http://www.post-gazette.com/sports/
September 8, 2011
The Penguins provided an immense public service by making Sidney Crosby and his doctors available to the overheated media Wednesday as they along with Penguins general manager Ray Shero brought into sharp focus the neurological challenges overcome and still to be overcome by the world's best hockey player.
If nothing else, what was easily the most interesting news conference in the short history of the new arena made every last one of its eyewitnesses thankful they didn't have a concussion because even someone with moderate fogginess would have struggled to process this sudden burst of good information, particularly after such a long period of little or no or bad information.
At one point during the presentation, I think I had figured out that Sid was getting a Ferrari for Christmas, had been forced off a roller coaster due to a perfect storm, and that the remedy for vestibular perception deficit was generally a matter of making sure all the cows are in the barn.
Bottom line though -- Sid will be fine.
As to the question of when, well, right here we'll quote Dr. Michael Collins, director of the UPMC Sports Medicine Concussion Program.
"No earthly idea."
Thanks Mickey.
He'll be ready when he's ready is the plain truth of it and, having heard that from Dr. Collins and Dr. Ted Carrick, professor of clinical neurology at the Carrick Institute of Cape Canaveral, Fla., I'm hoping earnestly that we can stop hearing from the medical people who are way too willing to help the media speculate on something for which both are unqualified to comment.
"You can't comment on the degree of injury," said Carrick, "without having done a hands-on examination."
What a concept.
It was Carrick, by the way, who started the Christmas story.
"It's Christmas for Sidney Crosby and the people who care for him," Carrick said. "It's Christmas because it's a celebration. Our greatest direction is to ensure that Sid has a very fruitful and positive life, that he can do anything he wishes to do in hockey and after hockey. This is going to have a very good outcome.
"He's markedly stable. His progress is absolutely marvelous. The problem is that the length of time that he's had this aberrance has led him into patterns that he now has to break."
And that will happen ...
"In the next little while."
Uh-huh.
I'm no doctor, although I play one in the newspaper, but I'm pretty sure that the space between "no earthly idea" and "the next little while" is not inhabited by Oct. 6, the date Crosby's teammates open the 2011-12 NHL season.
"Sid is a Ferrari," Collins explained, drawing an analogy for the way Crosby's brain processes his singular capabilities relative to acceleration, turning, cornering, etc. The task of tuning that brain to Ferrari standards, apparently, is daunting and arduous.
But that didn't explain the cows.
"I'm not putting any timetable, and Sid is not putting any timetable, and the Penguins are not putting any timetable on when he'll play," said Collins. "It's a matter of making sure the cows are back in the barn."
At the end of the first week in January, in which he had absorbed the worst of thunderous perfect-storm collisions with Washington's David Steckel and Tampa Bay's Victor Hedman five days apart, Sid's cows were all over the place.
Asked to describe the worst of it, Crosby was typically understated.
"I didn't want like to drive," Sid said. "I'd turn on the radio and find I didn't want to listen to the radio."
Hmph, just like me.
"It's a roller coaster," he said of the changes in his condition and his reluctance to talk about it. "I'd have been telling you a different story every two days."
So, since he couldn't, we did it ourselves.
The number of people who've contributed completely ignorant updates on Crosby's condition since Jan. 6 from the fan base, the media, and most shockingly, the medical community, is truly embarrassing.
"I knew we were in for a long recovery," Collins said. "It's a manageable injury. I anticipate him returning to hockey and playing well in the future."
But the future is not now. The cows are headed toward the barn, but some are slower than others, and a few probably didn't even watch the news conference. All that explained, the bluntest questions still had to be asked.
Did he ever consider retirement?
No.
Did he think he'd never play again?
No (but isn't that sort of the same thing?)
Fortunately, we stopped short of asking Sid whether he would draft Sid for Sid's fantasy team.
The best attempt at gaining the targeted clarity likely came when someone asked Sid if he'd guess as to whether he is likely to play this season or unlikely to play this season.
"Likely," Sid said.
Do I think he's correct?
No earthly idea.
That sounds right.
Gene Collier: gcollier@post-gazette.com. More articles by this author
Related:
Crosby making progress; return unknown -
http://www.post-gazette.com/pg/11251/1172979-61.stm
Crosby speaks up
By Bruce Arthur
National Post
http://www.nationalpost.com/
September 8, 2011
Sidney Crosby will not retire, though he intimated the thought did at least flit across his mind. When asked Wednesday if there was a chance he would never play again, Crosby said, "A pretty slight one. I wouldn't bet on it." When his doctors were asked if the Pittsburgh Penguins star would make a full recovery from the concussions which have sidelined him since early January, they almost made it sound as if he would return better than ever.
It all seemed very encouraging, given the vacuum of information that has swirled around the 24-year-old Crosby all year. Still, he is "not even close" to being cleared for contact; no timeline for a complete recovery exists. It sure could be better, even if it could have been worse.
But on the day Crosby broke his four-month silence, he also found his voice in a way he rarely has before. Crosby took his first media training classes at 14; he is careful, when he speaks. In March he had expressed cautious support for banning targeted hits to the head, but said he was not sure about accidental contact. He seems sure now.
"I think as a league, as a union, everyone, we've all educated ourselves a lot over the last six, seven months, and really looked at this," Crosby said at a news conference in Pittsburgh. "I think we can go further. At the end of the day, I don't think there's a reason not to take [hits to the head] out. I read a stat that there [were] 50,000 hits a year, and we're talking about 50, maybe, that are headshots. And to take those out, the game's not going to change.
"As players we're professionals, and the odd time maybe there's accidental contact, but for the most part we can control what goes on out there. For sure it's a fast game, but we've got to be responsible too, and if a guy's got to be responsible with his stick, why shouldn't he be responsible with the rest of his body when he's going to hit someone?
"Whether it's accidental or not accidental, you've got to be responsible out there, and like I said, at the end of the day, it could do a lot more good than what it's going to take away from the game."
It is not a new idea; it is not even a truly radical idea. But for Sidney Crosby to say that any contact to the head needs to be penalized, that players who hit others must be responsible for their actions, that the benefits would outweigh anything that would be lost - that is significant.
Of course, Henrik Sedin essentially said the same thing in March, and he has won as many Hart Trophies as Crosby. The kid from Cole Harbour, N.S., however, is the face of the game. This should resonate. Of course, it shouldn't take Sidney Crosby to shame the National Hockey League into doing as much as it can to protect its players, but here we are.
The best news, of course, is that Crosby will be around to make his voice heard. He said Wednesday he "didn't give a whole lot of thought" to retirement; he talked about the early symptoms, when he could not even stand watching video with the team a month after the injury. He was adamant that he would not play again until he is considered 100%.
On a day where hockey suffered its greatest single loss of life in professional history - the Yaroslavl Lokomotiv plane crash, which killed at least 43, wiping out an entire KHL team - Crosby's health was put into a sort of perspective. Which is not to say it was not important; just not tragic.
"The prognosis, first of all, is excellent that Sid will not have any long-term effects from this injury," said Dr. Michael Collins, a concussion specialist from the University of Pittsburgh Medical Center. "In fact, I'm supremely confident in that issue. The return to play issue I think is equally positive, and we'll get there. But we're not there yet."
Both Dr. Collins and Dr. Ted Carrick said Crosby did not appear to be at increased risk for further concussions when he does return; Carrick said, "It's Christmas, I think, for Sid Crosby and for people who care for him."
The doctors described how they had to retrain Crosby's sense of place, which is among the attributes governed by the vestibular system in the brain, which apparently took the brunt of Crosby's concussions. As Collins said, "Sid is a Ferrari. His vestibular system is better than anyone else's. That's why he's the most elite hockey player in the world . That system is why Sid is who he is."
Carrick described how Crosby's system was essentially knocked offline; in addition to typical post-concussion symptoms, he lost his ability to ascertain his place in relation to other things, and theirs to him. His socalled mental grid, so sharp before - the system that allowed him to judge the puck, the boards, other players, the ice, everything, all at the highest possible speeds - became imprecise.
"[Treatment] basically allowed us to build him a new grid," Carrick said. "We can change the representation of body parts and environment in the brain. We can do that pretty successfully. And Sid did very, very well . That is to say, where his right hand is perceived to be is where his right hand is. Where his right leg is perceived to be is where his right leg is . The function that we have between the head, the eyes, his neck, his spine is really absolutely marvellous."
If it sounded like they were reprogramming his brain, it is because they were. Carrick said Crosby's challenge now, in addition to progressing past the headaches that surfaced when he reached 90% exertion in August, is to get used to his new mental grid.
This sounds daunting; Crosby was wired to be the best hockey player on Earth, in a game measured by slivers of a second; retraining that mind to be better sounds like an almost impossible task, to laymen and some other neurologists alike. Concussion specialist Dr. Michael Cusimano of St. Michael's Hospital told CTV News that "I think it's unlikely he will ever have a full recovery and be exactly the same as he was before if the symptoms have lasted this long." Dr. Charles Tator sounded as though he had his doubts, too.
But as always, nobody truly knows. So now we wait. We wait to see what Sidney Crosby will do, and whether his marvellous brain will ever be as good as it was before. And we wait to see whether the NHL, having come this close to losing the greatest player of his generation, will listen to him.
ANATOMY OF A CONCUSSION
Michael Collins, the doctor treating Crosby, said the 24-year-old NHL star suffered an injury that affected motion and spacial judgment, such a blow being among the hardest to recover from among concussions.
1 Initial impact.
2 A shockwave passes through the brain and bounces back off the skull. The concussion usually occurs at the opposite side from the point of impact. In severe concussions, the brain twists as it rebounds.
3 The impact can cause bruising of the brain, tearing of blood vessels and nerve damage. In a severe concussion, the brain swells, putting pressure on the brain stem - which controls breathing and other basic life functions.
ROOM TO MOVE
The brain does not sit snugly in the skull. There is fluid-filled space between the two, therefore the skull and brain do not necessarily move in tandem.
When the head starts or stops moving suddenly ... ... the brain compresses into the skull ... ... and compresses again when it rebounds.
barthur@nationalpost.com
twitter.com/bruce_arthur
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