Sunday, April 10, 2011

Sit out the playoffs, Sid

By Joe Starkey, PITTSBURGH TRIBUNE-REVIEW
http://www.pittsburghlive.com/x/pittsburghtrib/sports/
Sunday, April 10, 2011

Sidney Crosby is 23. He is the best hockey player on the planet and could remain part of that conversation for the next decade.

He is the fulcrum of a franchise built to contend for multiple Stanley Cups.

Do you really want him thrown into playoff hockey's raging inferno after three months of recuperating from a brain injury, without a single warm-up game? With the NHL still turning a blind eye to head shots like the one Todd Bertuzzi recently delivered? With so much still unknown about concussions, most notably Crosby's?

You want to put him in the Indy 500 after a few twirls around the block?

I don't.

Crosby should sit out the playoffs and focus on training camp. I have to believe it will be his call, if he is medically cleared. It's not as if the Penguins could or would stop him. Here's hoping Crosby resists the temptation and prioritizes his long-range future.

I might feel differently if we weren't in the Dark Ages of concussion science. We are, and Crosby's case is proof. We still don't know when he sustained his injury, for goodness sake, or if he suffered separate concussions on hits from David Steckel and Victor Hedman.

It's astounding to hear people say, "Sid's doctors will know when he is ready."

Really? Will they be the same people who told Penguins coach Dan Bylsma to tell the world on Jan. 6 that Crosby had a "mild concussion" and would miss "about a week?"

That's not a criticism, although using "mild" next to concussion should be avoided. Medical science simply has not caught up to the brain injury known as a concussion. It's nobody's fault. We are in the primitive stages of knowledge regarding concussion diagnosis, treatment and clearance for returns to play.

"It's the safest return-to-play protocol ever," said Chris Nowinski, 33, co-founder of the Sports Legacy Institute, a nonprofit dedicated to solving what it calls the sports-concussion crisis. "You just keep your fingers crossed that it's enough. That's the scary part. We still don't have sufficient technology."

Would an extra five months of rest help gird Crosby's brain for the next big hit or even the next small hit?

Nobody knows.

"The answer, theoretically, is yes," Nowinski said. "But he could be 99 percent recovered now, to where the five months would only mean one more percent. Unfortunately, a lot of this is still a guessing game."

Some would say that is why Crosby might as well suit up for the playoffs if he is cleared. I would say the opposite. There is enough alarming research on repeated head trauma to make me want to err on the side of extreme caution.

Nowinski can vouch for that. A former Harvard football player and professional wrestler (whose career ended with a concussion), his institute partners with the cutting-edge Center for the Study of Traumatic Encephalopathy (CSTE) at the Boston University School of Medicine.

Nowinski, co-director of CSTE, recruits athletes to pledge their brains to the center after they die. More than 300 have agreed, including ex-NHLer Keith Primeau.

CSTE researchers believe they have discovered a link between repetitive head trauma and progressive degenerative diseases such as ALS and chronic traumatic encephalopathy (CTE). The latest diseased brain belonged to former NHL player Bob Probert, who died in July at age 45.

About a year ago, the group discovered the early stages of CTE in Owen Thomas, a Penn football player who'd hanged himself at age 21.

This doesn't mean CTE is killing these people. But the presence of it, particularly in such young men, raises serious questions — and is another reason to be extra careful in monitoring returns to play.

Dr. Paul Echlin, a sports medicine physician in London, Ontario, specializes in concussions and was the lead researcher of a study that tracked head injuries sustained by two junior teams during the 2009-10 season. Echlin declined to comment on Crosby but said, "We really believe that if the first concussion is treated right, there is a 100 percent recovery rate."

Was Crosby's first concussion treated right?

That is a problematic question, starting with the lack of clarity on when his first concussion occurred — this is assuming he did not suffer at least one earlier in his hockey career. Crosby's agent, Pat Brisson, told me he is convinced the concussion happened on the Steckel hit at the Winter Classic.

"No doubt in my mind," Brisson said.

Neither Crosby nor the Penguins have publicly pinpointed the origin of the injury. General manager Ray Shero, through a team official, declined comment on that and why Crosby — who was clearly shaken by the Steckel hit — was not seen by team physician Charles Burke until four days later.

Who knows if the Penguins would do anything differently? I believe their actions were innocent and merely underscored the lack of science regarding concussions. And that lack of science is more than reason enough to be extra vigilant moving forward.

Obey the caution flag, Sid. Focus on camp.


Read more: Starkey: Sit out the playoffs, Sid - Pittsburgh Tribune-Review http://www.pittsburghlive.com/x/pittsburghtrib/sports/s_731573.html#ixzz1J7jvXc3P

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