey League imposed no supplemental discipline finding that Chara did not deliberately target Pacioretty’s head. It was a tragic ‘hockey play’ that resulted in a player breaking his neck. In other words, it was an accident. Chara apologized and said he didn’t hurt Pacioretty intentionally.

The incident has sparked considerable debate. Columnists have called Chara’s conduct as acting with reckless disregard (don’t you love it when reporters write in legalese?) and that he knew exactly what he was doing driving Pacioretty’s head into the post.

Technically, Chara did not break Rule 48 which prohibits lateral or blindside hits to an opponent where the head is targeted and/or the principle point of contact. The problem is that the head must be targeted; the contact must be intentional. In a fast and furious sport like hockey, it is very difficult to prove in the balance of probabilities that there was intent.

If the league is serious about hits to the head and brain injuries they will have to adopt a strict liability approach similar to their existing rules about high-sticking (Rule 60) or delay of game when a player inadvertently shoots the puck over the boards while in their own end (Rule 63).

In spite of Sydney Crosby – the world’s best player – getting concussed by a hit more than two months ago which somehow went unpenalized when he was away from the puck and looking in the other direction from his assailant (Crosby hasn’t played a game since) and now Chara breaking Pacioretty’s neck, the NHL seems in no hurry to fix the problem.

Corporate Canada appears not to agree.

Air Canada sent NHL Commissioner Gary Bettman a letter which expressed concern over the incident and noted that, ‘From a corporate social responsibility standpoint, it is becoming increasingly difficult to associate our brand with sports events which could lead to serious and irresponsible accidents; action must be taken by the NHL before we are encountered with a fatality. Unless the NHL takes immediate action with serious suspensions to the players in question to curtail these threatening injuries, Air Canada will withdraw its sponsorship of hockey.’

This reminds me of a couple of the basic rules of business:

1st Rule of Business – money talks

2nd Rule of Business – league commissioners and team owners listen to money talking

So, in their way of thinking, if a bunch of whiners are upset with fighting and hitting in hockey but fans continue to go to games, the league will do nothing but hear the sound of turnstiles clicking into arenas and count their money.

But this is different. The carrier is one of Canada’s biggest brands and supporters of NHL hockey in the country. The criticism represents an assault on the league’s credibility and approach to violence.

Bettman is putting a brave face on the situation and even threatening retaliation saying that ‘It is the prerogative of our clubs that fly on air Canada to make other arrangements if they don’t think Air Canada is giving them the appropriate level of service.’

I don’t think he understands the gravity of the situation.

If the National Hockey League wishes to be taken seriously as a professional league then it will have to listen to the concerns of Corporate Canada. Bettman ignores the criticism at the league’s peril.

All of this represents a new front to the fight on hockey violence and even cracks to the foundation of sponsorship support to the league.  Hold on to your hats – this promises to get very interesting!

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No Race to Save Face: Lindsey Vonn’s Concussion

February 17, 2011

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The US Skiing and Snowboard Association’s win-at-all-costs approach and laissez-faire efforts at diagnosing brain injuries are dangerous to both skiing and its athletes.

Lindsey Vonn won the silver medal in the downhill at the world ski championships in Garmisch-Partenkirchen in spite of her clearly being concussed (click article here). That the US Ski Team would misdiagnose her condition and allow her to ski at speeds up to 90 mph on a course renowned for its spectacular crashes is careless and potentially negligent.

It brings to mind Vince Lombardi’s infamous quote, “Winning isn’t everything, it’s the  ….”  Uhhh, how does that go again?

Postscript – Somehow between Ms. Vonn sustaining a concussion in a fall on February 2 training run and miraculously recovering from her brain injury in time to win the silver medal at the world championships on February 13, she relapsed and has withdrawn from subsequent world championship races (click article here). I wonder if media criticism (click article here), Ms. Vonn’s confession (‘I definitely am injured’), or anger from some corners of the ski racing community (click article here – Canadian alpine skier Kelly VanderBeek asked ‘Who are Lindsey’s handler and who in their right mind would clear her to race?’) affected the decision to withdraw. Regardless of the motivation of the US Ski Team’s change of heart, it is proper that Ms. Vonn not race until she is recovered and we wish her well on the road to a speedy recovery.

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Another Concussion report released

February 24, 2009

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Source: http://www.29sports.com/29/london/home.html; http://sports.theglobeandmail.com/servlet/story/RTGAM.20090210.wsptconcussions9/GSStory/GlobeSportsHockey/?page=rss&id=RTGAM.20090210.wsptconcussions9

Another day, another report into concussions in sport! This time the recommendations come from a Panel of experts from the London Hockey Concussion Summit in Ontario. The statement issued by the Summit chair, Dr. Paul Echlin, recommends that fighting (the major cause of high / head hits) should be eliminated in order to remove the incidence of concussions. It is important to note however that this statement was not unanimous, but rather was intended to be a talking point providing recommendations for future discussion.

The panel also advised that:

  • a central ‘concussion certification program’ (Proposed name: Hockey Concussion Initiative) be set up in which trainers, coaches and officials would gain knowledge aimed at recognizing and treating concussion. While this agency would initially be focused on Hockey injuries, ultimately the Panel hope that it could serve as a model for all sports in which head injuries occur such as football, soccer, rugby, skiing, skateboarding and cycling.
  • an NHL/Ontario Hockey League role model program be adopted
  • Studies should be launched leading to a data collection system
  • Players should undergo pre-season screening
  • A survey should be conducted of protective equipment.
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Concussion Trauma

February 18, 2009

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Researchers from the Sports Legacy Institute for Chronic Traumatic Encephalopathy, working in partnership with Boston University have confirmed that Tom McHale (an ex-NFL veteran) who died in 2008, aged 45, was suffering from a degenerative brain condition similar to Alzheimer’s disease which has been linked to repeated head trauma.

Although Police said that the actual cause of death was OxyContin and Cocaine (which he took after developing chronic pain in his shoulders and other joints), an autopsy showed up the damage to his brain. The condition, which is caused by repeated trauma and can be diagnosed only in dead patients or by an invasive biopsy, is characterized by tangles of nerve fibers in the brain’s cortex. The symptoms can include memory loss, depression and dementia similar to Alzheimer’s disease and are typically found in elderly people in their 80s and in boxers suffering from dementia.

The NFL is currently funding an independent medical study of retired NFL players in an effort to understand this issue.

 

Source: http://sports.espn.go.com/nfl/news/story?id=3864644&campaign=rss&source=ESPNHeadlines ; http://sports.espn.go.com/nfl/news/story?id=2905142

 

See also: http://www.nytimes.com/2008/09/24/sports/football/24concussions.html?_r=4&hp&oref=login&oref=slogin ; http://www.sportslegacy.org/CSTE.asp

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‘Concussion Effect’ apparently lasts for decades

February 11, 2009

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“People concussed in their youth show subtle signs of mental and physical problems even more than 30 years later, say Canadian researchers. The study, published in the journal Brain, found athletes with a history of concussion had worse physical and mental test scores. However, the researchers stressed these minor changes did not affect day-to-day life.”

Dr Louis de Beaumont, who led the study, said: “This study shows that the effects of sports concussions in early adulthood persist beyond 30 years post-concussion, and that it can cause cognitive and motor function alterations as the athletes age. Athletes should be better informed about the cumulative and persistent effects of sports concussion on mental and physical processes so they know about the risk associated with returning to their sport.”

(The small-scale study involved just 40 former athletes aged between 50 and 60, 19 of whom had a history of one or more concussions in their youth).

Andrew Scheuber from the Alzheimer’s Research Trust said: “Sportsmen and women should take extra care to avoid head trauma. Some experts believe that footballers from the 1970s and earlier, including Danny Blanchflower and Billy McPhail, may have developed dementia as a result of heading old-style heavier footballs – though this is open to debate. Much more research is needed if we are to minimise dementia risk for everyone.”

Source: http://news.bbc.co.uk/1/hi/health/7851800.stm

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