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A Phoenix Coyotes helmet sits on the ice during an NHL game.

Christian Petersen/Getty Images

It was an extraordinary press conference. Four people were at the media table in a spare setting at Pittsburgh's Consol Energy Center: Penguins general manager Ray Shero, concussion specialist Michael Collins, chiropractor Ted Carrick and Sidney Crosby. They were serious and straightforward. Through nearly 45 intense minutes, they offered almost no smoke or spin.

The medical experts, not the GM or the hockey player, spoke first.

Dr. Collins, head of the University of Pittsburgh Medical Center's Sports Medicine Concussion Program, laid out the events surrounding the injury, Mr. Crosby's resulting symptoms, the diagnosis, the treatment and the ups and downs of his recovery since January. He was patient and thorough. He spoke as if he knew his audience was intent on hearing what he said and, despite his occasional medical jargon, would understand him in all the ways that mattered.

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With a few lapses, Dr. Carrick, a chiropractor and founder of the Carrick Institute for Graduate Studies in Florida, did the same.

Beyond the details, the specialists needed to convey that they were competent, professional and responsible – that Mr. Crosby is in good hands.

At times, they talked about Mr. Crosby's brain as if he wasn't there himself. Yet Mr. Crosby seemed undistracted. Respectful, he watched and listened as if the experts were only his trusted advisers. He was still the captain of his own ship.

When it was his turn to speak, Mr. Crosby was composed and informative, not seeming to hold anything back. He spoke of how he felt at each stage after his injury. At first, he had felt himself in a fog, he said, as if he was living one step removed from his own life, a spectator to it. Objects around him weren't quite where he knew them to be; once, Dr. Collins related, Mr. Crosby, feeling he was falling, found his body reacting when he wasn't falling at all. Even the flickering images on a TV screen moved too fast for him, making him dizzy – this in someone who had always seen everything so acutely, who at only 24 had seemed somehow to figure out hockey and life. Now, his board had been scrambled. Normal life, his medical people said, would return when, at full exertion, his headaches stayed away. Normal life as Sidney Crosby would return when everything went back into its proper orientation and, when confident of that, he could resume his Crosby-like creating, scrambling the board for everyone else instead.

The medical experts and Mr. Crosby said no one could predict when that would occur. Given where he had been and where he was now in his recovery, and pushed by the media's questions and by their own professional and human hopefulness, they put science to one side and declared that it would happen. Asked if he had played his last game, Mr. Crosby replied without bravado, "I wouldn't bet on that."

Before the press conference, it was clear; after, it is even clearer. The National Hockey League season that begins next week – whether Mr. Crosby plays at all, or how well – will be about Mr. Crosby.

This is a difficult time for the NHL, for its commissioner, Gary Bettman, and for hockey. It's no less difficult for the National Football League, for its commissioner, Roger Goodell, for the U.S. National Collegiate Athletic Association, and for football.

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Head injuries have become an overwhelming fact of life in sports. The immensity of the number, the prominence of the names, the life-altering impact on their lives and, more disturbing, if that's possible, the now sheer routineness of their occurrence. The hit on Mr. Crosby didn't seem like much. If it hadn't been him, the clip of the incident would never have made the highlight reel.

But if so much can happen out of so little, where is all this going? Who else? How many more? How bad might this get? Careers and lives of players, we know now, have been shortened, diminished, snuffed out by head injuries. What once had seemed debatable, deniable, spin-able now is not. What once had been ignored now is obvious. Not just contact or collision sports, hockey and football are dangerous sports.

Mr. Bettman, Mr. Goodell and sports leaders who came before them have done only what the players, fans and media have wanted them to do. They know we want our athletes to be better than they have ever been. We want them to be superhuman versions of ourselves – faster, bigger, stronger, more skilled, more committed. We want them, no matter the risk or pain, to prove beyond even unreasonable doubt that they are not in this for the money but for the love of their/our sport and their/our team, and to demonstrate that at every moment by being willing to do whatever it takes. The players, fans and media want great plays and thunderous hits. They need "wows" to compete against every other challenge – in sports, entertainment, news, politics – for the public's attention. And the players, and their commissioners, Mr. Bettman and Mr. Goodell among them, for the most part have delivered.

If the result has been collisions that are too dangerous, you "tweak" the rules, "tweak" the equipment, "tweak" the strategies of play, often in the face of great resistance – and the leagues have done this. But still the careers and lives of their players are being compromised, and now everybody can see it.

As a hockey or football commissioner today, you can't not know that many of your players this year, next year and every year will suffer head injuries. Some will have their careers ended; some, such as Paul Kariya and Eric Lindros, before age gets them, will begin their downward slide from superstar to journeyman; and some retired players will die long before their time, their final years, for themselves and their families, in the living death of dementia. This isn't being alarmist. This is alarming.

Mr. Bettman and Mr. Goodell can see this. So can the heads of the hockey and football players associations. So, increasingly, can the players, their wives and their families, and their lawyers. The commissioners and their leagues – mostly – are now beyond simple denial, defensiveness and counterattack. The challenge is no longer awareness of the problem. It's awareness of the solution. If you are Gary Bettman or Roger Goodell, what do you do?

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I come back to the Crosby press conference. I'm not sure how it could have been done better. The message was that we are in uncharted territory. We know some things, there is much more we don't know and we're going to do what we know and respect what we don't until we know better. This is serious, and we are serious. And we want you – all those who are watching – to experience what we have experienced and learn what we have learned because, as people who love sports, we're in this together. It is this same tone, attitude and approach on head injuries that Mr. Bettman and Mr. Goodell need to take.

For Mr. Bettman, it's time to say: This is a great game, but it has a big problem, one that will get only worse if we don't do what needs to be done now. Our players will not get smaller, they will not skate slower, the force of their collisions will not diminish. The equipment they wear will not improve fast enough to mitigate the greater risks they will face. "Tweaking" is not the answer.

Immediately, Mr. Bettman can say that we need to treat any hit to the head as what it is: an attempt to injure. A hit to the shoulder, torso or hip – depending – is understood as good positioning and good defence; not so a hit to the head. The head has always been thought of differently, requiring special protection with its own peculiar penalties. Highsticking is not for a blow to the shoulder or elbowing for a blow to the chest. In the future, if a play results in an incidental and minor hit to the head, or one that is the fault of the player being hit, no penalty need be called.

But now, the presumption needs to be that every hit to the head is an attempt to injure, with the onus on the player doing the hitting, through his actions and in the eyes of the referee, to defeat that presumption. As Mr. Crosby said in his press conference, if the league requires players to be responsible for their sticks, why not their bodies? Further, if an opponent purposely puts his head in a position to draw contact in order to cause a penalty to be called, just as with "diving" now, it is that player as "instigator" who will receive the penalty.

But what about the player who is carrying the puck with his head down, another oft-cited example intended to show how impossibly complicated it is to ban headshots?

In years past, the best way to move the puck forward was believed to be for a player to do it himself, stickhandling up the ice. Having his head down with his eyes focused on the puck was considered an advantage to him. It was only fair, then, that a defender have his own advantage and, unseen by the puck carrier, be able to blast him.

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Now, the best way to advance the puck is seen to be by passing, so a player with his head down is at a disadvantage already and doesn't require further punishment. He can be easily stopped with no more than incidental contact. In such cases, a crushing hit to the head (e.g., Scott Stevens on Eric Lindros) is nothing less than an attempt to injure. The common explanations – "Because he deserved it" or "Because I can" – are not good enough in this age of concussions and dementia.

What then about fighting? If hits to the head are banned, why not punches to the head? This isn't the time to re-engage the debate over fighting. Not directly. That will only distract from the more critical issue that must now be addressed. The problem of fighting, for most critics at least, isn't fighting itself. It's the consequences of fighting. To many, fighting seems out of place in sports, turning away prospective fans from a game that needs many more. To some, rather than acting as a "safety valve" to reduce further fighting, it creates increased ill will and generates more fighting. So why allow it?

What is relevant here is whether fighting relates to head injuries. Is fighting dangerous or not? Once, hockey players did their own fighting. An elbow to the nose or a slash on the arm, and – big or small; good fighter or not – a player had to right his own wrong.

Most players were bad fighters. On their skates, they wrestled, slipped and flung themselves around. It was vaudeville.

Now, most fights are between designated fighters. Each such fighter knows what he's doing, and though usually well-matched enough to be able to protect themselves, these fighters are also skilled enough to hurt each other. And questions have now arisen: Why did post-mortem studies on the brains of Reggie Fleming and Bob Probert, two brawlers of different eras, show brain damage? Why did three contemporary fighters – Derek Boogaard, Rick Rypien and Wade Belak – who were young and rich, and seemed to have everything to live for, die in recent months? We don't know the answers, but we know enough to know we need to find them.

The NHL rulebook is judicious in distinguishing a bodycheck to the head from other contact to the head, treating fighting as its own separate category. For an illegal check, it is necessary that "the head is targeted and the principal point of contact." But in a fight, is the head not "targeted"? Is the head not "the principal point of contact?" Is a fist not part of the body? And in fights today, with fighters who can truly fight, what's the difference between being hit in the head by Niklas Kronwall's shoulder or Zdeno Chara's fist? This is about head injuries, not fighting's place in hockey. This is about the outrageous damage that hits to the head are doing to lives and to a sport.

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Every time big changes are discussed, the same flood of examples comes forward in support of the aggrieved hitter and the historical game, and every time it steals focus from the gravity of head injuries and derails significant action. No more. The truly aggrieved is not the player or the team who receives the occasional unjust penalty. It's the player or family who has to live with years of an unfull life.

For Gary Bettman, the challenge is not to be distracted by history, by the voices of those who grew up as "hockey people," or by the overwhelming power of the status quo. He is the central custodian of the game. If he takes on head injuries aggressively – and he must – some of his changes might be ineffective, others might be embarrassingly inept, and he might very well be mocked by fans and the media. But he and we will learn, and it is far worse to be mocked by damaged players for not doing what clearly needs to be done.

Many of these steps can be implemented this season, and with significant impact if their purpose – to prevent or otherwise minimize head injuries – is not forgotten and the rules to support that purpose are applied unfailingly. Other steps will take longer and be of greater effect, but they can be set in motion.

The game will get better.

Most important, however, it's time to think about our sports a different way.

What would hockey look like if it were played in a "head smart" way? If the safety of the brain was central to the rules? What about football and other sports?

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What would we have to do differently? When do hits to the head happen? In what circumstances? In what parts of the ice? Against the boards? Against the glass? By whom? With shoulders? With elbows or sticks? They don't happen often. During most of the game, with most of the players, they don't happen at all. Why then? Why them? What about the big hits?

What would we need to do to minimize the risk? Because this isn't about no risk. It's about smart, informed risk. How would we make hockey safer? What would need to change? How would this game feel different to play? To watch? What would be lost? Unable to do some of the things they did before, what would players do instead?

My guess is that a lot less would change and for many fewer players than we think. My guess is also that many of the changes would make our games better, and not only for reasons of safety. If some rules are changed, players and coaches will find ways to adapt and to gain a competitive advantage, because that's what players and coaches do. They're dreamers and imaginers. They're competitive. They need to win.

Once, players and coaches came up with the forward pass in both hockey and football and gave flight to sports that had become a static snarl of bodies. They'll do it again. The mediocre will dig in their heels – they fear they can't change – and usually that's enough to stop everything in its tracks. But this time we have no choice. Not everyone will be affected the same way. Some things will change more for young kids but not for adults, or for girls and not boys, or for boys and not girls. The crucial point is that at every age and every level "head smart" will become the way we play.

This "head smart" movement should be global, not North American. We all face the same problems. Efforts might begin by gathering the most thoughtful coaches and players of a sport – in an area or in a country – and the best head-injury experts to begin putting together a "head smart" model for their sport. These models, as well as those created by other individuals and groups, would be put forward to the public and tested and debated through websites and later through local and international workshops and conferences. "Head smart" models generated in one place and in one sport would challenge and inform models in others, to make each model continually better.

The NHL, NFL and other sports leagues would engage with these efforts, sometimes as partners (in studies, in testing out proposals), sometimes financially, always in promoting the importance of the work.

The Crosby press conference suggests an opportunity. The future doesn't have to be one of pointed fingers and shouted denials. None of us knows the answer. All of us know the problem. We are all in this together. We love our sports. We love to play them and watch them. We love to argue over them. We love the inspiration and the excitement they bring. We want sports to be part of our lives forever. We know that sports will not go away, but we also know that the role they play in our lives is at risk. This is a fearful time, but it can be an exciting time.

The NHL and Gary Bettman and the NFL and Roger Goodell have an opportunity. This is the moment.

Ken Dryden, a lawyer and ex-MP, is a former NHL goaltender and is a member of the Hockey Hall of Fame.

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