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Pittsburgh Penguins' Matt Cooke (24) plays against the Boston Bruins in the third period of an NHL hockey game in Pittsburgh, Sunday, March 7, 2010. The Penguins won 2-1. Cooke injured Boston Bruins' Marc Savard on a blindside hit in the third period.Keith Srakocic

When it comes to the NHL's efforts to reduce concussions and eliminate head shots, there really is just one target, according to the league's director of hockey operations.

"It's not hits to the head, it's shoulder [hits]to the head," Colin Campbell said Monday after the first day of the annual general managers' meetings. "We've taken everything else out. Now, the question really is: Do you want to take shoulder hits to the head out of hockey?"

Campbell's point was all other forms of illegal contact with a player's head are covered by NHL rules. The latest controversial hit, for example, was subject to the rule banning players from using an elbow to make a hit - even though Matt Cooke of the Pittsburgh Penguins was not penalized for using his elbow to leave Marc Savard of the Boston Bruins with a concussion last Sunday.

At present, a body check using the shoulder is legal in most circumstances. The problem is many of the worst hits to the head seen by the league GMs in video presentations are the result of a shoulder check.

An NHL spokesman said part of the report presented to the GMs yesterday involved a study of 21 games earlier this season. All kinds of contact with players' heads were recorded, from light blows to hard checks. The average number of contacts with the head was 22 per game - 30 per cent of them were from the shoulder to the head. Of those 22, only an average of one per game resulted in a penalty.

Those kinds of numbers are why many GMs argue that eliminating head shots without taking too much hitting out of the game is difficult. "The hits are great until someone gets hurt," Campbell said.

At least one GM vowed it will not be done because of outside pressure.

"I don't want to hurt your feelings, but I don't care what sports writers think," said Brian Burke of the Toronto Maple Leafs. "The public pressure, the media pressure, should never be a factor in how you address the game."

There was a sense yesterday in talking to some GMs and NHL staff that they were feeling defensive about public criticism over the handling of the issue.

"Everybody should realize we are not dealing in a vacuum," Nashville Predators GM David Poile said. "We do not have our heads in the sand.

"There will be steps to reducing head injuries in the National Hockey League. I think we will definitely make progress. Some people think this just happened recently. We want to make it clear we have been talking about this for the last 20 years. It's a tough area to get an agreement on."

Burke, and several of his peers, argued the league has managed to eliminate most of the nasty stick work - which had been a high-profile issue in the past - through the supplementary discipline of suspensions.

"We can do the same thing with blindside hits [to the head]if we're careful how we add it," the Leafs GM said.

Suring yesterday's session, the entire group of 30 general managers heard a report from the league's hockey operations department on concussions and head shots, and an update on an ongoing study by an NHL committee chaired by Calgary-based concussion expert Dr. Winne Meeuwisse.

Meeuwisse and his colleagues showed some video footage of players suffering 200 concussions over the last three and a half years, and told the GMs about treatment protocols and testing.

Meeuwisse said the study showed concussions happen in every area of the ice surface and from all forms of contact (shoulders, elbows, sticks) with the head. The only identifiable trend, the doctor said, was "defensive players were injured more in the defensive zone than offensive players."

Today, a working group of eight GMs will study the issues in greater depth and make a report to the rest of their colleagues, likely tomorrow. Any recommendations for rule changes or new rules are expected tomorrow, and would have to go through the NHL's competition committee and then the League governors for approval.

As part of the presentation, the GMs were told that, in one NHL season, there are between 60,000 and 70,000 contacts between players that are classified as hits. Of those, about 20 are considered serious head shots, mostly from the blindside.

"We have to be very careful," New Jersey Devils GM Lou Lamoriello said. "This is a physical game."

Meeuwisse said the physical nature of hockey means there will always be concussions.

"I don't think we can eliminate concussions completely," he said. "What we have to do is make them a small fraction [of the current numbers]"

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