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When hockey players lace up their skates, they don't often ponder the risk posed by the razor-sharp blades attached to their feet. Dr. Michael Stuart has thought about it for years, as both a hockey parent and chief medical officer for USA Hockey.

Stuart has never forgotten the fear he felt when his son, Mike, took a skate to the neck while playing for Colorado College in 1998. Mike needed 22 stitches to close the wound. A week later, he returned to play against the Gophers at Mariucci Arena, narrowly escaping the kind of tragedy that occurred last Saturday when Hibbing native Adam Johnson died in a similar incident.

"It was very, very frightening," said Stuart, a Rochester resident and orthopedic surgeon at the Mayo Clinic. "Thank goodness our son was spared. These injuries are rare, but it's something we're striving diligently to prevent."

The primary tool in that effort is the neck laceration protector, which is getting renewed attention in the wake of Johnson's death. The former Minnesota Duluth forward, 29, died after he was struck in the throat by a falling opponent's skate blade last week, while playing for the Nottingham Panthers of England's Elite Hockey League.

“I strongly believe it's our responsibility to keep our student-athletes as safe as we can.”
Mike Randolph, St. Thomas Academy coach

Many hockey organizations do not require neck guards. They are rarely worn in the NHL, college hockey or top-level minor leagues, rejected by players who find them uncomfortable or restrictive.

Johnson's death has prompted calls to make neck protectors mandatory, though it's not certain that using one would have saved him. In Stuart's role with USA Hockey, he's been involved with testing and development of neck guards for several years. While designs and materials have improved, he said the effectiveness of protectors varies widely, and no current product can completely prevent fatalities or serious injuries.

Johnson is the second U.S. hockey player in two years to suffer a fatal skate cut to the neck. Teddy Balkind, 16, died in January 2022 when he was injured during a prep school game in Greenwich, Conn.

Balkind's death shook the sport to its core, but it did not lead any major U.S. hockey organizations to make neck protectors mandatory. With Johnson's fatal injury spotlighting the danger again, some are giving them another look, including Gophers men's hockey coach Bob Motzko.

"We've ordered [neck guards]," said Motzko, whose team plays Minnesota Duluth in a home-and-home series this weekend. "We're going to have them available for guys who want to wear them, and we're going to promote it.

"Should they be mandatory, especially at the youth age? Yes. I think it's time. And once you start wearing them as a kid, you wear them all the way through. Let's start a whole new generation of putting those on."

History of incidents

It isn't known how many players suffer skate cuts each year. In a 2009 study of USA Hockey registered players, 1.8% reported having a neck laceration.

There have been other high-profile incidents, including serious injuries to NHL goaltender Clint Malarchuk and forward Richard Zedník. Army forward Eric Huss suffered a severe neck cut in a college game last January. Former St. Cloud State defenseman Will Borgen of Moorhead was slashed on the neck in 2014, and Holy Family defenseman Michael Spinner of Prior Lake required surgery in 2017 when a blade slit his jugular vein.

Minnesota Duluth coach Scott Sandelin, a member of the NCAA men's ice hockey committee, hopes college hockey will resume its discussion of neck guards.

"We play a game. There's risk," said Sandelin, who coached Johnson for two seasons. "But if we can mitigate that in some way, I think it does need to be looked at."

USA Hockey, which oversees youth and amateur play around the country, "strongly recommends" that players wear protective gear that covers as much of the neck as possible. But that equipment is not required. The organization regularly discusses neck protection and said it will continue to consider a rule change.

Though USA Hockey members are allowed to mandate neck guards, Minnesota Hockey, its affiliate in the state, reiterated Tuesday it will continue to follow USA Hockey's guidance. The Minnesota State High School League also recommends but does not mandate neck protectors, in accordance with national high school rules.

St. Thomas Academy coach Mike Randolph — whose son Jake played youth hockey with Johnson — said the MSHSL should immediately make neck guards mandatory. After Johnson's death, he promptly asked his school's activities director and booster club to buy them for his team.

"I told them, 'I don't care if you think I'm overreacting,'" said Randolph, who won more than 600 games and two state championships during 32 seasons at Duluth East. "I strongly believe it's our responsibility to keep our student-athletes as safe as we can."

Some organizations do require neck guards, especially for young players. The International Ice Hockey Federation mandates them for players 18 and younger. Hockey Canada requires them in its youth and women's leagues, and all three of Canada's major junior leagues have made them mandatory.

Johnson played 13 games for the NHL's Pittsburgh Penguins, and that organization said Tuesday its top minor-league affiliates will now require neck guards.

Guards still imperfect

Wild defenseman Jonas Brodin grew up in Sweden, where neck protectors are mandatory. He wore them until coming to the U.S. and remembered them as "crusty."

"I'm pretty used to it," Brodin said. "I probably could go back to it. Some guys don't like it, but now, they probably have some good ones, so you don't even feel them."

Newer models are designed to be both comfortable and effective. There are turtleneck undergarments with built-in protection, as well as styles that wrap around the neck like a cervical collar. Many incorporate slash-resistant materials such as Kevlar, which is used in bulletproof vests. They can cost less than $10 or more than $100.

“Should they be mandatory, especially at the youth age? Yes. I think it's time. And once you start wearing them as a kid, you wear them all the way through. ”
Bob Motzko, Gophers men's hockey coach

No matter how expensive or high-tech they are, Stuart cautioned that none can completely eliminate the risk of injury. In the USA Hockey survey, 27% of people who reported neck lacerations in hockey games said they were wearing a neck protector. There is little data on the guards' effectiveness, and no validated testing methods.

"It's not as simple as it seems," Stuart said. "There is a risk the skate blade could contact an area that isn't covered by the protector, or the blade could deflect off the protector into an unprotected area.

"A lot of manufacturers are working very hard to come up with the best possible protective devices. I hope we can come up with one that would make these injuries 100% preventable, but we don't have that now."

Player acceptance grows

Stuart said professional players are showing more awareness and interest in neck protectors, a key factor in getting players at all levels to accept them. He noted that most NHL players now wear cut-resistant socks to protect the backs of their legs, and more are wearing protective arm sleeves.

Gophers forward Charlie Strobel said neck protection "is obviously something that needs to be addressed." He is willing to wear one, and so is Ella Huber, a forward on the Gophers women's team.

Huber used a neck protector in club hockey. After Johnson's fatal injury, she thinks many in the hockey community will consider wearing them.

"Comfort-wise, they're just annoying," Huber said. "But [Johnson's death] is a wake-up call. It's OK to be annoyed."

Change could come more slowly to the NHL. In 1968, when players didn't wear helmets, North Stars forward Bill Masterton hit his head on the ice at Met Center and suffered a brain injury that led to his death. Yet the league waited 11 years before it made helmets mandatory.

NHL Players' Association executive director Marty Walsh said he plans to continue discussions with Commissioner Gary Bettman about how to protect players from skate cuts. "We're going to explore everything," Walsh told the Associated Press. "It's a change for the players, but it's also about protecting them."

Wild forward Pat Maroon thinks players are ready to consider it. Last season, when he played for Tampa Bay, he was on the other side of a scary skate cut when his blade accidentally sliced the wrist of Edmonton's Evander Kane.

"If they put [neck guards] in, you have to wear it, right?" Maroon said. "If there's a vote and players have to vote, I'm sure people would vote and be on board."

Stuart, USA Hockey's chief medical officer, is now a hockey grandfather who recently advised his daughter on what kind of neck protector to buy for his grandson. He also will participate in an International Ice Hockey Federation meeting Saturday to reassess safety measures in the wake of Johnson's fatal injury.

Given his son's close call, Johnson's death has touched him in a deeply personal way, reinforcing his dedication to preventing one of hockey's most frightening injuries.

"We're going to keep working through the challenges to effectively make our sport safer," Stuart said. "This was a horrible tragedy. Maybe it will be an impetus for change."

Star Tribune staff writers Christa Lawler, Sarah McLellan and David La Vaque contributed to this report.