About half of NHL players suffer an injury such as a concussion that benches them, costing the league an estimated $218 million in lost time, say Canadian doctors who want arenas to be safer workplaces.

About 63 per cent of National Hockey League players missed at least one game because of an injury over three seasons between 2009 and 2012, researchers said in Monday’s issue of the British Medical Journal’s Injury Prevention.

The injuries added up to a total salary cost of about $218 million US a year.  

"While league owners and management are wary of making changes to the game to decrease aggression that could in turn affect profits, they must also consider the costs of injuries," Dr. Michael Cusimano, a neurosurgeon at St. Michael’s Hospital in Toronto, and his co-authors concluded.

"It is hoped that consideration of these costs will provide sufficient motivation for professional sports leagues like the NHL to consider taking further action to prevent player injuries."

Cusimano is particularly concerned about concussions, which he said is related to violent acts in 88 per cent of cases.
The researchers pegged salary loss to concussions at $42.8 million a year. After head/neck injuries, leg and foot injuries were the most common injury in the sample, accounting for 30 per cent of the total cost and about $68.2 million.  

They estimated games lost to concussions cost insurance companies $7.2 million a year and teams $15 million a year. Insurance companies pick up part of the salary tab for players with long-term injuries.   

Head shot rule changes enough?

In 2010, the NHL enacted Rule 48, banning blindside hits to the head. The following season, the rule was expanded to include targeted head shots from any direction.  

Both of these seasons were included in the study. Cusimano said the findings show the need for stiffer penalties, such as red cards in soccer that mean losing a player for the game.

The full costs of injuries are greater than estimated if the costs of treatment, personal suffering, potential later lost income and future medical care are considered.  

At a practice, some Toronto Maple Leafs players said there’s not much more that the league can do.

"I think it's always going to be a dangerous game," said forward Joffrey Lupul. "The league is doing a great job taking some of the high hits away and the checking from behind and those are two cases where there's been a lot of injuries."

Fellow forward James van Riemsdyk said he’s seen improvements over the last couple of years.

"Instead of hitting him in the head, you're making more of an effort to hit in a place where you're not going to basically kill him," he said.  

A concussion lawsuit against the NHL originally launched by 10 former players argues the league did not do enough to protect them from concussions. The NHL has said it intends to defend it case.

In August 2013, the National Football League agreed to pay nearly $800 million US to settle lawsuits from thousands of former players over concussion-related brain injuries.

The NHL did not immediately respond to a request for comment on the study's findings from CBC News. 

With files from CBC's Kim Brunhuber and The Canadian Press