"To see it was painfully obvious. The telling sign was when he tried to get up," said Dr. Wennberg, a University of Toronto concussion expert who also acts as a consultant to the National Hockey League's Players' Association.
Mr. Crosby's right foot slipped behind him as he got back on his feet, Dr. Wennberg said, and his mouth guard slipped out of his mouth – subtle signs that that the hit from Washington Capitals winger David Steckel jarred Mr. Crosby's brain.
So how could Mr. Crosby have been allowed to finish the Winter Classic and continue playing the next week?
The short answer is that he displayed none of the classic symptoms of concussion, which would have caused officials to pull him from the game. If trainers or doctors see one or more of those symptoms, they'll typically withdraw the player and ask him questions to determine whether he's okay.
Mr. Crosby had a sore neck, but experts say that alone is not usually a sign of a concussion. Concussions are not visible injuries and athletes are notoriously loath to admit to weakness or be pulled out of games.
The danger is that when the NHL's most famous player was hit a few days later, making his return to the game uncertain, his risk of more damage would have been increased if he had already suffered a concussion on Jan. 1, according to neuroscientists.
Critics are growing increasingly vocal in saying that if the rules for when a player is pulled out of a game after a hit to the head were followed in Mr. Crosby's case, perhaps the rules need to be changed. And this week, even Mr. Crosby's agent called on the league to consider making all contact with the head illegal.
Dr. Wennberg said he understands the pressure on the team trainer not to remove a star player from such a high-profile game, especially since Mr. Crosby didn't report of any of the constellation of symptoms used to assess whether a player has a concussion, including dizziness, headache, nausea and vomiting, blurred vision and confusion.
As such, Mr. Crosby's case illustrates the difficulties – and broad array of occasionally contradictory expert medical opinion – in assessing what is an uncommonly tricky and unpredictable injury.
Charles Tator, an eminent University Health Network neurosurgeon and leading authority on concussions, reviewed a video of the Jan. 1 hit, but couldn't tell whether Mr. Crosby sustained a concussion from what he nonetheless described as a "highly offensive, vicious hit."
It takes an experienced professional about five minutes to assess whether a player likely suffered a concussion, he said. They have to be inquisitive and ferret out symptoms.
"You need to ask some searching questions about how a player is functioning," said Dr. Tator, who is also based in Toronto.
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