Anybody that knows me (or that has set foot in our clinic) knows that one of my greatest passions in this world is hockey. I have read many books on the sport, including most recently “Game Change” written by NHL legend Ken Dryden. This book is unlike most other hockey books that I’ve read in that there is a clear message; something must be done to reduce the number of concussions in hockey.

The book follows the life of NHL journeyman Steve Montador. Even as a young man, Steve was never the best player on his team. He had to fight for everything he achieved in hockey (both literally and figuratively). As a “good teammate” Steve constantly put himself in harm’s way, and knowing that he was always one step away from the minors, he refused to admit when he was hurt. After several documented head injuries, concussions ultimately ended Steve’s hockey career and his life. Struggling with severe memory loss, mood changes, anxiety and depression as a result of his concussions, Steve was found dead as a result of drug overdose. He was 35 years old.

Steve is just one example of many hockey players whom have succumbed to the effects of what researchers now believe to be Chronic Traumatic Encephalopathy (CTE). CTE can only be diagnosed post-mortem and is shown by unhealthy tau proteins which break the bonds between neurons reducing the communication between centres of the brain and thus diminishing its function. Side note: if you haven’t seen the movie Concussion, make sure that you do!

In this book Ken theorizes about why there are so many more concussions in hockey in recent years. He speaks at length about the speed of the game and how that has increased the force of impacts between players. In its infancy, hockey players were only allowed to pass the puck backwards, but changes to the game such as the forward pass, the removal of the blue line, and changing lines on the fly have increased the speed of the game. Improvements in equipment and training have also increased the speed. Ken also mentions the increased incidence in fighting that occurred following the success of the Broad Street Bullies in the 1970’s. All of these changes (among others) he believes, have led to the increased incidence of head injuries.

The book finishes with some suggestions as to how to reduce the number of concussions in hockey. First he talks about the idea of “finishing your check”. This has been a part of hockey for decades now, but Ken suggests that this is interference. I’ve always maintained that the Scott Stevens hit on Paul Kariya back in 2011 was a late and dirty hit (this was essentially the beginning of the end of Paul’s career). Ken states that players should be penalized for these plays, not rewarded for interfering with a player.

The second suggestion that Ken makes is to penalize ALL hits to the head. He discusses how in the NHL rule book any contact with the stick to a players head (whether accidental or intentional) results in an automatic penalty, yet the same does not hold true for body to head or shoulder to head blows. If a player must be in control of their stick at all times, why not their body? And of course, the great exception to head contact rules if the fist! He questions why in hockey fighting has been allowed and even encouraged, while it is severely penalized in almost every other sport.

I must say that although I don’t agree with every point that Ken makes in this book, he certainly made me think. Although we have come a long way in our ability to treat concussions, our best defense is still prevention. So while we continue to invest millions of dollars into concussion research (though according to Ken, the NHL and Gary Bettman refuse to do their part), perhaps a couple of simple rule changes could go a long way in reducing the number of occurrences.

This book is just one example of how at South Simcoe Physiotherapy we are constantly seeking new knowledge (even in our leisure time!). If you or anyone you know has recently suffered a concussion, please call to book an appointment with one of our SHIFT concussion providers.

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