“I could’ve been paralyzed”

Josh Wagler sits at the kitchen table of his family’s rural home, minutes outside of Tavistock.

His upper body’s immobilized in a one piece body and head brace, forcing his body to move in unison for every twist and turn, making it impossible to look either left or right.

His skull’s encased in a head frame resembling a medieval torture device rather than the medical necessity it is. The frame keeps his neck and head in place, but the four screws inserted directly into his skull ensure his body’s kept in one piece.

Wagler’s eight weeks removed from being checked from behind in a juvenile hockey game and still feels the constant pain after breaking his neck with a C5 flexion teardrop fracture.

Despite the near catastrophic injury, he’s remained positive and smiles consistently through an hour long interview knowing he’ll make a full recovery with physiotherapy, but one look at his situation inspires a cringe.

“It’s almost depressing. You can’t move and it’s hard to get used to. You feel trapped and want to get out of the bars,” Wagler said of the frame keeping his neck isolated from sudden movement. “It’s like I’m in jail.”

***

Wagler and his Tavistock team were playing against a fellow juvenile team from Waterford Nov. 29, 2015. With five minutes left, he was shoved head first into the boards and stayed down.

When the trainer came out, Wagler laid on the ice, saying his neck was sore but skated back to the bench after being helped to his skates. He stayed on the bench but when he tried to shower after the game he couldn’t lift his hands above his shoulders to wash his hair and was the last one out of the room. He managed to carry his bag to his truck, drove himself the five minutes home and swayed his hockey bag back and forth through the hallway obstacles of his house before lying on the couch.

“I didn’t know I had a broken neck. All I had to do was sneeze or move one way too fast and I would’ve been paralyzed.”

After texting his friend Hannah, a nursing student, he drove himself to nearby St. Marys General Hospital. After being examined, he was sent by ambulance to Stratford General Hospital, immobilized in a neck brace then went back to St. Marys General Hospital for further results where it was deemed vital to send him to Victoria Hospital in London.

“That’s when it got really scary because you know London’s where they send the big problems,” Wagler said. “It’s scary not knowing what’s happening. I heard a nurse say if it’s a small fracture you might only have to wear a neck brace for awhile… Next thing they’re telling me I’m going to London.”

With no beds available at Victoria Hospital, he lied on a stretcher in the emergency room for 30 minutes and got a CT scan. He lied on a bed in a hallway for 10 hours overnight before doctors said he could have surgery or wear a halo.

“We (him and his parents) were shocked and looked at one another and said, ‘is there an option three?’ He (the doctor) said no,” Wagler recalls. “We tried to reason with him to find another way and he said as bad as the fracture is, those are the only two options.”

The halo was installed with four people inserting screws into his skull at the same time under a local anesthetic and each one torqued to eight pounds.

“The pressure was unbearable. I thought my skull was going to crack. You’ve got four screws into your skull and I’m sitting there with tears going down my cheeks. I’m clenching the nurses fingers and all I had was local anesthetic,” Wagler said. “I didn’t feel it going through the skin, but I could feel it turning into the skull with each turn. My mom’s in the hallway crying. It’s something no one should go through.”

***

In the last decade, checking from behind and spinal injuries has largely taken a back seat to concussions in hockey. After years of silence on the issue, hockey governing bodies began running initiatives and programs to educate players in attempts to limit spinal injuries. While changes weren’t immediately felt, over a 30-year period the amount of spinal injuries began going down as a new generation of player accepted and learned as new rules were introduced.

According to a 2000 report in the Canadian Medical Association Journal by Dr. Charles Tator, Dr. James Carson and Dr. Robert Cushman, between 1981 and 1996 there were an annual average of 14 spinal injuries in hockey, with six resulting in death. Of the 210 players with spinal injuries during the time frame, half were between 15 and 20.

Parachute, a group designed to raise awareness for injury prevention, has kept track of spinal cord injuries in hockey in a registry established in 1981. From 2006 to 2011, they found there were 44 spinal cord injuries in hockey, with Tator saying that number has also fallen in the years since. Minor hockey leagues have also brought in stiffer penalties and suspensions for checking from behind and individual associations also have programs to increase awareness.

“Injury prevention programs are working, but we continue to have to do a better job of raising awareness. It’s discouraging to see broken necks continue to happen, but it’s still nowhere near the peak years more than two decades ago,” Tator, who opened the first acute spinal cord centre at Sunnybrook Medical Centre in Toronto in 1974, said. “These aren’t trivial injuries, but lifelong ones that can cause permanent disability.”

While medical experts were the first to voice a change in the culture of checking from behind, the STOP (Safety Towards Other Players) program began to get minor hockey levels on board. Created in Windsor by Kevin Stubbington in 1997, the program put a three-inch patch shaped like a stop sign with the word stop capitalized in the centre on the back of each players’ jersey. The program spread throughout the Ontario Minor Hockey Association then all of Hockey Canada and is now used in much of the hockey world.

However, with a generation of players being used to the stop sign it’s become as normal as seeing a logo, number or name on the jersey.

“I’ve always had the stop sign on my jersey,” Wagler, who played in the Tavistock Minor Hockey Association, which is part of the Ontario Minor Hockey Association, who in turn is under the Ontario Hockey Federation then Hockey Canada’s governing umbrella. “You just get used to it after awhile. It’s almost like you don’t see it anymore.”

In 2005, Hockey Canada enhanced rules to limit checks from behind saying, “we want to continue to work to eliminate any contact from behind, as the resulting injuries, especially head and neck injuries, can be catastrophic.”

Under Hockey Canada’s most recent rule book, ‘Rule 6.4 checking from behind’ is under the discretion of the referee “based on the degree of violence of the impact; shall be assessed any player who intentionally pushes, body checks, or hits an opposing player from behind, anywhere on the ice.” The rule book further gives detailed guidelines for officials on penalizing plays that could result in spinal injuries.

Throughout the history of the sport, there’s been one identifying risk after another that could lead to player injury but safety measures have eventually been put in place. When goalies and players were hit in the face with pucks, masks and helmets were introduced. After incidents leading to eye injuries were a semi-regular occurrence, visors were brought in and eventually made grandfathered in for new players.

“The game changes slowly, but it does change. In the professional game, they believe violence is what the public wants,” Tator, a neurosurgeon with Toronto Western Hospital and the foremost expert in the field of spinal and head injuries in hockey, said. “However, the evidence mounted and rules were slowly altered to reflect the repetitive injuries that were occurring. There still needs to be a cultural shift in hockey.”

***

At the local level, their continue to be initiatives to educate players. While the bulk of attention has gone towards concussions, preventative lessons in avoiding checks from behind have continued, say five local minor hockey associations.

The Sentinel-Review contacted the Woodstock Minor Hockey Association, the Norwich Minor Hockey Association, the Tavistock Minor Hockey Association, the Embro Minor Hockey Association and the Ingersoll and District Minor Hockey Association with all five saying they run bodychecking clinics before players enter the bantam level at age 13 when checking’s begins. The Ontario Minor Hockey Association and Hockey Canada also have resources to train coaches.

“It’s been night and day in the last 20 years. I remember taking my kids to the rink when they were starting (hockey) and there wasn’t much for coaches. It had started, but it was a work in progress,” WMHA president Michael Collins said. “Now, there are clinics, coaches have to get certification, many hockey associations have a director specifically for initiatives like that but there’s always room to improve.”

For as much education is given, it can ultimately come down to the players, coaches, parents and hockey association administrators.

A 2014 York University study by Jessica Fraser-Thomas titled, “I like that you can hit a guy and not really get in trouble: Young ice hockey players’ experience with body checking” showed players enjoyed the hitting aspect of the sport but showed remorse if an injury came from a hit. The report focused on the psychological and social risks of body checking for youth hockey players.

“It’s more than just the young players not connecting the dots; their coaches and parents aren’t either,” Fraser-Thomas says in the report. “The control and intimidation, much of that message is coming from the parents. They are advocating and coaching the kids to ‘hit’ the other players. They are advised to use their body size, if they are physically bigger, to their advantage. And at that age, there is a significant difference of body sizes.”

Wagler mentioned the continuance of unnecessary violence at all levels was a constant scene in minor hockey.

“I love the hitting and it shouldn’t be taken out, but players have to know they can’t throw guys around. I’ve seen coaches say, ‘you need to take so and so out.’ Other times I’ve seen parents yell to attack another player,” Wagler said. “At times, it’s become a game of anger and to hurt someone. That’s not what hockey’s supposed to be.”

***

The number of spinal injuries have dwindled, but they still continue with one close call after another.

There was Montrealer Andrew Zaccardo, who was hit from behind in a 2011 midget ‘AA’ game and rendered a quadriplegic. Denver University’s Jesse Martin was hit from behind in 2011 and suffered three fractures to his C2 neck vertebra, but after a long rehabilitation was able to walk. Neil Doef of Smith Falls fractured his C7 vertebra in a Dec. 2014 Junior A game and Denna Laing of the Boston Pride in the National Women’s Hockey League suffered a spinal injury during the league’s outdoor classic game. The University of Michigan-Flint’s Andy Lay suffered a spinal injury five days before Wagler’s.

“I’d like to see it down to zero, but we’ve made progress. People, especially at minor hockey levels, are realizing the ramifications one single check from behind can have,” Tator said. “The game can be played safely and enjoyed without violence. If people want to see that, there are different sports.”

While initially despondent to his situation, Wagler decided to open up about his experiences and talked to local teams in an effort to educate and inform.

“I figured I may as well do something good about it. If you look at me, that sends a message,” he said. “I think seeing me with this on scares people. I have friends who see me and it’s traumatizing at first. I hope it makes people think I don’t want this to happen to anyone.

“I love hitting in hockey and it shouldn’t be taken out, but you can’t hit players in vulnerable positions,” he added. “I don’t know what needs to be in place if it’s people like me getting my story out. When you’re young there’s constant clinics to drill it into a players’ head, but as older guys there’s none of that. There’s nothing to stop someone from thinking twice about a hit… I could’ve been paralyzed.”