Unboxed: Stand-Up Desks Gaining Favor in the Workplace

THE health studies that conclude that people should sit less, and get up and move around more, have always struck me as fitting into the “well, duh” category.

But a closer look at the accumulating research on sitting reveals something more intriguing, and disturbing: the health hazards of sitting for long stretches are significant even for people who are quite active when they’re not sitting down. That point was reiterated recently in two studies, published in The British Journal of Sports Medicine and in Diabetologia, a journal of the European Association for the Study of Diabetes.

Suppose you stick to a five-times-a-week gym regimen, as I do, and have put in a lifetime of hard cardio exercise, and have a resting heart rate that’s a significant fraction below the norm. That doesn’t inoculate you, apparently, from the perils of sitting.

The research comes more from observing the health results of people’s behavior than from discovering the biological and genetic triggers that may be associated with extended sitting. Still, scientists have determined that after an hour or more of sitting, the production of enzymes that burn fat in the body declines by as much as 90 percent. Extended sitting, they add, slows the body’s metabolism of glucose and lowers the levels of good (HDL) cholesterol in the blood. Those are risk factors toward developing heart disease and Type 2 diabetes.

“The science is still evolving, but we believe that sitting is harmful in itself,” says Dr. Toni Yancey, a professor of health services at the University of California, Los Angeles.

Yet many of us still spend long hours each day sitting in front of a computer.

The good news is that when creative capitalism is working as it should, problems open the door to opportunity. New knowledge spreads, attitudes shift, consumer demand emerges and companies and entrepreneurs develop new products. That process is under way, addressing what might be called the sitting crisis. The results have been workstations that allow modern information workers to stand, even walk, while toiling at a keyboard.

Dr. Yancey goes further. She has a treadmill desk in the office and works on her recumbent bike at home.

If there is a movement toward ergonomic diversity and upright work in the information age, it will also be a return to the past. Today, the diligent worker tends to be defined as a person who puts in long hours crouched in front of a screen. But in the 19th and early 20th centuries, office workers, like clerks, accountants and managers, mostly stood. Sitting was slacking. And if you stand at work today, you join a distinguished lineage — Leonardo da Vinci, Ben Franklin, Winston Churchill, Vladimir Nabokov and, according to a recent profile in The New York Times, Philip Roth.

DR. JAMES A. LEVINE of the Mayo Clinic is a leading researcher in the field of inactivity studies. When he began his research 15 years ago, he says, it was seen as a novelty.

“But it’s totally mainstream now,” he says. “There’s been an explosion of research in this area, because the health care cost implications are so enormous.”

Steelcase, the big maker of office furniture, has seen a similar trend in the emerging marketplace for adjustable workstations, which allow workers to sit or stand during the day, and for workstations with a treadmill underneath for walking. (Its treadmill model was inspired by Dr. Levine, who built his own and shared his research with Steelcase.)

The company offered its first models of height-adjustable desks in 2004. In the last five years, sales of its lines of adjustable desks and the treadmill desk have surged fivefold, to more than $40 million. Its models for stand-up work range from about $1,600 to more than $4,000 for a desk that includes an actual treadmill. Corporate customers include Chevron, Intel, Allstate, Boeing, Apple and Google.

“It started out very small, but it’s not a niche market anymore,” says Allan Smith, vice president for product marketing at Steelcase.

The Steelcase offerings are the Mercedes-Benzes and Cadillacs of upright workstations, but there are plenty of Chevys as well, especially from small, entrepreneurial companies.

In 2009, Daniel Sharkey was laid off as a plant manager of a tool-and-die factory, after nearly 30 years with the company. A garage tinkerer, Mr. Sharkey had designed his own adjustable desk for standing. On a whim, he called it the kangaroo desk, because “it holds things, and goes up and down.” He says that when he lost his job, his wife, Kathy, told him, “People think that kangaroo thing is pretty neat.”

Today, Mr. Sharkey’s company, Ergo Desktop, employs 16 people at its 8,000-square-foot assembly factory in Celina, Ohio. Sales of its several models, priced from $260 to $600, have quadrupled in the last year, and it now ships tens of thousands of workstations a year.

Steve Bordley of Scottsdale, Ariz., also designed a solution for himself that became a full-time business. After a leg injury left him unable to run, he gained weight. So he fixed up a desktop that could be mounted on a treadmill he already owned. He walked slowly on the treadmill while making phone calls and working on a computer. In six weeks, Mr. Bordley says, he lost 25 pounds and his nagging back pain vanished.

He quit the commercial real estate business and founded TrekDesk in 2007. He began shipping his desk the next year. (The treadmill must be supplied by the user.) Sales have grown tenfold from 2008, with several thousand of the desks, priced at $479, now sold annually.

“It’s gone from being treated as a laughingstock to a product that many people find genuinely interesting,” Mr. Bordley says.

There is also a growing collection of do-it-yourself solutions for stand-up work. Many are posted on Web sites like howtogeek.com, and freely shared like recipes. For example, Colin Nederkoorn, chief executive of an e-mail marketing start-up, Customer.io, has posted one such design on his blog. Such setups can cost as little as $30 or even less, if cobbled together with available materials.

UPRIGHT workstations were hailed recently by no less a trend spotter of modern work habits and gadgetry than Wired magazine. In its October issue, it chose “Get a Standing Desk” as one of its “18 Data-Driven Ways to Be Happier, Healthier and Even a Little Smarter.”

The magazine has kept tabs on the evolving standing-desk research and marketplace, and several staff members have become converts themselves in the last few months.

“And we’re all universally happy about it,” Thomas Goetz, Wired’s executive editor, wrote in an e-mail — sent from his new standing desk.

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Port-strike talks continue even on Sunday, but stalemate goes on

At least they are talking, even on Sunday.

Labor contract negotiations are set to resume today in the now six-day-old strike at the ports of Los Angeles and Long Beach. Talks had continued past 9 p.m. Saturday night.

The strike, by the 800-member International Longshore and Warehouse Union Local 63 Office Clerical Unit, has shut down 10 of the 14 cargo container terminals at the nation's busiest seaport complex.

The labor fight pits the union against a group of shipping lines and cargo terminal operators calling themselves the Los Angeles/Long Beach Harbor Employers Assn.

The strike is considered a potentially disastrous event for the Southern California economy because the ports of Los Angeles and Long Beach are the leading contributors to the region's goods movement industry that employs about 595,000 people.

Last year, the two ports handled 39.5% of the total value of all cargo container imports entering the U.S. from origins worldwide, according to Jock O'Connell, international trade economist and adviser to Beacon Economics.

The union, which handles the vast amount of paperwork associated with the ports' container cargo, has been working without a contract since June 30, 2010.

The strike has crippled the port because of support from the ILWU dockworkers, who have 50,000 members on the U.S. West Coast, in Canada and in Hawaii. The dockworkers negotiate their contracts separately, but the 10,000 members who work at the Los Angeles and Long Beach ports have honored the smaller union's picket lines.

As a result, seven of the eight cargo container terminals at the Port of Los Angeles remain closed. Three of the six cargo container terminals at the Port of Long Beach are also closed.

The union says that its main issue is what it claims is the outsourcing of its jobs, which are being lost through attrition, retirements, illnesses or other reasons.

The shipping lines and terminal operators say the union's outsourcing claims are bogus and say they have offered "absolute job security."

The employers have repeatedly said the union members are the highest-paid clerical workers in the U.S., having a total compensation package of $165,000 a year, including wages, benefits, pension contributions and paid vacation. That package would be worth $195,000 a year under management's new offer, the employers have said.

On Saturday, the union offered a rebuttal, saying that the employers' claims were misleading. Wages reached $40 to $41 an hour, for an annual pay level of $80,000 to $82,200 a year, not counting overtime, retirement or benefits. The union has asked for a 2.5% raise, said union spokesman Craig Merrilees.

Merrilees added that the union has had one pay increase in the past four years.

Since the strike started, nine ships have either diverted at sea or briefly anchored outside the ports before leaving to unload at another harbor.

There were no new ship diversions reported on Sunday, said Capt. Dick McKenna, executive director of the Marine Exchange of Southern California, which tracks vessel movements.

Other than the lightly manned picket lines, the ships were the biggest evidence of the strike on Sunday.

Nine cargo container ships were anchored offshore Sunday: the APL London; the Hanjin ships Constantza, Algeciras and Chongqing; the Hyundai Hong Kong; the Ital Contessa; the Kota Wangsa; the Maersk Merlion; and the Liberian-flagged Talassa.

Normally, those ships would have gone straight to dock for unloading, but there is no room for them yet because of the strike.

Three more container ships are due to arrive today and 11 more container ships are scheduled to arrive on Monday.

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Jovan Belcher of Kansas City Chiefs dead in suspected murder-suicide

Jovan Belcher of the Kansas City Chiefs shot and killed his girlfriend, then drove to the team’s practice facility and killed himself in front of team officials, police said Saturday.

Police confirmed to the Kansas City Star the player was Belcher, 25, one of the team’s starting linebackers and a four-year veteran of the NFL.

PHOTOS: Jovan Belcher's NFL career

In a briefing outside of Arrowhead Stadium, Kansas City Police Department spokesman Darin Snapp said the player shot his girlfriend “several times” at about 7:50 a.m. local time Saturday. The victim’s mother was there and reported the shooting.

By the time police arrived, Belcher was gone. Twenty minutes later, police were called to Arrowhead Stadium’s practice facility. Belcher was outside of the facility’s front doors with a gun to his head. According to the Associated Press, Chiefs Coach Romeo Crennel and General Manager Scott Pioli were there at the time and were talking to Belcher.

The player shot himself just as police arrived.

Snapp said Belcher and his girlfriend had been arguing recently, but offered no further details.

The area where Belcher shot himself was locked down briefly but has since reopened.

The Chiefs coaches called a team meeting for later in the day, Snapp said.

NFL executives and players took to Twitter after the incident.

Said NFL Players Assn. Assistant Executive Director George Atallah: “There is nothing profound or comforting to say that can help us understand or explain a situation like this. We have been in touch with players. At a time like this, we can only come together as a family and a community.”

Oakland Raiders wide receiver Darrius Heyward-Bey tweeted: “Very sad day in the NFL FAMILY. My prayers go out [to] the Chiefs and families involved.”

Louis Murphy Jr., a wide receiver with the Carolina Panthers, tweeted: “Thoughts and prayers go out to the Kansas City Chiefs players and family.”

The Chiefs  are scheduled to play the Carolina Panthers on Sunday at Arrowhead Stadium. The NFL told the Panthers to continue traveling to Kansas City for Sunday’s game, the Charlotte Observer reported.

joseph.serna@latimes.com

twitter.com/josephserna

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JLo tones down concert in Indonesia

JAKARTA, Indonesia (AP) — Jennifer Lopez wowed thousands of fans in Indonesia, but they didn't see as much of her as concertgoers in other countries — the American pop star toned down both her sexy outfits and her dance moves during her show in the world's most populous Muslim country, promoters said Saturday.

Lopez's "Dance Again World Tour" was performed in the country's capital, Jakarta, on Friday in line with promises Lopez made to make her show more appropriate for the audience, said Chairi Ibrahim from Dyandra Entertainment, the concert promoter.

"JLo was very cooperative ... she respected our culture," Ibrahim said, adding that Lopez's managers also asked whether she could perform her usual sexy dance moves, but were told that "making love" moves were not appropriate for Indonesia.

"Yes, she dressed modestly ... she's still sexy, attractive and tantalizing, though," said Ira Wibowo, an Indonesian actress who was among more than 7,000 fans at the concert.

Another fan, Doddy Adityawarman, was a bit disappointed with the changes.

"She should appear just the way she is," he said, "Many local artists dress even much sexy, much worse."

Lopez changed several times during her 90-minute concert along with several dancers, who also dressed modestly without revealing their chests or cleavage.

Most Muslims in Indonesia, a secular country of 240 million people, are moderate. But a small extremist fringe has become more vocal in recent years.

They have pushed through controversial laws — including an anti-pornography bill — and have been known to attack anything perceived as blasphemous, from transvestites and bars to "deviant" religious sects.

Lady Gaga was forced to cancel her sold-out show in Indonesia in May following threats by Islamic hard-liners, who called her a "devil worshipper."

Lopez will also perform in Muslim-majority Malaysia on Sunday.

"Thank you Jakarta for an amazing night," the 43-year-old diva tweeted to her 13 million followers Saturday.

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Small Employers Weigh Impact of Providing Health Insurance

Erich Schlegel for The New York Times

Robert Mayfield, who owns Dairy Queen franchises in Texas, says he is “scared to death” of the new health care law.

Like many franchisees, Robert U. Mayfield, who owns five Dairy Queens in and around Austin, Tex., is always eager to expand and — no surprise — has had his eyes on opening a sixth DQ. But he said concerns about the new federal health care law had persuaded him to hold off.

Laura Pedrick for The New York Times

Bob Bellagamba, who runs Concorde Limousine in Freehold, N.J., says there is too much uncertainty about the new law.

“I’m scared to death of it,” he said. “I’m one of the ones sitting on the sidelines to see what’s really going to happen.”

Mr. Mayfield, who has 99 employees, said he was worried he would face penalties of $40,000 or more because he did not offer health insurance to many of his full-time workers — generally defined as those working an average of 30 hours a week or more. Ever since the law was enacted in 2010, opponents have argued that employers who were forced to offer health insurance would lay off workers or shift more people to part-time status to compensate for the additional cost. Those claims have drawn considerable attention — and considerable anger in response — in recent weeks.

John H. Schnatter, the chief executive of Papa John’s, the pizza chain, said some franchisees were likely to reduce their employees’ hours to avoid having to provide coverage. And an unhappy Denny’s franchise owner in Florida warned that he would raise prices 5 percent as a “surcharge,” adding that disgruntled customers could offset that by reducing their tips.

Some health care experts said comments like those came from outliers and sometimes resulted from confusion about a highly complicated new law, the Patient Protection and Affordable Care Act. Many of the provisions do not go into effect until 2014. Federal officials are still tweaking the fine print, like defining exactly what constitutes a 30-hour workweek. Even so, restaurants and hotels are among the industries likely to be squeezed the hardest by the law because they are low-wage industries that do not offer coverage to most of their workers.

Most employers, even small businesses, already offer health insurance, and the federal law is not expected to have a significant impact on what they do over the next year or so. But businesses that rely heavily on low-income workers, many of whom do not make enough to afford their share of the cost of the insurance premiums, are being forced to rethink their business models.

Almost half of retail and hospitality employers do not offer coverage to all their full-time employees, according to a recent survey by Mercer, a benefits consultant.

“They’re all developing their strategies,” said Debra Gold, a senior partner with Mercer who advises several major retailers.

Many who oppose the requirement say the cost of providing health insurance could mean hiring fewer workers. “Any dollar that gets diverted, whether it’s through Obamacare or increased tax rates, puts franchisees one dollar further away from being able to expand their businesses,” said Don Fox, chief executive of Firehouse Subs, a fast-growing chain of 559 restaurants based in Jacksonville, Fla. At the 30 stores the corporation owns, only full-time managers are offered coverage. Mr. Fox is wrestling with whether to absorb the considerable cost of covering 100 more employees or pay the penalties — which would probably cost him less — but risk losing valued employees to competitors who choose to offer coverage.

Employee health coverage now averages nearly $6,000 for an individual plan. That is considerable for businesses like restaurants in which the majority of workers make $24,000 a year or less, according to research by the Kaiser Family Foundation. The foundation found that only 28 percent of companies that employ large numbers of low-income workers offer health benefits. “This is where the biggest set of hurdles is,” said Gary Claxton, an executive with Kaiser.

By 2014, businesses with 50 or more full-time employees will be expected to offer as yet undefined affordable coverage, based on an employee’s income. For employers that fail to offer such coverage, the law typically calls for a penalty of $2,000 a worker, excluding the first 30 employees. As evidence of how sensitive the issue is, Mr. Schnatter of Papa John’s took some heat for his initial statements about the possibility that franchisees would cut employees’ hours to avoid penalties or having to provide coverage. His comments, made during a public appearance, were reported by a local newspaper in Florida, The Naples News. After facing a storm of criticism, he wrote an opinion piece for The Huffington Post, in which he said he had only been speculating about the law’s potential impact on franchisees.

“Papa John’s, like most businesses, is still researching what the Affordable Care Act means to our operations,” he wrote. “Regardless of the conclusion of our analysis, we will honor this law, as we do all laws, and continue to offer 100 percent of Papa John’s corporate employees and workers in company-owned stores health insurance as we have since the company was founded in 1984.” Through a spokesman, Mr. Schnatter declined to comment further.

This article has been revised to reflect the following correction:

Correction: November 30, 2012

An earlier version of this article misspelled the first name of an executive with the Kaiser Family Foundation. He is Gary Claxton, not Glary.

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Sharon Stone sells Beverly Crest compound for $6.575 million

Hot Properties columnist Lauren Beale talks with Chad Rogers, an agent with Hilton & Hyland in Beverly Hills, about real estate deals in Venice, Malibu, Santa Monica and Beverly Hills.

Actress Sharon Stone has sold a compound in the Beverly Crest area for $6.575 million.

The buyer is producer Lili Zanuck, widow of film producer Richard Zanuck.

Surrounded by walls and gated, the Mediterranean-style estate sits on 5 acres with pathways, bridges, waterfalls, fruit trees, a meditation garden, a swimming pool and a tennis court with viewing pavilion.

The main house, built in 1991, includes a paneled library, a wet bar in the living room and a master suite with dual bathrooms, dual dressing rooms and a terrace. The guest house contains a media room, a gym and two bedrooms, for a total of seven bedrooms, 8.5 bathrooms and four fireplaces. There is covered parking for about 14 cars.

Stone, 54, starred in the 1990s films "Total Recall," "Basic Instinct" and "Casino," for which she was nominated for an Academy Award. Her more recent work includes this year's thriller "Border Run," "The Burma Conspiracy" (2011) and appearances on "Law & Order: Special Victims Unit" (2010). She will star in the upcoming films "Gods Behaving Badly" and "What About Love."

The actress bought the property in 2006 for $10.995 million and put it back on the market later that year at $12.5 million, according to the Multiple Listing Service. She has since leased out the estate. It was most recently priced at $7.5 million.

Zanuck, 58, shared a best picture Oscar with her late husband for "Driving Miss Daisy" (1989). Her other credits include "Cocoon" (1985) and "Reign of Fire" (2002).

Joe Babajian of Rodeo Realty, Beverly Hills, was the listing agent. Marisa Zanuck of Hilton & Hyland represented the buyer. She is Lili Zanuck's daughter-in-law.

A-lister's place is a blockbuster

Actor Leonardo DiCaprio has put a Malibu investment property up for sale at $23 million.

The oceanfront Cape Cod-inspired compound was leased out for three months this summer at $150,000 a month.

All three homes, which sit on a lot that is less than a half-acre in size, have recently been remodeled. There are a total of seven bedrooms and 6.5 bathrooms in an undisclosed number of square feet. Outdoor features include a beachfront deck, a fire pit, gardens and lawn.

DiCaprio, 38, starred in "Titanic" (1997), "The Departed" (2006) and "J. Edgar" (2011). He will be Jay Gatsby in "The Great Gatsby," due out next year, and stars in "Django Unchained," to be released Christmas Day.

Public records show the property changed hands in 2002 for $6 million.

Kathryn Bentzen of Arete Estates is the listing agent.

Actor cast in Venice scene

Actor Matthew Modine and his wife, Cari, have bought a home on a walk street in Venice for $2.45 million.

Built in 2003 and designed for entertaining, the contemporary house features an open floor plan, heated polished concrete floors and sliding glass doors that open to a courtyard garden with a fireplace. Including the master suite, which takes up the entire second floor, there are two bedrooms, 2.5 bathrooms and about 2,000 square feet of living space. A bridge from the main house leads to the second bedroom above the three-car garage.

The property came on the market in late September at $2.395 million.

Modine, 53, was a regular on "Weeds" in 2007. He is in this year's Batman movie "The Dark Knight Rises" and will be in the 2013 biopic "Jobs."

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Tennis umpire Lois Goodman wants job back after murder case dropped

Professional tennis umpire Lois Goodman, who had been accused by prosecutors of killing her 80-year-old husband, will now try to resume her life after a judge dismissed the case against her Friday.

"This is a wonderful woman whose name was tarnished all over this country, and hopefully today everybody knows that she didn't do anything and she is absolutely innocent," defense attorney Alison Triessl, said.

Goodman's husband died in April in what she has maintained was an accidental fall. A coroner's investigator, though, found the death suspicious after determining that Alan Goodman died of "deep penetrating blunt force trauma," and a months-long investigation ensued.

Goodman, a longtime umpire for the United States Tennis Assn., was officiating qualifying matches at the U.S. Open this past summer when police arrested her in New York. The case generated national headlines.

At the request of the Los Angeles County district attorney's office, which said it "could not proceed," a judge dismissed the case without prejudice, meaning prosecutors have the option to refile charges against her. A spokeswoman for the district attorney's office said it will continue to investigate.

After Friday's court hearing, Goodman said she feels "wonderful" and thanked the D.A.'s office for "doing the right thing." She and her attorneys skirted questions about whether the investigation was shoddy and the charges premature.

"I don't know much about the system," Goodman said. "I feel I have been treated fairly now and it was just a tragic accident."
When asked if she would return to her job as a tennis umpire, Goodman said, "Definitely!"

"And to the USTA," Triessl added, "please rehire this woman. She is an amazing lines judge, and she deserves to work for you."

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Katy Perry, Carly Rae Jepsen get Billboard honors

NEW YORK (AP) — Billboard named Katy Perry its woman of the year, but the pop star thought her year was 2011.

"I felt like my year was last year ... I thought my moment had passed," Perry said in an interview with Jon Stewart at Billboard's Women in Music event Friday in New York City.

Perry released "Teenage Dream" in 2010, and the double platinum album sparked five No. 1 hits on the Billboard Hot 100 chart that spilled over to 2011. She tied the record Michael Jackson set with "Thriller" for most hits from a single album.

She re-released the album this year, which launched two more hits and a top-grossing 3-D film.

Perry thanked her fans, who stood outside of Capitale hoping to catch a glimpse of her.

"I don't really like to call myself a role model for my fans, but I hope I'm an inspiration, especially for young women," she said when she accepted the honor.

Perry also thanked her mom at the event, which honored women who work in the music industry.

In like fashion, newcomer Carly Rae Jepsen also thanked her mom — and stepmom — when accepting the rising star honor. The "Call Me Maybe" singer said she's happy and surprised by her success.

"It was sort of the key to unlocking the rest of the world for me and was something that none of us were expecting," she said, in an interview, of her viral hit.

British singer Cher Lloyd performed Perry's "E.T." at the luncheon, which also featured a performance from rising country singer Hunter Hayes.

Perry, who wore a fitted pink dress, joked about recording a follow-up to "Teenage Dream."

"Have you heard it? I haven't," the smiling singer said on the red carpet.

___

Follow Mesfin Fekadu on Twitter at http://twitter.com/MusicMesfin

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Hockey Coaches Defy Doctors on Concussions, Study Finds

Despite several years of intensive research, coverage and discussion about the dangers of concussions, the idea of playing through head injuries is so deeply rooted in hockey culture that two university teams kept concussed players on the ice even though they were taking part in a major concussion study.

The study, which was published Friday in a series of articles in the journal Neurosurgical Focus, was conducted during the 2011-12 hockey season by researchers from the University of Western Ontario, the University of Montreal, Harvard and other institutions.

“This culture is entrenched at all levels of hockey, from peewee to university,” said Dr. Paul S. Echlin, a concussion specialist and researcher in Burlington, Ontario, and the lead author of the study. “Concussion is a significant public health issue that requires a generational shift. As with smoking or seat belts, it doesn’t just happen overnight — it takes a massive effort and collective movement.”

The study is believed to be among the most comprehensive analyses of concussions in hockey, which has a rate of head trauma approaching that of football. Researchers followed two Canadian university teams — a men’s team and a women’s team — and scanned every player’s brain before and after the season. Players who sustained head injuries also received scans at three intervals after the injuries, with researchers using advanced magnetic resonance imaging techniques.

The teams were not named in the study, in which an independent specialist physician was present at each game and was empowered to pull any player off the ice for examination if a potential concussion was observed.

The men’s team, with 25 players and an average age of 22, played a 28-game regular season and a 3-game postseason. The women’s team, with 20 players and an average age of 20, played 24 regular-season games and no playoff games. Over the course of the season, there were five observed or self-reported concussions on the men’s team and six on the women’s team.

Researchers noted several instances of coaches, trainers and players avoiding examinations, ignoring medical advice or otherwise obstructing the study, even though the players had signed consent forms to participate and university ethics officials had given institutional consent.

“Unless something is broken, I want them out playing,” one coach said, according to the study.

In one incident, a neurologist observing the men’s team pulled a defenseman during the first period of a game after the player took two hits and was skating slowly. During the intermission the player reported dizziness and was advised to sit out, but the coach suggested he play the second period and “skate it off.” The defenseman stumbled through the rest of the game.

“At the end of the third period, I spoke with the player and the trainer and said that he should not play until he was formally evaluated and underwent the formal return-to-play protocol,” the neurologist said, as reported in the study. “I was dismayed to see that he played the next evening.”

After the team returned from its trip, the neurologist questioned the trainer about overruling his advice and placing the defenseman at risk.

“The trainer responded that he and the player did not understand the decision and that most of the team did not trust the neurologist,” according to the study. “He requested that the physician no longer be used to cover any more games.”

In another episode, a physician observer assessed a minor concussion in a female player and recommended that she miss the next night’s game. Even though the coach’s own playing career had ended because of concussions, she overrode the medical advice and inserted the player the next evening.

According to the report, the coach refused to speak to another physician observer on the second evening. The trainer was reluctant to press the issue with the coach because, the trainer said, the coach did not want the study to interfere with the team.

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