MONTREAL -- This used to be the hockey's mindset towards concussions.
Shaun Van Allen was playing for the Edmonton Oilers in 1992-93 and was in on the forecheck against the Washington Capitals, chasing Caps defenceman Kevin Hatcher behind the Caps net in the old Cap Center in Landover, Md.
"I was trying to get a stick on him when I lost my balance and went backwards into the boards," Van Allen said. "I knocked myself out."
He was wheeled off the ice on a stretcher and came to in the dressing room.
"I didn't know I was in the NHL. It's every kid's dream to play in the NHL and I didn't even know I was there. I didn't know I was married," Van Allen said.
Out on the Oilers bench, coach Ted Green -- who had a steel plate in his head after a stickswinging incident with Wayne Maki -- wondered about Van Allen's possible return to the game.
"He doesn't know who he is," the trainer said.
"Well," Green said, "tell him he's Wayne's Gretzky."
Van Allen spent the night in hospital and the team moved on to its next game.
"I think I got some help from a nurse to put me on a plane the next day to fly back to Edmonton," Van Allen said. "I took a whole month off before I played again. I was kind of like in a fog. It was like time stopped and the next thing I knew, the day was over."
It's pretty much taken a generation of hockey players, but that attitude of "shake it off and get back out there," toward concussions is changing. Unfortunately, it took the generation of hockey players who started hitting each other in the head on a regular basis to affect the change.
"It just isn't a ding or seeing stars. It's a brain injury," said Dr. Charles Tator, one of Canada's leading experts on concussions and their effects. "The definition of a concussion has changed and many people don't know that, including members of my profession. People with concussions are being mismanaged by their medical practitioner."
"If you see a teammate on crutches, with a cast or a brace, you don't question their integrity or their commitment to their teammates," said Dr. Paul Dennis, the sports psychologist who worked for two decades with the Toronto Maple Leafs now retired and lecturing at York University and the University of Toronto.
"When it's a concussion and it's invisible, it's not considered a real injury because it's hidden."
Several myths about concussions have been dismissed as both the attitude toward them and the knowledge of diagnosing and treating them has evolved, particularly over the last decade.
"There isn't any more peer pressure in trying to force a guy back from a concussion," said Ottawa Senators forward Ryan Shannon, who has suffered at least two concussions. "If a guy has a sprained ankle in the playoffs, guys might say, 'hey, shoot it up, let's get on with it,' but when it comes to the head, that has been removed. It has been a gradual process."
"Ten years ago, there were a lot of misconceptions toward this injury and I think it's beginning to change now," said Dr. Ruben Echemendia, the NHL's neuropsychologist. "I think people are starting to recognize how truly complex this injury can be and it really doesn't show up the same in two people.
"If I could just wave a magic wand, I would wave the wand so that players would understand that they absolutely have to be honest about their symptoms. The earlier they tell us what is going on with them, the less time lost and the better off they're going to be down the road."
The body of knowledge about concussions is growing as more and more research is focused on the issue.
"Not all concussions are obvious," said Dr. Jamie Kissick, the former team physician for the Ottawa Senators whose main clinical interest is concussions in athletes.
Tator said only one in 20 concussions occur along with the player being knocked out.
"A concussion is caused by the brain moving inside the skull," Tator said. "That jiggling is not prevented by a helmet.
"Regardless of what you hear or who you hear it from, there is no such thing as a concussion helmet. They don't exist."
"My message would be take as much time as it takes. If you haven't been feeling (any symptoms) for two weeks, take another two weeks," said Kevin Mailhiot, a former first-round draft pick in the Quebec Major Junior Hockey League (sixth overall in 2002 by Drummondville).
He told the Hockey Canada concussion seminar he suffered seven concussions in his young career before deciding to quit after sustaining his last concussion in practice. He couldn't resist his love for the game, however, and he was allowed to return to play. The anxiety he felt about sustaining another concussion finally overwhelmed his love of the game.
He simply couldn't consider going through another post-concussion experience like he had.
"Not to be sensational, but I remember crying for two months, morning, lunch and night," he said. "School had always been important to me and I was a good student, but my grades slipped to 60-65% and those were not the best grades for me. I couldn't remember what was taught. I couldn't read.
"I knew that was it for me," he said. "Today, with the information I have (about the long-term effects of repeated concussions), I might have made a different decision about coming back."