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Dave Feschuk: Proof linking head hits and CTE is a game changer. Just not in the NHL

It’s been touted as a breakthrough study that ends what the National Hockey League still considers a debate. A multi-university analysis published last month claims to conclusively demonstrate that repetitive head impacts are a definitive cause of CTE, or Chronic Traumatic Encephalopathy, the degenerative brain disease that’s been found in athletes with a history of taking head hits.

It’s an impressive piece of science, authored by 14 of the leading experts in the field, that analyzed data using a methodology that once helped cement the cause-and-effect link between smoking and lung cancer — another accepted truth once called into question by a big industry with something to lose.

“The evidence is conclusive,” said Chris Nowinski, CEO of the Concussion Legacy Foundation and one of the study’s 14 authors.

“THE DEBATE IS OVER ON CTE!” tweeted Allan Walsh, the agent to NHL players such as Jonathan Huberdeau and Marc-André Fleury. “Waiting for statement from Gary Bettman and the NHL.”

There was decidedly less jubilation about the study’s publication emanating from the NHL head office. Bettman, the league’s commissioner, has long insisted there is “no conclusive link” between repetitive head impacts and CTE, which has been found in a long list of league alumni — among them Stan Mikita, Bob Probert and Rick Martin. And the publication of this latest study apparently has not changed the league’s view.

“A single medical article does not determine our view on these issues,” Bill Daly, the league’s deputy commissioner, wrote in an email. “We rely on the consensus opinion of medical experts to guide us. Currently that consensus view does not align with the conclusions reached in the article you forwarded.”

Nowinski did not sound surprised to hear of the NHL’s dug-in position.

“Bill Daly saying one scientific paper won’t change his view shows you that either he or the people he’s working for aren’t interested in thinking critically about this issue,” Nowinski said.

Daly, to be fair, is not technically wrong on this. There is one consensus view that does not align with the conclusions reached in the article. That’s the most recent view published by the Concussion in Sport Group, a scientific panel organized by the global sports industry. The Fifth Consensus Statement on Concussion in Sport, authored by a group of experts from around the world, concluded that, at the time, there was no definitive science to declare a link between repetitive head trauma and CTE.

But there are a couple of things to understand about that consensus statement. For one, it was released in 2017. Blame COVID for squashing more than one attempt by the group to reconvene and issue a more recent take. For another, the group’s chair and lead author of that consensus statement, Dr. Paul McCrory, resigned his post in March amid plagiarism accusations.

Mathieu Perreault of the Canadiens awaits the trainer after an elbow to the head in a game against the Blues in 2021.

“(The members of the Concussion in Sport Group) are people hand-picked by the largest sports industry bodies in the world to produce a report that I think at one point was intended to do good things, but now has lost its way,” said Nowinski.

So, never mind that the United States Centers for Disease Control and Prevention have acknowledged that head hits cause CTE. Never mind that even the National Football League quit arguing to the contrary in 2016. And never mind that this new study has been endorsed by the likes of Dr. Charles Tator, the Toronto brain surgeon who has long been at the forefront of concussion research and care in Canada, who called it an important addition to the literature that “confirms what most people in the medical field have decided, and that is that there is a relationship between repetitive impacts to the head and CTE.”

Forget all that. Until further notice, the NHL is sticking by the 2017 work of the group then headed by an accused plagiarist. The Concussion in Sport Group is next scheduled to come together to assess the state of the science in October.

“(The NHL) will obviously be interested in whether the group modifies its previous views,” Daly wrote in an email.

Said Nowinski: “If the Concussion in Sport Group, in its next report, does not acknowledge that causation has been established beyond any reasonable doubt, that repetitive head impact causes CTE, then the group will no longer have any relevance.”

If the group does, indeed, modify its view, it’ll be worth watching how the NHL reacts. The publication of the new study has seen Ken Dryden, the Hall of Fame goaltender, renew his call for the NHL to install a zero-tolerance policy on hits to the head. Bettman has previously scoffed at the practicality of the idea.

“Such a rule is very easy to propose, but is difficult, if not impossible, to implement,” Bettman said in 2019.

All the same, the study Nowinski helped author is calling for changes in how games are played, especially for children.

“We wrote this paper to talk to the parents out there who are putting their kids in sports that are causing CTE to say: You don’t have to listen to Gary Bettman on this. Listen to the scientific community. Read the evidence for yourself,” Nowinski said. “Everything that’s ever been raised as a doubt about why CTE might not be caused by head impacts has been proven wrong.”

Bettman has argued that NHL players are adults who know what they’re signing up for and like the way the game is played. Nowinski, for his part, said it’s his experience that “very few” NHL players are aware of the risks they’re being exposed to.

“I am continually surprised when I speak to professional athletes how little they understand about CTE, because they’ve been fed so much misinformation over the last few years. I don’t believe there is informed consent right now,” Nowinski said. “The problem with the guys running the sport right now, they don’t want to risk that their profit will dip 10 per cent with no head hits, even though the risk of CTE could dip 90 per cent. But they’re also not the ones out there taking risks. Maybe we ought to have the people out there taking risks making those decisions.

“Because it’s literally a life-and-death issue, and the brains are stacking up. And no one (from the NHL) is calling to ask questions.”

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