It's the elephant in the room for the National Football League—a hot-button issue that has come into the public eye after years of being ignored.
It's a problem that has been blamed for the death of more than one man, and for ruining the post-football lives of any number of former players.
It's spawned a lawsuit from thousands of former players—a suit that could shake the NFL to its very foundations.
The issue is concussions in football, and for all the press it's gotten, it's still an even bigger problem than people think for a number of reasons.
Concussions are back on the front page thanks to an article by Mike Freeman of CBS Sports, in which former Denver Broncos and Washington Redskins running back Clinton Portis revealed that he had countless concussions during his playing days.
Literally countless, as in, he lost count:
"The truth is I had a lot of concussions," he said. "It was just the way things were at the time. I'd get hit hard and be woozy. I'd be dizzy. I'd take a play off and then go back in. Sometimes when I went back into the game, I still couldn't see straight. This happened all the time. Sometimes once or twice a game."
How many concussions does he think he had?
"Numerous," Portis said.
"More than that, I think," Portis said.
"I can't put an exact number on it," he adds. "I just know it was a lot. I stopped counting at some point."
As unsettling as that news is, Portis considers himself lucky, telling Freeman, "I have a few aches and pains, nothing major. None of the, 'I can't stand up or walk' stuff. I got away from the game at the perfect time. To be 31 and retired and spending time with my kids, I love it."
If that's the case, then he's one of the lucky ones. Consider the case of former linebacker Gary Plummer, who told Cam Inman of the San Jose Mercury News after the suicide of teammate Junior Seau that the pair had thousands of concussions between them:
In the 1990s, I did a concussion seminar. They said a Grade 3 concussion meant you were knocked out, and a Grade 1 meant you were seeing stars after a hit, which made me burst out in laughter. As a middle linebacker in the NFL, if you don't have five of these (Grade 1 effects) each game, you were inactive the next game.
Junior played for 20 years. That's five concussions a game, easily. How many in his career then? That's over 1,500 concussions. I know that's startling, but I know it's true. I had over 1,000 in my 15 years. I felt the effects of it. I felt depression going on throughout my divorce. Junior went through it with his divorce.
Or the case of former linebacker Steve Hendrickson, who played seven seasons in the NFL. As Tim Keown of ESPN The Magazine reported, Hendrickson sustained 15 Grade 3 (blackout) concussions over his career. At 46 years old, his memory his shot. The Social Security Administration has declared Hendrickson "permanently disabled."
Still, these are all cases that occurred before the NFL's recent emphasis on concussions. Surely things are better now, right?
In many respects, yes.
The NFL's rule changes and concussion protocols are certainly a step in the right direction. As sad it was to see concussions likely end the career of 24-year-old Detroit Lions running back Jahvid Best, it would have been infinitely worse had he been allowed to keep playing and do even more damage to his brain.
Therein lies a big part of the problem. Given the opportunity, Best may well have played on, his own health be damned.
The vast majority of NFL players are fighting for their careers on an almost weekly basis. Admit that you have a concussion, and you're out of the game, quite possibly for weeks. Admit more than one, and you could very easily be out of the NFL altogether.
These are young men living a dream they've had since they were 10 years old; most of them aren't inclined to worry about what's going to happen to them in 20 years. They're worried about the here and now, and the here and now is playing football.
Even Hendrickson, after all the damage that's been done to his body, told Keown he'd do it all again if given the chance. He also hopes that his son will play in the NFL one day.
It's not like the teams are much better. As Dan Diamond of Forbes reports, data compiled by The Concussion Blog shows that the Oakland Raiders have reported a total of 32 concussions over the past three seasons. The Houston Texans, on the other hand, have reported a total of three.
That data would seem to indicate that either an inordinately large number of anvils are falling from the sky in the Bay Area, or someone in Houston is cooking the books.
Then there's the NFL—the champion of player safety. The league presents itself as being very concerned with the welfare of its players, but commissioner Roger Goodell continues to espouse the possibility of extending the regular season from 16 games to 18.
This, despite concerns such as those expressed by Jim Gossett, the athletic trainer at Dartmouth University, to Samantha Lin of The Harvard Crimson:
I think [hits during kickoff returns] tend to be the most high-velocity hits...but I think when you start to look at some of the concerns on the neurological problems, it may not be the full-blown concussion that’s at the root of the problem. It may be these subconcussive hits that are happening multiple times per day, per week, that have a cumulative effect. That’s the bigger question.
A number of neurologists have expressed similar worries, but as recently as the May owners meetings Goodell said that an 18-game regular season was "still on the table," according to Mike Florio of Pro Football Talk.
It shouldn't be, but that's only one of several steps that needs to be taken. There needs to be an independent neurologist on the sidelines at every NFL game—a doctor who isn't beholden to a particular team for his paycheck.
There also needs to be a universal standard for teams reporting concussions, and severe penalties for those who don't. No more of this nebulous "head" injury nonsense.
Even then the problem will hardly be "solved." The simple fact is that when you put 22 very strong, very fast men on a field and have them smash into one another at full speed, people are going to get hurt.
It's the nature of the sport. After all, it wasn't that long ago that the hits we all wring our hands about were celebrated. They still are by many fans, whether they want to admit it or not.
Maybe that's the biggest problem with concussions—not only in the NFL, but in all of sports, especially those with hard contact like football, hockey and boxing.
Maybe it isn't the players, or the teams, or greedy owners...
Maybe it's us and our 21st-century thirst for blood.