TORONTO -- With NHL training camps starting this weekend, the issue of concussions is front and center for a group of doctors, researchers and players who want to educate the public about the potential long-term effects of the brain injury.
A meeting being held Saturday at Toronto's St. Michael's Hospital will also look at the situations under which concussions occur and how they can be prevented, with a focus on teaching young players about the dangers of head trauma and how to better protect themselves.
"There's still an attitude out there that brain injury is like a broken arm," said neurosurgeon Dr. Michael Cusimano, who helped organize the conference.
"We take our brains for granted, and we need to have people realize that you can't take your brain for granted."
Michael Hutchison, a postdoctoral fellow in injury prevention at St. Michael's, will present findings from a study of almost 200 concussions that occurred among NHL players from the start of the 2007 season to midseason 2010.
By analyzing video clips of incidents that led to those brain injuries, Hutchison found that most are caused by direct hits to the head involving actions by other players -- predominantly head shots with a shoulder, elbow or gloves. About one in 10 were the result of fights.
The study also showed that forwards incurred more concussions than defensemen and goalies, likely because there are more of them on the ice and "because they have the puck more often," he said, noting that brain-rattling blows often occurred during breakaways or a rush to the net.
He found that concussion-causing checks taken by forwards could take place anywhere on the rink.
"They were not all violent activities at center ice. They occurred in many places around the ice -- in the middle, along the boards."
Defensemen, however, were "more likely to get injured in the defensive zone, which would make logical sense because that's most often the point where they have the puck," he said.
The research also showed that more concussions were sustained in the first period than the other two periods, a finding that Hutchison said is contrary to other hockey-related injuries, which tend to occur the longer play goes on.
"Generally athletic injuries have been thought to be sustained later on in the game when people are tired and fatigued," he said. "And this was a situation where most of the concussions occurred in the first period."
Hutchison, who coaches minor hockey and is an assistant coach for the University of Toronto's varsity men's hockey team, also found there weren't a lot of penalties called on the NHL hits that caused concussions.
"So there weren't any repercussions on the ice at the time for actions resulting in concussions. So there was a possibility that if a rule were to be put in place, that behavior would likely go down."
Conference speaker Rob Zamuner, a player representative for the NHL Players' Association, said concussions in the sport have become a hot topic -- and that's a good thing, resulting in rule changes by the league aimed at preventing the brain injury.
"It's a serious issue," said Zamuner, who suffered at least two concussions before retiring from the NHL in 2004-05.
"I think the great thing about this is we're talking about it and we're having these discussions and we have to push forward to see how we can make the game better and safer for everybody involved."