Why USA Hockey is not ready to require neck guards in wake of Teddy Balkind tragedy

Photo of Paul Doyle
The CIAC announced on March 10, 2020 that all Connecticut State High School Playoff tournaments going forward would be cancelled due to the on going growing concerns and spread of the COVID-19 Coronavirus outbreak. An empty net and darken arena at Terry Conner's Rink, highlight the effects of the decision made, the dreams of many seniors hoping to play and fulfill their high school careers as they look for one last opportunity to bolster the college resumes.

The CIAC announced on March 10, 2020 that all Connecticut State High School Playoff tournaments going forward would be cancelled due to the on going growing concerns and spread of the COVID-19 Coronavirus outbreak. An empty net and darken arena at Terry Conner's Rink, highlight the effects of the decision made, the dreams of many seniors hoping to play and fulfill their high school careers as they look for one last opportunity to bolster the college resumes.

Matthew Brown / Hearst Connecticut Media

The hockey world was grieving when the USA Hockey staff and volunteers gathered in Florida for the organization’s annual meetings seven months ago.

The accidental death of St. Luke’s junior varsity hockey player Teddy Balkind after a game in Greenwich a week earlier was reverberating throughout the sport. And in the days after Balkind died after a skate cut his neck, focus settled on a piece of equipment — a neck laceration protector.

With the backdrop of an on-ice accident in Connecticut, USA Hockey officials huddled in Florida to discuss a litany of items. Among them, the use of neck laceration protectors and the governing body’s public view of the equipment.

Following Balkind’s death, USA Hockey has recommended the use of neck protectors, reinforcing that recommendation and the recommendation of wearing other gear like cut-resistant socks and sleeves that aims to protect players from skates. There has been discussion among those on the safety and protective equipment committee about mandating the use at all levels.

Yet, the organization that oversees rules for thousands of players across the country left Florida without issuing a mandate, deciding to “reinforce” the recommendation of neck guard use.

In an interview with CT Insider, Kevin Margarucci, USA Hockey’s manager of player safety, said the accident in Greenwich was very much on the front of minds at the January meeting. But the organization was not ready to change policy.

“There were heightened discussions after the tragic incident in Connecticut,” Margarucci said. “We haven’t closed the door on anything. But as of now, our information on the neck laceration protectors comes out of some of the research that was done and some of the only research that’s been done on neck laceration protectors.”

It’s still unclear whether Balkind was wearing a protector. A Greenwich Police report did not answer the question, but Balkind was not required by his prep school league to use the protective equipment.

Within days of Balkind’s death, a friend created a change.org petition demanding USA Hockey mandate the use of neck protectors. The petition, still active, had more than 134,000 signatures as of Thursday.

The research USA Hockey cites was conducted by Dr. Michael Stuart, a Sports Medicine Specialist at the Mayo Clinic and the volunteer chief medical officer for USA Hockey. Stuart, whose own son sustained a neck laceration injury while playing at Colorado College, has helped design the organization’s policy based on his research.

Among the findings: over one quarter of neck laceration incidents involved players wearing a current model of protector, so the guards do not completely eliminate risk.

The research used by USA Hockey also finds more lacerations are superficial, with nearly two-thirds requiring only a bandage. Stuart’s study and survey also found that some guards can decrease “cervical spine range of motion” and others shrink after washing, which decreases coverage area and reduces effectiveness.

The result was a new statement from the organization: “USA Hockey continues to recommend a neck laceration protector for all players. The heightened discussions around lacerations from a skate blade reinforce the recommendation that players wear a neck laceration protector that covers as much of the neck as possible along with cut-resistant socks, sleeves or undergarments. USA Hockey, led by its safety and protective equipment committee, will work with equipment companies and maintain efforts to ensure the safest possible environment for all participants.”

The official policy announced in January: “USA Hockey recommends that all players wear a neck laceration protector, choosing a design that covers as much of the neck area as possible. Further research & improved standards testing will better determine the effectiveness of neck laceration protectors.”

Mandating neck protectors?

The issue for USA Hockey is whether to mandate a piece of equipment that is still being perfected.

Still, other governing bodies do mandate some form of neck protections. The equipment is required for amateur players in Canada and Sweden, and the International Hockey Federation mandates the use.

Margarucci said there are two standards used for neck protectors. The Canadian standard required the protector to have material approved by an organization in Quebec — known as the Bureau de normalisation du Québec (BNQ) — and is the model produced by Bauer that is used throughout North America. There is also a version used in Europe and manufactured with a different set of standards.

“But there’s also no real requirement for manufacturers to meet these standards at this time,” Margarucci said. “And it is an old standard. It’s back from the early 90s and people have realized it’s a little antiquated.

“There’s some gaps in that standard and there are entities working on a new standard for the neck laceration protectors, and we’re hoping to get to a point where if there’s a standard and we show that something is truly effective that we are not saying it’s going to happen … then there may be a higher comfort level with shifting from a recommendation to requirement. But I don’t think we’re near that point right now.”

Margarucci maintains the body’s recommendation for use is significant. USA Hockey mandates the use of just two pieces of equipment: helmet and facemask for players and goaltenders, items certified by the Hockey Equipment Certification Council, an organization based in Cooperstown, N.Y. that tests and certifies hockey equipment.

“So there’s really no other piece of protective equipment that we require,” Margarucci said. “Things are made for the sport of ice hockey, but there’s no standard that those pieces of equipment have to meet that are currently on the market.

“So if you look at our playing rules, we require a HECC certified helmet and facemask. We require a mouthguard at the 12U age category and above. Every other piece of equipment that we have … it reads kind of funny because it says, ‘Other protective equipment should include …’ There’s no real requirement.

“The only piece of equipment that we actually highly recommend is a neck laceration protector.”

It also should be noted, Margarucci said, that the updated statement in January includes the recommendation that players wear cut-resistant socks, sleeves and undergarments to cover other vulnerable areas such as the wrist.

But enforcing the mandate of such equipment may be difficult. In Connecticut, the CIAC, which governs most public and private high schools, requires the use of neck laceration protectors. The Connecticut Hockey Conference, the state’s governing body for USA Hockey, passed a motion in February that required players to wear “an unaltered, BNQ certified neck guard” beginning on March 1. Teams from other states playing in Connecticut will be recommended to wear neck guards.

Also, a penalty for a player not wearing the protection will first be a warning for both benches and then a misconduct.

The NEPSAC, which governs St. Luke’s where Balkind played and other private preparatory schools, follows USA Hockey’s rules, which now only recommends, not requires, neckguards.

The NCAA, following USA Hockey guidelines, also does not require neck protectors.

The NEPSAC’s communications specialist said in a statetment, “As is our charge, NEPSAC continually examines rules of play that govern our sports in partnership with our Sport Medicine Advisory Committee. As always, we will share more with our community should our standards change.”

Where neckguards are required, enforcement remains an issue. A helmet, faceguard and mouthguard are visible and easy for coaches, officials or even parents to identify.

Margarucci said his committee heard stories about players wearing a version of a neck protector that rests under the shoulder pad and ultimately pulled off the neck, exposing skin.

“So the kid was meeting a mandate but was it actually protecting what it was supposed to protect,” said Margarucci, a certified trainer who has coached high school hockey in Colorado. “So that’s when you get into enforcement, too. Is it just, do you have it on? Is it, are you wearing it properly? Is it, has it been altered and can you tell?

“I know there are a lot of kids in areas where it is mandated and they actually cut the padding out of it so it’s not that bulky around their neck. So they’re just wearing a piece of cloth around their neck, but to the eye they’re meeting the mandate and they’re not going to get called for a penalty for not wearing one.

“There’s just a lot to it. I’m not saying those are things that should deter us from moving towards something or that should be a barrier, but there’s a lot of things on enforcement. And if there is a mandate, we look at the medical and legal complications. If there is a mandate, and there’s an injury to a player who is wearing one … is there liability there? Because we know that the current ones on the market are not full proof. It’s not like wearing body armor where you can say you’re 100% protected. So yeah, there’s definitely a lot more questions and answers right now. And obviously we’re working towards answering a lot of those questions.”

State Rep. Nicole Klarides-Ditria, R-Derby, introduced legislation that would make neck protectors mandatory for all youth players in the state and the House of Representatives voted to create a task force to study the issue — as part of a broader look at youth sports safety — but both measures stalled.

State Sen. Saud Anwar, D-South Windsor, said some medical experts who testified before the Children’s Committee said some neck guards could place excessive stress on the cervical spines.

“They said they can be more dangerous than helpful,” said Anwar, a physician. “We need to make sure that in our passion for protecting our youth, that we get experts to look at the issues and to come up with sound, appropriate ways of protecting athletes.”

While USA Hockey has reiterated its recommendation for neck guards it begs the question: will the organization ever move to a full on requirement?

“The dialogue has never been closed on this topic and, again, obviously we want everything to be as safe for our players as possible,” Margarucci said. “But we don’t want someone to put something around their neck just to meet a mandate. That’s why I think the recommendation holds a little more weight at this time, because we’re telling people how to wear it and what they should look for, not just telling them to put something on because of a mandate. With the information that we have, I think that’s just where we’re at right now.”