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NFL and Head Trauma: A Need for Brainstorming

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In recent weeks there has been much in the news about head trauma and its long-term effects in the NFL. Last month, an NFL-commissioned study on dementia show increased likelihood of dementia for NFL players compared to the rest of the population. Yesterday, a survey was released showing all the effects, concerns and fears that NFL players have about the need to "play through" and hide these injuries. And recently there were Congressional hearings on the matter, with NFL Commissioner Roger Goodell put in a rare defensive posture about what the league is doing to stem the problem.

Hearing and reading all of this, I am left me wondering whether I, as a front office executive for nine years with the Packers, did enough to prevent this from happening. The honest answer is: I don't know.

I saw the fuzzy looks when some of our players came off the field. I took calls from wives, mothers, fathers and brothers of players who had suffered concussions. I watched players vomit in the triage of the training room after concussions.

Fuzzy Favre

I vividly remember a game against the Giants in 2004 when Brett Favre (heard of him?) was slammed to the turf at Lambeau Field. Brett stayed down, causing the stadium to turn eerily silent; sounding as if the president had been shot. The doctors took Brett off the field and to the sideline, where we assumed he would stay.

A couple of plays later, Brett took it upon himself to tell the coaches he was fine, and he went back in and threw a touchdown pass. And as we all know, Brett played the next week and the next week and so on.

Although it added to the legend of Favre on the field, I wondered about the long-term effects. I did, the doctors did, but I'm not sure Brett did.

Testing improvements

Soon after that incident, we instituted baseline testing of brain function and ImPACT testing (Immediate Post-Concussion Assessment and Cognitive Testing) before the season so we would have better detection and monitoring of concussions. ImPACT involves a 20-minute test using words, shapes, colors and patterns to measure attention, memory and reaction time. Since that time, I don't remember a situation in which a player was allowed on the field was at risk.

Football is an organized series of train wrecks. It is not a contact sport; it's a collision sport. Not only are its most bone-jarring hits canonized in highlight packages on Sunday night, but also they are further glorified in segments like ESPN's now-canceled segment "Jacked Up." The media bemoans the violence but sells it mercilessly (more on that below).

It's one thing to commission surveys like the one done through the University of Michigan and report the findings. I applaud the NFL for doing so. The hard part is deciding what to do about the results.

This is also a public relations battle the NFL will never win. On one side of the debate is the $8-billion business of the National Football League. On the other side, there will always be mentally infirmed players such as John Mackey -- for whom the NFL's assistance program for dementia and Alzheimer's, Plan 88, is named -- who invoke tremendous empathy from the media and public.

Style over Safety

With these stories in the news, there are companion stories about new designs for helmets, mouth guards, additional padding, etc, that would lessen the effects of trauma. My experience, however, is that players don't want the added equipment, no matter what the risk.

There have been helmet designs -- both from Riddell and Schutt -- that are safer, bigger, more cushioned and designed to absorb more impact. They are also bulkier and not as streamlined. I talked to players about wearing heavier helmets, but they joked that the bulkier helmets made them look like the Great Gazoo from the Flintstones cartoons. They laughed about it and, I must regrettably admit, so did I.

Where to go now

So what to do? Baseline and ImPACT testing is one obvious preventive measure all teams should take if they have not already. No information passed along to players, including grave disclaimers about the equipment they wear on the labels, is too much information. Continued education about concussions, dementia and Alzheimer's is necessary and valuable. More studies like the one just released certainly help as well. The question becomes what to do with that data?

The bottom line is that the majority of football players are all about right now. They are not even thinking that their careers will end, which most do before age 30, let alone the long-term effects of the game -- arthritis, joint degeneration, brain illness and perhaps even longevity. The immediate present is playing the game, earning a contract and squeezing every drop they can from a career in professional football. The shots of cortisone and toradol, the painkillers dispensed like Pez candy after games, have become an accepted part of game day in the NFL. Every day, there are hundreds of skilled players trying to take the job they have, and management is bringing in players all the time. Players do what it takes.

A couple of immediate steps could certainly be taken.

First, the football side of every NFL franchise has to step out of the equation and defer to the medical staff (this is being done now with Brian Westbrook of the Eagles). Team doctors and specialists in this area need to have the freedom, independence and empowerment to treat, advise and make recommendations on head injuries, from the equipment used to the ability to play short-term and long-term. Players, coaches, front office and ownership should not have a say in this. As this week's headlines suggest, this is bigger than football.

And second, the media needs to stop glamorizing the violent aspects of the game. The opening sequence of ESPN's Monday Night Football features animated helmets that crash violently into each other and explode. Let's be smart here. This is an issue that has drawn the attention of Congress and is finally receiving attention with potential changes about how teams treat head trauma and brain injury. There's no need to further glamorize high-impact collisions. ESPN and the NFL should revise that opening. That would be a nice start towards putting words into action about this problem.

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