The NHL Has a CTE Problem. Fans and the League Don’t Care.

(Bloomberg Opinion) — Bobby Hull, one of the greatest players in the history of the National Hockey League, was celebrated for his physicality on the ice. But those talents, it turns out, came at a cost. This week Hull’s widow revealed that he suffered from chronic traumatic encephalopathy, or CTE, when he passed away two years ago. The disease, caused by repeated brain injuries, is associated with memory loss, impaired judgement, aggression and other symptoms.

The NHL doesn’t seem to mind. During this week’s highly touted 4 Nations Face-Off matches between the USA and Canada, fighting and physicality were widespread and celebrated. That’s a brutal and sorry memorial to Hull, and a reminder that fans, hockey media and the league have yet to reckon with the well-documented toll of the NHL game.

Consider the three fights that broke out over the first nine seconds of the USA-Canada match last Saturday night. They were crowd-pleasers, a fact that could be heard in cheers and read after the game online. The hockey press, rather than condemn fighting at an international match, wrote encomiums to the players who pre-planned the battle and described the crowd as “absolutely rocking.” Finally, after the match the players praised the battles as “pretty fun.”

They probably were fun in the moment. The problem is that getting repeatedly bashed in the head with a fist isn’t very good for an athlete, especially over the long term.

As far back as the 1920s, in fact, physicians recognized a connection between boxing and degenerative brain diseases. By the mid-2010s the evidence was so overwhelming that the National Football League — which had long denied a link between its sport and CTE — conceded it.

Hockey isn’t immune to the impacts. In 2009, researchers at Boston University confirmed long-standing suspicions when they announced the first-ever diagnosis of an NHL player with CTE: Reggie Fleming. Unsurprisingly, Fleming, who played in the league between 1960 and 1971, was known for his ability to “fight and agitate,” according to a New York Times remembrance.

Fleming is far from alone. A 2023 study of 6,039 NHL players active between 1967 and 2022 found that enforcers — whose primary role is to protect teammates with physical force — died 10 years earlier than those who play other positions. They were also more likely to die from drug overdoses and suicides, both causes of death associated with CTE. Meanwhile, a December 2024 study, also from Boston University, found that the odds of having CTE increased by 34% for each year of hockey played.Yet the NHL is most unmoved. In 2016, and again in 2023, Commissioner Gary Bettman publicly denied any link between hockey, concussions, and CTE.

He has his reasons. Years of polling show that hockey’s most devoted, hardcore fans like fighting, and the league clearly doesn’t want to alienate them. At the same time, the league believes that violence is an intrinsic part of the game and that fighting is the safest means of expressing it.

“I think fighting acts as a thermostat to keep other things [orderly],” Bettman told a trade show in 2013. “I’d rather them be punching each other than swinging the sticks at each other.” He repeated this ridiculous rationalization as recently as November 2023, despite a lack of quantifiable evidence that throwing fists deters other violence during a hockey game.

In fairness, the NHL has implemented several rule changes over the years that improve player brain safety. In 1979, the league finally instituted a mandatory helmet rule (older players were still allowed to go without). Likewise, in 2010, the NHL prohibited deliberate checks to the head of an opposing player, with the specific goal of reducing concussions.

The league has also put in place changes designed to reduce fighting, including harsher penalties for players who start a fight (the so-called instigator rule) and a penalty for removing a helmet prior to engaging in a fight. These changes, combined with the NHL’s greater emphasis on skill players (rather than enforcers), have led to a drop in fighting, from 889 altercations during the 1986-87 season to 311 in 2023-24.

That’s all good, but nobody should take it to mean that the NHL is serious about reducing concussions or recognizing their connection to CTE. Fighting remains a sanctioned and regulated activity in the league’s rulebook. Players who engage in it can generally expect a five-minute penalty, and then a return to the game.

Contrast that with other leagues and tournaments. For example, the rulebook for the International Ice Hockey Federation, which oversees hockey at the Olympics, explicitly warns: “Fighting’ is not part of international ice hockey’s DNA.” Officials who oversee Olympic matches embrace that as a statement of purpose and are aided by rules that subject fighting to an automatic ejection (with referee discretion). The approach seems to work: fights at the Olympics are exceedingly rare. In 2014, the NYT reported that there had only been eight fights in more than 500 games since 1960.

The NHL could implement a similar warning and penalties. In light of everything that’s known about CTE and concussions, it absolutely should. By not taking these simple steps (which wouldn’t alter the quality of the hockey on the ice), the league has rendered itself complicit in the brain injuries that current players will incur in the name of entertaining its fans.

That decision will make for good viewership and attendance. But in time, it means that more players will die with neurodegenerative diseases.

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Adam Minter is a Bloomberg Opinion columnist covering the business of sports. He is the author, most recently, of “Secondhand: Travels in the New Global Garage Sale.’

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