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Ottawa Senators forward Milan Michalek, left, collides with teammate Erik Karlsson during the second period of an NHL hockey game in Buffalo, N.Y., Tuesday. (David Duprey/Associated Press)
Ottawa Senators forward Milan Michalek, left, collides with teammate Erik Karlsson during the second period of an NHL hockey game in Buffalo, N.Y., Tuesday. (David Duprey/Associated Press)

Skinner, Michalek join NHL's growing concussion list Add to ...

Yes, a player like Crosby needs time to heal. But once he comes back, can he ever be treated like a “normal” player?

“I think the difficulty in dealing with the injury is that there's not a lot of general comparisons in dealing with individual players,” Penguins coach Dan Bylsma said. “Last year we had other players as well, at the end of the year, that were dealing with a concussion and they all seemed to follow different symptoms, different patterns, different recoveries and different lengths of time.

“It's tough to say, ‘This is how we're going to treat this instance different.“’

Unwanted as his condition is, Crosby's plight put the spotlight on concussion treatment.

“Things that have gone on the last few years have certainly raised the awareness, and the protocol that we use to treat players has changed drastically over the last number of years,” Holmgren said. “So that's a good thing. We're looking after the players.

“They're our most important asset.”

One asset is the NHLPA/NHL Concussion Program that was instituted during the 1997-98 season.

The ImPACT test has transformed the way concussions are managed by giving a tangible measure of what's going on in the brain — and proof for eager athletes that their heads may not be ready to take the next hit. It's a computer-based series of fast-paced quizzes involving words, pictures and colours. Scores reflect how quickly and correctly the questions are answered, and are compared to a baseline test that athletes take at the beginning of a season.

The test was developed in the early 1990s by Lovell and Dr. Joseph Maroon, the longtime neurosurgeon for the NFL's Pittsburgh Steelers.

Not even the imPACT test is foolproof. Crosby, who had 12 points in eight games, passed the test and still suffered from symptoms.

“For some people, one concussion is too much. Three concussions you're done,” Lovell said. “The one thing we do know for sure is that we do not want people going to back to play while they're still having symptoms because that definitely ups the risk.”

But can a player become fully healed? Crosby was out 10 months and still suffered a serious setback.

Lovell said “most people get better” with proper rest and treatment.

Critics who howl for a total ban on head shots as a solution won't get their way any time soon. Fighting is here to stay, at least until concrete evidence is presented that shows punches are a major cause of hockey concussions.

The NHL continues to cite data that states concussions are caused more often by accidental contact with players, the boards, the glass and ice, than by hits to the head.

“The majority of concussion issues that you see are not linked to fighting,” said Lovell, who has consulted with the NHL. “I'm not endorsing it. I'm saying hits on the ice tend to be more involved with people having concussive issues.”

The concussion is the toughest, most complicated injury, to diagnose. Safer equipment, visors, larger Olympic-sized rinks and a greater respect for the opponent could all lessen the chances of concussion.

Not all players want to err on the side of caution.

Washington Capitals centre Brooks Laich railed against the NHL's increased safe-than-sorry stance on concussions in October.

“I'm sick of hearing all this talk about concussions and the quiet room,” Laich said. “This is what we love to do, guys love to play, they love to compete, they want to be on the ice. How do you take that away from somebody?

“We accept that there's going to be dangers when we play this game and you know that every night you get dressed. Sometimes it feels like we're being babysat a little too much. We're grown men, we should have a little say in what we want to do.”

Laich's views are a throwback from another era when players like former Flyers centre Eric Lindros were ripped for expressing concern or sitting out over head injuries.

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