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Hockey and Traumatic Brain Injuries



I was really tempted to make the title “Hockey and Traumatic Brian Injuries” to act like I’ve had a few myself, but figured it’d be a tough joke to get since you probably don’t check my spelling all that closely.  Anyways, let’s get on with it!


My oft-mentioned brother is an ambassador for the Rick Hansen foundation (Rick Hansen is the Canadian dude with Spina Bifida that WHEELED AROUND THE WORLD), which provides funding for research on Spina Bifida and other spinal cord injuries. 

And, my oft-mentioned fiancee is an Occupational Therapist at St. Joseph’s Barrow Neurological Institute, a world renowned treatment facility that people from all over the country fly into when they need the best care (the one Bret Michaels was just at).  She works in the acute brain injury rehab unit, dealing with people who’ve had traumatic brain injuries (henceforth, TBI’s).

So, when I had someone reach out to me about raising awareness of brain injuries in hockey (Mark Savard, David Booth, whatever happened to Daniel Carcillo at some point in his life), I figured my site was a perfect fit.  Chelsea Travers of CareMeridian asked if she could run a piece she wrote on Bourne’s Blog, and we’re happy to have her contribution on the site.  The more we talk about it, the more we’ll do about it, I figure. 

Happy Humpday!

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Author Bio:
Chelsea Travers is an outreach representative for CareMeridian, a subacute care facility located throughout the Western United States for patients suffering from traumatic brain injury, spinal cord injury or medical complexities, such as neuromuscular or congenital anomalies.

Hockey and TBI


Hockey is arguably one of the most physical professional sports. Hockey players are constantly getting body checked, slammed into boards, falling to the ice, slapped by a stick, hit by a dense, speeding puck or getting punched during a fight. If that isn’t bad enough, hockey players take part in one of the longest regular seasons of any sport, effectively taking on harsher pain for a longer amount of time throughout the year. Risk of injury couldn’t be clearer as you all too commonly see hockey players missing their front two teeth. With all of the injuries that can occur, one of the most dangerous is a traumatic brain injury (TBI).

It was clean, though. Um, right?

TBI is a silent injury that can cause harm to the mind and body of an individual. An injury to the head or brain can alter someone’s life and can even require long-term rehabilitation and care from a skilled nursing facility. These injuries are often far too common in the sport of hockey and if not properly treated can permanently leave a hockey player’s life more challenging than the game they play.

TBI is an injury that Philadelphia Flyers player Ian Laperriere knows all too well. In game 5 of an NHL playoff game with the New Jersey Devils, Laperriere took a slap shot to the face that immediately caused him to bleed excessively from the wound above his eye and lose sight. Laperriere was diagnosed with a brain contusion after having a MRI a few days later. While Laperriere may have originally thought that losing sight in one of his eyes was the worst of the two injuries, in reality the bigger concern could wind up being the long-term effects of the brain injury.

Concussions have been dismissed as minor injuries as the physical nature of most sports cause them to occur regularly, but, frequently occurring or not, they are still head injuries where the brain is forced to move violently within the skull and the way it functions could change permanently. When the brain moves in such a manner, it can bruise, bleed, and even tear, which can cause irreversible damage to the victim. For a sport like hockey, this type of injury is very common and unfortunately at times ignored.

Meanwhile, this liney is knuckles deep... that can't help.

Many hockey players don’t take into account the possible effects of the injury and because it might not seem like a serious problem exists at first, they keep on skating as if nothing occurred. Being unaware of the injury makes it much more dangerous, as a mild brain injury can turn into a life threatening injury in a very short period of time without seeking immediate medical treatment.

Studies by the National Academy of Neuropsychology’s Sports Concussion Symposium in New York have shown that since 1997, 759 NHL players have been diagnosed with a concussion. Broken down, that averages out to 76 players per season and 31 concussions per 1,000 games of hockey. That is far too frequent of an occurrence for such a serious injury. It’s a frightening statistic that should send up a red flag to hockey officials that actions need to be taken to further prevent this type of injury from occurring.

The best, and sometimes only, treatment for TBI is prevention. For the National Hockey League new rules are being considered that preserve the game but also help protect the players. Rule changes concerning blindside hits, rink size (which effects players space from each other and their proximity to walls), and stronger helmet requirements all have been considered to help curb TBI and its effects. This demonstrates that the NHL is aware of the seriousness of the injury and is taking proactive steps to help prevent it from happening.

Hockey is one of the most popular sports in North America and has millions of people participating in it every year. Unfortunately, the sport comes with the risk of a TBI. With the right awareness of the injury and the necessary precautions in place, the game should be able to continue with players excited to lace up their skates and enjoy it.

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Okay, hi, it’s Bourne again.  Ten cents here:

We have to mandate soft(er)-cap shoulder/elbow pads.

We have to enforce the blind-side rule.

We have to accept the fact that playing hockey (or any sport) comes with some dangers, and if you really don’t want to get hurt, don’t play (that’s not being hardcore, or me saying “toughen up”, I mean seriously, choose not to play).  We can’t turn hockey into Scrabble because sometimes people get Scrambled.

Charging and elbowing should be called when people charge or elbow (crazy concept).  Everyone is pretty mutant-big at this point, so I’m not sure the extra decapi-stride is necessary.

And otherwise, I think the game is fine.  It’s fast, and there’s contact, so it’s dangerous.  Let’s enforce the rules as they are, but most of all, guy’s need to have some freakin’ respect for each other, and hopefully, by realizing just how serious these injuries are (MuhammedAli, MuhammedAli), hopefully guys will start taking less liberties on the ice.  It stops being a game when guys like Patrice Cormier makes opponents convulse for no apparent reason.


17 Responses to “Hockey and Traumatic Brain Injuries”
  1. KForbes says:

    A couple of months ago, before I started actively commenting, I dropped you an email about Mark Moore’s book, Saving The Game.

    For the viewers at home, Moore is brother to Steve and Dominic Moore and retired just before the lockout due to post-concussion syndrome.

    Anyway, he wrote this book just as hockey was coming out of the lockout and in it he profiles some of the problems he sees with the game and how he would propose to fix them. It runs the gamut, from on-ice product to business and marketing, but he spends a significant amount of time on the topic of injuries, officiating and preventing these issues before they happen (which makes sense, considering what happened to him and to his brother Steve).

    Your list of things that has to happen definitely mirrors his own recommendations, but there is one more thing that he brought up, which is quite a bit more radical: 4-on-4 all the time.

    I know what you’re thinking, immediately, it’s a stupid idea. But his reasoning was solid for what it would do for the on-ice product. Keep roster sizes the same, more room on the ice, more room for skill and scoring, fresher players on the bench, more energy on each shift, harder to shut it down and line guys up on the blue line late in the game to preserve the lead and so on. Obviously, it is a significant change, hockey last dropped a player (the rover) about 100 years ago.

    But his real reasoning was to do with injury prevention. Players are much bigger, stronger and faster than they were even 20 years ago. Even kids are now playing 12 months of hockey and the whole training and conditioning aspect of the game has exploded. But still they are playing on the same size rink. Bigger players, same size rink, less room to operate and more dangerous contact.

    The other oft-repeated option is to switch to international sized ice (something that I’ve heard a bit, because in the QMJHL, Chicoutimi plays on the larger rink). But retro-fitting all of the NHL arenas (just to start, not to mention the trickle down to the other pro leagues) would be a fortune and the owners would never go for it to lose seats right against the glass. Has anyone done a study on concussions in the European leagues that use that larger surface.

    It’s an interesting thought and I keep flipping back and forth on whether I really like it or not, but I wanted to pass it along. The whole issue is hard to approach because most view it as a desire to take hitting or physical play out of the game, but at what point are fans being shortchanged when their top scorer, team captain and two of their defensemen are on the IR with preventable injuries?

  2. jtbourne says:

    Thanks for the comment, it’s a good one.

    I see both sides of that argument, I really do. But I’d hate to get away from the traditional 5-on-5 hockey which rewards thinking and passing far more than 4-on-4 which rewards, well, speed. I wouldn’t support such a drastic change to the game.

    That said, I see the point. All that room out there would undoubtedly keep guys safer, as guys are getting bigger and faster.

    I played in the WCHA in college (NCAA D1), and 7 of the 10 rinks are Olympic sized surfaces. I’m not sold on the fact that it makes for more exciting hockey, as some claim it does, but I am sold on less likelihood of a concussion. There’s simply more ice to skate to, and that’s how you create room, not by altering the amount of guys on the ice. Guys are bigger, ice gets bigger. Logical (expensive) fix, and I don’t think you’d see the game change as much as we would all pretend it had.

  3. MWL says:

    Great read, nice job. I, personally, am against 4×4 hockey. i think it takes away a lot of the zone play. It obviously opens it up but then it turns into a game of fast breaks. Not that it wouldn’t be exciting, but i like the traditional forecheck v. d-zone battle.

    JB, on another NCAA note, I have heard they are going to go to a half shield mandate vs. the current full shield. Apparently a concussion expert was at the national coaches meeting and presented an argument for going to the hafly and it sounds like it was passed pretty easily. Not sure what the correlation between the two are but it’s an interesting development if it does happen.

  4. NWM says:

    The biggest step the NHL can take in reducing injuries is to consistently enforce the rules they currently have regardless of the outcome of the infraction. An elbow is an elbow no matter what happens to the receiving player. Why should one elbow get a suspension because a player got hurt, while another elbow gets nothing because the player lucked out and didn’t get hurt?

    The message the NHL sends is that you can do whatever you want as long as no one gets hurt, but if someone gets hurt, depending on who it is and who you are, you may or may not get a suspension for a random amount of games. This does nothing to prevent injuries or protect the players.

    As for Olympic sized ice, I can’t actually see it making a difference either way. It is a two way street, you may have more room to move, but so does the guy who is going to catch you with your head down. Similar to elimination of the ‘clutching a grabbing’ style of game, the skill guys are free to roam around, but so are the heavy hitters.

  5. jtbourne says:

    NWM – a fair point, but think about it. Would you rather have a guy bearing down on you in a bowling alley or a real alley? At least it gives the guy’s with their head up somewhere to escape to when they know they might get plowed.

  6. NWM says:

    If you have your head up it doesn’t matter if you are in a hotel hallway, you should be able to get out of the way, or at least protect yourself.

    With your head down you can be on a airport runway and still not see the train coming.

    I don’t think increasing the size of the size will have either a positive or negative effect on the game. Although increasing the rink size for the sake of reducing injuries, if one of the reasons for the increase of injuries is that players are faster then they were 20 years ago, seems counterproductive.

    The total number of injuries may be reduced, but I’d be willing to bet that the severity of injuries will increase.

  7. nightfly says:

    Great read, JB. Thanks. Especially agree with the soft caps on elbow and shoulder pads. Lots of players are essentially skating around with helmets on their arms, which they use to strike other players. It’s incredibly dangerous. If it actually hurt a bit to toss elbows at someone’s armored head, then people would be less inclined.

  8. KForbes says:


    That actually reminds me of another part of Moore’s book (cripes, I sound like his publicist now)
    I’m pretty sure he quoted from studies about how the harder pads were actually increasing the chance on injury among children. Not other players being injured from hitting the harder pads, but the actual wearer getting injured from falling or being hit and the body not being able to move freely against the hard pads and then things like sprains developing.

  9. Frank ( says:

    Well done sir.Chelsea actually reached out to me as well and I posted the article for her as well. Technically challenged that I am.

    SInce you’re a former player, I’d like to ask your opinion of today’s game in one aspect.

    No touch icing. Are you for it or against it? We didn’t ahve it in the Olympics and I don’t really think it was missed. As for me, I love hard hitting and finishing your checks, but aren’t we at the point where it’s time for this rule?

  10. nightfly says:

    Frank – if you don’t mind a rec league keeper and ref jumping in… I vote against. Being able to occasionally beat out an icing should be part of the game. With no-touch icing, there’s pretty much never a chance for that, because you have to beat the puck to the red line instead of the other player to the puck. These are superbly-conditioned athletes playing at the absolute highest level, they should have as many chances as possible to demonstrate their skill and athleticism. (The trapezoid is stupid for the same reason.)

  11. Frank Rekas( says:

    Nightlfy. Good points. It just seems that sometimes and while not often there are some players that stupidly go into the corner or backend and use their stick just enough to trip someone.

    On the other hand, removing the trapezoid I think would certainly change that.

  12. Simone says:

    Good stuff by Ms. Travers.
    Although by this statement is she referring to Canada? “Hockey is one of the most popular sports in North America and has millions of people participating in it every year.”
    I realize hockey is gaining in the USA, but isn’t it still fourth behind football, baseball, and basketball?

  13. KForbes says:

    key words being “one of”
    I would hedge a guess that by the numbers, soccer is also more popular than hockey (talking about participants, not media attention/fan attention/finances of the pro game)

  14. Kerstin says:

    Wear a dmn full visor..

    Can’t understand that so few people understand that such a little change can avoid so many tremendous injuries…

  15. Greg says:

    Pros – checking (and fighting) are an exciting part of competitive men’s hockey.
    Cons – checking (and fighting) result in serious injury to players, and are an impediment to youth hockey recruitment efforts.

    For a player, no-check hockey is DIFFERENT from checking hockey, but no less fun.

    Likewise for a fan, no-check hockey is DIFFERENT to watch, but no less entertaining. (Was the USA-CAN women’s match lacking excitement?)

    Bottom line, keep doing what we are doing and we’ll keep losing players to concussions etc.
    We’ll keep repelling the well-meaning families who want their kids in sports but rightfully recognize basketball as being much more safe.
    Or we eliminate checking and fighting. We keep 100% of the current players and 99% of the current fans (we’ll miss you Don Cherry), and we get Soccer Moms to start seeing hockey as a legitimate alternative to Tall Ball.

  16. Jack L. says:

    I have to completely disagree with you. Taking out checking in the game would lose a significant amount of fans, as well as players. That is a key element to the game of hockey that should never be replaced. All hockey needs to do is crack down on the illegal hits. Make the punishments very severe so players understand that cheap hockey will not be tolerated. I understand the argument of taking fighting out of hockey, and I would have to say there are both pros and cons to fighting. My personal opinion is leave it in the game. It provides a jump to a team that needs it, as well as helps police hits that should not be allowed in the game. The big picture though is that no matter what the NHL decides to do with fighting, people will always be on both sides of the argument. I think it is key though that hockey keeps checking and fighting in the game, otherwise it will cause a great deal of loss of interest.


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