Boston University researchers have found a degenerative disease linked to head trauma in the brain tissue of the late NHL great Rick Martin, the first 50-goal scorer for the Buffalo Sabres and a member of their famed French Connection line.
Martin, who died in March of hypertensive heart disease at age 59, becomes the third former NHL player found by researchers to have had chronic traumatic encephalopathy (CTE) — a disease that causes cognitive decline, behavioural abnormalities and ultimately dementia.
After his death, Martin's family donated his brain to the Centre for the Study of Traumatic Encephalopathy, a collaboration between Boston University Medical School and the Sports Legacy Institute.
All three former NHL players who agreed to have their brains studied post-mortem at the centre — Martin, Bob Probert and Reggie Fleming — have now been shown to have had CTE, but Martin is the first who did not play an enforcer role and regularly participate in on-ice fights, the centre says.
Neurosurgeon Robert Cantu, who co-founded the institute and is co-director of the CTE centre, told CBC News the findings in Martin's case are alarming because he only suffered perhaps one concussion in his career, unrelated to fighting.
"What I can tell you bothers me: The first two cases in the National Hockey League, Reggie Fleming and Bob Probert [were] renowned fighters, 400 recognized fights during their ice hockey career, God knows how many in bars," Cantu told CBC's Stephanie Jenzer in an documentary airing Wednesday on The National, in which CBC News was granted rare access to the brain centre's lab.
"And so the amount of brain trauma they took from fighting was horrendous. And it could be thought logically that their CTE is related to their fighting. And indeed it possibly is.
"But when we look at this most recent case of Mr. Martin, that's a problem because he wasn't a fighter, he'd only had perhaps one concussion. And so we've got to be concerned that the jostling of the brain just from the skills of the sport of playing in the National Hockey League led to him having chronic traumatic encephalopathy when he died."
Star's head struck ice
Born in Verdun, Que., Martin was an NHL star in the 1970s with 384 goals and 317 assists for 701 points in 685 games, all but a handful with the Sabres.
During his time in Buffalo, Martin combined with fellow French Canadians Gilbert Perreault and René Robert to give Buffalo the top line in the league for a time, and they helped lead the Sabres to the 1975 Stanley Cup final in just the franchise's fifth year of existence.
Martin was remembered as much for his goal-scoring abilities as a frightening incident in 1978, when he was hooked from behind and his helmet-less head struck the ice. He was knocked unconscious and went into convulsions on the ice before being carried off on a stretcher.
Martin was back the next season with a helmet, as were many other players on his team.
Over the years, Martin adopted Buffalo as his home, and died there in March when his heart failed while he was driving.
Chris Nowinski, a co-founder and president of the Sports Legacy Institute, tracked down Martin's widow after his death, not long after the brain lab made the results of former NHLer Bob Probert's CTE case public.
"Mrs. Martin said Rick would have wanted people to learn from him," Nowinski, the only Harvard graduate to wrestle at the WWE, is widely credited with putting the concussion issue on the map, told CBC News. "If other hockey players could be safer by studying his brain then he would have been all for it."
The centre's researchers said Martin's disease was relatively mild and suggested he was resilient to the disorder and less susceptible to its severity than some of the other athletes whose brains they've studied.
'No question' Martin would have developed dementia
Martin only had stage 2 disease at 59 years old, and by that age most cases in the centre's brain bank have advanced to stage 3 or 4.
But Nowinski said had Martin lived longer, the disease would have progressed.
"Who knows how quickly and who knows how badly, but he would have eventually developed dementia had he lived long enough," Nowinski said. "No question."
Dr. Ann McKee, the brain centre's co-director who diagnosed the two previous former NHLers Probert and Fleming with CTE after their deaths, said it is unlikely that Martin's disease was triggered by just the 1978 on-ice incident.
"I'm going to imagine that there were many other more trivial blows to the head," she told CBC News chief correspondent Peter Mansbridge in an interview.
"He didn’t play with a helmet for most of his years. So any blow to the head may have been a contributing factor."
Ex-players hope brain study gives answers
There is growing concern about players suffering head trauma and struggling with physical and mental health issues later, especially amid this summer's tragic off-season for the NHL, which saw the deaths of three NHL enforcers: Derek Boogaard, Rick Rypien and Wade Belak.
Cantu and his team have examined Boogaard's brain but the results are not yet public.
Keith Primeau and Ryan VandenBussche, two former players forced out of the game because of traumatic brain injury, have agreed to have their brains donated to the centre for study after their deaths.
Both skilled and physical on the ice, Primeau never shied from aggressive play, even as the concussion tally mounted.
Six years on from his last concussion, Primeau still only counts the number of days he doesn't suffer from the effects of the brain injury — dizziness, headaches and torment that can come with depression — in days and weeks.
"I have periods where I feel much better and I enjoy them while they last, but I have the ability to regress and show symptoms again," Primeau said at a hockey tournament, where he was coaching one of his kids.
"You become very emotionally volatile. People around you take the brunt of it, so that is sad. So it is almost a domino effect of emotions, and nothing you can really do or are capable of stemming it other than ride it out."
Looking back on his career, Primeau said it was one of his four documented concussions — he believes he suffered "north of 10" in his career — which should have been the wakeup call. On May 2000, a devastating hit at centre ice sent him to the hospital. But 48 hours later, Primeau was back for another game.
"For me, probably, I would reflect that as being the beginning of the demise," he said. "I grew up with the mentality that you get out there at all costs. You play through injury and you play through pain, and I was no different."
VandenBussche told CBC News he first brought up the idea of donating his brain to the centre with Probert, his former roommate.
"I remember chatting to him that I was going to donate my brain and we both agreed that's what we were going to do," he said. "Why wouldn't you?"
A fellow tough guy of the league who famously ended the career of Nick Kypreos with a knockout punch, VandenBussche said he tried to conceal several of the more than a dozen concussions he suffered during his playing days, first to avoid being considered concussion-prone, then later just to stay in the NHL.
"I hid every one of them that I possibly could hide," he said.
Concussions and other injuries ended his career in 2007. His body battered, today he's almost constantly in pain. But VandenBussche never imagined that a few years later, his friend would be dead and his brain might be used to help solve the concussion riddle.
"I believe I don't know the facts," he said. "I wanna be able to see it. I mean I hear a lot of stuff but whether or not you believe it, you have to go figure it out yourself. I am sure it has got some sort of correlation to that. There is no doubt about it if you take repeated blows to the head, there is going to be some sort of effects later on down the road. So I just don't know to what degree."