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Colby Armstrong Scolded for Trying to Hide Concussion

posted by SK Brain Injury    |   December 29, 2011 10:00

Toronto Maple Leafs general manager Brian Burke gently scolded injured forward Colby Armstrong on Monday, a week after the popular 29-year-old winger tried to hide the fact he had suffered a concussion from the team.

Armstrong was concussed against the Vancouver Canucks on Dec. 17, and fell ill during a session on the exercise bicycle the next day. On Dec. 19, as he was planning to play the Los Angeles Kings, Armstrong was nauseated again and was diagnosed and pulled from the lineup.

“Everyone tries to play hurt, but you should never try to conceal a head injury — no one admires that or respects that,” Burke said Monday. “We grudgingly respect when players hide other injuries, because they do it routinely. (Head injuries are) one where we absolutely insist the players be forthcoming.”

There is no timeline for Armstrong’s return. The concussion was the latest in a string of injuries he has suffered over two seasons in Toronto, a list which includes a scratched cornea and a tendon that mysteriously popped of his hand during a game.

“Once the season starts, during the entire season, you’re never pain-free as a hockey player,” Burke said. “Something hurts every day, with varying degrees of severity. I don’t think he’d had a concussion before. He wanted to see if the symptoms resolved on their own. He got through a practice OK, and then felt terrible. He’s in the protocol now.”

Article found at www.nationalpost.com

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Concussions: A Guide for Parents

posted by SK Brain Injury    |   December 28, 2011 19:00

The subject of sports concussions has been in the news a lot lately. But while the recent media  focus has been on hits to the head in the National Football League which have led to player fines and, most recently, a suspension, and to legislative action at the state and federal level on return to play guidelines, the important role parents play after their kids suffer concussions hasn't received the same kind of attention.

The fact is that an athlete's parents, along with teachers, coaches, school nurses and administrators, play a crucial role in a child's treatment and recovery from a suspected concussion, especially the all-important decisions about when to return to school and everyday social and home activity, and, in most cases, to sports. 

Parent involvement in their child's recovery from a concussive event is, of course, not surprising, considering that:

  • Active involvement of the parent is standard practice in pediatrics (especially, of course, for younger children);
  • The student-athlete's everyday environments at home and at school are important places to observe post-concussion symptoms; and
  • Parents and teachers possess a wealth of information about the child's behavior and ability to function in these settings that is directly relevant to an assessment of their post-concussion symptoms and when it is safe for them to return to the classroom (often with accommodations) and sports.

Parent concussion checklist

But what, exactly, is the parent's role?  Here's a 10-point checklist.

1.  Regularly and closely monitor athlete for first 24 to 48 hours.2

  • Most sport-related concussions are mild, but the potential always exists for a more serious, life-threatening head injury, such as an epidural hematoma (bleeding between the skull and the brain), subdural hematoma, subarachnoid hematoma, or from second-impact syndrome (a rare, but often fatal brain injury suffered before the brain has fully healed from previous brain trauma).
  • Because delayed onset of symptoms during the first 24 to 48 hours is possible (and more likely in children), parents - or another responsible adult - should closely monitor the athlete during this time. 
    • Even if an athlete has been removed from a game or practice because of a suspected concussion (as is required under laws in an increasing number of states), he or she should not be sent to the locker room alone, and should never be allowed to drive home.
    • The traditional rule has been to wake up a concussed athlete every 3 to 4 hours during the night to evaluate changes in symptoms and rule out the possibility of an intracranial bleed, such as a subdural hematoma.
    • The new thinking3 is that there may be more benefit from uninterrupted sleep than frequent wakening, which may make symptoms worse.  As a result, waking up your child during the night to check for signs of deteriorating mental status (see #2) is now recommended only if your child  experienced a loss of consciousness or prolonged amnesia after the injury, or was still experiencing other significant post-concussion signs or symptoms at bedtime. There is no need to check your child's eyes with a flashlight or test their reflexes. 

2. Immediate hospitalization if condition deteriorates. If your child experiences any of the following signs of deteriorating mental status, take her to the hospital immediately:

  • Has a headache that gets worse
  • Is very drowsy or can't be awakened (woken up)
  • Can't recognize people or places
  • Is vomiting repeatedly
  • Behaves unusually, seems confused or very irritable
  • Experiences seizures (arms and legs jerk uncontrollably)
  • Has weak or numb arms or legs
  • Is unsteady on his feet or has slurred speech.

3.  Use acetaminophen (e.g. Tylenol®) or codeine for headache.  Do not give aspirin or non-steroidal anti-inflammatory medicine(NSAIDs)(e.g. Ibuprofen/Advil®). An ice pack on the head and neck is okay as needed for comfort.  A 2010 clinical report from the American Academy of Pediatrics' Council on Sports Medicine and Fitness3 notes that, because no studies have actually documented any harm from use of NSAIDS after a sport-related concussion, the common recommendation against their use is based more on a theoretical risk.

4.  No drugs, alcohol: Warn your child about the dangers of drinking alcohol, engaging in recreational drug use, or using any other substance that could interfere with cognitive function and neurologic recovery.  Do not give sleeping tablets.

5. No driving until symptoms have cleared.  While an athlete is experiencing concussion symptoms - such as sensitivity to noise or light or dizziness, inability to detect quick movements of the head, sleep problems, problems with memory or concentration, or anxiety, even a narrowing of their field of vision - he should not be driving.  If symptoms persist, it may even be advisable for the athlete to be undertake a more formal evaluation to determine whether it is safe for him to resume driving a car. 

6.  Normal diet: Limited information is available regarding the recommended diet for the management of concussion. A normal well-balanced diet that is nutritious in both quality and quantity should be maintained to provide the needed nutrients to aid in the recovery process. Avoid spicy foods.

7.  Physical and "cognitive" rest:

  • Treating young athletes after a concussive event is uniquely challenging, because their brains are still developing. The cornerstone of concussion management of young athletes is physical and cognitive rest until symptoms clear, and then completion of a 5-step graduated exercise program leading to medical clearance and return to play.  
    • limit their day-to-day and school-related activities until symptom free
      • This generally means no homework, video games, text messaging and staying home from school while still experiencing concussion symptoms (although some experts, mindful of the fact that it is difficult for parents to constantly be monitoring their child and to enforce strict limits, along with the lack of research in this area, suggest that the most important thing for a parent to take a common sense approach about their child's level of cognitive activity, having the child avoid activities that seem to make their symptoms worse).
      • Academic accommodations, including temporary leave of absence from school, shortening of the athlete's school day, reduction of workloads in school, and/or allowing an athlete more time to complete assignments or take tests, may be necessary.
      • Taking standardized tests while recovering from a concussion should be discouraged, because lower-than-expected test scores may occur and are likely not representative of true ability.
    • Avoid strenuous activity until the athlete has no post-concussion symptoms at rest because physical activity may make symptoms worse and has the potential to delay recovery.  While bed rest is not recommended, some evidence suggests that a limited amount of physical activity may aid in recovery, and the effect of physical activity on concussion recovery has not been extensively researched, there is general consensus among concussion experts recommending broad restrictions of physical activity, including: 
      • the sport or activity that resulted in the concussion
      • weight training
      • cardiovascular training
      • PE classes
      • sexual activity
      • leisure activities such as bike riding, street hockey, and skateboarding that risk additional head injury or make symptoms worse.3

    • No further treatment is required during the recovery period apart from limiting physical and cognitive activities (and other risk-taking opportunities for re-injury) while concussion symptoms are still present,  and the athlete typically resumes sport without further problem.

8.  Graduated, individualized, conservative return-to-play. The Zurich Consensus Statement on Concussion in Sport and the American Academy of Pediatrics3 recommend against - and most of the new state laws and rules enacted by a growing number of athletic associations at the state and national level  prohibit - same day return to play under any circumstances, or, at the very least, while the athlete is still experiencing symptoms at rest or during exercise.  When returning athletes to play, they should follow a 5 step, symptom limited exercise program with each stage taking 24 hours or longer to complete, and the athlete returning to the previous stage if symptoms recur with exertion or at rest. 

Parents need to remember that concussion management is not one-size, fits all and that it needs to follow an individualized course tailored to their child's unique situation, as each athlete will recover at a different rate (especially for athletes who have a history of multiple concussions).

However, as a general rule, because a number of studies have shown that younger athletes take longer to fully recover cognitive function than college-aged or professional athletes, a more conservative, "when in doubt, sit them out" approach is recommended in deciding when a pediatric and adolescent athlete can return to play, even if they show no symptoms of concussion.

9.  Further testing/management. It used to be that concussions were "graded" based on severity, with the concussion grade, the number of concussion suffered, and whether the athlete suffered a loss of consciousness or amnesia determining return to play. Over the last decade, however, concussion grading scales and one-size fits all return to play guidelines have been abandoned in favor of a much more individualized approach. 

The most recent consensus of experts calls for consideration of so-called "modifying factors," the presence of any of which may suggest the need for more sophisticated concussion management strategies,  such as examination by a specialist, more sophisticated testing, and a longer recovery time.  These factors include:

  • Lingering symptoms. In most cases, obvious symptoms of concussions clear within a week. The presence of post-concussion signs or symptoms lasting more than 7-10 days, or symptoms that recur with exercise, suggest a more serious concussion;
  • Extensive LOC or amnesia.  An athlete who experiences concussive convulsions or prolonged loss of consciousness (LOC) (one minute or more) or amnesia at the time of injury should be treated more conservatively;
  • Multiple concussion history.  If the athlete has suffered one or more concussive events in the past, especially where the injuries appear to be recurring with progressively less impact force (e.g. a minor blow) or takes longer to recover after each successive concussion, a longer recovery time, or even a recommendation against returning that season or to that sport in the future may be warranted; and
  • Other neurological disorders present.  A concussed athlete with learning disorders and/or attention deficit hyperactivity (ADHD) may require different concussion management that takes these conditions into account.

10.  Trust your instincts. Be as involved in the management of your child's concussion as your instincts tell you to be. Don't be afraid to ask your child how he is feeling, or take him to his pediatrician or a specialist if you suspect something is wrong or you notice a change in his/her personality, or that he is "off."  Remember: you know your child better than anyone.  Because there is a lot medical science does not know about concussions, a common sense approach makes - in a word - sense.

"[P]arents should be acutely aware of [concussion] symptoms, potential differences between girls and boys, and alert coaches and healthcare workers to behavioral changes," advises Susan A. Saliba, PhD, PT, ATC, an Assistant Professor at the Curry School of Education; Physical Medicine and Rehabilitation at the University of Virginia, and the co-author of a 2010 study on concussions among high school athletes.

"Parents have the ability to observe the athlete longer and can perceive changes that may affect the outcome.  Any lethargy, continued headache, or change in behavior or affect can be concussion symptoms, especially if agitation or difficulty in concentrating are present.  Many times the parent cannot identify a specific symptom, but should nevertheless alert someone that the athlete is 'not him or herself.' Early return to play during this time presents the most danger," she says.

An athlete's school and coaches should maintain regular contact with his or her parents to update them on their progress.

For the most comprehensive, up-to-date concussion information on the Internet, click here

Article found at www.momsteam.com

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Wyoming Bill to Assist Brain Injury Survivor

posted by SK Brain Injury    |   December 28, 2011 12:30

A Wyoming program that helps the disabled has a long waiting list, but a state bill to be introduced next year could help.

The Star-Tribune reports that a bill to be introduced during the upcoming legislative session would provide $28 million in state and federal funding for Wyoming's Home and Community Based Waiver Program (http://goo.gl/7kL60).

The waiver program provides services for people with disabilities. More than 450 people in Wyoming are waiting for adult, child or brain-injury waivers.

The waiting list includes people like 27-year-old Melissa Dixon, who was born with fetal alcohol syndrome. She's unable to leave home because she has poor motor skills, but she craves independence.

"It makes her feel like she's still a little kid," said D.J. Dixon, her adoptive mother. "And she'd prefer to be around people who have more in common with her."

If the Dixons could get a waiver, the money could pay for an assistant who helps her with social skills and job training. Melissa's been on the waiting list for a year and a half.

"It's not that we want money or anything like that," D.J. Dixon said. "We just want her to have services so she would be able to feel good about herself."

Wyoming established the waivers to help people with developmental disabilities remain in their communities, rather than be institutionalized. The state's adult and child disabilities programs began in the early 1990s and now provide services for more than 2,000 people. Another 170 adults receive assistance through the acquired brain injury program, which began in 2001.

Wyoming expects to spend about $214 million on the waivers over the next two fiscal years, with about half the cost paid with federal dollars.

The funding isn't enough to meet existing demand for the waivers. As of the end of November, 184 disabled adults, 199 disabled children and 72 people with acquired brain injuries were on waiting lists. Disabled adults spend an average of more than two years on the list; children and people with brain injuries each typically wait more than a year.

"They only have a set amount of money," said Rep. Keith Gingery, R-Jackson, who presented the bill to a legislative committee earlier this month. "Until someone goes off the program, they can't let someone else on."

The bill would provide funding to cut assistance gap times to six months for adults and children and one month for people with brain injuries. It would also require the governor to inform lawmakers whenever those times exceed the guidelines.

Gov. Matt Mead has offered his own funding proposal. He has recommended the state spend $12.5 million, rather than $14 million, to shrink the waiver waiting lists. His budget would eliminate brain injury assistance gap times, but would cut adult and child waits to a year, rather than six months, spokesman Renny MacKay said.

The exact funding details can be worked out, Gingery said. But the waiting list issue should be addressed, even amid a time of budget tightening.

"No one with a child should have to wait two or three years to get services," Gingery said. "For these adults who want to be independent, we should be doing everything we can to help them be independent."


Article found at trib.com

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Concussions in the NHL: Waiting for Science

posted by SK Brain Injury    |   December 28, 2011 09:30

I like Gary Bettman. I was ready to like him before I had ever met him. He had gone to Cornell University; I went to Cornell. That was a good place to start. When I was president of the Toronto Maple Leafs, I dealt with him often, most directly in NHL governors' meetings. He would sit at the middle of a long table at the front of a room with the league governors, usually team owners, beside him. Team owners are rich. In their own communities, they are important. They are also used to seeing themselves as important, and like to see themselves that way. In their communities and in their companies, they are also used to having their own way, and do not give up their way easily. To suggest that directing them is akin to herding cats is to give cats a bad name.

At the front table was this expressive, bug-eyed bundle of nerve endings. He spoke in bursts of words and emotions. Quick-witted, quick-tongued, aggressive, smart, well prepared — there was never any doubt who commanded that room.

His is a tough job. He presides over a league, but in many ways he also presides over a sport. In Canada, hockey matters. If Canadian NHL teams aren't doing well — on the ice or off — the hundreds of thousands of kids and adults who play recreationally don't seem to be doing as well. And because hockey seems to be a metaphor we as Canadians have applied to ourselves, and others have applied to us, when hockey isn't going well, we don't seem to be doing as well, either. As NHL commissioner, Bettman has a responsibility that the commissioners of the NFL, NBA, and MLB do not have.

In the U.S., Bettman has a different challenge. He has to try to make hockey matter for more than just an intensely dedicated minority, in more than just the North and Northeast of the U.S. In the U.S., it's baseball and football, then basketball, then … hockey. It's MLB and the NFL, then the NBA, then … the NHL. His is a perpetual struggle for attention and importance. To gain that status, it means having teams in parts of the U.S. where the struggle first must be for survival. Ask any CEO what it's like when one quarter of his or her stores, for example, drag down the others. Ask them what they would do. Shut them down; focus on their business' strengths. Bettman can't do that.

In our dealings, I've disagreed with him at times, sometimes strongly, but I've found him right far more often than wrong. Of all the NHL presidents or commissioners I've seen or dealt with, as a fan, a player, an administrator, and a fan again — Clarence Campbell, John Ziegler, and (briefly) Gil Stein — Gary Bettman is easily the best.

Now Bettman, and one day his successors, have a bigger challenge: head injuries. Amid the dangerous mess of the past few years — the premature deaths of former players, suicides, career-shortening or career-ending concussions, and the grave uncertainty over the future of the NHL's biggest star, Sidney Crosby, I was sure there would come a point when Bettman would say, "Enough." That he would intervene as forcibly as he has on franchise and collective bargaining issues. Instead, he has left matters first to Colin Campbell, an NHL executive formerly in charge of player safety, and now to former star player Brendan Shanahan.

Bettman is a lawyer. A good lawyer understands his client's position and advocates strongly for it. A very good lawyer gets inside his client's position, tests and challenges it, shapes it where it needs to be shaped, and comes to know it, and embody it, as well as the client himself. Bettman is a very good lawyer. His relentless rigor gives him his confidence, his presence and posture. When a meeting begins, he's sure — he knows — that he's the smartest guy in the room. For him to be as aggressive and assertive, for him to be him, he needs to know that. That's what allows him to herd his cats.

But on those matters where he can't quite get inside his client as deep as he needs to go, when he can't quite know something as they do, his manner changes. He knows how much hockey means to Canadians, but as an American, he can't quite know. He knows how proud and noble, almost warrior-like, hockey players see themselves, but as someone who has never played the game, he can't quite know. Often criticized in Canada for being an American (and all that means to Canadians), he has been a determined advocate for things Canadian. He knows that hockey's soul resides in Canada. He knows that the NHL isn't strong and healthy unless hockey in Canada is strong and healthy. On matters Canadian, he is respectful and deferential. He listens. About on-ice matters, he is the same. Respectful and deferential, he listens to his "hockey guys."

The problem is that his "hockey guys" are so immersed in a game they have loved and played all of their lives, so steeped in and so respectful of its traditions and understandings, they haven't fully seen all the changes that have occurred. They have seen the changes in technology, strategy, and training that have allowed now bigger players to go faster and with more forceful impact. To Bettman's "hockey guys," these are the natural evolutions of the game. They are good. They are allowed. (Indeed, if you're going to have fighting, why not a better fighter? Why not the best?)

To these natural evolutions, Bettman's "hockey guys" have also seen some unintended consequences — most notably, more, and more serious, injuries — and have responded to them with efforts toward better protective equipment, better medical treatment, and, where these are not enough, "tweaks" to the rules. What they haven't seen fully is that technology, strategy, and training, driven by the creativity of coaches, players, scientists, and entrepreneurs, always run ahead of equipment, medical treatment, and "tweaks" to the rules. Better helmets, more muscular necks and shoulders, MRIs, and Rule 48 haven't offered the answer to 220-plus-pound players moving at 30 mph. Not even close. So concussions are more frequent and more serious. But to intervene with anything else — with significant rule changes or imagining a game played in a more head-conscious, "head-smart" way — to Bettman's "hockey guys," is unthinkable. Natural evolutions that change the nature of a game are OK, but anything else are "unnatural intrusions." They are bad. They aren't allowed. Bettman's "hockey guys" forget that hockey's natural evolution was once toward a jammed-up, goalless future until some president or commissioner intruded unnaturally with player substitutions and the forward pass. Imagine what the "hockey guys" of that time would have said.

When Bettman listens to his "hockey guys," because as someone who never played the game he can't quite know, this is what he hears.

I decided about two months ago to get back in touch with him ("Go Big Red!"). It was a few days after the start of the new season. I sent him an e-mail to congratulate him on the return of the Winnipeg Jets. A minute later, he e-mailed back. This led to a back-and-forth over the next several minutes, at the end each of us promising the other (when I'm in New York; when he's in Toronto) that we'd catch up. Not long ago, we e-mailed each other again. I had been traveling; he'd been traveling. We'd both be away for the holidays, but sometime early in the new year, we would make this happen. And I had no doubt we would.

What I'd say to him is what I've said here, but also that it's time for him to not be so deferential and respectful on hockey matters, on head injuries, but to take these on in his aggressive Bettmanesque way. The stories, almost every week, of another player being concussed (or, to allow for the possibility of a more acceptable earlier return to action, another player having "concussion-like symptoms"), or of a former player now living with the consequences of his head-injured past, are real. They have happened. They are not just a case of bad luck that will surely turn. You have to know that this is your future and the future of all those owners, governors, and players, every week, for so long as you and they are commissioner, owner, governor, or player. You can try to deny the problem or try to manage it or do something. And as overwhelming as it seems — just imagine if even most of this is true: the on-ice consequences, the post-career consequences for former NHL and recreational players, the liabilities, etc., etc. — a lot can be done. The changes that may be necessary are not undoable. Few are blaming you. Most know there is so much we don't know and can't know. We don't know the dimensions of the problem. We don't know the dimensions of the answer. But we do know there's a big problem, and we do know there are some things we need to do.

Hockey isn't the only sport in need of this action. If anything, football's problem is far greater. Soccer and other sports are experiencing their own head-injury problems. Outside sports, the military is faced with many of its personnel suffering the effects of new, more concussive weapons. And for decades, we've imagined the problems without having paid much attention to the consequences of victims of head trauma in child-abuse cases.

It is OK not to know, I was intending to say to him. It is not OK not to begin to puzzle through with others toward some answers.

You and the NHL can do something. You don't need to lead this effort — in fact, it's better if you don't, to avoid the conflicts of interest that would naturally occur and any perception of them, and so not to hold back the work. But you can acknowledge the seriousness of the problem and your determination to deal seriously with it, now and in the future. One way to signal this might be to help create some ongoing structure that would encourage and generate public discussion, ideas, proposals, and action on head injuries in sports, notably hockey. It could begin with an annual conference, hosted by a university, the first one in Canada, but in subsequent years in the U.S. and Europe. The NHL could be one of the major sponsors. You, and not just your "hockey guys," could be there to show that on this "long run" problem you're in this for the long run, and are willing to puzzle through with others how we can do better.

The best brain scientists would be there to talk about what they know, and what they don't know. Players who have suffered brain injuries will provide their personal stories. League officials at different levels, in different sports, will talk about what steps they have taken, what's worked and what hasn't. The best coaches and best players, past and present, will be there to talk about what they've been trained to do and what they've done all their lives. Faced with an opponent, in this case a new "head-smart" set of rules and way of playing that keeps you from doing some things one way, what do you do? What new creative answer can you come up with? What can you do that is even better than what you did before? Each year, there will be new findings, new ideas, and fresh challenges to players, coaches, officials, scientists, and entrepreneurs who, in their DNA, feed on fresh challenges.

There is no running away. Next week's headlines have already been written. The need is to begin.

That's what I was intending to say to him in January or February when I was sure we'd be in touch again. Then I saw his video interview on the New York Times website.

The Times had published an outstanding three-part series of articles by John Branch on Derek Boogaard, a 28-year-old NHL "enforcer" who had died a few months earlier. This was Branch's follow-up video interview with Bettman. Bettman had experienced many interviews like this before, where he was asked to answer questions that weren't really questions, about violence and fighting in the NHL, and he had his usual nervous energy mostly under control.

In response to a question, he began by telling his often-repeated story — fighting has a long history in "the game," he said. Players move at 30 mph in an enclosed area; they carry sticks. There's physical contact. Different from other sports, fighting in hockey is penalized only in a limited way — with a five-minute penalty, not expulsion from the game — not to sell tickets, as is often alleged, but because fighting acts as a kind of "thermostat," as Bettman puts it, so that "things don't go too far." The threat of fighting helps to keep other matters in a game under control. And because fighting is this organic part of hockey, the frequency of fighting changes as the game changes, he says — sometimes more, sometimes less — so you can't predict its future. As for the off-ice deaths in recent months of three former NHL "enforcers" — Boogaard, Rick Rypien, and Wade Belak — he reacted to the deaths more like a father than a commissioner, describing their deaths as a "tragedy" and his "almost disbelief at the coincidental timing of [them]." "The circumstances of all three were different," he continued. "It was a tragic, sad, unfortunate coincidence." When asked by the interviewer to clarify if he thought the circumstances, not the timing, were a coincidence, he replied, "Yes."

Later, the interviewer pointed to the recent findings by Boston University's Center for the Study of Traumatic Encephalopathy that Boogaard had the presence of CTE, chronic traumatic encephalopathy, a close relative of Alzheimer's disease, in his brain, which is thought to be caused by repeated blows to the head. Boogaard is the fourth former NHL player — the others being Reggie Fleming, Bob Probert, and Rick Martin — to show these same indications. What about this research on CTE, the interviewer asked? "I think it's very preliminary," Bettman said. "There isn't a lot of data and the experts who we talk to, who consult with us, think it's way premature to be drawing any conclusions at this point because we're not sure based on the amount of data evaluated." He repeats how "preliminary" all this is, again citing the "handful of samples," all the possible factors in these players' deaths, how with CTE, Alzheimer's, and dementia there's so much we don't know. "There's a long way to go in medical science before people can make definitive judgments," he concludes.

Gary Bettman has arrived at Stage 2 in the NHL's response to fighting and violence. Stage 1, as embodied by Colin Campbell and former Boston Bruins coach and immensely popular TV commentator Don Cherry, was aggressive, belligerent, and dismissive. Look, this is hockey. This is how the game's played. Always has been. If you don't like it, don't play it. Stage 2, as embodied in Bettman's interview, is more modulated, more thoughtful-sounding, and more reasonable-sounding (aided by the interview's setting, a room lighted dark and warm, almost cozy; there's a reason 60 Minutes' interviews and congressional committee hearings are done in the glare of bright lights). Occasionally he strays into a lawyer's gentle, prickly combativeness, but mostly he stays on his message: It is Boston University's scientific work on the brain samples of former players that helped bring head injuries to a focus, he is saying. It's science that I'm going to argue back. Science isn't impressed with anecdote and story. Science demands proof. Four brain samples are merely four anecdotes, and that's out of the thousands who have played this game. Mine is the reasonable, responsible position. Mine is based on science. Science demands proof, and I demand proof, too. And when science gives me what science insists upon for itself, I will go where science takes me. In the meantime, even with science on my side, I will continue cooperating with doctors and researchers and generate rule changes where appropriate. That's how reasonable I am.

By waiting for science, thousands of asbestos workers and millions of smokers died. The fact is, as a society we rarely have the luxury of waiting for science on big, difficult, potentially dangerous questions to meet its standard of proof. We need to take the best science we have, generate more and better information, then apply to it our best intuition and common sense — and decide. Scientists are always disparaging of politicians and other decision-makers for being so influenced by anecdote. But an anecdote, well observed, thorough, rigorous, and truth-seeking (not ax-grinding), can tell a lot. At any moment, it may also be the best information we have.

It is only by tragic fluke — his early death — that we have the Derek Boogaard "anecdote." Normally, we'd have to wait many more years to know what had happened many years before. But now we have this gift from Derek Boogaard. The NHL can also learn from the NFL experience. Many more football players than hockey players are dying now in their 60s and 70s after having spent the last several years of their lives in the living death of dementia. Football, for that generation of players, just as with hockey, was played with primitive equipment. But in football, then as now, every play involves many collisions involving many players, and one final collision. In hockey then, the game moved much more slowly with players playing coasting, two-minute shifts with few collisions. In hockey now, the game moving in full-abandon, 35-second shifts with bigger players, the collisions are never-ending and shuddering. And hockey fighters, once normal-sized and untrained, inflicted little damage. Today, far bigger and having been trained in combat much of their lives, they can cave a face with one punch and have their brains rattled in return.

Gary Bettman said in his online video interview with the Times that he hasn't talked to the doctors at Boston University. I hope he does soon. I also hope he has spoken with Derek Boogaard's family and friends to hear, really hear, about what his life was like. And with Paul Kariya, Eric Lindros, and Keith Primeau — in depth — or with any of a number of players who have had their careers ended early, about what life felt like after their injury, and what it feels like now. Or — in depth — with Sidney Crosby. As hard as it was in the 10 months of recovery after his injury — the pain and discomfort, the unknowns, the hopefulness, the crashing disappointments — now must be his darkest time. It was the sheer routineness of this latest hit. So invisible amid the action that observers assumed it must have been from a collision with his teammate Chris Kunitz. So routine it was only on replay: Crosby and Bruins player David Krejci yapping at each other from their player benches — what could've caused that? — then running the action backwards; Crosby and Krejci shoving at each other on the ice after the whistle — what could've caused that? — and backwards some more; Crosby skating toward the puck near the boards; Krejci, the puck in his skates, bent over, his back to Crosby; as Crosby bumps him, Krejci turns slightly, his left elbow striking Crosby in the visor. It was the kind of light blow that is exchanged without notice or consequence hundreds of times in a game. Krejci, in everything that follows, looks befuddled — Why is he so mad? What did I do? But knowing how he feels, Crosby knows.

If after 11 months this is all it takes …

I hope Bettman and Crosby have a good long talk.

There are debates among doctors, now played out in the media, over the correlation between hockey's blows to the head and CTE, between blows suffered now and a player's long-term future. These debates will continue. But there can be no debate about the impact of those blows on players now. Almost every day there's someone new — this week it's star Flyers' defenseman and tough guy Chris Pronger and his teammate Claude Giroux, the NHL's leading scorer — both gone and for who knows how long. The debate about CTE is important, but it's a distraction. The debate over fighting is a distraction. This is about head injuries. This is about what we can see. This is what we absolutely know. This is about now.

Bettman and the NHL cannot wait for science. They can't hide behind science, using it as their shield. They must move, and move quickly, out of Stage 2 to Stage 3. No amount of well-modulated, reasonable- and responsible-sounding words change the fact that a hit to the head, whether by elbow, shoulder, or fist, is an attempt to injure that needs to result in expulsion or suspension. No amount of hopefulness and crossed fingers will change the fact that the NHL, like the NFL, must begin to imagine and introduce more "head-smart" ways to play. Bettman needs to be Bettman. We look back on those people 50 years ago who defended tobacco and asbestos and think, How could they be so stupid? Bettman and the NHL cannot wait for this generation of players to get old just so they can know for sure.

Article Written by Ken Dryden.

Article found on Grantland.com

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CTV Saskatoon Reports on the Dangers of Head Injury at Every Age

posted by SK Brain Injury    |   December 27, 2011 19:00

Head injuries in sports have always been a problem, but they've been in the spotlight lately due to a number of star athletes missing significant time on the ice because of concussions.

But the injuries don't just affect NHL players. Young Saskatchewan athletes deal with the reality of concussions every time they lace up their skates.

Bryden Serafini, a forward from the Prince Albert Ice Hawks says dealing with a concussion is not easy for an active player. "You don't know what to do. You can be going for two weeks of no symptoms, than you ride a bike and its boom, you're back to square one. It's a tough thing to deal with; you don't know what to do. It's not like a broken arm you can put in a sling, it's your head."

Serafini says he's now suffered from two concussions in his career. But like many, it hasn't stopped him from playing.

Allan Pasloski, the Ice Hawks general manager, says the league is taking action to prevent the injuries. "We don't get a lot of head shots anymore, because it simply isn't tolerated, you get 3 major head shots in the year, you're done for the season. We've really cracked down on headshots and checking from behind."

Signs of a concussion can include dizziness, headaches, loss of vision, and an uneasy feeling. With many athletes refusing to admit when they're hurt, it may fall on others to look out for their well-being, and to make sure they don't return to action too soon.

Parkland Ambulance EMT Lyle Karasiuk says it's important to recover fully from a concussion before getting back on the ice. "Coaches, parents, teachers alike need to be reminded. Don't send them back to the sport, don't say ‘sit out this period' or ‘sit out this game', they need rest, need to see a doctor, and return them to the sport properly."

Pasloski thinks a big reason for many concussions is a lack of respect in sports. Many players are looking for the highlight reel hit, which has led to young hockey superstar Sidney Crosby being put on the shelf indefinitely with concussion symptoms.

"You don't want to see guys like Crosby, one of the best players ever to play the game, being gone for this long. It hurts everybody. You've got to give these guys a bit of respect and let them play, because it makes the game more enjoyable," says Pasloski.

Medical professionals say the best way to prevent a concussion is to wear the proper protective gear. And that doesn't just mean wearing a helmet; it means finding one that fits properly to protect the brain from injury.

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Looking Back on 2011: Rise in Brain Injuries

posted by SK Brain Injury    |   December 27, 2011 13:00

The tragic toll from traumatic brain injury continues to climb among athletes who routinely hit their heads -- or use them as weapons -- during play on the field or fights on the rink.

The Boston University Center for the Study of Traumatic Encephalopathy, where researchers last spring diagnosed the late football star Dave Duerson as having chronic traumatic encephalopathy (CTE), now has 60 confirmed cases of athletes with CTE in its brain bank, according to neuropsychologist Robert A. Stern, PhD, co-director of the center.

Cases from the Gridiron

The first case of sports-related CTE was reported in Neurosurgery in 2005. The report enraged officials at the National Football League, who vehemently denied the possibility of a causal connection. By 2008, however, it had become clear that some football players indeed were experiencing sequelae of their frequent head trauma.

The Boston University research initiative was established at that time, soliciting tissue donations from deceased players. In addition to Stern, co-directors include Ann McKee, MD, Robert Cantu, MD, and Chris Nowinsky, a former football player and professional wrestler with a history of multiple concussions.

"When we first started our center three-plus years ago we expected to find CTE in a small number of athletes, and specifically in those who had a history of significant concussion," Stern told MedPage Today.

That turned out to be wrong. Not only have there been many more cases than anticipated, but many of the affected individuals had only subconcussive injuries – though lots of them.

"These are the types of hits that a lineman in football gets, where in every play of every game and every practice – some 1,000 to 1,500 times each season -- he hits his head against his opponents with a force of about 20 G, which is not a minimal force," Stern said.

The end results in susceptible individuals, according to autopsies done by his group, include widespread abnormalities similar to those seen in Alzheimer's disease, including neurofibrillary, glial, and astrocytic tangles and abnormalities in tau proteins.

The Rules Tighten

In response to the escalating concerns about brain injury, the National Football League has tried to crack down on dangerous play, instituting a program of enhanced enforcement for safety violations. This season, for instance, Detroit Lions player Ndamukong Suh received a two-game suspension after being observed stomping on another player's arm in a Thanksgiving Day game.

More recently, the Pittsburgh Steelers' James Harrison was suspended for one game in December as punishment for a helmet-to-helmet hit that left quarterback Colt McCoy of the Cleveland Browns with a concussion.

Even though the blow was witnessed by millions on television, the Browns' medical staff failed to realize he had suffered a head injury and cleared him to return to play a few minutes later. The Sport Concussion Assessment Tool -- mandatory in the NFL since 2009 -- was not administered to him until the next morning.

Stung by criticism of the oversight, the NFL responded this week with a new system in which trainers, stationed in the coaches' booth above the field, will watch specifically for potential concussions. They will then tell teams on the sidelines when they need to evaluate players with the assessment tool.

But a growing number of players are not satistifed with the NFL response and are determined to force the league to acknowledge their long-term health problems relating to concussions.

This week, four former players sued the NFL in U.S. District Court in Atlanta, according to an Associated Press report. In their lawsuit, Jamal Lewis, Dorsey Levens, Fulton Kuykendall, and Ryan Stewart allege that the league has been aware for decades of risks of head injury, and "has done everything in its power to hide the issue and mislead players associated with concussions." The players claim to experience problems such as headaches, memory loss, and sleep disruptions.

Hockey Under Scrutiny

The focus on head injury also now has expanded to violence on the hockey rink. The death of the National Hockey League player Derek Boogaard in May from an overdose of alcohol and pain killers, and the subsequent finding of extensive CTE – in a man only 28 years old – added to concerns about safety in contact sports.

Boogaard, known as Boogeyman, had been an "enforcer" for the NHL, meaning that he was a designated fighter who routinely collided with other players and engaged in fistfights on the ice to intimidate his opponents and delight the audience.

During the 2009-2010 season, he had been knocked down during a fight and struck his head on the ice, after which he complained of headaches. According to a story in the New York Times, he became withdrawn and sullen and was having memory losses while drinking heavily and taking numerous drugs such as oxycodone. He entered rehab, but left and became more reclusive, erratic, and returned to substance abuse.

He was found dead in his New York City apartment on May 13.

Unlike the NFL, the hockey league has shown no interest in banning fighting or otherwise changing the culture of the game, according to the Times article, despite the deaths of other scrappy players. These included Rick Rypien, who committed suicide at 27 after struggling with clinical depression during a career with the Vancouver Canucks marked by frequent fighting, and Wade Belak, who also had experienced periods of depression and died in uncertain circumstances at 35 after playing for a number of teams including the Toronto Maple Leafs.

The Alzheimer's Link

Research into CTE is still in its infancy, Stern said. But because of the similarity in pathologic findings between CTE and Alzheimer's disease, his group has been building on the substantial body of knowledge about Alzheimer's, using the latest technologies and techniques such as neuroimaging and basic science approaches.

"All the neurodegenerative diseases have complex neuropathogenetic pathways, involving genetics and epigenetics, environmental risk factors, and aging-related factors," Stern said. "Although the initiating event in CTE appears to be trauma, in all the neurodegenerative diseases early in the disease course there is some disturbance of neuronal integrity leading to a cascade of pathophysiologic events that ultimately results in neurodegeneration," he explained.

But not everyone with repetitive head trauma develops CTE, so Stern and his colleagues are now trying to tease apart other potential contributory factors, such as individual players' specific trauma history, age at first injury, total duration of trauma exposure, and the length of rest between injuries.

Stern also has recently been awarded a grant from the National Institutes of Health to develop biological markers that could be used to identify CTE earlier, rather than in postmortem neuropathologic exams. To do this, his group has enrolled 100 former NFL players who were linemen, linebackers, and defensive backs -- the positions with the greatest exposure to repetitive brain trauma -- and 50 noncontact sport athletes with no history of brain injury.

They are performing extensive clinical, neurologic, and neuropsychological examinations to look for factors common among those who develop the disease.

Stern and his colleagues also are collecting blood for DNA genotyping, doing lumbar punctures to analyze proteins such as tau, and conducting extensive brain scans including diffusion tensor imaging, as they puzzle out the steps in the lethal pathway to CTE.

Kids at Risk

It isn't just professional athletes who are at risk for these injuries. "We are appreciating more and more the particular potential vulnerability of, and long-term consequences to the young brain as a result of concussive and subconcussive brain trauma experienced through participating in certain youth sports," Michael Bergeron, PhD, of the University of South Dakota in Sioux Falls, told MedPage Today.

Participation in sports can provide numerous benefits to young people, as well as being fun. "However, the motivations of some adult stakeholders are sometimes in conflict with these objectives, and the professional model of development and high-impact styles of play for young players are increasingly encouraged, prevalent, and accepted," cautioned Bergeron, who is also the executive director of the National Youth Sports Health and Safety Institute.

"My hope is that there will be a change in the way children and adolescents train, compete, and safely return to play after an injury. By promoting healthy coaching, training, and competition overall and emphasizing fitness, skill acquisition, diversified athletic experiences -- and fun -- we can reduce overall injury risk, including head trauma," he said.

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Kevin Pearce, Snowboarder, Back on the Snow After Brain Injury

posted by SK Brain Injury    |   December 27, 2011 09:30
 

Kevin Pearce was known as one of Shaun White's fiercest snowboarding competitors – but on New Year's Eve of 2009, suddenly everything changed after he incurred a traumatic brain injury on the half-pipe.

Almost exactly two years since his death-defying accident, Pearce got back on his board at Breckenridge Ski Resort in Colorado.

"It felt so good," Pearce, 24, told PEOPLE shortly afterward. "It just feels so much like before. There's nothing really new for me that I have to relearn, so that was nice."

Says Pearce: "I'm really in the right state to be snowboarding right now."

The Vermont-based athlete – who says if it were up to him instead of the doctor, he would have been back at his craft a year ago – explains the difficult recovery he continues to undergo since his life-changing injury.

"I've been working hard at a lot of things, whether it's physical therapy or eye therapy," Pearce says. "I got eye surgery about a month and a half ago. Even though my eyes are a lot better now, they're not perfect, so I have been doing exercises with them. And I've been in the gym, working out. I've been getting everything together and working on my balance."

Still, he faces significant challenges that will never go away.

"A brain injury is always a brain injury, and unfortunately I'm always going to be a brain-injured kid," Pearce says. "The real issue I have is my memory. It's hard to explain, because everyone's always like, 'Oh, my memory sucks, too.' But nobody has any idea how much my memory affects me on a day-to-day basis."

"And," he says, "my balance is really bad. I used to have really, really good balance."

Pearce, who stays "positive and hard working," says the support of his loving mom, Pia, has helped his recovery along.

"She was really nervous [about me going back out there]," he says. "I think she dealt with it really well, though ... I couldn't even imagine how I'd handle it if my son almost died, and then he tried to go back and do it again. She just wants me to do the best I can. She's just there for me all the time."

Kevin Pearce Snowboards Again Two Years After Traumatic Brain Injury| Health, Real People Stories

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New Technology for Detecting Brain Injuries at Accident Sites

posted by SK Brain Injury    |   December 23, 2011 09:44

US researchers have created a prototype handheld near-infrared imaging device that can quickly detect traumatic brain injuries.

When accidents that involve traumatic brain injuries occur, a speedy diagnosis followed by the proper treatment can mean the difference between life and death.

A research team, led by Jason D. Riley in the Section on Analytical and Functional Biophotonics at the U.S. National Institutes of Health, has created a handheld device capable of quickly detecting brain injuries such as hematomas, which occur when blood vessels become damaged and blood seeps out into surrounding tissues where it can cause significant and dangerous swelling.

The device is based on the concept of using instrumental motion as a signal in near-infrared imaging, according to the researchers, rather than treating it as noise.

It relies on a simplified single-source configuration with a dual separation detector array and uses motion as a signal for detecting changes in blood volume in the tough, outermost membrane enveloping the brain and spinal cord (see video).

One of the primary applications for the finished device will be the rapid screening of traumatic brain injury patients before using more expensive and busy CT and MRI imaging techniques.

In cases where CT and MRI imaging facilities are not available, such as battlefields or on the scene of accidents, the team believes near-infrared imaging will help to determine the urgency of patient transport and treatment, as well as provide a means of monitoring known hematomas at the bedside or outpatient clinic.

The study has been recently published in the Optical Society's (OSA) open-access journal Biomedical Optics Express.

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Headgear in Rugby Won't Prevent Concussion

posted by SK Brain Injury    |   December 19, 2011 17:00

A medical study claims protective skull caps like those worn by Rugby World Cup winner Victor Vito do nothing to protect against concussion.

And as concern grows over the prevalence of head injuries, it can be revealed that the International Rugby Board has funded an onfield trial involving experimental protective helmets.

The helmets were put through their paces in a study involving 4000 players.

Over a period of about 30,000 playing hours, the group was split into three – one wearing the trial helmets, one wearing regulation skull caps, and another wearing whatever they normally played with, including no head gear.

In an article on an Australian academic website called The Conversation, Caroline Finch – a professor in injury research at Melbourne's Monash University – has written of the trial study, which was funded by the IRB.

"We did that in a randomised control trial – the gold standard for studying these sorts of preventative measures – and we found there was actually no reduction in head injury or concussion rates with protective helmets, at all," Finch wrote.

"We didn't even find it with the players in the modified helmets, which had thicker padding. So we've got no evidence really that soft-shell helmets help prevent concussion, although they may prevent against superficial injuries. But we certainly wouldn't be saying at this stage that this is a protective device that is going to prevent everything."

Finch wrote that an earlier lab-based study by Andrew McIntosh – an associate professor of biomechanics at New South Wales University's school of safety science – had shown that current headgear "might prevent superficial grazes but it won't prevent concussions".

"I have to say, too often people say the answer is to just put a helmet on, that's going to solve everything," she wrote.

Current IRB rules state most players who suffer concussion must complete a three-week playing and training stand-down.

The exception is for elite players, who are allowed to return to action earlier if they are deemed symptom-free by a neurological specialist.

Finch expressed concern about how the issue of concussion was being policed, referring to a recently published study by the British Journal of Sports Medicine which surveyed 2000 UK club players aged between 15-48.

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Brain Injuries in the NHL: Something to Worry About

posted by SK Brain Injury    |   December 19, 2011 15:00

No matter what the statistics might tell us, the optics are bad and getting worse. The NHL has something wrong with its head, specifically the concussed brains of its rank-and-file stick carriers, and no one is sure what to do about it, or if there is anything that can be done to make an inherently dangerous game substantially less a killing field.

Nothing on the KO front should surprise us anymore, but the hockey Twitterverse exploded Thursday night when the Flyers revealed that captain/hardened warrior Chris Pronger would be shut down for the duration, including the playoffs. Diagnosis: severe postconcussion syndrome. Bruins fans know the drill all too well, given the histories of Patrice Bergeron (now doing very well) and Marc Savard (not expected to resume his career).

Pronger’s move to neuropsych purgatory after missing 11 games came the week after the Penguins said superstar center Sidney Crosby, after playing in only eight games (2-10-12), would need more time out of action. Sid the Kid came back only last month after getting cranked twice within a week at the start of January.

According to multiple reports, the 24-year-old Crosby figures it was an elbow from the Bruins’ David Krejci Dec. 5 that exacerbated his latest woes. Krejci, it should be noted, is tough enough to withstand the daily NHL grind, but he is anything but a mauler. If Crosby can’t withstand Krejci-like knocks, his troubles may be far from behind him, possibly irreparable. At this point, no one would be surprised if, like Pronger, Crosby were to shut it down for the season, rest, and try again come training camp in September 2012.

Headed into weekend action, Pronger and Crosby were joined by fellow brothers of the concussed Claude Giroux and Brayden Schenn (both Flyers), along with the high-profile likes of Milan Michalek, the league’s top goal scorer from Ottawa, and Jeff Skinner, the Hurricanes’ scoring whiz who was last season’s Rookie of the Year. The slick Giroux recently topped the list of the game’s top point-getters.

The fact that such talented players are getting concussed brings a brighter, hotter spotlight to a persistent and difficult issue, but brain injuries have to be taken seriously, no matter if the player is a fourth-line plumber or a face of the franchise (see: Crosby, Pronger).

To its credit, the league has paid attention for a while, implementing baseline testing and return-to-work protocols that were ahead of, or at least in lockstep with, other professional leagues. Sadly, it dragged its feet disgracefully, if not negligently, in the days when Colin Campbell was meting out discipline from his corner office at league HQ. Players were egregiously smashed over the head by opponents (see: Matt Cooke’s hit on Savard) and Campbell too often let offenders skate, noting that the league’s rulebook didn’t give him the language or the license to suspend or fine the perpetrators. While he rifled through the pages to find only excuses, and the Lords of the Boards hemmed and hawed, heads remained on sliver platters, and nitwits such as Cooke feasted at the table of wanton destruction. Nice governance.

Again to its credit, the league has since moved Brendan Shanahan into the chief disciplinarian role and also placed him in charge of player safety. Things are improving under Shanahan’s watch, at least from a penance-and-pay standpoint. If the Lords and general managers let him keep up the heat, and the NHL Players Association supports his decisions rather than tosses up picayune objections, then it will become a safer workplace. Nothing gets a player’s attention like lost wages.

There are numerous other ways to dial back on the concussions. Such as:

- Shoulder pads and elbow pads need to be made smaller and their materials less destructive. In the last 15-20 years, manufacturers have preached improved protection through greater size and granite-like materials. Some of the paraphernalia has been softened. But even when not deliberately used to hurt people, the armor is hurting people.

- Stiffer penalties on hits to the head. The league last spring finally upgraded the rulebook, making some targeted hits to the head illegal. But brain injuries continue, and it’s increasingly clear that the Lords need to punish all hits to the head. They are in the business of selling violence, and as the game’s fathers they don’t want to give up what sells. As fathers, would they stop selling if these damaged players were their biological sons and not merely their issue of profit?

- Contrary to myth, people get hurt in hockey fights, often severely, and some suffer concussions. The NHL, when I asked again on Friday, would not reveal statistics on concussions. The game has grown five-fold from its Original Six days. It is a multibillion-dollar industry. The NHL is a tremendous product and will be all the greater when it realizes it can relegate its bar fights strictly to its Board of Governors meetings.

- When the most recent lockout ended in the summer of 2005, I was among those who saw the need of opening up play, and lauded the idea of taking the red line out of the offside equation. Good idea, bad result. Some of these concussions are because of incredible heads of steam that players gain now through center ice. There has to be a better way to mitigate trapping, grappling tactics in the neutral zone. I am convinced a slower game would diminish concussions. It would also lead to better, more artful puck control and playmaking. Bonus.

- Finally, the helmet. There has to be something better. And players need to be smarter about wearing their helmets properly, tightly, with fitted mouthguards. NHL icon Mark Messier a few years ago put his name on a Cascade product, its design borrowed from lacrosse. Be it Cascade or a different vendor, it’s time for a better mouse trap.

Some of these suggested fixes, despite varying degrees of pushback from both sides, and even from the audience (what, give up fights?!), are easy to implement. A handful of bright guys could get in a room today and cherry-pick from the list provided here and substantially change the culture of the sport and still maintain its entertainment factor.

When they all finally face the reality and get down to business, let these words be their guiding light: brain injury is not sport.

ETC.

LA has found its new king

When the Kings were on Causeway Street Monday night, with John Stevens substitute teaching for fired coach Terry Murray, all the talk was that Darryl Sutter would be the new coach of the Crowns. Stevens was still the bench boss last night, with the Kings in Detroit to take on the Red Wings. But Sutter, who was fired a year ago as the Flames’ general manager, has agreed to take the job, according to a report in the Los Angeles Times. Sutter coached in San Jose when Dean Lombardi, now the Kings’ GM, ran the Sharks. There had been some thought that another NHL club had reached out in hopes of hiring Sutter. But the Times report said Sutter will take over the Kings Tuesday.

Back to where it began

Teemu Selanne, 18-plus years removed from his rookie season with the Jets when he scored 76 goals, made his first return to the city’s new NHL franchise last night. One of the game’s greatest goal scorers, he was shipped to Anaheim midway through his fourth season (1995-96) with the Jets. “I was totally shocked,’’ the Finnish Flash recalled last week. “Two weeks before that trade, the club told me, ‘Don’t worry, you’re going to be a big part of our future in Winnipeg.’ ’’ The trade came in February ’96, only weeks before the Jets left town to do business in Phoenix as the Coyotes. “I felt like I failed,’’ said Selanne, now 41 and likely playing his final NHL season in his second tour with the Ducks. “I was from Finland, and no one ever gets traded in Finland.’’

Helmets a fitting choice

Jay Bijeau was an assistant hockey coach for the men’s club squad at the Naval Academy a few years ago when the team, after consulting with the players, opted to buy Cascade helmets in hopes of better protecting the players’ heads. “Two of our guys had concussions at the time,’’ recalled Bijeau, these days a lieutenant commander on the USS Alaska submarine. “We felt it was the way to go.’’ The helmets arrived, soon followed by complaints, the players saying they didn’t like the fit. Twice, said Bijeau, Cascade reps visited and made certain the fit was perfect for each player. Bijeau eventually realized that the fit was fine, but the players simply didn’t like the look of the slightly larger Cascade design. “Top-of-the-line helmet, best product out there,’’ said Bijeau. “But the kids decided it wasn’t the helmet for them - and the bottom line was, they just didn’t like the look. And trust me, that’s all it was. The captains came up and said, ‘Look, no one wants to say it, but the reality is, the guys think they look goofy in these things.’ ’’ To his chagrin, said Bijeau, vanity ruled the day and the players went back to their old helmets. “Except the two guys who had the concussions,’’ said Bijeau. “They knew what it was like to live with that kind of injury.’’

Black and Golden oldies?

The disdain here for the canned music played at TD Garden during Bruins games is nothing new to my regular readers. As offensive as it has been in recent years, it seems even worse in 2011-12, and I know that may sound like an old man yelling from his porch, telling his kids to get off the lawn. So be it. But I can tell you that I’ve asked a number of 20-somethings and 30-somethings in the building to name those tunes, only to get blank stares or shrugged shoulders as response. In my opinion, it’s audio porn. Before the season’s over, I’d love to have one intermission - just one - when organist Ron Poster takes us through the tattered pages of John Kiley’s playbook. Ah, house lights down, a little “Norwegian Wood’’ (Beatles, ’65) over the PA and a picture of the smiling Kiley up on the Jumbotron. Please!

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