Concussions: The NFL's Biggest Headache

Chris SurovickContributor IJanuary 6, 2010

GLENDALE, AZ - OCTOBER 05: Starting Quarterback Trent Edwards #5 of the Buffalo Bills suffers a concussion after getting hit by Strong Safety Adrian Wilson #24 of the Arizona Cardinals during the first half of their NFL Game on October 5, 2008 at Stadium in Glendale, Arizona. (Photo by Donald Miralle/Getty Images)
Donald Miralle/Getty Images

If Brian Westbrook’s vision isn’t too fuzzy, and the fog engulfing his consciousness not too dense, the concussed Eagles running back might want to thank Joseph Mason Reeves.

Reeves too was a football player, a genus of athlete noteworthy for its tendency to be both headstrong and head-weak. His teammates called him “Bull”, though frequently he was too dazed to hear them.

An undersized tackle on Navy’s 1893 team, Reeves’ unpleasant duty was to plow headfirst into the flying wedges opposing offenses ran with a deadly—literally, on occasion—efficiency.

In retrospect, “headfirst” was probably an unwise strategy, considering that football heads like Reeves’ were not yet helmeted. In what was the sport’s infancy, players actually believed they could protect their heads simply by growing their hair long.

Few got haircuts in-season. Many got concussions.

Reeves, who like Ronald Reagan was born in Tampico, IL, must have had thin hair. He was knocked out so frequently that late in that 1893 season a Naval Academy physician warned him the next could result in death or “instant insanity.”

While deaths weren’t uncommon in a football era so brutally violent the sport would nearly kill itself, insanity was something else. The prospect of a nutty Naval officer at the helm of an American battleship, the first of which was then under construction at US navy yards, was not something the academy superintendent could condone.

So even though the fourth annual meeting with Army was next on Navy’s schedule, Capt. Robert L. Phythian summoned the 21-year-old to his office. “Reeves, my good man,” he told the senior, “I cannot in good conscience allow you to play in the upcoming game with Army.”

But Bull Reeves, who though he failed to recognize the peril of persistent head injuries did foresee the value of aircraft carriers, possessed the resourcefulness of a future officer. The future admiral sought out an Annapolis cobbler and asked him to create a head-protector out of moleskin.

The result looked like something Attila the Hun might have worn to a pillaging party – as conical as it was comical. Even so, the odd-looking device satisfied Phythian. Reeves starred in a 6-4 Navy victory and the football helmet, though it wouldn’t become mandatory for nearly a half-century, was born.

In the decades since Reeves preserved his playing status and presumably his sanity, helmets have undergone constant and considerable changes. Physicians, trainers, engineers, pilots, and coaches all have tried to perfect them. Straps were added, then padding. In the late 1940s, the switch began from leather to molded plastic. Facemasks were soon incorporated and later air-cushioning devices.

Today’s state-of-the-art helmets are as shiny, sleek and handsome as sports cars. They cost hundreds of dollars apiece. They are effective marketing devices, with tens of thousands sold annually not just to teams, but to collectors and obsessive fans as well.

And yet, as is illustrated by the problems Philadelphia’s Westbrook, Washington’s Clinton Portis and at least a dozen other players have endured this season, head injuries continue to be a major headache for the NFL.

By the league’s own estimate, there are 120 to 130 concussions a season—a number a recent Associated Press survey suggests may be vastly underreported. “Guys today are a lot bigger, a lot faster than they used to be,” said Sam Huff, the Redskins broadcaster and former linebacker. “The game is violent and it’s always going to be.”

That rationale doesn’t help much in a hyper-litigious era. So Commissioner Roger Goodell ruled recently that no player suffering a concussion will be permitted to return to action. Players are also under increasing pressure to sit out the game after their injury.

"Once removed for the duration of a practice or game,” Goodell’s memo reads, “the player should not be considered for return-to-football activities until he is fully asymptotic, both at rest and after exertion, has a normal neurological examination, normal neuropsychological testing, and has been cleared to return by both his team physician(s) and the independent neurological consultant."

The conundrum football faces in this health-conscious age cuts to the very nature of the sport: How do you remove violent impacts from a sport of violent impacts? With better helmets? Tougher penalties? Stricter medical policies?

So far, none of those options has done much to quell the epidemic. Baseball, if it wanted to, could merely legislate away its most violent aspect, beanballs. Basketball has been successful policing stray elbows and in-the-lane muggings.

Hockey is probably closest to football among the four major sports in its proclivity for head-jarring hits, but on the ice they don’t take place nearly as regularly.

All that the NFL knows at this early stage of what is becoming, for the league anyway, an increasingly unpleasant topic, is that something must be done.

In addition to Goodell’s new edict, a Player Advisory Forum, headed by Tony Dungy, was formed. Its purpose is to get input on hot-button issues from players around the league and feed it to Commissioner Roger Goodell.

It already has asked helmet manufacturers to come up with a safer design. What happens after that is anyone’s guess. "Players continue to be an invaluable resource in providing direction and insight into a wide range of programs and policies," the commissioner said in the release announcing the formation of the committee. "Tony's experience and expertise in working with players makes him an ideal leader.”

The committee almost certainly will discover what a recent survey by the University of Michigan’s Institute of Social Research found. That study revealed that 6.1 percent of the players responding were suffering from Alzheimer’s disease, dementia or some other memory disorder. That’s five times the national average for men their age.

The numbers were even worse for younger NFL alumni. Those between 30 and 49 reported suffering from those infirmities at a rate 19 times the American average.

A subsequent Associated Press survey of 160 current NFL players revealed that half had suffered serious head injuries—and that many had hidden that fact from their teams.

Much of the blame, of course, can be attributed to the peculiar physics of football. Large, physically gifted linebackers and defensive backs hurl themselves like missiles at each other. Helmets, designed to protect, often become dangerous projectiles as players ram them into backs, pelvises and occasionally other heads.

Less noticeable, but equally insidious, even-larger linemen regularly butt heads in the steel-cage battles of the pits.

And running backs and receivers diving for extra yards frequently get kneed in the head—as Westbrook did—by onrushing defenders. Not surprisingly, these repetitive convulsive acts can have a dangerous cumulative effect.

According to a recent New Yorker magazine article, researchers believe the majority of these stricken former players have a neurological disorder called CTE (Chronic Traumatic Encephalopathy), the result of repeated brain trauma.

Autopsies uncovered various degrees of CTE, the magazine said, in the brains of Steelers Hall of Fame center Mike Webster, who was a homeless recluse when he died; Andre Waters, the hard-hitting Eagles safety who, severely depressed, killed himself with a bullet to the head, and Justin Strzelczyk, the one time Steelers lineman who died when he drove his car the wrong way on a freeway and slammed into a truck at 90 mph.

If football players retired after their first serious head injury, experts contend they’d likely experience fewer problems later in life. But, unfortunately, there wouldn’t be many players left to form a league.

Virtually every NFL player, at some point in his career, has been knocked unconscious during a game or practice. Far too many don’t reveal the depth of their problem because they fear losing their position. Dungy, for example, told a radio interviewer that he had done exactly that. And after Westbrook suffered a concussion earlier in the season, he sat out two games, returned, and was concussed again.

The New York Times reported that Pittsburgh safety Troy Polamalu had suffered six documented concussions since high school. The total was three for Steelers QB Ben Roethligsberger, who missed a game recently after being knocked out.

How many will end up like former Steelers Webster and Strzelczyk?

“It’s not that you’ve just lost cognitive skills,” Douglas H. Smith, a professor of Neurology at the University of Pennsylvania’s Center for Brian Injury and Repair, told The Philadelphia Inquirer , “but you’ve also increased the chances of having a worse problem later in life.” Right now, the NFL can’t think of a worse problem.

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