Thank you, honourable members. I appreciate your invitation to be here to discuss the important matter of concussion in sports. Recognizing that my time for remarks is limited, the NHL is also providing a written submission to the subcommittee today that contains further details with regard to the matters I'm about to discuss.
For over 26 years, I've had the privilege of serving as the commissioner of the National Hockey League. NHL hockey, as you all know, is played in an enclosed environment at high speeds by players of different heights, weights and skills. By its very nature, professional hockey is a collision sport and contact is sometimes unavoidable. In some circumstances, injuries, including concussions, may inevitably occur. Consequently, during my tenure as commissioner, the health and safety of NHL players has been a top priority for the league, its member clubs and the players' association. In fact, the NHL has pioneered a number of player safety initiatives that have served as a model for other sports entities.
For example, since 1977 the NHL and the NHLPA have had mandatory league-wide neuropsychological baseline testing as part of its concussion program. This was the first program of its kind in professional sports. The NHL was also the first professional sports league, in any sport, to adopt league-wide electronic medical record systems for tracking player injuries, and the first to create a department of player safety, which, among other things, monitors games and assesses player compliance with NHL playing rules. Over the years, we have built on this work by remaining current with medical and scientific developments regarding concussions, and have fostered a culture in our sport in which players, teams and their respective medical staffs work co-operatively to manage these injuries.
Today I will describe for you the current landscape in the NHL related to concussion management. For additional specifics, please refer to our written submission. The NHL has already shared extensive information regarding this topic with representatives of all levels of hockey. We have organized collaborative summits. They were organized, sponsored and hosted by the NHL. We conducted them in 2018 and 2019. In addition, the NHL participated in conferences with other so-called collision sports leagues and governing bodies from all over the world in 2017 and 2018, which were organized as forums to share best practices regarding concussion management and to align on data collection and research to aid in that effort.
For obvious reasons, not all initiatives undertaken at the NHL level will be applicable or appropriate at other levels of hockey or for other sports. Nevertheless, I am pleased to share our practices and approach, and to provide you with information that I hope may help this subcommittee fulfill its mandate. The NHL's policies and procedures relating to head injuries are set forth in a comprehensive concussion protocol that was first codified in 2010 and has been updated regularly. The concussion protocol addresses the provisions of education to players, on-ice officials, athletic therapists and trainers, and club medical staff. It requires baseline testing for all players, sets forth the procedures surrounding the identification and evaluation of possible concussions, and establishes the process for diagnosis, management and return to play following a concussion. Our clubs are committed to compliance with the protocol and actively support and follow it.
The first step under the concussion protocol is ensuring that adequate efforts are being made to identify potential concussions. To that end, the protocol includes a list of, quote, “visible signs” of potential concussions, and authorizes and directs various parties to remove a player from play if one or more of these visible signs are detected. For example, there are two league-appointed individuals who watch each NHL game with the sole job of identifying players who exhibit visible signs of possible concussion—a central league spotter and an in-arena league spotter.
The protocol also tasks each club with the responsibility to identify and remove players who exhibit visible signs, for an acute evaluation for possible concussion. On-ice officials are also instructed to remove players for evaluation if they observe players who exhibit visible signs of possible concussion. The ultimate result of our protocol as designed and executed is a multi-layered system that is intended to ensure the removal of players from the game for evaluation as soon as possible.
Ultimately, all concussion diagnoses must be made through an individualized assessment drawing on the clinical expertise of club medical staff, following administration of a standardized concussion assessment tool that reflects the latest consensus in the international community of concussion experts.
While the NHL is fortunate to rely on highly qualified medical professionals and benefits from the use of a standardized concussion assessment tool, input from the player remains a critical factor in concussion evaluation and diagnosis. To this end, players are provided with extensive education by the NHL and the NHLPA on the identification of symptoms and the importance of promptly and accurately alerting club medical personnel if they are experiencing any symptoms of possible concussion.
Once a player has been diagnosed with a concussion, the protocol establishes specific criteria that must be met before a club physician can clear a player to return to play.
One, we require that there be a complete recovery of concussion-related symptoms at rest.
Two, we require that there be no emergence of concussion-related symptoms at exertion levels that are required for competitive play and that a graded return to play progression be completed.
Three, we require that the player be judged to have returned to his neurological baseline by the club physician, and to a neurocognitive baseline following an evaluation by a club consulting neuropsychologist.
The protocol does not permit a player who has been diagnosed with a concussion to return to practice or a game on the same day that the event occurred, irrespective of how quickly his symptoms resolve. This reflects the current approach set forth in the “Consensus statement on concussion in sport” as promulgated at the most recent international conference on concussion in sport, which was held in Berlin in 2016.
The NHL's baseline testing program plays a critical role in the return-to-play decision and is worth highlighting here. Under the protocol, each player undergoes pre-season neuropsychological testing to establish a baseline score, which is compared to a player's score on an identical battery of tests administered during the player's recovery process. If a player has not returned to his cognitive baseline, he will not be cleared to return to play under the protocol.
Turning next to building awareness and providing education, which is a central component of our protocol, it is a required element of the protocol that education is provided to all relevant members of the NHL community on the identification, diagnosis and management of concussions, emphasizing the importance of taking this injury seriously.
As others have noted, hockey players are fiercely competitive and often instinctively want to return to play as soon as possible, regardless of whether they have fully recovered from injury. Accordingly, the NHL and the NHLPA have developed a number of educational initiatives to inform players about the common signs and symptoms of a possible concussion; the importance of reporting symptoms to medical experts; what to expect once a player is diagnosed with a concussion; what players can do to assist in their recovery from concussion; and the scientific debate regarding the possibility of long-term consequences of concussion.
Our education program to players is robust, and it starts on the first morning of training camp each season. Clubs are required to begin with a meeting where players and club medical personnel watch and discuss an educational video on concussions. The protocol's education program continues at multiple intervals throughout the season and is provided to players, and in some cases their families, using many mediums, such as posters, videos, direct presentations and brochures.
Our education efforts are not limited to the players. We provide common messaging on our protocol to all important stakeholders at each club and to the NHL's on-ice officials. Club management, coaches and on-ice officials all watch the same video that the players view at the beginning of training camp. In addition, NHL on-ice officials receive in-person education and training on the protocol prior to each season and the league provides regular concussion program updates and education to general managers, coaches and the NHL board of governors.
With regard to educating the broader hockey community outside of the NHL, our league has played a leadership role in organizing, sponsoring and hosting hockey safety summits in each of 2018 and 2019, with representation from and participation by decision-makers at all levels of amateur, collegiate and professional hockey. These summits have facilitated the important exchange of information regarding best practices and key learning from each group on safety-related initiatives, including concussion-related matters. As already noted, the NHL has also participated in international collision sports conferences in each of 2017 and 2018, and we will be the host of the 2019 conference. The 2017 conference focused on each league's implementation of the Berlin consensus statement.
In addition, the NHL and the NHLPA are currently producing a concussion education video that is being specifically crafted for the larger hockey community, which we anticipate distributing later this year. In past years, the NHL and the NHLPA have contributed to a number of other videos illustrating the potential dangers of concussions and recommending the best ways to play the game of hockey safely. In those efforts we have worked with two individuals who have already testified before this committee, Dr. Charles Tator and Eric Lindros.
The NHL has also contributed to the scientific literature addressing concussions through numerous articles published by expert members of the NHL and NHLPA concussion subcommittee.
I would also like to highlight several of the concrete steps the NHL and the NHLPA have adopted to make NHL hockey safer for our players. The NHL and the NHLPA have taken a collaborative and proactive approach to achieve this critical goal and will continue to do so moving forward.
With regard to our playing rules, the NHL and the NHLPA have worked diligently to adopt changes to the game that reduce the incidence of concussions while working to preserve the essential physical nature of our sport.
One such rule that the NHL and the NHLPA have adopted is rule 48, which prohibits all hits to an opponent's head where the head was the main point of contact and such contact was avoidable. Since implementing rule 48, there has been a demonstrable drop in the percentage of concussions resulting from body checks involving head contact.
There are some individuals who have called for a blanket rule prohibiting all hits that result in head contact, whether intentional or accidental, including some who have testified before this subcommittee. Such a rule is very easy to propose but is difficult, if not impossible, to implement and apply in practice. The prevailing view of stakeholders associated with rules development in the NHL, including the NHLPA with whom any such rule would need to be negotiated and agreed to, is that it would not be possible to consistently and fairly enforce a rule that prohibits head contact of any kind or nature if the NHL is to be maintained as a physical contact sport.
That view has informed our approach and while we will continue to monitor and evaluate this important issue, as we do with respect to all issues concerning player health and safety, we believe that the current iteration of rule 48 strikes the correct balance for NHL hockey.
Enforcement of playing rules through supplemental discipline further promotes player safety and represents an important deterrent to player conduct that is inconsistent with the physical contact permitted in NHL hockey. The NHL department of player safety monitors every game and assesses every hit to ensure adherence with the league's standards for safety. When those standards are violated, the department issues supplemental discipline, which can include significant player suspensions and/or fines.
Before I wrap up, I would like to address the issue of fighting, which has been brought up before this subcommittee and has been a topic of public debate for decades, and well before I became commissioner.
Fights in the modern game are at an all-time low. Eighty-five per cent of regular season games are fight free, which is the highest percentage of fight-free games since the 1964-65 season.
That said, many involved in our game, including numerous players and the NHLPA, continue to adhere to the belief that fighting, while penalized—or, more specifically, the threat of fighting—actually deters and reduces the incidence of other types of dangerous and potentially injurious play. Moreover, many current and former NHL players have stated that the threat of fights helps protect the most highly skilled players from being inappropriately targeted.
With respect to concerns about fighting, and concussions specifically, it is worth noting that relatively few concussions result from fighting. For example, based on video analysis of our games, there have been an average of 2.6 diagnosed concussions per season over the last five seasons that were arguably caused by a player's participation in a fight with an opponent.
Mr. Chair, I know that your subcommittee has focused on concussions among younger athletes in youth hockey. Through our research, educational videos and hockey summits, the NHL is committed to sharing best practices with all hockey organizations, but I understand and agree that not everything done at the NHL level should apply to younger non-professional players.
Our players like the way the NHL game is played and understand the implications of playing a physical contact sport at the highest professional level in the world. Hockey organizations at each level of the sport must make appropriate rule-making decisions for themselves and their constituents and, as I mentioned, we firmly believe our rules are appropriate at the NHL level.
In conclusion, the NHL and the NHLPA have worked collaboratively to change the culture of the game in a positive way. On a nightly basis, we see examples of players making the extra effort to avoid dangerous plays and unnecessary contact. This cultural shift in the game has resulted from an increased awareness of the seriousness of concussions, appropriate diagnosis and management of concussions and greater player willingness to report symptoms and seek out medical care.
The NHL and its member clubs, together with the NHLPA, will continue to work together to address all aspects of game safety while remaining committed to preserving the core elements of our sport. At the same time, we will continue our work with hockey organizations at all levels to assist with their best practices and awareness campaigns.
Mr. Chair, I want to thank you and the honourable members for your time, and I look forward to answering your questions.
Five minutes? Okay, you'll give me a little bit of a warning before we get to the end.
On your question about the officials, as I indicated in my statement, we educate the officials to, among other things, look for visible signs of concussion. An official can cause the removal of a player from the game if he doesn't like what he sees. I think that's an important buy-in in terms of what takes place. They're on the ice and they may conceivably have the best view of what happened.
The officials are charged with enforcing the rules. They are regularly instructed on rule compliance. They are given coaching videos on a regular basis in terms of how the game should be called, what's legal and what isn't legal.
When we talk about the essential elements of the game, bodychecking—physical contact—is something that's part of the game and has been forever. It's something that makes the game exciting, appealing and entertaining. It's something that our players think is an important element of the game as well.
What we have learned is that whether or not it's ultimately concluded that a concussion leads to something else down the road—whether it's one concussion or 20 concussions—we can all agree that it's better if players are not concussed. There's no question about that.
Rule 48 has reduced, I believe, the incidence of concussions from head hits from 61% to 40%, so there has been a dramatic decline in the percentage of concussions caused by contact with the head. There are rules against hitting from behind. There are rules against elbowing. There are rules against cross-checking and high-sticking.
It's all part of a pattern of trying to keep the game as safe as possible. We've also changed equipment, reduced the size of shoulder pads and elbow pads. We've softened the environment to get rid of tempered glass and replace it with Plexiglas. We've required players—with the agreement of the players' association on all rule changes—to put on visors. We do a video analysis of injuries, including concussions, every year to see what's causing injuries and what adjustments have to be made. It's too easy to make blanket statements about changing a rule when in fact the rule that you're changing may not be addressing where the injuries are being caused.
We have the educational videos, and as importantly, we have the department of player safety, which is evaluating every hit. When there's a hit that is not appropriate, that transcends the rule, players get suspended for sometimes long periods of time, costing them potentially hundreds of thousands of dollars. All of this is part of a mosaic, if you will, that gets everybody—the constituents—to buy in and creates a framework and a culture that encourage safer play in a game that is inherently physical.
How am I doing on time, Mr. Chairman?