HEAD CASES : With More Players Missing More Time Than Ever Before, Concussions Are a Part of the Game That Has NHL Walking on Eggshells

The news was not what he wanted to hear, so New York Islander right wing Brett Lindros went to another doctor, then to a third and a fourth, hoping to find some shred of hope.

Each time, the diagnosis was grim. The cumulative effects of a series of concussions put him at risk for permanent brain damage if he played hockey again.

Lindros couldn’t believe it. He knew he had experienced memory lapses, making plays and forgetting them before he returned to the bench. And he knew it took longer for the headaches to fade after he sustained his fourth concussion, his third in less than two NHL seasons. But he was only 20, young enough to still think he was invincible. His career was just beginning.

It ended last week, when he reluctantly announced his retirement.

“Each time I got the same answer from each doctor,” said Lindros, whose promise and pedigree--he’s the younger brother of Flyer star Eric Lindros--led the Islanders to trade up and pick him ninth in the 1994 entry draft. “No matter how much I hoped it would be different, it was the same.”

His teammate, defenseman Dennis Vaske, was luckier. Vaske, who was slammed into the boards from behind by King forward Eric Lacroix last Nov. 22 and suffered a concussion, was recently cleared to return next fall.

Despite sitting out most of the season and enduring “a real emotional roller coaster” of slow progress punctuated by frustrating relapses, Vaske said he would oppose any attempt by the NHL to set stricter safety standards for helmets in an effort to reduce the occurrence of head injuries.

“Isn’t that the American way, individual preference? Isn’t that in the Constitution?” Vaske said. “If they do come up with something better, from what I’ve gone through, I would consider it, but I don’t think it should be mandatory.”

The frequency of concussions this season has been alarming, even allowing for better diagnosis of such injuries. According to data compiled by a physiologist who tracks injuries for the NHL, players lost more than three times as many games to concussions through March as in the entire 1993-94 season, the last full season. Concussions increased from 41 that cost players 60 games in 1993-94 to more than 50 that resulted in 200 games missed this season. Injuries incurred in April haven’t been tallied.

Besides Lindros and Vaske, the most significant injury was suffered by King forward Tony Granato, whose career was jeopardized when he had surgery to stop bleeding deep in his brain from a congenital problem exacerbated by a concussion. In the last few years, Michel Goulet of the Chicago Blackhawks and the Kings’ Dave Taylor were forced to retire because they were unable to shake the headaches and vertigo caused by repeated concussions.

“When the doctor first asked me, I didn’t think I’d had that many,” said Taylor, who still can’t exercise as strenuously as he did before his last concussion, which he suffered in December, 1993. “But once I thought back and remembered how I’d felt, I figured I must have had eight or 10.”

Concussions used to be--and still may be--ignored by players and not reported because hockey’s macho code calls for stoicism after even the bloodiest injuries. Blows to the head are laughed off as “getting your bell rung.” It’s also common for clubs to hide injuries to keep opponents from exploiting those weaknesses. But there are too many head injuries to hide them anymore.

“You have to take into account evolution of your players and the increased speed and size,” said former NHL defenseman Doug Wilson, now coordinator of player relations and business development for the NHL Players Assn. “You also have to factor in that unlike when I played, players aren’t keeping their sticks down. There was a kind of unwritten code when there were a lot of guys who didn’t wear helmets. There’s a false sense of security now.

“There’s a lot of factors in the equation. You have to have data on why these things are happening. That’s one thing the league has not done. There have been some scary injuries the last few years.”

Brian Burke, the NHL’s director of hockey operations, said head injuries are “a small number of occurrences in terms of the total number of players in the league,” but acknowledged his concern. To him, the answer is simple.

“The primary line of defense is, we’ve got to get the proper headgear on all players in this league,” he said. That he didn’t wear a helmet when he played “does nothing but prove I was extremely stupid,” he said.

Although Burke preaches the virtues of safe helmets, the NHL in 1992 modified its mandatory helmet rule to allow players to play without helmets if they signed releases. None has done so. Craig MacTavish of the St. Louis Blues is the last bareheaded player in the NHL because of a grandfather clause in the helmet rule exempting players who joined the league in 1979 or before.

Not until this season did the NHL seek a comprehensive study of head injuries. Eventually, concussions will be analyzed according to how they occurred, the type of helmet the player was wearing and the thickness of the helmet’s protective liner, which is designed to reduce the impact of a collision.

“It’s one of those issues that for better or for worse have been put on the back burner for years, when you’re dealing with strikes and lockouts in a billion-dollar industry,” said Ken Baumgartner of the Mighty Ducks, a vice president of the NHLPA.

It’s a priority now. But the union and the NHL haven’t agreed on what should be done to protect players--or if anything should be done at all.

“It might take [a player’s death] in order for them to be cognizant there are a lot of things going on out there that are dangerous,” said Ed Tyburski, medical trainer for the New York Islanders.

“Hockey has changed so much the last few years, and it’s gotten to be very big and powerful as far as money goes. [Clubs] don’t want players to miss games when they’re paying them. That, plus an increased schedule, has an effect. Say we go from New York to Anaheim and the next night to San Jose. Traveling like that, physiologically you’re not as good the second night. It’s been proven. Your reaction time decreases. . . . It seems to be the minor concussions that do the most damage. Guys get hit and say, ‘I must have gotten my bell rung.’ But there’s a change in the chemical balance of the brain and a change in the metabolism and his reaction time, and he gets hurt again.”

The NHL proposed standards for all equipment during negotiations on the last collective bargaining agreement, but the union resisted. They resumed talks a few months ago, but the NHLPA said the league’s data didn’t pinpoint causes or link injuries to specific helmets or liners, so it couldn’t tell members to use different equipment.

“It becomes more than a safety issue. It becomes a liability issue, a contract-guarantee issue, a licensing issue, and for some players, an endorsement issue,” Baumgartner said. “There’s a wide variety of equipment available, and players have enjoyed the freedom of choice. As one player of 700, I didn’t want to mandate what everyone else had to do.”

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Helmets can’t prevent every head injury, but good helmets can cushion the impact of severe blows. However, many players’ helmets don’t meet standards set by the American Society for Testing and Materials or the Canadian Standards Assn. Also, players often reduce the effectiveness of approved helmets by removing part of the foam lining or loosening the chin strap.

“Players are bigger and stronger and hit much harder than ever before, but the rink is the same size,” said the ASTM’s president, Dr. Cosmo Castaldi. “We’ve got to make the helmet more protective.”

The ASTM writes standards for products ranging from concrete pipe to surgical implants; a subcommittee sets standards for sports equipment. The CSA determines performance standards for hockey helmets and develops methods for evaluating helmets.

Hockey helmets are intended to protect against multiple impacts, unlike bicycle or motorcycle helmets, which are meant to be discarded after a crash. On a descending scale, motorcycle helmets are the most protective, followed by football helmets, hockey helmets and bike helmets.

Standards for helmets used by NHL players were developed in the 1970s to prevent focal injuries to the head, such as subdural hematomas or brain contusions. The CSA standard says approved helmets with five-eighths of an inch of padding on each side of the head should protect the wearer from serious injury in collisions where the impact is less than 275gs, or 275 times the acceleration due to gravity. CSA and ASTM standards are nearly identical.

Players at the youth level in Canada must wear CSA-approved equipment, but its authority does not extend to the NHL. In the United States, the Hockey Equipment Certification Council takes the ASTM’s standards and tests equipment used at the youth level. Players in USA Hockey programs must wear HECC-certified helmets and full face protection up to age 18. The HECC has no jurisdiction over professional players.

“Helmets that are manufactured and approved to CSA standards have been doing a very good job of providing protection from serious head injuries,” said Dr. Patrick Bishop, chairman of the CSA and a professor of kinesiology and impact biomechanics at the University of Waterloo in Canada. “The difficulty has come in cases such as Michel Goulet, who was not wearing a CSA-approved helmet. Consequently, when he fell into the boards, he didn’t have nearly the protection that someone with an approved helmet would have had.”

Gretzky, Detroit’s Igor Larionov and New York Ranger defenseman Marty McSorley wear helmets similar to Goulet’s, made by the Swedish company JOFA. Castaldi said Gretzky’s helmet “is like a cereal box.” But it’s better than nothing, which Gretzky almost wore. He considered taking his helmet off in 1992 but decided that might set a bad example for children.

“Wayne is the first to say to youngsters, ‘Do as I say, don’t do as I do,’ ” said his agent, Mike Barnett. Gretzky has tried a more substantial helmet and “might make the switch,” Barnett said.

Baumgartner switched this season from a non-approved helmet to one that meets standards.

“I was lucky for 10 years,” he said. “The Goulet incident was one thing. And I have two young daughters who I want to be able to read stories to at bedtime.”

Vaske blamed the increase in head injuries on the NHL’s attempt to cut obstruction penalties. Wilson agreed, saying that when he played, his defense partner could create a moving pick and block opponents from hitting him. That might now draw an interference call.

“You can’t hold anybody up, and guys are getting bigger and stronger every year, so you get hit harder,” Vaske said. “They have to look at maybe making [better helmets] an option, but you’ve also got to look at what they’re doing to the parameters of the game.”

Burke disagrees with them about the effect of the obstruction directive but said the NHL wants to work with players to reduce head injuries, not argue with them. “We’re extending an olive branch, not a boxing glove,” Burke said.

That branch was extended too late for Brett Lindros. Will there be a remedy before other players’ careers are ended prematurely?

“I would like to see standardization, and I’d like to see them get rid of some of the helmets guys like Gretzky are using,” Tyburski said. “But you’ve got to remember, we’re working with a league that still allows people not to wear helmets at all. I don’t claim to understand it.”

Times staff writer Lisa Dillman contributed to this story.