Cold, slippery and unyielding, ice is a lethal surface to play sports on.
Even the best skaters get badly hurt when they fall; broken bones, cuts, fractured skulls and concussions.
The worst head knocks can be deadly; some instant, others much later.
“Just one visit to the hospital for concussion and the suicide risk goes up years and decades,” US neuroscientist Dr Chris Nowinski said in an interview.
Nowinski says there’s a clear link between concussion, epilepsy and suicide but Dr Peter Braun, the chief medical officer at the Olympic Winter Institute of Australia (OWIA), isn’t convinced.
“To my knowledge, there is no evidence to support such a link. Anecdotal reports and case series exploring a potential connection are subject to a number of errors,” he said.
As The Australian and The Daily Telegraph exclusively revealed, Katia Alexandrovskaya suffered multiple concussions from a young age as well as numerous seizures and was eventually diagnosed with epilepsy last January. She took her own life in July.
Neuroscientists have been warning sporting organisations for years about the effects of traumatic head injuries and most have got the memo.
Prize fights are now stopped the instant a punch-drunk boxer’s legs turn to jelly.
Footballers are dragged straight from the field to be assessed the moment they get whacked and if they can’t remember the Prime Minister’s name or what day of the week it is, they can’t go back on.
Ice hockey, the most macho winter sport of them all, won’t let anyone – players and referees included – even step on an ice rink without wearing a safety helmet.
The same applies in speed skating and snowboarding and bobsleigh and pretty much every other sport played at the Winter Olympics, with one glaring exception.
There are no helmets worn by figure skaters.
The tiny teenage girls who dominate the sport wear skimpy costumes, mini skirts that expose their briefs and inner thighs, lipstick, fake eyelashes and nail polish but not protective headgear.
No mouthguards, either. No padding. Not in competition. Not even in training.
The International Skating Union’s rules on what competitors are allowed to wear on the ice are curiously vague.
Long trousers are compulsory for male skaters while female skaters are warned against “excessive nudity” but protective head gear is not regulated.
Figure skaters can wear helmets if they choose but the ISU President Jan Dijkema was non-committal when asked if they should be mandatory. “The ISU safety policy is continuously under evaluation,” he said
Dr Nowinski said the rules were absurd. “Tradition is a terrible reason to give children brain injuries,” he said.
“The value of a prevented concussion is immeasurable because we’re talking about people’s lives, we’re talking about the quality of their lives, even if it doesn’t take their life.”
Figure skating has always been box-office gold for television broadcasters but child protection groups say the dress-to-impress culture sexualises and exploits young competitors instead of prioritising their health.
Olympic champions make everything look so graceful and effortless after years perfecting the complex jumps and rotations that impress the judges but the physical toll and health risks they face are real.
When skaters spin, they turn so fast that blood rushes into their heads, causing nosebleeds and bursting tiny vessels in the whites of their eyes that the television cameras don’t show.
When they jump, they generate forces up to five times their natural body weight, putting enormous strain on their ankle, knee and hip joints, making falls even more hazardous.
The layer of ice that skaters compete on doesn’t allow for soft landings because it is just five centimetres thick and hiding a slab of concrete embedded with metal pipes that help with refrigeration.
In 2014, the devastating effects of head knocks were laid out for everyone to see when Japan’s teenage Olympic champion Yuzuru Hanyu was involved in a sickening collision while warming up for a competition in China.
He lay motionless on the ice, which was stained red by the blood seeping from a head gash, before being taken to a medical centre so doctors could stitch up his jaw and close his wounds with a stapler.
A quarter of an hour later, he was back on the ice, protected by nothing more than an elastic bandage, but was still so groggy he fell five times.
The response from skating officials to the outcry that followed was telling: ‘nothing to see here.’
Alexandrovskaya’s death has been met by the same deafening silence.
Dr Nowinski says her symptoms bore all the hallmarks of chronic traumatic encephalopathy but the degenerative brain disease can only be diagnosed through autopsy and there’s never been a study allowed on the brain of a figure skater.
No-one kept count of the number of times Alexandrovskaya hit her head on the ice but multiple sources have told The Australian and The Daily Telegraph she experienced multiple concussions and were present when she filled out a concussion report form for the New South Wales Institute of Sport.
Dr Braun says the OWIA has never been notified formally about any concussions to skaters in their programs.
“I can advise that our figure skating program (dating back to 1999) has not given rise to any incidents of concussion in training, competition, or other non-sport-related activities undertaken by figure skaters supported by us,” he said.
The OWIA has some of the strictest protocols in the world for the management of concussion but privacy laws and the code of silence and stigma around head injuries indicates not all cases are reported.
Olympic aerials champion Lydia Lasilla said she suffered five concussions throughout her career and the OWIA was always “very careful” in managing her injuries.
“We used a baseline testing COG Sport … that’s the one I used, you generally just do a test when not competing, and then often you do one at the start and if you do have a knock to the head, you will do it again and you will do a physical testing protocol,” Lassila said.
“For example if I had a head knock and saw stars, it was a minimum of seven days off and you could only return to sport if your COG sport results were the same as your baseline or better.”
The five-time Winter Olympian said there was also “a bunch” testing of the cardiovascular system and balance.
“It was still very scary to go back and jump, you would think; ‘I think I am OK after my test’ but you do have that hesitation … I know with my team, particularly when your head knocks a lot, that we took it really seriously.”
While she felt well looked after, she said she saw athletes she competed against retire early because of concussions, and ongoing headaches and vertigo resulting from them.
“Really significant stuff,” she said. “It’s really serious.
“I have seen other countries not manage it well, I have seen athletes take a really big hit and their coach has sent them straight back up … it’s pretty scary.”