‘Play through it’ mentality diminished amid concussion research

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It took a while, Donald Fehr admits, but he says is now a true "hockey person."

The 66-year-old Kansas-born lawyer will never be a hockey trivia expert or even a beer-leaguer, but entering his fifth year as executive director of the NHL Players' Association he can now claim a deep appreciation for the speed and beauty of hockey – as well as the dangers inherent in large, strong, fit men hurtling about the ice on knife blades.

"When you watch what they do," Fehr says, "with that combination of speed, power, constant exertion level and the 360-degree environment in which they play, I don't know anything that is remotely comparable."

Before taking over the NHLPA, Fehr spent a quarter of a century as executive director of the Major League Baseball Players Association. He's well used to taking tough stands, having successfully taken on baseball owners for colluding against the players and being the only union head to have led players through work stoppages in two major sports.

Hockey now has labour peace, but there continues to be a major work-safety issue that involves concussions and the long-term effect of blows to the head that have led to multiple early retirements and current lawsuits from former players seeking redress.

"Hits to the head and hits that cause rotational movement to the head are obviously things to which you have to pay attention to," Fehr told The Globe and Mail this week. "There's a lot of effort being put into that and it will continue."

The NHLPA's executive director did not play the game, but he knows that in any sport played at such speed on a hard surface and contained by a hard enclosure is going to have injuries that exist apart from any rule book.

"Intentional hits to the head are already [banned]," he says. "I'm not sure how it is that you would go about eliminating things that are not intentional. That's part of the problem. You don't want to eliminate contact. You don't want to eliminate players in close proximity to one another. We are going to have boards and so on. So we have to make whatever efforts are reasonable and consistent with what the players want, because they are the ones on the line."

There is much talk in all hockey circles – NHL, players' association, Hockey Canada – about how the game can find that perfect spot where rules and enforcement give maximum safety yet leave intact the game players wish to play and fans want to watch.

"When I got here," Fehr says, "there was more of an attitude of 'you play through it.' At least in the concussion area I think that has diminished substantially. That's really a positive thing."

The NHLPA's objective, he says, is to minimize the risk of such injuries and also to enhance the treatment both in terms of quality and speed. Players now have the right to request a second opinion. The players' union also keeps two qualified physicians, one a neuroscientist, on call to advise players and to meet with the teams to discuss symptoms and treatment.

"Everybody wants to provide the best care for the players, which is both diagnosis and treatment," he says, "[so] you have to pay attention to advances in the field.

"The caution I have in terms of staying up with the science is that there tends to be from time to time a lot of publicity about some new study, some new report, some new advance, and where those become replicated and where it looks like the study is sound, that's good.

"But until that happens you have to go through the process of evaluation."

The authors of the academic paper on the cost of concussion injuries to the NHL and players have suggested that all potential concussions be seen by an "independent" physician rather than a team doctor who might feel pressure from both the employer and the player to allow him back into the game more quickly than might be wise.

Fehr is quick to defend team physicians who, he believes, have the player's health as the proper priority. But, he adds, there is a certain merit to independent physicians, as is the practice of some other sports.

"Could I ever envision a point in time coming in which there would be always be independent physicians present?" he asks. It would have to be in practices as well as games, he cautions, as accidents often happen during practice, but "if circumstances appeared to require it we would have little hesitancy in suggesting it."

Head injuries are, and will remain, a serious issue in hockey, Fehr knows, but he does believe he has seen some progress in the more than four years during which he has headed the players' association.

"The thing that strikes me as the most positive in terms of the players," he says, "is that they are much more willing when there are symptoms of an actual or a potential concussion, or when they have issues recovering, to insist that they get the right treatment, exercise their right to a second opinion, and do not push to come back before they are ready to come back.

"They seem to be much more aware."