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NFL’s ‘concussion settlement’ with retired players won’t end growing concern about brain injuries

The issue of football-related brain injuries (and similar ones sustained in other contact sports) is not going away.

Research has shown that modern helmets do not offer protection against concussions.

The proposed $765 million settlement announced Thursday between the National Football League (NFL) and more than 4,500 retired NFL players has been declared a victory by both sides.

The retired players would have more financial resources to help them receive care for debilitating brain injuries that they claim are associated with concussions sustained on the football field. And the NFL does not have to open its files to show what it knew (and when) about the link between football-related concussions and later neurological illness.

The settlement apparently also protects the NFL from any lawsuits from current or future players, as NBC sports writer Mike Florio points out:

Judge Layn Phillips, who brokered the settlement, has made it clear that the courts will be taking a dim view of future allegations that the NFL concealed the impact of concussions or failed to protect players from head injuries.

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“For a variety of reasons, the underlying theory of this lawsuit about what took place in the past would be difficult to replicate in the future,” Judge Phillips said in a Q&A document released in connection with the settlement. “Everyone now has a much deeper and more substantial understanding about concussions, and how to prevent and manage them, than they did 20 or even 10 years ago, and the information conveyed to players reflects that greater understanding.  In addition, the labor law defenses asserted by the NFL would represent a very substantial barrier to asserting these kinds of claims going forward.  The combination of advances in medical research, improved equipment, rules changes, greater understanding of concussion management, and enhanced benefits should, and hopefully will, prevent similar lawsuits in the future.”

In other words, current and future players are being forewarned: If they sustain any brain injuries during their career, well, they should have known better.

A premature assumption

But Judge Phillips’ assumption that “improved equipment, rules changes [and] greater understanding of concussion management” will make the game of football much safer for players is, at best, premature.

Research has shown that modern helmets, for example, do not offer protection against concussions. And very little is understood about managing concussive head injuries. In fact, as reporter Melissa Healy notes in the Los Angeles Times, just diagnosing a concussion can be problematic:

Even in the immediate wake of a ferocious blow to the head, traumatic brain injury can be difficult to show unless there is evidence of bleeding in or swelling of the brain.

CT scans can’t detect the brain’s massive metabolic disturbance in the wake of trauma. Nor can they measure the shearing of fat-covered axons — the “white matter” that carries electrical impulses across the hemispheres of the brain and from region to region. And yet research suggests both of those processes may be key to concussion’s most damaging cognitive consequences.

Nor is damage evidence on a CT scan conclusive. Even when such imaging does suggest brain injury, many will not immediately suffer the headaches, fatigue and loss of memory and concentration that signal the brain has been hurt. Others who may have come up “clean” on a CT scan may complain of subtle symptoms for weeks or months after a blow to the head.

So the diagnosis of concussion can be hard to make even when a player is rushed from the field to a hospital — a rare response in a sport where players have been urged to ‘walk it off’ and get back in the game.

Small hits matter, too

As for rule changes…. Yes, the NFL has instigated tougher penalties against players who engage in illegal tackles. And they have reduced the number of full-contact practices that players must participate in.

But, as Healy also points out, recent research suggests “the grim possibility that the small hits matter as much as the big ones.”

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“When researchers at Purdue University wired the helmets of a high school football team in Lafayette, Ind., with accelerometers recently,” she reports, “they found that some players with no sign of concussion — players who took many, less forceful blows to the head during the season — began showing cognitive deficits as the fall wore on.”

“Whether those effects accumulate or the brain heals completely between seasons, no one yet knows,” Healy adds. “But it does suggest that professional football players, who generally cut their teeth (and rock their brains) for years on high school and college gridirons, may not have only the NFL to blame for their late-life problems.”

Changing attitudes toward the game

Parents, fortunately, have already begun to pay attention. Various reports suggest a growing number of them are refusing to let their children play football because of safety concerns. Even many former NFL football players — 56 percent, according to a Washington Post survey taken earlier this year — don’t believe young people should enter the sport.

It remains to be seen, of course, whether this parental concern will abate once the settlement announced Thursday is finalized and the story of the retired NFL players’ brain injuries loses its headline-grabbing urgency.

I believe it won’t, however. The issue of football-related brain injuries (and similar ones sustained in other contact sports) is not going away. And without parents who are willing to put their children on the gridiron, professional football will not survive — at least, not as the huge cultural (and revenue-generating) phenomenon it is today.

That’s something the NFL will not be able to mediate away, at any price.