Head Games: Injury Prevention in Mind as Full Shield Debate Escalates

First in a series

Significant exposure has been given to head injuries in sport — particularly hockey — in recent years. Many leagues have constant debate on how it can better protect its players from significant injuries to the spinal cord, head and neck.

That debate was brought to the forefront in the NHL last season when Boston forward Marc Savard was sidelined with a severe concussion as a result of a hit from Pittsburgh’s Matt Cooke. The on-ice officials did not call a penalty and many were shocked the next day when NHL discipline chief Colin Campbell didn’t impose any sort of suspension for Cooke, who delivered a blind-side shoulder to Savard that left the star forward unconscious on the ice.

Campbell explained that his hands were tied. At the time, there wasn’t in place any sort of rules to punish a player for a legal, blind-side hit.

Notre Dame's Ben Ryan and every other college hockey player have to wear full facial protection under NCAA rules, but some say wearing visors could actually help protect players (photo: Melissa Wade).

Notre Dame’s Ben Ryan and every other college hockey player have to wear full facial protection under NCAA rules, but some say wearing visors could actually help protect players (photo: Melissa Wade).

In the days following, though, the NHL implemented a rule that stated that any blind-side hit would be subject to supplementary discipline pending review by the league. This offseason, the league will continue to review and decide if on-ice penalties need to be added. With the addition of the in-season change, the addition of a penalty for blind-side hits seems inevitable.

The college game, to its credit, has long held blind-side hits to the head as illegal. That, however, hasn’t stopped debate about head injuries in the game.

The debate, in fact, may reach a milestone this week when College Hockey Inc., the administrative and marketing arm for the five college hockey conferences, makes a presentation to the NCAA asking it to allow players to reduce their facial protection from a full cage or shield to a half shield (also called a visor).

Intuitively, the proposal seems to move in the direct opposite direction of protecting players. In theory, no one can remove a layer of protection and say that players will be better protected.

That’s simply not true, according to Paul Kelly, College Hockey Inc.’s executive director.

“I don’t know what the statistics are in terms of head injuries at the college game,” said Kelly, who was instrumental in fighting for better protection of players as the executive director of the NHL Players’ Association prior to landing in his current role. “We have raised the visor/facemask issue for a number of reasons.

“We’re concerned about the fact that kids at the college level who wear full cages play the game with a certain level of recklessness because they feel invincible. The coaches agree with us that a lot of that is brought on by wearing of a full cage.

“They just feel that no harm is going to come to them. That they can just throw themselves in front of pucks and they can just throw themselves into situations and against the boards. That they actually feel impregnable in some respect.”

One of Kelly’s battles is proving this fact. Though a recent vote of coaches at the Division I level showed unanimous support for Kelly’s theorem, hard numbers don’t exist proving that there are less injuries when players use visors versus full shields.

One study, in fact, refutes Kelly’s concerns.

A 1999 study conducted by professors and staff at the University of Calgary that surveyed players in the Canadian Inter-University Athletics Union showed that wearing a visor increased the overall number of injuries to the facial region, but severe injuries, such as concussions and spinal cord injuries, were unchanged.

“For intercollegiate ice hockey players wearing half shields compared with full face shields, we found that the risk of sustaining a head injury (excluding concussions), facial laceration, and dental injury was 2.52, 2.31, and 9.90 times greater, respectively,” the study concluded. “We found no evidence in this study to support the speculation that full face shield use increases players’ risk of sustaining a neck injury or concussion.”

Kelly’s argument, though, isn’t based on sheer numbers. He believes that the visor-versus-full shield debate should be more about the culture of the game.

“The experience in all those leagues that have gone to visors — whether it’s the IIHF, the USHL, the Canadian Hockey League — it has changed the culture of the game on the ice,” Kelly said. “The players [wearing half shields] play with a level of awareness and respect for what’s going on on the ice. They keep the sticks down, they don’t throw themselves into situations to the same extent that players with full cages do.

“We actually think that by making the switch from full cages to half visors that you’ll actually make the game safer. You’ll change the mind-set and the culture of the player and you’ll increase the visibility of the player and his peripheral vision.”

In play sanctioned by USA Hockey, the American governing body of the sport that doesn’t have a direct say into NCAA rules, skaters under age 18 have to wear full shields. Once they turn 18, they have the option of switching to visors, except in high school and on Under-18 teams.

Kelly and his staff made a presentation to the NCAA coaches and staffs at the recent American Hockey Coaches Association annual convention in Florida. According to Kelly, the presentation addressed the issue from two directions: safety and liability.

“We think we can improve safety and reduce liability. It’s kind of counterintuitive because you think by taking off some level of protection from the face that it sounds less safe,” Kelly said. “The full cage might contribute to the number of concussions because [players] wear these chin cups and they never wear them properly. They always wear them loose.

“If a guy gets hit in a certain way, that full cage and that chin cup pushes the jaw up into the head and that causes that concussion. It’s not a direct head hit but it’s a concussion that is caused by the jaw moving up into the head.”

"We actually think that by making the switch from full cages to half visors that you’ll actually make the game safer. You’ll change the mind-set and the culture of the player and you’ll increase the visibility of the player and his peripheral vision."

— Paul Kelly

Dr. Robert Cantu, a head injury specialist based at the Emerson Hospital in Concord, Mass., has seen plenty of athletic related head injuries. He treated the Boston Bruins’ Patrice Bergeron as he recovered from not one, but two, concussions sustained on the ice. According the Cantu, he hasn’t noticed any clear separation between the visor and full shield. That, though, doesn’t mean that he doesn’t believe the game can be safer.

“My opinion is that what they need to do to make head injuries go down is to make the head off base in terms of a point of contact,” said Cantu. “Right now, it’s left that if you intentionally try to injure somebody by hitting them in the head it’s a [more severe] penalty that will be called.

“Right now, the word intention is in there and we know from football that the referees will never call it. They don’t want to be in the position of trying to determine if someone had intention in their heart.”

Cantu’s suggestion that all head contact is severely penalized may seem extreme, but it also may be a better solution than putting officials in a position where their ability, or better yet desire, to delineate between accidental and intentional, is placed on the table.

Cantu also noted that he doesn’t believe that the visor or mask, regardless of size, is related directly to concussions.

“If you’re asking [the current helmet] to protect against a stick or something, they do their job,” Cantu said. “But the visor or the mask don’t protect against concussion; if anything, they torque the head more.

“I’m not suggesting they come off for other reasons. The cages don’t, though, in any way decrease head trauma. They just give the players a feeling of invincibility and they play a little rougher.”

In the end, though, Cantu makes Kelly’s same point. Playing with facial protection, whether half of the face is covered or the entire face is covered, delivers an artificial sense of security to the player. The more shield there is, the greater that invincibility is.

Kelly goes on to make a further point that a full shield isn’t just potentially detrimental to player safety. It also can play a significant role in convincing NHL and other professional general managers that a player is able to play a clean, physical game when the facial protection is removed in the professional ranks.

He notes that he’s had conversations with general managers that indicate one knock on the college player is that there’s simply no way to predict how that player will react when playing without facial protection. Major Junior players in the Canadian Hockey League all have the option to wear the visor. Most do.

Thus, the full shield-versus-visor debate goes beyond just safety and also fuels the fire for those who advocate for teenagers to choose the Major Junior route and forgo college altogether.

Kelly, in his role at College Hockey Inc., is charged with moving the perception on which road is best to get to the NHL from Major Junior to college. Thus, adding the visor option, according to Kelly, might be seen as a competitive advantage and one that could reinvigorate the college game.

Still, the battle ahead is an uphill one. The NCAA is not typically administered by people familiar with the niche sport of hockey. There are 335 active Division I member institutions, and only 32 of the 58 current Division I teams are full Division I members (all of said school’s sports play at the Division I level) and thus have voting rights. Simple math, then, shows less than 10 percent of the overall NCAA voting membership sponsors men’s ice hockey.

With the NCAA’s focus on protecting the student athletes and up to 90 percent of its membership not familiar with hockey-related issues, it will take a supreme argument to push this legislation forward.

Kelly, though, remains hopeful. He also knows this might be his only shot at making this change.

“I’ve been told we’ll only get one chance [in front of the NCAA],” Kelly said.

It’s a chance that Kelly hopes to make count.