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Will the NFL's head-injury crisis lead to football's demise?

I hate to rain (or sleet) on anyone’s Super Bowl parade this weekend, but if you’re going to be watching the big game on Sunday, you should first read Ben McGrath’s Jan. 21 New Yorker article on football’s concussion crisis.

As the article suggests, “people at home on their sofas, happily consuming Budweiser and buffalo wings” need to realize the very real health consequences of all that head-butting they’re watching (and relishing) on their TV screens. For many of the men hitting (literally) the field at Cowboys Stadium on Sunday (20 percent by one quoted source’s estimate) will be playing with incipient dementia (or mild cognitive impairment), a brain condition that causes mild memory problems, but which is also believed to be a risk factor for other neurological problems, including depression and Alzheimer’s disease.

And some of those men, experts say, will go on to develop chronic traumatic encephalopathy (CTE), a devastating dementia-like brain disorder that’s been linked to sports-related concussions. CTE is being diagnosed at an alarming pace in a number of former football players and other athletes, including those who played the sports only in high school and/or college.

As McGrath points out, CTE does not just result from major, news-making collisions on game days (about 10 pro football players, on average, are concussed each weekend during the fall football season), but also from the steady accumulation of less noticeable subconcussions during practices.

No wonder, then, that retired NFL players are, as McGrath reports, five to 19 times more likely that the rest of us to be diagnosed with a dementia-related brain condition.

Cracking down on rule-breakers
NFL officials say they’re trying to change the culture of football, and this fall they began to be stricter about enforcing the game’s existing tackling rules, levying heavy fines on players, like Steelers’ linebacker James Harrison, who flagrantly ignore them. They seemed particularly eager to act after October’s so-called Black and Blue Sunday, which racked up an above-average number of serious concussions.

But will those efforts be enough to stem the run of injuries — and to keep football from eventually becoming as marginalized in American culture as boxing?

The anecdotal momentum suggests no, says McGrath:

Two weeks after Black and Blue Sunday, on October 28th, an honor student in Spring Hill, Kansas, returned to the sidelines after making an interception at his high school’s homecoming game and told his coach that his head was hurting. Soon afterward, he fell to the ground, suffered a subdural hematoma, and died. The next week, Jim McMahon, the ex-quarterback, confessed at a twenty-fifth reunion of the 1985 Super Bowl champion Chicago Bears that his memory is “pretty much gone,” and that he often walks into a room without knowing why. …
A few days later, a Cleveland Browns linebacker collapsed at his locker-room stall, after practice, in the presence of reporters, and was taken to the hospital. Shortly after that, two high-school players died on the same day — one on the field, in Massachusetts, of a heart stoppage, and the other, in North Carolina, by suicide, five weeks after suffering a season-ending concussion. The same week, two Division I college players announced their retirement, out of concerns relating to concussions, and team doctors at the University of Utah “medically disqualified” a sophomore from continuing his career.

Liabilities may become too great
Footfall’s fate may be ultimately decided by lawyers and insurance companies, for, as McGrath notes, “with new medical evidence may come new legal risk and liability, and recalibrated insurance premiums, for schools as well as for individuals."

“Football may go the way of gymnastics, where these private entities will come forward and have teams,” author ("Out of Their League") and former (1960s) St. Louis Cardinals linebacker David Meggyesy told McGrath. Meggyesy envisions, McGrath added, “a scenario in which the social pecking order at American high schools is not driven by quarterbacks and their doting cheerleaders.”

And without a large pipeline of players coming up through high school, who will be taking the field on future Super Bowl Sundays?

You can read McGrath’s New Yorker piece in full here.

Footnote: In a related story, a study published late last week in the journal Drug and Alcohol Dependence found that retired NFL players use opioid painkillers (drugs like morphine, Vicodin, codeine and oxycodone) at four times the rate of the general population. The researchers attributed the increased use by the players to their on-the-field injuries.

The study also found that many of the players are misusing the drugs — taking a painkiller for a reason other than the one for which it was prescribed or taking a painkiller prescribed for someone else.

A major reason for this misuse of the drugs: an undiagnosed concussion.

“Many of these players explained that they didn’t want to see a physician about their concussions at the time,” said study co-author and Washington University (St. Louis) epidemiologist Simone Cummings in a prepared statement. “These men said they knew if they reported a concussion, they might not be allowed to play. And if you get taken out of a game too many times, you can lose your spot and get cut from the team.”

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Comments (5)

And yet boxing goes on without crisis head punch after head punch.

Good article. Brain injuries are serious business. After Jim McMahon went public many ignorant people (and Monday morning quarterbacks) speculated about all kinds of things but were mainly derisive about his disclosure. It seems there are a lot of sandlot jocks out there who refuse to try to understand the facts about brain injuries.

A few minutes googling showed a lot of comments about Jim McMahon doing a lot of helmetless head-butting.

The boxing "Palooka" and ban on bare-knuckle boxing goes back a century. I recently watched the entire 40 hours box set of the 1980's HBO series "1st and Ten" which frequently dealt with debilitating and crippling injuries in pro-football.

The concept of latent brain injuries like these was not discussed in the HBO series but the idea has rapidly caught on. I've heard it discussed a number of times in commentary during NFL games this year. The case of
local wrestler Verne Gagne has brought more awareness locally so we are ahead of the curve here.

That said, this seems low on the list of threats to pro football. Topping the list is the threat of labor unrest and the US Supreme Court ruling against revenue sharing. http://www.minnpost.com/derekwallbank/2010/05/24/18428/sports_armageddon...

I have tried to watch several soccer World Cups including last summers and am convinced that viewing that can cause someone raised on US TV brain damage . I could write an essay on why soccer won't become mainstream entertainment in the US. I watched for World Cup entertainment tie ins in the outer ring suburbs where our local "soccer row" started in the 1980's (and the original "soccer kids" are now adults) and couldn't find anything. Even 1st and Ten" had an episode about pro-soccer and empty stands. (For starters soccer plays something like 45 minutes without a break which does not allow for commercials or instant replays)

By contrast, during this NFL regular season eighteen of the twenty top rated network (and Fox) TV shows were NFL games. The ESPN NFL games also did very well. I heard a figure that the US pro football is an eight billion dollar industry. That is around $25 per capita in the US. More than two thirds is from broadcast rights. Contrast that with gymnastics, which had relatively weak broadcast appeal outside of the Olympics. (the Beijing Olympics were said to be a financial and ratings disaster for NBC.)

Our pro football is also adaptable. Pro football has already instituted rules and tends to be very adaptable. Also, our best and brightest tend to be fans and offer suggestions. People like me also do. My suggestion for late/hard hits. Besides the down and yardage penalty have an immediate game time penalty of five or ten minutes clock time for the hitter if refs make the call. The NFL has a premium "all games" cable/dish option so a "judgement committee" can review the plays and vote on additional team penalties and potential removal of the player from the rest of the game if they deem the charge legitimate. This can easily be done in five minutes of playtime. If I can figure that out the NFL can.

The "legislation through litigation" strategy has never been popular in the polls. The tobacco litigation, is something I consider mostly a "charade" (I quit smoking in the early 1970's) This involves the withholding of
"informed consent" as a legal claim. Heck, if an NFL player tapes or Tivos a game and watches it they will hear discussions on the head injury issues. Union reps and agents should be aware of this and suggest reasonable adaption in the game.

In the early 1970's, before his foray sheltering the Symbionese Liberation Army during the "lost year" Jack Scott" was a very vocal authority on the alleged dangers of college and pro sports. Most athletes he cited in articles and his book "The Athletic Revolution" were deemed "sour grapes" who didn't make the cut by the public.

The public support of the NFL might, in large term be a "backlash" response to the forces of "political correctness" and the Nanny state. This won't go away. Also there is "low hanging fruit" if someone wants to take this on. One prime example is cable wresting. Lot's of alleged brain damage there!

For what it's worth I didn't watch much pro-football until the Brett Farve era of the Vikings. I want our sports gladiators to "live long and prosper". We need creative adaption, not litigation in pro-football rules.

Wow, you mean to tell me there are careers that expose you to health problems? Have you heard about the Lindbergh baby?

Tell firefighters, coal miners, construction workers, etc. about the dangers of a profession that carries possible health risks but pays you millions of dollars. Somehow, all your concern is going to be lost on them.