The NFL and Unnecessary Head Trauma

AP Photo/Gail Burton, via Pittsburgh Courier

The hit Le’Veon Bell didn’t remember, by Raven’s defensive back Jimmy Smith

Two years ago i wrote an offseason rant about head trauma. It was not, however, about the trauma players at least sometimes necessarily undergo during the course of a play.

The NFL has implemented a number of changes in the past several seasons with the avowed purpose of reducing injuries, particularly head injuries. I admit I was, and still am, skeptical about the actual purpose of these regulations.

This is because it seems as if the owners and league officials are not motivated so much by concern for the players as they are by a fear of tainting the NFL brand. How else to explain their protection for receivers and quarterbacks, the “marquee” players, while ignoring the positions who are probably more at risk over the long term—the linemen, running backs, and so on?

But my purpose was not to start another fist-shaking exercise at the NFL front office. In the article I suggested something which would not impact the game of football in any way and yet would prevent a great deal of avoidable head trauma. I was proposing halting the seemingly harmless and collegial practice of head-slapping and/or head butting as a way of congratulating a guy who has made a good play.

If you look at what we now know about head trauma/CTE (Chronic Traumatic Encephalopathy,) perhaps this doesn’t seem like such a pointless exercise:

  1. Head trauma is cumulative.
  2. It doesn’t require a particularly forceful blow to cause damage.
  3. Any damage is bad. (See Item No. 1.)

It’s worth reviewing what constitutes a concussion—the players themselves are slowly coming to realize there is a stricter standard for injurious head contact than they had long assumed:

  1. A concussion can occur (and generally does) without loss of consciousness.
  2. The onset of symptoms of a concussion may not occur until many hours after the hit takes place, and not all are evident to the victim.
  3. Although the initial symptoms, if any, (dizziness, fatigue, headache, irritability, and so on,) usually disappear within a few days, the underlying damage doesn’t necessarily completely resolve for six to 18 months. The $65,000,000 question is whether the damage ever resolves.
  4. Repeated concussions can cause permanent damage, including mild cognitive impairment, CTE, and post-concussion syndrome. The latter is what they used to call shell shock.

One of the most disconcerting things to come out of the still-emerging evidence about TBI (Traumatic Brain Injury)/concussions is the cumulative nature of head trauma, especially within a short period of time. The victim suffers an initial concussion, and before the damage from this concussion has been fully resolved, a second impact occurs. This impact doesn’t need to be particularly forceful.

Pittsburgh Penguins center Sidney Crosby was a cautionary tale of the more dramatic form of this. He was blindsided on January 1st of 2011 by Capitals center David Steckel. He didn’t look good when he got up, but took a shift later in the game. Four days later he was driven into the boards headfirst by Tampa Bay Lightning defenseman Victor Hedman. Crosby finished the game, flew to Montreal with the team, but was sent back to Pittsburgh with disquieting symptoms.

It turned out to be just the beginning of an odyssey for both Crosby and Penguin fans. He eventually returned to the ice after well over 11 months. A great many days were spent in a darkened room. He had headaches, spatial and balance problems, and other manifestations that left many wondering not when but if he would ever be able to play hockey again. His story has a happy ending, sort of. There are certainly those who know a lot more about hockey than I do who say he has never been quite the same player since.

About the time I wrote the original rant, Jahvid Best, the running back who the Lions traded up to get at the end of the first round in 2010, had suffered two concussions during the 2011 season within the space of six weeks or so. As of that writing he had been unable to play for well over a year after the second concussion. I thought I would see what happened to him.

The news isn’t good. He tried to return for the 2013 season, but he had so many concussion-related health problems that the Lions released him. He joined the men’s basketball coaching staff at California while finishing his degree there. He has just begun running track. Clearly he will never play football again—or any sport which carries the risk of a head injury, if he has any sense whatsoever.

Big hits like the ones which felled Crosby or Best are obviously a problem. But constant minor hits can also cause a great deal of damage.

This rather counter-intuitive conclusion was reached after studying soccer players, as detailed in the linked article in the New York Times:

[In 2013,] the journal Radiology published results of a study by [Dr. Michael L.] Lipton and others of 39 amateur adult soccer players, with a median age of 31, who had played soccer since childhood. It concluded that “heading is associated with abnormal white matter microstructure and with poorer neurocognitive performance.”

Those who most frequently used their heads while playing showed a losses in parts of their brains involved with memory, attention and the processing of visual information. Only one of the study participants reported ever suffering a concussion, and yet the damage pattern was consistant with that from a traumatic brain injury.

Note these are amateurs. The number of head “hits” they were reporting averaged out to two or three per day.

This is why I propose to do away with what seems at first blush a harmless and traditional practice. I first begin thinking about this when I read this item from “Wolfley’s View from the Sidelines” following the second Ravens game in December of 2012:

On the bus heading for the airport after the game, I happened to be sitting a row ahead of Heath Miller. So I asked Heath how Kelvin Beachum had done. Heath said he played great and then went on to say that during warm-ups Beachum head-butted him so hard that Heath almost crumpled to his knees. Heath said, “I figured he was good to go.”

This comment made me really start paying attention to how often players slap each other’s helmets or use their own helmeted head to hit the helmet of a teammate. A touchdown catch appears to require head slaps or bumps from any and all surrounding teammates. When the player returns to the bench, the coaches start slapping them upside the head. But almost any play considered to be well-done can bring on a volley of head-bumps or slaps.

It may seem silly to worry about a friendly head slap or bump, but my question is, why even take the risk? In a small way it is adding to the burden playing football places on the player’s brain. If you are going to play anything resembling what is currently called “football,” there is going to be some amount of unavoidable brain trauma. Why not remove the avoidable forms?

If nothing else, I would hope coaches and parents of children will eliminate this practice at the youth level. It is already clear that children’s brains are more easily damaged than even those of young adults. And if kids don’t grow up doing it perhaps it will eventually die out altogether. But if I had any power in the NFL it would have been eliminated a long time ago, whether the players liked it or not.

If you want some depressing reading, check out the PBS “Concussion Watch.” As of yesterday there were 25 reported concussions.* Of those, here is a position breakdown:

  1. Quarterback: 5 (That would include the Brown’s Josh McCown. It was a really nasty hit he took.)
  2. Running Back: 1 (I assume this does not include Carlos Hyde, since he reportedly passed the concussion protocol Sunday.)
  3. Wide Receiver: 2
  4. Tight end: 2
  5. Offensive Line: 3
  6. Defensive Line: 2
  7. Linebacker: 4
  8. Defensive back: 6 (One of those is presumably Will Allen.)

Interestingly, they get their data only from NFL reporting, as it might look suspect otherwise. But there is always the question of unreported data, and it undoubtedly doesn’t include players who came off the field but passed the concussion protocol. And if a player comes off the field you can bet your socks there is some damage, even if it doesn’t show to the extent of triggering the concussion rules.

Football is a violent game, and violent hits are somewhat inevitable. But surely it makes sense to eliminate non-essential head contact.

Some guys are getting smarter. And some, like Chris Borland, aren’t even taking the chance at all. I’ve watched three games this season so far—the two Steelers games and the Week 1 Cowboys/Giants game. (I was visiting my brother, who is a huge Cowboys fan, and naturally we watched it.) As I watched the players after a successful play I was alternately heartened and discouraged. Some of the players are clearly taking the trouble to come up with alternate methods of congratulations. But plenty of them aren’t.

And here’s a particularly egregious example, from a game I only watched the highlights of, namely the Week 1 Monday night matchup between the Vikings and 49ers.

If the video isn’t working, presumably the NFL found it on YouTube and shut it down. If you couldn’t watch it, my point was, Colin Kaepernick blocked for Hyde for a touchdown. Then they smacked helmets. And then, just to make sure they did the maximum amount of damage, they smacked them again. After that two other teammates came up to Hyde and smacked helmets, just to make sure. It’s so pointless, and grieves me. I wish they would stop.

*I followed the link on the PBS website to the NFL injury report to see what they were looking at. As far as I can tell, the number is only for Weeks 1 and 2, but if a player is on the report for two weeks this will be reported twice. So the Steelers had a concussed quarterback, Matthew Jones, who was on both the Week 1 and Week 2 report. It took some agitation of my own brain matter to work out they were talking about Landry Jones. Maybe that’s his middle name… It also included, naturally, anyone who was still on the report from the preseason, so for instance RGIII was on the Week 1 report. So while the numbers don’t look quite as bad when cast in this way, it’s definitely bad enough.

But we do have to give the NFL this—the days of sending a guy back out who doesn’t even know for sure which is his sideline seem to be receding into the distance. May it continue to improve.

14 comments

  • Need to stick with the good old fashioned butt slap.

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  • Thanks for the read. I’m often surprised by how vociferously some fans reject the notion that football can cause CTE — as if anything that can threaten the game they watch on tv shouldn’t be considered. Your skull is there to protect you, of course, from the occasional knock or two in your life. It didn’t evolve to absorb regular, repeated contact.

    This is a complete tangent, but it reminds me of an episode of a tv show I saw a couple of years ago…the show dealt with ‘extraordinary people’ that had some strange ability that most don’t (one episode was a dude who could imitate an entire orchestra with his mouth… he had taught himself to flex all parts of his vocal cords and mouth, something most folks never approach. I suppose this is like me learning to waggle both eyebrows or move my ears..but I can still only curl my lip on the left side, not the right…anyway, I digress from my digression). In any case, the episode was about a man who could smash a lot of things on his skull..things that would seriously injure others. They figured out that he, and apparently it was hereditary, had a skull that was 20% thicker than the norm for humans. That’s all it took for him to basically be able to run headfirst into anything.

    In any case, people like to see clear, obvious reactions to clear, obvious events before it can be believed. Colt McCoy getting blown up by Harrison? Sure..that was enough to concede that a concussion may have occurred. Slap on the helmet after a 30 yard gain? No way!
    Chinese water torture was a real thing. The impacts are small individually, but they can do damage long term. Having your skull constantly battered..whether in a friendly way or through plays on the field…it will add up. And it shouldn’t take a guy wobbling off the field for folks to see that.

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    • I’m actually trying to imagine you waggling your eyebrows as you move your ears. My husband taught himself to waggle his eyebrows independently as a child after seeing a children’s TV host who did it, but I don’t think he can move his ears, too.

      And to your point, surely any decent person is going to be conflicted. But the way to deal with the conflict is not to pretend it doesn’t exist.

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  • It obviously is very difficult for a player to remove himself from a game when he knows something is not right but that “something” may not be evident to others. He wants to stay in the fight. Would you take yourself out of a game with everything on the line, maybe even your career?

    The NFL and US Army have been working together on concussions. General Odierno said. “We all base ourselves on the warrior ethos and the soldiers’ creed as soldiers. If you have a problem and you identify it, to me that is courageous, too. But self-selection is really difficult. There has to be a bond to take care of each other.” changing the culture is the biggest test.

    I think there is a similar type of bond to take care of each other between most players in the NFL.

    Yes the players need to take care of each other. Thanks for the story Rebecca you are spot on.

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  • The game is such that its very difficult for players to remove themselves unless they are literally at the verge of collapse. Many players don’t want to do anything that could be viewed as ducking out of a fight. And there is the perception of giving in to weakness. And then there is the matter of career survival. Pressure comes from a variety of directions, including the fans, that is very unsympathetic to injury. The issues that fans had with Shazier and Jones last year, and Cortez Allen are at injury related. There are limits to what we will tolerate in terms of injury from the players. After that they are seen as liabilities.

    It this aspect that may be the hardest to transform.

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    • This goes back to the reaction, I gather, among many Niners fans after the young ILB retired. How anyone thinks it is their business as to whether a young man chooses to possibly his future clarity of mind for the entertainment of the great unwashed floors me.

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      • They probably think he should have made that decision before declaring for the draft and getting enough money to retire on. I kind of understand their point if that is their opinion.

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        • How so?
          Plenty of people take a job, regret it, and quit for something else. Do they feel bad for the Niners? Did they think Borland somehow tricked their poor owner and robbed him of immeasurable wealth? I’m sure they’d all ‘jump at the chance’ to be the one getting hit in the head regularly. Or so they say.
          Why is it different? Just because he’s an athlete?

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          • A draft pick is an investment, how would you feel if Dupree up and decided he was going to retire after this season. Wouldn’t you as a team and as a fan feel robbed of a 1st round draft pick? I would.

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            • A draft pick is a way to dole out employees to force parity between rival companies. I won’t use the term ‘investment’, since the players are people, not commodities.
              If a team drafts a player and he quits a year later, that is no different than if the player simply busts…or he gets injured… or if the team cuts him. Did you feel robbed of a 7th round pick when the Steelers cut Holliman?

              Honestly, if during the offseason, Dupree announces his retirement because of health concerns…I’d wish him the best. It isn’t always about the fans.

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  • cold_old_steelers_fan

    This is a bit late for a reply but I am having trouble coming to terms with the issue. I love football but the concussion issue makes me slightly disgusted with myself about it. Even more so as one of my sons has had to quit football because of the concussions (the other had to quit because of other injuries not all of which where from football… can you say rugby).

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