Hockey is one of the hardest-hitting professional sports in the United States. It often feels like something is missing if a hockey game reaches its conclusion without at least one fight between opposing teams or someone in the penalty box for upending a rival player. Despite specialized padding and safety equipment, head injuries can be prevalent on the ice. How common are head injuries in the NHL, and what is the league doing to protect their athletes?

A Culture of Violence

While ice hockey isn’t the most dangerous sport when it comes to concussion frequency — that honor belongs to rugby and American football — it’s among the top five. Bare-knuckle boxing is part of the game’s culture, with enforcers from one team picking fights with enforcers from the other to energize their teammates and put on a show audiences will remember for years to come. You could make a name for yourself, like St. Louis Blues forward Todd Ewen did in one of his first games in 1987, by knocking an opposing enforcer out cold on the ice with a single punch.

Concussions are part of the game and an unfortunate result of full-contact sports, but they also may be part of the problem.

The Danger of CTE

CTE stands for chronic traumatic encephalopathy, a degenerative brain disorder researchers believe to result from repeated head trauma. Concussions damage a protein in the brain called tau. This damage kills the surrounding neurons, causing memory problems, changes in behavior and other neurological conditions.

Most of the research surrounding CTE focuses on football players. Research published in 2018 found that a whopping 110 out of the 111 former NFL players studied had CTE. All of these diagnoses come from brains donated to science after the player’s death. While concussions are nearly as common in hockey as they are in football, there aren’t enough brains to study to demonstrate a definitive connection between the sport and this sort of neurodegeneration.

Suppressing Important Research

In 2013, former NHL players filed a class-action lawsuit against the organization for failing to protect players from injuries that could lead to CTE, and not warning them of the potential dangers. The NHL settled the case for $19 billion in 2018. However, last year, the widow of former NHL enforcer Ewen, who committed suicide in 2015, sued the NHL, accusing them of dismissing the risks and ignoring the dangers of CTE.

Ewen is one of many diagnosed posthumously with CTE, but the NHL isn’t only ignoring the problem — they’re also actively working to pretend it doesn’t exist. During the case, the NHL brought in 19 highly paid expert witnesses to repeat under oath that there’s no link between head trauma and CTE — and even, in some cases, that CTE isn’t a genuine medical concern. The league’s lawyers argued that since Ewen killed himself, linking his death with CTE would scare other players into committing suicide out of fear. The NHL — and athletic culture overall — are going out of their way to suppress concussion research.

Preventing Head Injuries

The NHL and other professional sports aren’t going anywhere anytime soon, so what can players do to protect themselves and prevent head injuries while on the ice? When it comes to avoiding hockey-related concussions, it’s all about rules and equipment. Start by ensuring each player has a well-fitting helmet that’s in good condition. If it starts to wear out, it needs repairs or replacing

Make it a point to limit player contact during practices and scrimmages, and ensure everyone follows the rules and demonstrates good sportsmanship. The most significant changes must come from the top down. The NHL needs to start supporting its players and taking steps to prevent these severe head injuries. Instead of suppressing research into CTE in hockey players, the organization needs to fund studies and look after athletes to prevent these injuries from adversely affecting people who work all their lives to reach their sport’s highest levels.

The Future of the NHL

It’s too early to tell how these lawsuits will affect the NHL, but our guess is that not much will change. The league must advocate for player safety, protecting athletes from head injuries and offering support when those injuries inevitably become something more.