The National Hockey League has implemented a new policy for the 2015-2016 season: using “concussion spotters” at every game. Spotters will be stationed at every single game to watch the games live, and will have access to live feeds with replay capabilities.
The NHL will introduce spotters for every game this season. The spotters will be for purposes of determining visible signs of concussion.
— Renaud Lavoie (@renlavoietva) September 14, 2015
Concussion spotters recently made headlines in the NFL, when the league increased the capabilities of their concussion spotting system. The NFL’s spotters, who view games from the press box, officially have the power to stop games when a player exemplifies concussion-like symptoms—making the NFL the first league to allow their medical personnel to halt play.
According to the NFL’s rules, the player that is believed to be concussed will have to miss at least one play while undergoing concussion protocol. No teams will lose a timeout for this medical stoppage.
The NFL’s senior vice president of health and safety, Jeff Miller, told The Boston Globe: “Concussions and head and neck injuries are really important and they need immediate attention. Therefore that was going to predominate over any potential competitive concerns.” Named the “Julian Edelman Rule” after Julian Edelman of the New England Patriots, who remained in play during Super Bowl XLIX after concussion spotters radioed to the sideline that he needed medical attention. Although Edelman passed the concussion protocol after eventually leaving play, the NFL was still concerned over a potentially concussed player continuing in a game.
NHL spotters will not mirror NFL spotters entirely. For example, the NFL’s spotters have to meet certain requirements, such as (but not limited to): at least ten years of athletic training experience, a valid certification by the National Athletic Trainers’ Association, and have professional (or major college) sports experience. Additionally, in order to become an NFL spotter, that person could never have been employed by an NFL team as a head athletic trainer, nor have been employed by an NFL team in the last twenty years. Miller said the NFL instituted those requirements to avoid “any potential conflicts,” and make the spotters more like officials.
In contrast, NHL spotters do not require medical training. Deputy commissioner Bill Daly explained the rationale for this decision to Renaud Lavoie: “No medical expertise is needed to do the job they are being asked to do. They aren’t evaluating the players or diagnosing whether or not they have a concussion. That’s the job of the doctors and trainers. All they are doing is alerting team medical staff where they witness or identify an incident where there is a visible sign of concussion. Those signs aren’t ‘medical’ – they are objectively observable and they have already been precisely defined in the protocol.” However, spotters are required to study and take online seminars mandated by the NHL.
Further separating the NFL and NHL’s protocol is the spotters’ employers—NFL spotters are employed by the league, while NHL spotters are employed by the home teams. Team-employed spotters could relieve the league of some liability, since the hiring of any ineffective spotters would instead put the hiring team at fault.
Two spotters will be assigned to each game, with one per team. But, each visiting team has the right to designate their own spotters, rather than using the home team’s spotter. The league will also have independent spotters that can be utilized by those teams looking to designate a spotter other than one of the home team’s staff spotters. Daly explained the logic behind league-employed spotters, “By introducing League-employed-and-trained spotters, we are simply providing our clubs with another alternative to adequately and properly execute the spotter responsibility… Most clubs so far have indicated a preference to continue with a club-spotter approach, but certainly there will be situations where a club will opt to utilize the League spotter.”
League-designated spotters will be responsible for logging all incidents involving players exhibiting at least one visible sign of a concussion, even if the player receives medical attention. On the first of each month, the league-employed spotters will have to send in their information logs from these games. On the other hand, team-employed spotters will communicate differently—by using a two-way radio to notify the training staff on the bench of a player’s symptoms. “Depending on the nature of what is reported to him, the trainer has the next call on whether the player needs to be removed for evaluation,” Daly said, meaning the spotter’s call could be ignored or overridden. Daly continued by contrasting the NFL’s spotters’ ability to stop games, “You’re not really in a position where you’re going to have to stop games. But clearly there are some visible signs which a club is mandated to remove a player from the game for evaluation.”
The concept of a team-employed spotter had caused skepticism though. In the past, teams have turned a blind eye towards concussed players—whether it was the team that overlooked it, or the player that concealed his symptoms and chose to remain in the game.
James Wisniewski was violently hit into the board in a Game 6 elimination game in the 2014 Stanley Cup quarterfinals. He purposely told trainers that his back was injured from the hit, rather than admitting it was his head in order to avoid undergoing the twenty minute concussion protocol.
Matt Calvert of the Columbus Blue Jackets claims he did not realize he had concussion symptoms, nor did any trainer notice. His coach, Todd Richards, even though he may have concealed his symptoms just to avoid being taken out of the game. When Calvert returned, he added a tinted visor to his equipment because he was having issues with light sensitivity—a sign of a concussion, meaning that he was likely returning too soon. So not only did he initially play through a traumatic brain injury, but he returned too early, and the team allowed it for whatever reason without any suspicion over a player that was believed to have lied about his injury. Although it is not uncommon for players returning from concussions to add the tinted visor—as David Perron did when returning from a concussion—it is suspicious coming from a player who likely purposely played through a concussion.
There is no question that hockey players are tough; Rich Peverly wanted to return to a game in which a cardiac event occurred on the bench, and Patrice Bergereon played through broken ribs and a punctured lung, but it truly is unwise for anyone to play through a traumatic brain injury. Different measures have to be taken particularly when dealing with a potential brain injury, especially since discovering the connection between concussions/sub-concussive hits and the irreversible damage caused to the brain, such as the degenerative disease chronic traumatic encephalopathy (CTE). Concussions have to be recognized as more than simply a player “getting his bell rung.” Especially when both the NFL and NHL are constantly under fire for continuing to allow players to play through concussion symptoms and even more especially when their training staff should be able to recognize these symptoms. It is critical for the league to prove that positive measures are being taken for any player who may have this injury.
Although the onus is on a player to report his symptoms, trainers are expected to be capable of identifying player symptoms to avoid anyone playing though a concussion, which is incredibly dangerous for any athlete and heightens the risk of CTE. So when a spotter is hired by the team (the same team that is either not careful enough with their players or intentionally allows players to make the decision on whether to play through a head injury by ignoring or concealing their symptoms), what would stop the team from telling spotters to simply ignore whatever symptoms they notice or risk being fired or having their pay docked?
Rendering this position even more ineffective, spotters will have to identify at least three clear concussion symptoms. A person may not exhibit concussion symptoms immediately after impact, nor will someone concussed necessarily exhibit three clear symptoms.
Implementing a system of concussion spotters is a step in the right direction for the NHL, which has made some noteworthy advances in concussion detection and prevention. For example, the NHL was the first professional sports league to actually authorize baseline and neuropsychological testing for concussions. However, the NHL has made some missteps, including attempting to relinquish themselves from the responsibility of their players dying as a result of the symptoms of CTE and conducting a somehow inconclusive study on concussions that essentially wasted fourteen years.
Overall, their progress here is less than satisfactory, and their new concussion symptom spotting system does little to overcome their shortcomings in the field. The NFL’s initial system, which in many aspects was superior to the NHL’s even then, needed to transform in order to be effective—so why is the NHL beginning with a seemingly faulty system, rather than following the NFL’s improved system in the from the start? Ideally, the concussion spotter will not be utilized often because so many on the sidelines are capable of noticing these symptoms, but that does not mean the system should be fundamentally inadequate to begin with.