Following numerous lawsuits alleging the NHL did not do enough to protect players from concussions and traumatic brain injuries (TBI), new NHL concussion rules were implemented to reduce the risks of long-term brain damage in players. Although those rules have had a part in pulling players who were likely to have suffered a concussion from games, following a recent fall by Sidney Crosby only days he after suffered a concussion, some analysts argue NHL concussion rules need to be strengthened.

Crosby Involved in Two Unsettling TBI Incidents

Crosby suffered his initial injury during a Stanley Cup playoff game between his Pittsburgh Penguins and the Washington Capitals on May 1. At 5:24 during the first period, Crosby was hit by Capitals defenseman Matt Niskanen, who was penalized with a game misconduct for his hit.

Crosby suffered a concussion in the incident—his third as an NHL player and his second in the 2016-2017 season—and did not play the following game. He was, however, in the next game. It was during a game a week after he suffered his concussion, on May 8, that Crosby tripped over Braden Holtby’s stick and collided in the boards headfirst. Even though he was slow to get up and appeared dazed, and even though he had suffered a concussion only a week before, Crosby was allowed to finish the game and was not evaluated for a concussion or TBI.

League: NHL Concussion Rules Don’t Cover Crosby’s Situation

The league has defended the decision to allow Crosby to stay in the game despite new NHL concussion rules that some say should have been triggered. Under the new NHL concussion rules, centralized spotters who monitor games via television and are tasked with watching players for signs of a head injury have the authority to pull players from a game if they believe a traumatic brain injury or concussion has been suffered. Arena spotters are also on the lookout for signs of a concussion, but do not have the authority to pull a player. Once the player is pulled, he is then evaluated by a doctor and testing is done to determine if the player can return to the game or needs treatment.

There are specific situations that trigger spotters to pull players from games, however, and none of them involve crashing into the boards, no matter how many concussions the player has already suffered.

According to NHL deputy commissioner Bill Daly, speaking with USA Today, because Crosby crashed into the boards and not the ice the spotters had no authority to demand Crosby be pulled from the game.

“Depending on the mechanism of injury, ‘slow to get up’ does not trigger mandatory removal,” Daly said. “The protocol has to be interpreted literally to mandate a removal. ‘Ice’ as compared to ‘boards’ is in there for a reason. It’s the result of a study on our actual experiences over a number of years. ‘Ice’ has been found to be a predictor of concussions—’boards’ has not been.”

Experts disagree with that reasoning, and point out that any head injury has the potential to cause a concussion or traumatic brain injury.

“Any head contact is a possible mechanism of injury,” Chris Nowinski, co-founder and CEO of Concussion Legacy Foundation, said to USA Today. “I can’t believe we have to say that in 2017.”

Furthermore, Daly noted, concussion spotters don’t factor a player’s history of concussions into their decision to pull a player from a game.

Experts Criticize NHL Response to Sidney Crosby Hit

In an ideal world, players would recognize when they had suffered a traumatic brain injury, demand to be removed from play, and the team would support them in that decision. That’s not how athletes think, and it’s certainly not how they respond during play-off time. Athletes are trained to play through pain and injury no matter what the cost. Players like Connor McDavid fight when NHL concussion protocol required they be pulled from a game where they exhibit brain injury symptoms.

“And of course [players] will want to stay in the game,” Satchel Price writes for Second City Hockey. “They’re trained from young ages to withstand pain and put forth their best effort on the ice. But this was before the emergence of more information on how head injuries impact long-term health.”

Crosby has been true to athlete form, telling reports after the game that his collision with the boards “knocked the wind” out of him and calling the incident “a fluky fall.”

Teams want to win, so they’re reluctant to pull their star players without definitive proof of a concussion—or without being forced to by the league. That’s why critics argue NHL concussion rules need to be updated to allow for any type of head injury to trigger the player’s removal.

Effects of Traumatic Brain Injury can be Devastating

Of concern is not just how Crosby and other players feel today or tomorrow—although that is a cause of concern too—but what long-term effects repeated concussions will have on athletes who do not take enough time to recover from their head injuries. Long-term damage can affect a person’s thinking, emotions, and behavior. Repeated concussions can lead to Chronic Traumatic Encephalopathy, a progressive degenerative brain disease that is linked to memory loss, depression, impaired judgment and dementia.

There is too much at stake for players and the NHL to not take the risk of brain injuries seriously.