Daniel Carcillo speaks about concussions at a neurology conference.

[Cali Panthers Fan]

I don't know if many of you remember, but Daniel Carcillo has several articles/videos on the Player's Tribune about his experiences in the game, his struggles after retirement, and his experience with concussions. You can google search those on your own time.

Well today, he presented a brief lecture to a neurology symposium that I am attending run through the Carrick institute. Below I have some notes I took from his presentation that I thought would be interesting to share.

For those of you who don't remember, The Carrick Institute and Dr. Carrick specifically, have been on the front lines of concussion management in sports through functional neurology. Famously, Sidney Crosby lost significant playing time earlier in his career due to post-concussive syndrome which was only effectively rehabilitated through Dr. Carrick's care.

https://www.macleans.ca/society/rebu...crosbys-brain/

Here are my notes from the presentation from Carcillo today:
• Started by listing a long list of sports related injuries related to limbs and spine. Then ended with this: 6 undiagnosed and untreated TBIs. Said the other injuries won't kill him, but the TBIs might.
• Met Dr. Carrick in 2013 through Steve Montador who died from CTE.
• Sobriety was the first step in attempting to assess current state of the brain.
• Credits Dr. Carrick and Dr. Antonucci for saving his life.
• Trauma experienced as a young boy (13?): Head smashed into brick wall and immediate symptoms of TBI. First incident of TBI he can remember.
• Loved his parents and they gave him a great upbringing, but his household lacked a way to give him an emotional outlet, and he used hockey as an emotional release, hence his style of play (borderline). It allowed him to release his frustration, confusion, and anger. The physical play of hockey that was taught to him was about intimidating the opponent and breaking the opponent down. Take their will to play away. He was taught to hit as hard as you can (cleanly) as part of the game. If you want the puck you have to work harder than me to get it.
• Hockey taught him to be comfortable in uncomfortable situations. Lacking mental strength in any way means you won’t make it to the NHL. Yet the mental makeup of players is not regarded highly enough in terms of their health.
• Went into an 8 month opiate addiction after his grandfather died, shortly after retiring in 2015.
• Carcillo was one of Dr. Carrick’s worst cases in 2013, and he went on to experience 2 more undiagnosed concussions before retiring.
• Now runs a foundation to help athletes transition into life after the game.
• Dreaded waking up since any set of symptoms might present any day. (post-concussive and CTE symptoms)
• Splitting headaches resulting from minor light exposure, anxiety depression, suicidal thoughts etc.
• Recognized that is isn’t normal to experience these thoughts or feelings at his level of success and lifestyle and sought treatment.
• Claimed the NHL had a big hand in killing Montador and other players: Listed the famous and not so famous players who died young, Boogaard and others.
• Andrew Alberts and Nick Boynton are now patients after the recommendation from Carcillo.
• Carcillo is now free of neck pain, headaches, depressions, anxiety, autonomic problems (unregulated blood pressure), and is sober.
• Not once did anyone talk to him about head trauma, the physicians always talked about his neck.
• Is now on a mission to spread the information about TBI and the possible treatments. Has advocated for case studies in active athletes to humanize the issue, even stating that he would like to tap into the financial resources of the NHLPA to do so.
• Andrew Alberts went to 75 doctors before arriving at Matt Antonucci’s office and started receiving appropriate care.
• *His presentation ends with a standing ovation from a room full of neurology experts*
• Q: How would you change the way you play or how do you think the game will change? &
A: You can’t stop concussions, the game is too fast. Used the example of JT Miller hitting Backes in the playoffs and Miller saying he held up but it still resulted in a dangerous hit and a concussion. He just wants them to be aware of the risks of TBI and the proper treatments and protocols.
• Said there’s no poster about brain awareness, but there’s ads with Sidney Crosby telling him how to dress. There are websites now, but no case studies of NHL players and little in terms of good scientific data.
• Didn’t say the player name (Montador?), but after 4 concussions in 60 days, the player left the team because he wasn’t getting better with their treatments. Once he signed the “fit to play” release, they sent him to the AHL and blackballed him from the team. Used this as an example of the serious lack of understanding in the NHL and the rough tactics used by teams when player's focus on their health above the team.
• Q: what can we do as a prevention measure when kids idolize athletes?
• A: he worries about his own son following in his footsteps and head trauma in the sport, and might try to steer him away from contact sports. It’s about constant education and empowerment of athletes to be self-advocates.
• Q: where does the gladiator-like physical nature of the sport come from?
• A: The NHL knows about the effects of fighting. Carcillo has experienced a lot of hate on social media because he’s been campaigning against head injuries in the sport: “Hey Dan, didn’t you give out countless concussions?” He says: "You’re ####ing right I did, but it’s me or you. That’s the way I was taught to play. The archaic rhetoric comes from the way the game is portrayed in popular media and the NHL." Brought up the way the league hyped the fight in game 7 between the Caps and Lightning in social media and other forms.
• Q: who do nhl player look up to for education?
• A: guys like me. I’ve spoken to 60 players since I left the clinic. I’ve posted 2 videos on the player’s tribune. We basically have to take care of each other.


I just thought this would be interesting to discuss. He was frank and honest, and didn't shy away from personal criticisms. He is pretty well read on this subject now and came across as earnest in his desire to help his fellow players understand this issue.

Traumatic Brain Injuries, and Chronic Traumatic Encephalopathy is a hot topic in the NHL, and I think player's like Carcillo and others are going to significantly change the discussion in the game.

[PepsiFree]

Not much to say, but thanks for posting this. I think a lot of people forget (the NHL included) that these are human beings. The game is what it is, but contact sports have to get much better at taking care of their people, making sure their aware of the risks, and ensuring they have access to the right medical treatment.

[Jiri Hrdina]

The player was Montador for sure, as based on that description it aligns precisely with what was written in the Dryden book.

[cam_wmh]

Thanks for sharing Cali. Knowing more, it’s sad how posts like this follow the NHL’s M.O, of trying to bury the concussion cases.

Originally Posted by Weitz

I've seen him jumping over a lot of tweets trying to get people talking about what he wants when they are clearly not talking about it in the specific thread. Bissonette called him out last night. Maybe looney tune was a little harsh, I will admit that.


On the Wilson suspension, usually they are announced by now. Could we just be seeing a fine? Will be interesting to see as there is a large faction that don't think it should be suspended.

Guys like Bisonette tow the NHL line, not wanting to rock the boat and stay within their circle. The league needs to address this, and I look forward to a reconciliation with the players, or they’ll get their pants sued off, and rightfully so.

[MJK]

Originally Posted by Cali Panthers Fan

Traumatic Brain Injuries, and Chronic Traumatic Encephalopathy is a hot topic in the NHL

I can tell you it's a hot topic across Canada with National consultations happening as I write this. Next step will be recommendations by Ministers based on the consultations toward protocol and policy for all sport organizations ranging from community clubs, Provincial/Territorial Sport Organizations and National Sport Organizations.

[Cali Panthers Fan]

Further to this:

I cornered Carcillo after the day was done, letting him know my support of his initiative. I asked him a couple of questions about this.

-What's the NHLPA's position on this and how are they currently communicating this issue to players?

- They largely aren't because they know they are liable at this point. There are a few cases ongoing that need to be resolved before they can state a more progressive position on this issue. They are aware of the problem, but due to legal proceedings, they can't really do anything at the moment. There is also a massive class-action suit coming that limits their ability to act, because if they admit knowledge, they are liable.

He goes on to say...

-I have footage of Bettman and others in the upper ranks of administration stating in front of courts that a punch occurring during a hockey fight is less destructive than boxers with all their padding and wrapping on their fists. They are in deep trouble once the data has been presented.

*I edited out the "####in's" which were every other word with Carcillo. It wasn't surprising to hear him talk that way once he was away from the podium.

[cam_wmh]

This is about to get real interesting...

Shortly before a lunch break, a lawyer for the group of ex-NHLers suing the league asked Jacobs a direct question: Have you ever heard of the neurodegenerative disease known as CTE?

“No,” Jacobs answered.

A video camera recorded the exchange as Jacobs said he couldn’t recall reading about CTE or hearing it being discussed at any NHL meetings.

Jacobs was later asked whether he was aware CTE, or chronic traumatic encephalopathy, had been found in the brains of former professional football players.

“I don’t know,” he said.

https://www.tsn.ca/years-into-concus...-cte-1.1095287


Is TSN too tied to the NHL, even without a TV deal, to put them on the coals in this 5 part series?

[GioforPM]

Originally Posted by cam_wmh

Guys like Bisonette tow the NHL line, not wanting to rock the boat and stay within their circle.

toe It's a boxing reference so kinda related.

Originally Posted by Cali Panthers Fan

Further to this:



-What's the NHLPA's position on this and how are they currently communicating this issue to players?

- They largely aren't because they know they are liable at this point. There are a few cases ongoing that need to be resolved before they can state a more progressive position on this issue. They are aware of the problem, but due to legal proceedings, they can't really do anything at the moment. There is also a massive class-action suit coming that limits their ability to act, because if they admit knowledge, they are liable.

The union has, in my view, never taken its job to ensure player safety seriously enough. They've taken the wrong side of helmets, visors, skateguards, etc.

[Weitz]

Originally Posted by GioforPM

toe It's a boxing reference so kinbda related.



The union has, in my view, never taken its job to ensure player safety seriously enough. They've taken the wrong side of helmets, visors, skateguards, etc.

Aren't they just representing what the players want in reference to these things though? Is it the job of a players association to do anything other than what the majority of players want?

I only assume they took these stances because of some sort of process they followed to come to the conclusions they recommend.

[GioforPM]

Originally Posted by Weitz

Aren't they just representing what the players want in reference to these things though? Is it the job of a players association to do anything other than what the majority of players want?

I only assume they took these stances because of some sort of process they followed to come to the conclusions they recommend.

Should a construction workers union advocate for less safety equipment based on a poll of uneducated construction workers? Or should it educate the workers on the dangers.

I don't think they actually have voted on stuff like this. And if they do, I think lots of players vote against their self-interest out of a macho thing. I think some players would be happier if they weren't given the choice.

[Jetfire]

I didn't really like Carcillo at all as a player, but I've been a fan of him since he spoke so sincerely and from the heart about Montador a couple years ago.

It's really nice to see him putting such an effort into this important cause.

[Travis Munroe]

I have just started listening to "spittin chicklets" podcast and they should really get Carcillo on. A completely unfiltered but candid to the point interview could pry even more from Carcillo.

Some of those points about guys receiving multiple concussions in such short spans is disgusting yet I can see how it slides by. I am sure the player, team dr, coach, management, game, etc all play their own role in a bad decision so the league should implement a much stricter policy to leave it out of these guys hands. Take a head shot of any degree and you have to sit out 2 games with an independent review. This includes fights (which as exciting as they are, would reduce fighting even further than it has been and benefit players). For the league to prove they are taking this serious, they need to put twice the focus on the cause of head trauma and not recovery. High hits should be more than a 2 minute penalty and there is no reason a guy who causes a concussion on a dirty play should be sitting out a few games when the guy he hit could be out for weeks if not months!

[cam_wmh]

Originally Posted by Realtor 1

I have just started listening to "spittin chicklets" podcast and they should really get Carcillo on. A completely unfiltered but candid to the point interview could pry even more from Carcillo.

Some of those points about guys receiving multiple concussions in such short spans is disgusting yet I can see how it slides by. I am sure the player, team dr, coach, management, game, etc all play their own role in a bad decision so the league should implement a much stricter policy to leave it out of these guys hands. Take a head shot of any degree and you have to sit out 2 games with an independent review. This includes fights (which as exciting as they are, would reduce fighting even further than it has been and benefit players). For the league to prove they are taking this serious, they need to put twice the focus on the cause of head trauma and not recovery. High hits should be more than a 2 minute penalty and there is no reason a guy who causes a concussion on a dirty play should be sitting out a few games when the guy he hit could be out for weeks if not months!

https://twitter.com/CarBombBoom13/st...21013893287937

[CroFlames]

Originally Posted by GioforPM

Should a construction workers union advocate for less safety equipment based on a poll of uneducated construction workers? Or should it educate the workers on the dangers.

I don't think they actually have voted on stuff like this. And if they do, I think lots of players vote against their self-interest out of a macho thing. I think some players would be happier if they weren't given the choice.

I doubt its a macho thing and more of a performance-entertainment balance.



The smartest and safest thing to do is full face cagaes mandated for 100% of players. However, I bet 99% of players will argue it hinders performance (probably correct) and therefore they reject it.



Removing slap shots, using a softer puck, eliminating body checks and all stick-work will certainly improve safety but hinder entertainment.

[Scroopy Noopers]

I don’t understand why someone can’t have a preference to the way they do things, that has zero affect on others, without being accused of just trying to be macho. I don’t wear a visor when I play hockey because I don’t like it. Simple as that. I understand the risks but I like the wind in my face and the clear view of the ice. No one else should care.

[GioforPM]

Originally Posted by Scroopy Noopers

I don’t understand why someone can’t have a preference to the way they do things, that has zero affect on others, without being accused of just trying to be macho. I don’t wear a visor when I play hockey because I don’t like it. Simple as that. I understand the risks but I like the wind in my face and the clear view of the ice. No one else should care.

No one is accusing you of anything. I just know for a fact that some players don't want the blowback of playing tough or fighting while wearing a visor. Have you never seen a guy in a penalty box making a visor gesture at the other guy? I also know if those players were mandated to wear them, that would be seen as "not on them".

I also didn't wear a visor, until the day I got a stick in the eye.

[Inglewood Jack]

looks like Johan Franzen is also having a hell of a time trying to recover from his head injuries:

https://www.freep.com/story/sports/n...ife/649351002/

"To see the disappointment in their eyes when (they ask), 'Dad, why can't you play with us?' It breaks your heart," Franzen said. "For two months, not being able to pick up your kids, or play with your kids, for more than 2 minutes — it makes you think a little bit. I was in a really dark place, maybe not the first month because then you still think it's going to get better, but then when it doesn't get better, you kind of start wondering."

[cam_wmh]

The NFL’s poster asserts that repeated head trauma may lead to dementia and early onset of dementia. The poster also advises players that repeated concussions “can change your life and your family’s life forever.”

The NHL went in a different direction.


The posters are still displayed in locker rooms throughout the league
Posters hung in NHL locker rooms do not include the word “dementia.”

https://www.tsn.ca/nhl-lawyer-reques...ster-1.1097016

[speede5]

Originally Posted by Scroopy Noopers

I don’t understand why someone can’t have a preference to the way they do things, that has zero affect on others, without being accused of just trying to be macho. I don’t wear a visor when I play hockey because I don’t like it. Simple as that. I understand the risks but I like the wind in my face and the clear view of the ice. No one else should care.

If you want to play rec hockey without a visor that's your business, sort of. As soon as you lose an eye out health system has to support you, and the league you are playing in faces liability.

In the NHL, the owners are obligated to keep their employees safe, and they should be able to mandate the equipment required to do so, just like a construction company. Current concusion litigation proves the employers are responsible for their players well being.

There is a lot more on the line, and the union is the only reason visors and helmets have taken time to implement. It's absurd really, that the employee can dictate what safety equipment they can forego. But the NHLPA has influenced this in the past.

[GioforPM]

Originally Posted by speede5

If you want to play rec hockey without a visor that's your business, sort of. As soon as you lose an eye out health system has to support you, and the league you are playing in faces liability.

In the NHL, the owners are obligated to keep their employees safe, and they should be able to mandate the equipment required to do so, just like a construction company. Current concusion litigation proves the employers are responsible for their players well being.

There is a lot more on the line, and the union is the only reason visors and helmets have taken time to implement. It's absurd really, that the employee can dictate what safety equipment they can forego. But the NHLPA has influenced this in the past.

It's counterintuitive because unions usually have to fight for safer equipment, not oppose it. I suppose this union is different because in most workplaces the members don't stand to make more money by being recognizable and keeping their face uncovered (although the MAF experience in Vegas belies this) and don't actually try to hit each other as part of their job.

I still have to wonder how a player vote on, say, visors would go if it was a secret ballot. Right now I think player votes on these kind of things are just done by the player rep on each team, by show of hands.