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Pittsburgh Penguins Sidney Crosby (87) celebrates his first goal of the season against the New York Islanders in the first period of their NHL hockey game in Pittsburgh, Pennsylvania, November 21, 2011.DAVID DENOMA

At one level, it was just another hockey game, one of five scheduled seasonal meetings between the Pittsburgh Penguins and the New York Islanders.

It's early in the season. Nothing, particularly, was at stake.

But for 24-year-old Penguins captain Sidney Crosby, for his team, for the entire NHL roster of players, coaches, managers and owners, for the agents, lawyers, merchandisers and TV networks that feed at the league's extended groaning board, indeed, for Canada itself, where nothing has more cultural resonance than hockey, perhaps no single game in recent memory has had more importance.

Not even the historic gold-medal match between Canada and the United States at the 2010 Winter Olympics, where Sid the Kid, of course, scored the winning goal in overtime.

How many Canadians know, for example, that this weekend in Lake Louise, Alta., Canadian alpine ski team member Robbie Dixon will compete on the World Cup circuit for the first time since December, 2010, when he was concussed during a race in Italy?

But who is not aware that, until he jumped on the ice last night at Pittsburgh's Consol Energy Center – to a thunderous ovation – Sidney Patrick Crosby, the game's marquee athlete and ambassador, acknowledged heir to the hallowed mantle of the Great One himself, Wayne Gretzky, had not laced on his game skates since January.

Who had not watched – and watched again – the ugly footage of Crosby's head colliding violently with the right shoulder of Washington Capitals centre David Steckel during the Winter Classic on New Year's day? Or the hit he sustained only days later, when Tampa Bay Lightning defenceman Victor Hedman drove him into the boards?

For Mr. Crosby and his considerable retinue, the ensuing months have been a kind of nightmare: the private ordeal of headaches, dizziness, nausea and disorientation.

After three months of rest, Mr. Crosby felt well enough to skate with the team in April. But as soon as he ramped up the exertion level, his symptoms reappeared.

While fans and critics fumed at the NHL's seeming failure to protect its core asset – the players –from gratuitous, career-threatening hits, Mr. Crosby continued with a seemingly endless battery of neurological and other medical tests.

In the cybersphere, Crosby watchers generated a Twitter-fed tumult of questions, rumour and speculation about his future. When, if ever, would he play again? Would the unconventional, high-tech therapy Mr. Crosby had adopted, administered by Atlanta chiropractor Ted Carrick, be effective?

Other neurologists expressed skepticism about the approach, but when Mr. Crosby appeared at a press conference in September, Mr. Carrick insisted that his unorthodox methodology – it included spinning his patient's body, upside down, inside a whole-body gyroscope at different speeds – was making a difference. Mr. Crosby wasn't ready for full-contact hockey, Mr. Carrick allowed, but he was moving in the right direction.

Toronto sports lawyer Gordon Kirke, who helped nurse now-retired NHL star Eric Lindros through a series of career-shortening concussions, says attitudes among both players and the league have changed enormously since that time – and for the better.

"Back then, you'd be told to shake off a big hit and get back out there on the ice, though we now know that is potentially catastrophic. And with these changes have come alternative remedies and approaches. It doesn't surprise me at all that Crosby would try unconventional therapies, as long as they're not invasive."

Still, the larger question looms. Doctors have finally sanctioned Mr. Crosby's return, but what will the impact be of his extended layoff on his game?

"I think we have to be very careful with our expectations," Boston Bruins coach Claude Julien says. "It could take a while for him to get back to where he was. Maybe he'll find his stride right away, but I think people have to be prepared to be patient with Sidney."

Mr. Julien knows a thing or two about concussive injury. Bruins forward Patrice Bergeron, a friend of Crosby's, missed an entire season with a concussion. And the promising career of teammate Marc Savard, a victim of repeated brain injury, is likely over.

Sidney Crosby's physical well-being is "not going to be something anybody can read for a period of time," observes hockey legend Ken Dryden. "The nature of this kind of injury is that it seems to recur. Everybody wants good things to happen, even his opponents. You don't really know."

Mr. Crosby, Mr. Dryden adds, is singular not only by virtue of his enormous on-ice gifts. "Anybody can play model or ambassador. What Crosby is, and what Gretzky was, is that they seem absolutely real. Crosby seems hard-working and dedicated and determined and smart, and able to carry the load of hope and expectation, and to rise to the occasion. Anybody who is those things has to put circumstance first and not himself first. Only the real can be real."

Toronto neuropsychologist Robin Green, chair of research at the Toronto Rehab Institute, says part of the miasma surrounding concussive injury is that "conventional tests don't do a perfect job. It's a challenge to determine when a person is fully asymptomatic and when it's safe to return. It's been hard historically, challenging, to determine how to manage concussions when clinical assessments show people operating within normal parameters. But my impression is the NHL is listening."

For the moment, at least, the greatest player of his generation is back on the ice.

Now, Mr. Dryden says, "all we can do is hold our breath. We watch. We wait. We hope."

With a report from David Shoalts

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