One of the upsides of leaving professional ice hockey would be to live a normal life, Keith Primeau said when he retired three years ago as captain of the Philadelphia Flyers.
He had lingering brain damage after multiple concussions while playing center for 15 years and could not pass the team physical.
Now Primeau, 37, is coaching kids and studying for a college degree but says his life is still not normal. He recently decided to donate his brain upon his death to a landmark study and has made it a priority to warn parents and their children about the dangers of concussions.
He says he will always know "I've done damage" to his brain.
For starters?
"When I exert energy, I get lightheaded," he says. "I coach youth teams. I can go out on the ice for three or four hours with them and be fine, but if I ever try to participate and elevate my heart rate, I get lightheaded and it feels like my head is disconnected from my body. I just can't (work out)."
And when he gets sick?
"I can't get my head off the pillow for a couple of days," he says. "Any illness goes straight to my head. I get a headache, and it feels like it's a hundred-pound cinder block. I go into a natural fog. I wouldn't be able to focus.''
A pledge to science
Primeau is one of nearly 120 athletes who the Sports Legacy Institute has signed up to pledge their brains after they die to the Center for Study of Traumatic Encephalopathy at Boston University. The latest: Don Hasselbeck, a tight end who last played for the New York Giants.
Since the center was created in 2008, research conducted on the six brains of deceased NFL players at the Boston University School of Medicine found that all had chronic traumatic encephalopathy (CTE), a degenerative brain disease similar to Alzheimer's. It is found in people who have had multiple concussions. Studies show it also afflicts wrestlers and boxers.
The array of CTE symptoms includes loss of memory, confusion, emotional problems and early-onset dementia. The troubles can begin months, years or decades after the last injury. The only way to diagnose CTE, says Robert Cantu, co-founder of SLI with Chris Nowinski, is after death when the brain is dissected.
Most of the SLI studies have been done on retired athletes, but January research reported early evidence of CTE in the youngest person to date, an 18-year-old who suffered repeated concussions in high school football.
Concussions can be very hard to detect since not everyone passes out. Nausea, blurry vision and confusion are other symptoms. Within the past several years, increased awareness about concussions and "post-concussion syndrome" has led most professional and college teams to start using computer-based programs that measure attention, memory, processing speed and reaction time to one-hundredth of a second.
It is too costly for most high schools and youth programs, where it could help coaches and trainers identify problems and sideline players. Concussions account for almost one in 10 sports injuries for people ages 15 to 24, according to the Centers for Disease Control and Prevention.
Yet nearly 41% of high school athletes return to action too soon after concussions.
Primeau endured a career of blows to his head but adds that he won't forget one that knocked him out:
"I spent the night in the hospital, flew the next day and was back in the lineup that day. That was the beginning of my demise."
He now knows resting -- and not playing until the concussion is healed -- can help prevent long-term damage. He has started to use tests to determine if his athletes have concussions and has made decisions to keep kids off the ice.
"I can tell when a child has suffered a concussion," he says. "I do not put them back on the ice. I've told parents I'm not putting their child back in. And I've actually had instances where parents will want to go in a different direction and the kids will go out on the ice and get sick."
And other times, players are not honest. That was true of Primeau's oldest son, Correy, who plays club-level hockey for Neumann College in Aston, Pa., and respects his father's concerns.
"I played once with a concussion last year," Correy says. "I wouldn't do it again. I had trouble afterward for about a week, but I just didn't want to let my team down at the time."
The effect can subside
Primeau says he and his wife never considered keeping their kids out of contact sports. "It's what they want to do," he says. "I just hope they remain safe and healthy."
But he drew the line on playing football.
"My wife is from Texas, and she would have liked to see the kids play football," he says. "I said, 'No way, it's way too dangerous.' That's the one sport I would not let my kids play."
He laughs and says he knows ice hockey has been rough on him, but he hopes life will be normal again. Cantu says post-concussion syndrome can eventually subside.
"Within the past couple of weeks, I think I improved again," Primeau says. "I think I'd become accustomed to living with head pressure. But within the past couple weeks, I haven't had that feeling. I'm afraid when it's going to come back, but I've always accepted it."
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