A recent announcement by the NFL happened to come out on my birthday this year. In the article, “NFL sees significant drop in concussions during the 2018 season” http://www.nfl.com/news/story, the league claimed a 24% decrease in reported concussions, dropping from 281 in 2017 down to 214 this past season. League officials suggested the decrease was due in part to rule changes and to the more advanced helmets many players are now using. The only problem with that is most scientists who study concussions agree that, “The current design of American Football helmets are not fit for purpose in reducing the risk of concussion or CTE.” (https://www.the42.ie/concussion-american-football-3179351-Jan2017/). The better helmets might help prevent skull fractures, but do little to protect the brain. It’s all about the hits! Please watch this video discussing important research on the subject (https://www.youtube.com/watch?v=lCOrjuxboQA).
So why the continued emphasis on concussions? It’s simple. First off, the deniers of CTE often begin a discussion on brain injury with the statistic that more concussions occur while riding a bike than because of football! That may be true, but so what. It has nothing to do with the real issue (see below). Next, league officials are quick to point out that with the decreasing number of concussions there has “never been a safer time in history to play football.” Again, that may be correct, but there has never been a safer time in history to get into a serious car crash, or hit yourself in the face with a hammer. Both these comments are nothing more than a distraction, hoping we are naïve enough to accept this information on face value and continue to believe their product is safe, as is.
Over the last 10 years the NFL has successfully created a huge distraction in focusing all the public and media attention surrounding brain injury and disease on concussions. It has been suspected for many years, and recent research has confirmed that the greatest cause of brain injury in general and Chronic Traumatic Encephalopathy specifically, is the cumulative effect of sub-concussive hits. Concussions are a serious head injury and are also referred to as a mild traumatic brain injury (mTBI). However, many authorities have real concerns that the NFL and the NCAA’s focus on concussions is a smoke screen. Ann McKee is quoted on this false belief saying, “The continued focus on concussion and symptomatic recovery does not address the fundamental danger these activities pose to human health.”
Dr. McKee is the face of CTE research and has been interviewed often by the media. She is a Neuropathologist and expert in neurodegenerative disease at New England Veterans Administration Medical Centers and is Professor of Neurology and Pathology at Boston University School of Medicine and Director of Boston University CTE Center. She was recognized in 2017 as the ‘Bostonian of the Year’ and in 2018 was named one of the 100 most influential persons in the world by Time magazine. When my wife and I met with her while we were in Boston, she was gracious and compassionate. I believe her motives with the CTE issue are sincere and that she is driven to find the truth and a solution.
There are several problems with focusing on concussions when searching for the truth. One is that there is no consistent or reliable way to diagnose one without the presence of extreme signs and symptoms. “Concussions can be difficult to diagnose,” Virginia Tech football team physician Gunnar Brolinson said. “There’s no one thing that’s a hallmark of a concussion. A 2015 study in Neurotrauma reported, “Although concussions and other brain trauma are an important area of scientific inquiry, terminology used to describe head impact phenomena are not wholly agreed upon or used uniformly.” It is well documented that brain injury often occurs, and/or persists, without any of the obvious signs or symptoms of a ‘concussion’.
Next, and this may be the most important fact; most football players simply do not report possible concussions. Dr. David Camarillo from Stanford University said, “Under-reporting has plagued research studies and is a major problem in player health that may still be unresolved”. Chris Nowinski, Ph.D. Co-founder of Concussion Legacy Foundation is quoted, “Ninety percent of concussions on the football field go undiagnosed because the impact was relatively minor and a player was able to play through it.” Why don’t the players report a serious hit? I played middle linebacker in college and the CFL, and over a 5-year period I was credited with more than 500 tackles. I can’t say how many times I was dinged, saw stars, was stunned, or even lost consciousness. Yet I never reported, was treated for, or sat out due to a concussion! Not even one time.
Players believe head banging is just part of the game. They do not want to miss playing time and the threat of losing their position because of something most believe they can play through. Aggressive players experience hits that create sensations in their head that would certainly be classified as a concussion all the time and not tell anyone. Also, the collisions that cause a sudden jerking motion of the head or a rotational (shearing) motion, all create internal injury that is impossible to detect on the sideline, and go unnoticed and unreported.
Finally, because of under reporting, research has not established a solid relationship between concussions and long-term brain disease. Deniers use that all the time. Dr. Robert Stern was quoted in an television interview on Greater Boston saying, “we’re not really concerned about concussions, the stuff we’re looking at are all the multiple hits that don’t result in the symptoms of a concussion, the ones that happen a hundred or thousand times a season.”
The relationship of compromised brain function exists between the sub-concussive impacts, or collisions. Dr. Omalu has recently been quoted, “The fundamental issue is not concussions but repeated blows to the head–with or without concussions, with or without helmets.” He continues, “For one documented concussion, there are thousands of sub-concussive blows. It is not about concussion, we should make that very clear. Although the research has been crucial in helping teams choose quality equipment to protect their players, helmets are actually the least important factor in reducing concussions and limiting the cumulative effect of non-concussive impacts.”
Again, why the focus on concussions? Its simple, if the football hierarchy is willing to admit that football has a problem – a billion dollar settlement and extensive rule changes suggest they recognize a problem exists – they need a solution. Football is collisions. That is the sport, colliding into your opponent to move him or bring him to the ground, usually as violent as possible. To compare football to riding a bike is insulting. Violence is the goal on every single play. To eliminate collisions is to change football so dramatically, viewership would decrease even more than it has and football ceases to be such a lucrative business. With concussions, football has a bad guy. It’s a number that can be counted and tracked. Rules can be changed and new helmets can be developed lessening the severity of, or even eliminating concussions. And if they can convince the moms and dads that the problem has been identified and is under control, they can declare football safe.
Unfortunately none of that is true or possible. A typical NFL game has 128 plays. All 32 teams play 20 games per season, 16 regular season and 4 preseason. During each play, assuming 15 of the 22 players on the field collide (down lineman, linebackers and a percentage of the skill players) there would be a conservative estimate of 1,228,800 collisions each season in the NFL. Adding in the contact during the 24 total weeks of practices, that number easily exceeds 1.5 million collisions each year. In 2017 the NFL reported 281 concussions, or 0.0187% of the total collisions. As a Ph.D. and successful ex-football player, as well as any logical thinking person concerned with this issue, the suggestion that 250lb to 320lb men colliding at full speed 1.5 million times per year resulted in a meager 281 concussions or 1 concussion for every 6,600 collisions, is beyond ridiculous. But for those who want to believe, it is a great distraction.
Instead of saying there are over 1.5 million possible brain injuries each year, the NFL focuses on 281, a number that is statistically insignificant. With the most recent data, concussions are down 28%! This is why the commissioner could say recently, “Football has never been safer.” He would follow that statement in a 2016 interview with, “If I had a son, I’d love to have him play the game of football because of the values you get. There’s risk in life. There’s risk in sitting on the couch.” Is he really comparing sitting on the couch to purposely colliding at full speed thousands of times each year, year after year? Robert Kraft (yes the same one who has been in the news lately, joined Mr. Goodell in testifying on the safety of football in 2017, “I really think that may be overdone a little bit. I mean, I don’t think the game has ever been safer than it is now.” Chris Borland, the young San Francisco star linebacker who retired unexpectedly because of the CTE issue has also called these people out on such disingenuous and misleading statements.
The commissioner of the NFL influences millions when he speaks. They trust him and probably think no one would make such a claim if the sport weren’t safe, and he certainly wouldn’t value his $40 million salary over the health of his own son, if he had one. Dr. Bennett Omalu was quoted during a New York Press Club talk in 2017, “Someday there will be a district attorney who will prosecute for child abuse [on the football field], and it will succeed. It is the definition of child abuse.” These are dramatically opposite positions from 2 influential individuals. If it is your son, father, or husband out on the football field banging heads, whom are you going to believe? The stakes are too high to simply ignore it any longer.
As the research continues to mount, and more and more ex-players join the voices calling for answers, parents will eventually reject the excuses and lies. Changes will not come from those who benefit from the game, either emotionally, or financially. It will only come through the actions of parents who take the time to search for the unmistakable pattern. Changes are coming.
THERE IS HOPE. THERE ARE ANSWERS!
Football and the Brain 