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Nathan Horton (Winslow Townson)
Nathan Horton (Winslow Townson)

RULE 48

One small step for the NHL Add to ...

The writer is a post-doctoral research fellow in neuroethics, at Dalhousie University in Halifax.

The hits keep coming. After a season during which high-profile players were sidelined by concussions, and a number of "vicious" hits raised concerns about unnecessary violence in hockey, controversy continued in the National Hockey League's Stanley Cup finals.

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In a game on June 6 between Boston and Vancouver, Canucks defenceman Aaron Rome threw his shoulder into the head and neck of Bruins winger Nathan Horton seconds after Horton had released the puck. The blow sent Horton airborne; when he landed, he sprawled unconscious on the ice. He was removed by stretcher, and is out for the remainder of the season with a severe concussion. Rome was penalized for interference, with a game misconduct, amid debate about whether or not the hit violated the NHL's Rule 48, which prohibits lateral and blindside hits to the head of a defenseless player.

Rome drew the penalty for making a late hit, because the blow came after Horton had released the puck. In other words, the check that left another player unconscious on the ice was technically legal - it just came a second too late. The following day Rome was disciplined by the league with a four game suspension - the longest suspension ever issued during the Stanley Cup finals, and one that caused him to sit out the remainder of Cup competition. Now the league is debating broadening Rule 48 to include any hit to the head of a defenseless player.

Earlier this month, following years of controversy about head injuries in youth hockey, Hockey Canada adopted a "zero tolerance" policy regarding hits to the head in junior and minor hockey. Intentional hits to the head will draw a major penalty; unintentional hits to the head will draw a minor penalty. Eliminating checks to the head is a small, important step in the right direction, a step towards the goal of reducing brain injuries in youth hockey players.

It's time for the NHL to take that same small step, and ban hits to the head.

There is sufficient medical evidence to warrant this change. Sport-related concussion is a brain injury that can have serious and long-lasting effects on athletes. In contact sports like ice hockey and tackle football, athletes are especially vulnerable to repeat concussions, and to post-concussion syndrome, which is associated with an array of debilitating symptoms that can prematurely end an athletic career and lead to lifelong disability.

Hockey players are also routinely subjected to the sub-concussive head impacts that are implicated in Chronic Traumatic Encephalopathy. CTE can result in early dementia, depression, behavioural changes, suicidality, and motor neuron disease. Evidence of the brain changes associated with CTE have been found on autopsy in athletes as young as 18, as well as in athletes with no history of concussion. Clearly, more must be done to protect athletes, including youth athletes, from the dangers of sport-related concussion and traumatic brain injury.

In ice hockey, body checking is the leading cause of brain injuries, so eliminating checking would be the most effective means of reducing concussions and sub-concussive brain injury. The NHL is not going to eliminate body checking however. To do so would radically alter the game in a way that, for many fans and players alike, would be unacceptable.

But the league could eliminate checking to the head without diminishing the quality of the game, or dramatically changing its character. In fact, a lot of NHL players are already quite experienced at playing hockey under rules prohibiting checking to the head. Both Olympic and European ice hockey are played according to International Ice Hockey Federation rules, which differ from NHL rules. Under IIHF rules, a hockey player is prohibited from any form of checking to the head, directing "a check or blow, with any part of his body, to the head and neck area of the opposing player" or driving or forcing the head of an opposing player into the boards or glass. Under IIHF rules, Rome's hit to Horton would have been illegal, and because it resulted in injury, would have led to a match penalty, ejecting Rome from the game.

The two hits that felled the Pittsburgh Penguins' Sidney Crosby in January, and sidelined him for most of the season, would have been illegal under IIHF rules too. Crosby led the Canadian team - all drawn from the NHL - that won gold in the 2010 Olympic winter games. The USA team they beat was also composed of NHL players. Hockey players know how to play the game, and play it well, without pounding each other in the head.

Pro hockey players are top athletes. They're physically and mentally fast and agile on the ice, and they can adapt to new rules. What's happening in hockey now is that the players are not sure what they are and are not allowed to do. Rome thinks his suspension was arbitrary and unfair, and he's got a point. Rome's hit on Horton was not significantly different from a hit earlier in the season involving another Bruin, Zdeno Chara, that saw the Montreal Canadiens' Max Pacioretty out cold and taken off the ice on a stretcher. And Chara didn't draw a penalty. It's unfair to the players, and leads to an unsafe atmosphere of uncertainty, if the rules are not clear, or are not consistently enforced. When players are on the ice, making split second decisions, they don't have time to interpret the nuances of Rule 48. And they shouldn't have to. The NHL needs to adopt unambiguous rules about hits to the head, and enforce them consistently. The players are professionals - they can play under a rule change as long as the rule is clear.

The NHL should ban hits to the head outright to protect its athletes from the risk of serious head injuries. Banning hits to the head won't eliminate 100% of concussions. Hockey is a fast game played by big guys on a hard surface, and there's no way to completely eliminate the risk of concussion and brain injury. But that doesn't mean nothing can be done to reduce the risks, and we're well past the point where it's possible to pretend that the league is doing enough to prevent brain injuries in hockey. The players and the fans know it isn't enough. Out of respect for the game, and respect for the players, the NHL must do more.

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