Will head injuries kill football?

Both the Minneapolis Star Tribune and the New York Times published articles over the weekend on former National Football League (NFL) players whose lives were devastated by football-related head injuries.

The articles emphasize the impact that the injuries have had on the families of the players.

The Strib piece, written by Mike Kaszuba, focuses on the family of Wally Hilgenberg, the former Minnesota Vikings linebacker who died in 2008 at age 66. He had been diagnosed with amyotrophic lateral sclerosis (ALS), but an analysis of his brain after his death has led a group of Boston scientists to conclude his symptoms were more likely the result of repeated trauma to his head.

In the New York Times article, reporter Judy Battista describes what life is now like for 34-year-old Mitch White, who signed on as an offensive right tackle for several teams, including the New Orleans Saints, but who never played a regular season game because of injuries. His most devastating injury was a crushing hit to his head during a 2005 NFL training camp. White now suffers incapacitating migraine headaches and at times has difficulty thinking, talking or even moving. These symptoms have made it impossible for him to hold any kind of job or to care for his two young daughters.

White is among the more than 3,000 former NFL players who are suing the league for allegedly ignoring evidence of the link between football-related concussions and long-term brain injury. Hilgenberg’s widow, Mary, and their son, Eric, are lead plaintiffs in a wrongful death lawsuit filed earlier this year against the NFL in federal court.

Conflicted feelings

These aren’t the first articles written about former NFL players whose health was destroyed by repeated on-the-field head injuries. Nor will they be the last. Neuroscientists have only begun to research and understand the impact of concussions — even seemingly “minor” ones — on the brain, and we will be seeing a string of new studies on this subject in the coming months and years. Just this month, for example, the Centers for Disease Control and Prevention reported that professional football players are three times more likely to die from neurodegenerative brain disorders — including ALS — than the general U.S. population.

But what I found striking about both the Strib and the Times articles was the families’ highly conflicted attitudes toward the sport.

Although Eric Hilgenberg refuses to allow his sons to play football, his two sisters have children involved in the sport. And White, whose wife is expecting their third child, a son, later this year, says he would not stop the boy from playing football.

“I don’t hate the NFL,” White told Battista. “I love the sport. I in no way want to damage the league. I just thought I’d get better eventually. I had no idea this could be for the rest of your life. That this will affect you, your family, your wife. I expected to be hurt. I knew there was a possibility I could be paralyzed. Did I know I could get brain injury and be like this? No. I couldn’t fathom that happening.”

Apparently, he can’t fathom it happening to his son, either.

A change in perception

These families may be conflicted about letting their children play the game, but others aren’t. As ESPN’s Tim Keown reported last week, some evidence suggests that a growing number of parents, concerned about long-term brain injury, are keeping their children away from the sport:

You want to see the impact of our increased awareness of football’s dangers? Look down, not up. Most of the high-minded discussions of safety in football center on the college and professional levels, where athletes are bigger and faster and the consequences of throwing your skull around for years are far more lasting and serious. But the biggest change in perception is taking place at the high school level. This is primarily anecdotal evidence, but, through three weeks of the season in California, there are some definite trends taking shape.

There are more schools struggling to round up more than 20 players. There are more and more comically lopsided scores — 50-0, 60-0 — making the dreaded second-half running clock a more frequent occurrence. The difference in participation, skill level and coaching ability between the schools with rich football traditions and those without them is growing exponentially. It’s not a surprise that top-tier schools — Northern California’s De La Salle, to pick one — feel compelled to play other top-tier schools from out of the area or out of state to get competition. There’s a variety of demographic factors at work — private vs. public, parental involvement, off-campus vs. on-campus coaches — separating the haves from the have-nots.

I talked to the athletic director of a small private school in Oakland that has 20 players and no junior varsity team. It lost 62-0 in its first game — to a bad team. Against a worse one the next week, it lost 62-26.

“It’s really tough to see a future,” he told me.

As irrelevant as boxing?

Will football survive? As Ben McGrath pointed out in his excellent 2011 New Yorker article on concussions and football, the sport had an earlier violence-related crisis. At the turn of the 20^th century, football was almost banned as a result of the appalling number of deaths that were occurring on the field — 18 in 1905 alone. Changes to the game, especially the introduction of the forward pass and new safety equipment, saved the sport.

Similar actions to reform football are being discussed today, but many neuroscientists remain skeptical that they will make the game any safer for the brain. Football’s future really lies in the attitudes of families who must weigh the risks and benefits of letting their sons play the game. If families — and their sons — increasingly conclude that the risks are not worth it, football will become as irrelevant as boxing.

In an interview at Wimbledon this summer, former basketball star Charles Barkley said he expects young African-American athletes to turn away from football to play less brain-risky sports, such as tennis and golf.

Two-thirds of NFL players are African-American.