Hitless or Witless?
Protecting football players from serious head injuries is making news again. Accused for years by outside critics and even Congress of dismissing the danger of concussions, the National Football League has finally installed measures to safeguard players during games and, when they are injured, to treat them more effectively.
The latest effort, a locker-room poster being sent to all NFL teams this month, alerts players to signs of concussion—such as nausea, dizziness and double vision—and urges anyone exhibiting these symptoms to be examined by a doctor. The initiative is supported by both the NFL and the players union.
The message embraces caution in what, for players, is a high-risk environment. Football is a collision sport. At the professional level, collisions occur between the biggest and fastest players and can wreak havoc. A vivid reminder of this came last week when safety Jack Tatum, nicknamed "The Assassin," was back in the news. Tatum, who passed away July 27, made a devastating hit on Darryl Stingley during a 1978 preseason game. The hit turned Stingley into a quadriplegic; no penalty was assessed.
One new rule enacted last season penalizes hits against defenseless players such as quarterbacks and wide receivers. In December, the league banned players who show symptoms of a concussion from returning to play or practice on the same day; they must also be cleared by the team physician and an independent neurologist. The biggest change came this March when the NFL replaced the doctors leading its brain- injury committee—who discredited mounting evidence linking concussions to serious brain damage—with doctors alarmed by the danger.
Welcome changes all, yet the glorification of violence remains a well-entrenched part of football.
"Violent collisions are perhaps the NFL's biggest appeal," wrote sportswriter Gene Wang on the Washington Post's website in 2008. "Football fans love nothing more than a fierce hit, whether it's defensive back on wide receiver, linebacker on running back or defensive lineman on quarterback."
If live games don't offer enough mayhem, online videos—pirated, according to the NFL—promise "a compilation of the most violent NFL hits." Check them out. The collisions are horrific; the music, inspiring.
Many players feed on the violence while they play, and miss it when they retire. "I think violence is a big part of who we are and what the game is," said Ross Tucker, an offensive guard who played the last of his five seasons in 2005 and now writes for SI.com. "I miss paychecks, but what I really miss is the physicality. I miss being able to run over and hit another human being as hard as I can."
The resulting injuries are an accepted part of football. Jon Runyan started 190 consecutive regular season games from 1997 to 2008 despite injuries that included a broken tailbone. "The difference between a starter and a backup in the NFL is opportunity," said the recently retired offensive tackle, now campaigning for New Jersey's third congressional district. "If you don't let the guy behind you prove that he can play, they're not going to get rid of you."
Survival and other motivations—including loyalty to teammates who also play hurt—keep athletes on the field when they should be in a therapeutic hot tub. It is the attitude on which careers are built, a warrior ethic that has come to characterize pro football. The axiom that "you can't make the club in the tub" is taken as gospel.
But skeletal and muscular injuries are different from concussions. Recent studies confirm that the effects of concussions can be serious and permanent. And it needn't take long. In June we learned that Chris Henry, the Cincinnati Bengals wide receiver who died in December when he fell from the back of a truck, had suffered from chronic traumatic encephalopathy (CTE)—brain damage usually associated with older players. He was just 26.
"Athletes who suffer a concussion or multiple concussions and return to play before completely recovering are at increased risk of suffering early-onset dementia, cognitive impairment, memory loss, emotional instability and depression," said Richard Ellenbogen, co-chairman with H. Hunt Batjer of the NFL's new head, neck and spine medical committee. Still under research are what causes these effects—one big brain trauma, or several concussions without recovery—and why some suffer serious consequences and others none at all.
One of the biggest obstacles here is the athletes' code of playing hurt.
"My goal is to end that warrior culture of putting the player at additional risk, especially when he's had a neurological injury," said Thom Mayer, medical director of the NFL Players Association. "Think of the way we talk about this. 'I didn't have a concussion; I had a ding.' We need to make clear that these are neurological injuries that may have long-term effects."
Another goal is to limit injuries by reducing what Dr. Mayer calls concussion-prone incidents. Current union talks with the NFL target a 20% to 25% reduction, achieved through fewer contact drills per week or per practice.
None of this can work without player support. The man charged by the union with leading that effort last summer was Sean Morey, who signed with the Seattle Seahawks in March to play his 10th pro season. Mr. Morey plays on special teams, made up of men who run down the field for kickoffs and punts to collide head-on with the opposition; they're referred to as "suicide squads."
"The game doesn't have to change a whole lot, but it does have to change so that players aren't in the doghouse for reporting a head injury," he said, pointing to the pressure coaches place on players. "The mentality of most coaches is that they [themselves] played through countless concussions. And a lot of them are fine, but others suffer with degenerative brain disease, cognitive impairment and depression. We'd like to help stop that."
Hearing this from a special-teams player carries weight because he is known to confront the reality of serious injury on every play, and to fight against the fiction that players are invulnerable. The issue became painfully relevant in Mr. Morey's case.
"I'd had concussions in the past and not taken myself out—that's reckless," admitted Mr. Morey, adding that communicating with the team's medical staff last season led him to sit out several games. He was prepared for the same this season, but that changed last week when a doctor recommended he retire. "The reality is that I never fully recovered from last season—I can't hit without getting dinged. I didn't want to change the way I've played or become a liability to my team or my family."
On the last day of July, Mr. Morey retired rather than put his future at risk. It is a battle many players will have to fight.