December got off to a good start with the Penguins getting twin body bags (YEEAAAHH!!!) for the Sabres Friday and Saturday night. Buffalo is such a steaming pile. As hard as they supposedly tried to make adjustments last night, the Penguins still smeared them to the wall, winning by four goals again with a goalie making his sixth career start. When a moral victory is “only” losing 5-1 because you broke your week-long goalless drought, then maybe it’s time for the Sabres to re-evaluate their “Sharpen your Swords” franchise mission statement.
Here is every team’s reaction when they see Buffalo coming up on the schedule.
One of the sadder items to come across the wire this past week was the news that Derek Dorsett of the Vancouver Canucks is retiring due to the risk of permanent damage from neck injuries. Dorsett had cervical disc herniation surgery about one year ago that resulted in temporary arm numbness. He resumed playing this season only to experience a recurrence of stiffness in his neck and back a few weeks ago from another cervical disc herniation. His doctors advised against returning to play.
Derek Dorsett, NHL career finished at 30.
There is a 30-year old blueliner on the Penguins who suffered the same type of injury and had to undergo the same type of surgery as Dorsett, namely Kris Letang.
When the Penguins got off to a sluggish start for the first six weeks of this season, many felt Letang was conspicuous in his lack of productivity, especially in October, based on cursory stats – zero goals and two assists at even strength. On the defensive side of the puck, while the entire team struggled for the first six weeks of the season, Letang, as the team’s top defenseman, often receives the most scrutiny. His late reaction in the third period of the Black Friday loss was a costly mistake, enabling Boston to score on a breakaway.
Yet, in consideration of Letang’s neck injury, surgery and rehabilitation, I sometimes wonder if the simple nature of recovery from a serious condition is preventing Letang from functioning at his usual – pardon the pun – break-neck, all-star style of play: a catalyst on offense/fourth forward, taking risks, while having the speed to fly back into his own zone when the puck turns the other way.
Objectively, based on Game Score, the composite-weighted stat that gives a snapshot of a player’s single-game contribution first developed by Dom Luszczyszyn, Letang definitely struggled in October relative to his career norms, posting a 0.48 Game Score per game in the season’s first month. In November, Letang clocked in at 0.76 Game Score per game for the month. He is trending in the right direction.
However, it does raise the question: how long does it take to safely recover from a major neck injury and return to a pre-injury comfort level? Why did Dorsett suffer a recurrence while Letang plays on? Was it just an unlucky fluke?
Dr. Ian Cohen, a physician at the University of Toronto MacIntosh Sport Medicine Clinic graciously answered some questions via email about cervical disc injuries and treatment. Dr. Cohen is the team doctor for the varsity men’s hockey team and also served as an assistant medical director at the 2010 Vancouver Winter Olympics Whistler Sliding Centre.
(*As he has not personally examined Letang, Dr. Cohen’s comments are general and not specifically about Letang’s condition. Medical imaging shown below is for illustrative purposes only.)
“The disc sits between the bony vertebrae. Think of a disc as a jelly donut. The dough is composed of a tough but flexible fibrous tissue that surrounds a gel filled centre. The gel gives the disc the ability to deform in any direction when loaded and the fibrous tissue gives the disc structural support to stay between the vertebrae,” Dr. Cohen explained. “A disc herniation has occurred when the fibrous tissue tears and some of the gel escapes beyond the edge of the disc. This can happen either acutely from sudden overload, or gradually from repetitive loading … it appears that injuries from behind (whiplash type) are a more common cause of disc herniations than contact from the front.”
Indeed, Letang’s original neck injury was from a check from behind during the 2016 Eastern Conference Final against Tampa Bay which rendered him unable to turn his head left or right for a day. He played through it but began experiencing pain in training camp the following year when he was hit. Still he played on until the Penguins decided to rest him in mid-February. After six weeks of rehab, he was set to return just before last season’s playoffs when Letang felt discomfort and doctors found something major that required immediate surgery. Letang went under the knife on April 13.
“Surgery is usually indicated when the disc herniation is compressing an adjacent nerve root and causing pain to radiate into the arm. It may be associated with weakness or loss of sensation. Surgery is indicated if arm pain is worsening or neurological weakness is progressing,” said Dr. Cohen. “We sometimes see surgery done earlier in the course of this injury in professional athletes when the time to recover with conservative management will be prolonged and have an impact on their ability to return to play.”
Letang first skated post-surgery in July, then began taking full physical contact in September’s training camp and pre-season schedule, fitting in the general range for recovery that Dr. Cohen notes – “from 6 weeks to 6 months. If the bones are delayed in fully fusing then it could be out to a year.”
After learning this information about neck injuries, it certainly gives one an appreciation for the skilled eye of team physicians and the patience we should have when a recovering player struggles or doesn’t meet our often unreasonable expectations. For Derek Dorsett, the doctors may have saved his life or prevented paralysis. For Letang, the doctors may have saved his career.
Let’s hope that Letang continues to recover and adapt to playing a style that protects him from risky, dangerous or vulnerable situations while still allowing him to maintain his creativity.