HockeyConcussion doctor weighs in on Crosby debate

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Sidney Crosby of the Pittsburgh Penguins walks off the ice after the 2011 NHL Bridgestone Winter Classic at Heinz Field on Jan. 1. The NHL's leading scorer has been sidelined since last Thursday after exhibiting concussion-like symptoms before a game against Montreal. (Jamie Squire/Getty Images)

When it comes to Sidney Crosby, the Pittsburgh Penguins and concussions, it really doesn't matter what I think. And, no offence, it doesn't matter what many of you think, either.

But Dr. Robert Cantu? Yeah, he matters.

He is one of the doctors we consulted for our concussion feature back in October. When it comes to sports-related head trauma, there is no one more qualified than Dr. Cantu, who created the Grades 1, 2 and 3 concussion-ranking formula.

His opinion on what happened? It depends on how long Crosby needs to return.

"The longer it takes, the greater likelihood he was playing symptomatic (against Tampa)," Cantu said Monday.

Dr. Cantu was careful in his commentary, because he wasn't there to personally diagnose Crosby after the Dave Steckel hit.

"He certainly seemed to be a person in a fog ... Thought it looked like he had a concussion. But there's no way I can be accurate ... Would take a neurologic assessment and I don't know what kind of exam he got or didn't get."

(By the way, Dr. Cantu completely dismissed criticism that Pittsburgh allowed Crosby to fly twice with the injury. "Pressurized environment ... Not a factor.")

Under heavy criticism, Crosby and Penguins coach Dan Bylsma defended the organization's treatment of its franchise player on Saturday.  "There isn't a person who we would put on the ice that has concussion symptoms," Bylsma said.

"Throughout the (Tampa) game I didn't feel right. Does that mean I had all these huge symptoms? No," Crosby added.

Victor Hedman's penalty came late in the second period, and without asking Crosby directly, it's difficult to tell what "throughout the game" means, exactly.

But this does show the real challenge. Crosby - like most of his peers - badly wants to play. And, if you don't have "huge symptoms" that show up on whatever tests are conducted, players are going to dress and teams are going to let them. (This is one reason I am completely opposed to non-guaranteed contracts. Imagine the health risks then.)

"The concern I have is not just that he's more vulnerable," Dr. Cantu said. "It's that if there was a previous concussion, the symptoms will last a lot longer than they ever would have. That's what I worry about, repeat concussions. A mild concussion, you can recover in a few days or week. (With a repeat), it now can take weeks or months to heal."

Hopefully that won't happen. Don't want to see Crosby - or anyone else - suffer long-term problems. But, what this should do is advance the debate. If a player is down, should he be out?

30 THOUGHTS

1. Those of you who accuse me of being Toronto-centric will love this: As we were shooting the Mike Babcock Inside Hockey feature, Red Wings assistant coach Paul MacLean put a Toronto highlight on the coaches' video screen, because "We've got to give the Maple Leafs their 15 seconds of airtime." Didn't get used, though.

2. It's hard to predict supplemental discipline, but here's a number to know: 0.5. Learned during my concussion piece a couple of months ago that any head hit arriving later than 0.5 seconds after a player gets rid of the puck is going to raise a red flag. Tom Kostopoulos on Brad Stuart was right there. Shane Doan on Dan Sexton was the big one.

3. Kostopoulos is not, technically, a repeat offender, since his previous suspension didn't come within 18 months of this one. However, there is some real similarity between his hits on Stuart and Mike Van Ryn. Kostopoulos has a lot of momentum coming from far up ice and the victim is extremely vulnerable. No way that escaped notice.

4. No hearing, by the way, for Steve Downie. Lucky man. Mr. Downie: don't destroy the improved reputation you are getting.

5. What have we learned so far this season? If you really want an important piece, be proactive. James Wisniewski, Dwayne Roloson, Jamie Langenbrunner - already gone. Don't know how much more the Islanders have to deal, but the Devils are definitely open for business. Also: very few teams are willing to take on salary. (Columbus and Toronto are exceptions.) That's going to make it tougher on cap-strapped Pittsburgh, Chicago, Detroit and Boston. The Blackhawks and Bruins have a surplus of picks, too.

6. Once the Islanders and Devils are filleted, the next question becomes: When does the next group of teams surrender? We're talking some combination of Toronto, Calgary, Florida. Those decisions will be crucial to market activity, because there is the sense a few teams (Columbus, Ottawa, Buffalo) won't quit, because jobs are on the line.

7. Mike Commodore's situation is a perfect example of the challenge of being a GM in places like Columbus. (Not a shot at the city, which is really underrated, it just doesn't have a big NHL pedigree.) If you really want a free agent, you must overpay. In 2008, Scott Howson saw Commodore as a guy who can make a difference, which proved true when he played a big role in getting the Blue Jackets to the playoffs for the first time. Now, they want to get rid of him, and he's still owed almost $9 million US. Same with Kristian Huselius (benched Saturday) and Sammy Pahlsson.

8. Would be stunned if Commodore ends up in Springfield. When it really goes bad between a player and an organization (see Souray/Oilers) teams try to keep them away from their prospects.

9. Smart thing the Flyers are doing with their cap: keeping Ian Laperriere on long-term injury and not having him retire. Since he signed an over-35 contract, a retirement would mean his $1.167 million figure stays on the books this year and next. By listing him as injured, Philly gets extra room.

10. You can see the respect the Red Wings have for the Canucks. Detroit considers Vancouver a very serious contender.

11. Good to see everyone was so outraged about Linus Omark's spinarama that we're seeing one every 10 minutes.

12. Is anyone else concerned about Marc Savard? It's not just the point production. Savard was a fierce battler, really competitive. Not seeing that right now.

13. At the 2003 world junior championship, Marc-Andre Fleury's backup was David LeNeveu. LeNeveu got a round-robin start against Finland, didn't play well, and was yanked. After the game, Coyotes GM Mike Barnett made a point to go up to him and say, "Hey, we still believe in you." It meant so much to the kid. Hopefully, several other NHL GMs did the same for their Team Canada prospects.

14. At the 2008 Beijing Olympics, Marianne Limpert (1996 200 IM silver medallist) told me, "The hardest places to finish at the Olympics are second and fourth." We try to tell people that a silver is nothing to be ashamed of, but the reality can be very different. Brad Boyes won that medal in 2002, and happened upon a replay of the final game on Christmas Eve. "I still get upset at the chances I missed that game," he said. Carlo Colaiacovo won two silvers and admits, "While I'm proud of them, I do think: How much nicer would they be if they were golds?'" It's tough.

15. Boyes, by the way, was planning a bet with some of his U.S.-born teammates before the semifinal. "We were thinking that if Canada lost, I'd have to wear a USA hockey jersey. I was 100 per cent certain Canada was going to win, but I couldn't make that bet. There was no way I could put on that jersey."

16. Tim Thomas on Mark Visentin: "If you can move on, put that behind you, and play well... Then you've got what it takes."

17. Debate: Will the defeat hurt Dave Cameron's chances at an NHL job? "No way," says one NHL coach. "That's ridiculous," said an executive. "He'll certainly have to discuss and explain what happened in any interview he gets, but that won't destroy his chances." The coach did say that he was concerned more about Cameron's pre-game interview than the third-period timeout. "He looked really uncomfortable."

18. Jack Johnson ran afoul of the Carolina Hurricanes early in his NHL career when they asked him to turn pro, deciding instead to return to Michigan. However, he erased any doubts about his commitment with the cap-friendly deal he took in Los Angeles. That's a good contract for the player and the team.

19. There was a lot of angst in LA when the Kings struck out with Ilya Kovalchuk and Paul Martin in July. (There is a great story about Dean Lombardi putting his feet up and lecturing Kovalchuk about making a decision, already.) In the long run, those misses will turn out to be fortuitous for the Kings, although Drew Doughty's extension may not be as easy as Johnson's.

20.  On Chris Osgood: there is concern it's a hernia. For a skater, that's six weeks. For a goalie, it can be much longer.

21. More on the Red Wings coach: I wasn't in the room when he addressed the Strathroy Rockets Junior B Team, but that's quintessential Babcock. Young men too nervous to ask a question, he forces them to. He believes in pushing people out of their comfort zone: players think they're going their hardest all the time, but they're not.

22. One Red Wing: "Pavel Datsyuk can dangle; score a beautiful goal. The bench will go crazy and (Babcock) won't be impressed. But, if someone shoots the puck off the goaltender's pads and the rebound is knocked in, he's so excited." Babcock laughed at that and said, "Stevie (Yzerman) told me, 'That's not the way I got my first 656' or whatever he had at the time."

23. Most interesting off-camera moment: He had a little regret at agreeing to our feature, because the Red Wings were struggling a bit. I told him I understood that Vancouver was a big game and he really gave it to me. "Every game's a big game. What, you don't think we wanted to beat Dallas last game? That wasn't a big game?" Won't make that mistake again.

24. The Montreal Canadiens have two defenceman under contract for next year - Jaroslav Spacek and PK Subban. Hal Gill approached the Canadiens about an extension and was told they'd like to wait. "You win games, you win a new contract," Gill said. "I understand that."

25. Very interesting that the Penguins didn't start Fleury in Montreal last week. A few people who know him well say he was really affected by losing to the Canadiens last year, especially when it came to going home in the summer. On the third day of this season, he gave up two goals in 24 seconds late in the third period to turn a 2-1 lead into a 3-2 defeat against them. Mental block? Let's see who starts in Montreal this week.

26. Not surprised Jamie Langenbrunner waived his no-trade to go to Dallas. He never wanted to leave in the first place. About a year after being dealt to New Jersey, he was still upset about the process. He'd asked then-Stars GM Doug Armstrong about the rumours and was told there was nothing going on. Armstrong's Blues were interested in him this time, too.

27. Carey Price admitted to feeling "zombie-like" during the team's seven-game road trip over Christmas and New Year's. "You feel like you're doing nothing but sleeping and playing hockey," he said. "But every player in this room goes through it." Not every other player is as important as Price, who said he felt much better last week and certainly played like it. Price is on pace for 76 games. The only guy in the last 30 years who played that much and won: Grant Fuhr, 75 in 1988. (Martin Brodeur did get two Cups in the low-70s.)

28. Wisniewski said the biggest difference between Montreal and the Islanders is what the two teams want you to do with the puck. Canadiens want you to make a play. Isles want it off the boards.

29. Does seem pretty strange that Logan Couture, who played 25 games last season, is eligible for the Calder, but Alex Pietrangelo, who played 17 over two seasons, isn't. And Pietrangelo is 10 months younger. I'm certain, though, the NHL is tired of Darren Pang's emails about it.

30. Some day, Tom Gaglardi would like to own an NHL team. If you think it's tough in Kamloops, wait until you lose in the big leagues.

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