Grange on Leafs: Tuning out the C-word

Joffrey Lupul was not in attendance at Toronto Maple Leafs' practice on Wednesday.

Joffrey Lupul’s day was a short one.

The Toronto forward came out on the ice early for the Maple Leafs’ game-day skate at the Air Canada Centre, skated a few gentle laps, lined up for some shooting drills and that was it.

After about 15 minutes he glided over to the Leafs bench and disappeared up the tunnel. Lupul would miss his second straight game, Leafs head coach Randy Carlyle announced later without acknowledging it was because he had suffered a concussion.

Like all of us, Lupul is now officially day-to-day.

The question of course, is why?

Why so vague? Why so evasive? Why is one of the most visible pulpits in hockey — head coach of the Toronto Maple Leafs — the place where an informed discussion of concussion and its significance for the sport falls on deaf ears?

Once again the Leafs, with Carlyle as spokesman, refused to give name to the condition that has kept Lupul out of the lineup since he was pinballed in the corner by a pair of Philadelphia Flyers, his head whiplashing into the hard-shell shoulder pad of former teammate Jay Rosehill in the opening moments of the Leafs’ 5-3 loss.

From there Lupul staggered to the bench, unable, once he got there, to find the door to get off the ice. Once that problem was solved he required help to get to the Leafs dressing room.

It was obvious to anyone — medical experts and laymen alike — watching that Lupul had suffered some kind of trauma to his brain, or a concussion.

But with the hockey world watching the Leafs prefer to cover their ears and sing the alphabet at the top of their lungs.

Worse, on Thursday night Carlyle suggested Lupul had a 50-50 chance of practising on Friday. On Friday he wasn’t yet ruling him out for their game in New Jersey Saturday and on Monday, by having Lupul on the ice for the skate, there was the implication he was in the mix for being in the lineup against the New York Rangers Monday night.

All of which might be a reasonable approach for a strained knee or tender groin. But with the ultimate soft tissue injury there is really only one path, according to world leading experts in the field, and holding out the possibility of playing a few days after a concussion is not it.

“That’s against the general principles of the management of concussion,” said Dr. Charles Tator, project director of the Canadian Sports Concussion Project at the Krembil Neuroscience Centre, Toronto Western Hospital. “Once someone has had a concussion, the earliest they should come back is one week. There are six steps in the return-to-play process and each step should have 24 hours between so under the best circumstances they should be out a week. And for children and youth should at least double that.

“But we often see the pros not adhere to the international conventions on concussion management. If they let him come back early it’s against common medical advice in 2013.”

Why the Leafs won’t even say the C-word is another question all together. But in dancing around the subject — part of an organizational bad habit that predates Carlyle — they come off sounding like they’re in denial.

“You’re the one who likes that word, so you diagnose as you want on him,” Carlyle said when asked if Lupul had a concussion. “We’ve said he’s day-to-day and that’s basically it.

“Lupul skated beforehand and he’s now listed day-to-day. That’s basically all I have on him.”

The Leafs have to improve their message. Other teams have. In Pittsburgh — thrust to the forefront on the issue due to the experience they’ve had with Sidney Crosby — head coach Dan Bylsma can say concussion and has yet to melt. The Penguins seem to have done fine on the ice, too.

For example, on Friday the Penguins’ James Neal was elbowed in the head and left the game.

On Monday Bylsma’s message was plain and to the point: “James Neal has a concussion and will miss the (three-game road) trip,” he said.

Imagine that.

The Leafs have a duty to do better than they are doing on this issue, whether they choose to embrace it is another issue.

For one thing they cultivate a fan base in the heart of the largest minor hockey market in the world. There’s not a game that goes by that the Leafs aren’t reaching out as an organization to young hockey players and minor hockey associations.

Hey kids, just don’t ask about the brain injuries, okay?

There’s also the possibility of litigation, though it might be a remote one. The NFL is facing a battery of class-action suits in part because of allegations that the league actively suppressed the significance of brain trauma. There is no evidence the NHL has ever actively minimized concussion as a risk to players.

But individual teams? That’s a different story. One theory about why teams don’t like using the C-word is that it invokes a formal protocol for dealing with concussions that requires players to be symptom-free for seven days. If you don’t call it a concussion and the player is feeling good after five days and there’s a big game that night …

“Trying to avoid the reality is not good for anyone,” says Paul Anderson, a lawyer based in St. Louis and an expert in the class-action litigation facing the NFL. “If they’re not going to say anything about it there’s logical inference that they might try to step around it and say ‘okay he didn’t have a concussion’ and allowed him to go back in.”

“(And) if a coach or a doctor or an athletic trainer didn’t abide by the concussion protocol and allowed a guy to return too early and the guy was subsequently injured, yeah, that might be grounds for a lawsuit.”

Last season the Leafs benefitted when Mikhail Grabovski kept playing after being evidently dazed on a hit in a game against the Boston Bruins. That he came back and scored the game-winner means nothing — NHL history is full of examples of players who could perform after concussion; it’s what happens after that that’s the problem.

If concussion wasn’t such a dirty word around the team would James Reimer have convinced himself he was fit to play last season? Would the team not have been better off if he hadn’t? Would Colby Armstrong have tried to lie about his condition last season if the team was so strange about how they talked about concussion?

No one knows.

And for all we know the Leafs are at the absolute forefront of concussion identification, treatment and prevention.

But everyone remains in the dark because they can’t even get the words out.