By Jack Blatherwick, Ph.D.
Let’s Play Hockey Columnist

As a football or hockey parent, you might think, “My son never had a concussion, so I’m not worried about CTE (chronic traumatic encephalopathy).” But you’d be wrong, according to each of the neuroscientists and retired football players who testified in a recent congressional hearing. The C-SPAN video is a must-see for parents of children who participate in contact sports: https://www.c-span.org/video/?435696-1/medical-experts-former-nfl-players-testify-traumatic-brain-injuries.

Dr. Anne McKee, a neuropathologist at Boston University, testified about post-mortem examinations she has done on hundreds of brains, donated by families who recognized mental dysfunction, pain and abnormal behavior in their former athlete-relative. Of these brains, 87 percent had the telltale chemistry and anatomical lesions of CTE.  

These were the brains of former NFL and college football players, along with some from other sports, including hockey. A scary fact that should cause us all to think is that of the deceased athletes whose brains had CTE, 20 percent never had a diagnosed concussion!  

Dr. McKee emphasized that it is the total number of sub-concussive hits to the head in a career – the kind that occur every play in a football game and are not called “concussions” – that is a potent cause of degenerative brain disease, CTE.

Dr. Robert Stern spoke passionately of his concern for children. He cited a study that followed young (8-13 year-old) football players for one season, looking at MRI brain scans before and after the season. The study showed that lesions to the white matter of the brain were statistically related to the number of sub-concussive hits during the season, measured by accelerometers. That’s just one season!

So, what can we do? First, a personal note: I love football, but according to the researchers and players on the panel, nothing we can reasonably do will make it safe.  

“I won’t let my grandson play football,” said former all-pro linebacker, Harry Carson, who suffered years of pain and symptoms himself after retiring.

He explained the mechanism of a concussion in laymen’s terms. The damage occurs when the brain bangs against the inside of the skull from a direct head hit or even from whiplash when the contact is not to the head. It’s like the yolk inside an eggshell. “Therefore, improving helmets is not the answer,” Carson explained.  “A helmet protects the skull, not the brain.”

Can we make hockey safer for young brains at a critical time in cognitive and motor development? The answer is, “YES, if we care enough.”  
The first step is to enforce the rules as they are written. Amazingly, that has never been tried in hockey. More than any other sport, we play by traditional, unwritten rules that encourage hostility. 

We allow trash talk, cross-checks and punches to the head after the whistle, violations that would be penalized during play. Each violation should result in a misconduct penalty for every offender. Penalize the trash-talkers as well. There should be five-minute misconducts so referees find it easier to call them every time. Right now, the tradition is for referees to act like impotent pro-wrestling refs, trying to separate undisciplined children. 

Let’s reinstate charging penalties to the referee’s arsenal. I venture to say almost no one reading these words has seen a ref’s signal for charging. Every hit from a “run-up” distance more than two strides is charging, whether into the boards or in open ice. 

Finally, players should not be allowed to pound their sticks on the boards after a big hit, because this elevates the hostility in the arena. That’s not a new rule – it’s unsportsmanlike and worthy of a misconduct. 

It is leadership failure that allows players and negative traditions to dictate the terms of sportsmanship and discipline. Consequently, hockey looks more like football each year, and youth football is not likely to survive the trauma to young brains. Hockey can thrive by enforcing rules and emphasizing skills rather than violence.