No one seems to know with certainty how many concussions players suffer each season in the NFL. For too long, they went unreported and untreated. Too many players simply write them off as an occupational hazard even now. There's still only so much agreement, even among doctors and researchers, about the long-term effects. And all the while, the hits that produce them keep filling up highlight reels.
No one seems to know with certainty how many concussions players suffer each season in the NFL.
For too long, they went unreported and untreated. Too many players simply write them off as an occupational hazard even now. There's still only so much agreement, even among doctors and researchers, about the long-term effects. And all the while, the hits that produce them keep filling up highlight reels.
"At every level, there's an incentive to play through it," Cardinals receiver Sean Morey said. "High-school players want scholarships, college players want to make the pros and pros don't want to let their teammates and coaches down. ...
"If you're lucky enough to have a long career, you're looking at, what, 30,000 collisions?" he added. "How many caused concussions? And at what level? Those are questions we need to be able to answer. Players, and not just those in the NFL, need to be cognizant of long-term effects."
Concussions made headlines on those rare occasions when they force stars like Troy Aikman and Steve Young to the sidelines. Or when former players like Andre Waters and Justin Strzelczyk die violently just a few years after leaving the game — bouts of depression that autopsies suggest resulted from repeated blows to the head.
Or, as happened earlier this week, when Morey, Ravens center Matt Birk and Seahawks linebacker Lofa Tatupu became the first active players to announce they will donate their brains and spinal cord tissue to a Boston University medical school program to further studies on sports brain injuries.
"I don't think it would have happened if all three guys weren't Pro Bowl players," said Chris Nowinski, co-director of BU's Center for the Study of Traumatic Encephalopathy. "Because they're not only informed about the consequences, they're secure in a way plenty of others might not be.
"When people hear about the donations, they might assume they've had issues. And in their business, no player wants to be perceived as concussion-prone. When the issue gets discussed, too many guys' reaction is 'No way, I'll get cut.' But by talking about it, hopefully, these guys will inspire trust."
The league figures it's concussion rate at roughly one every other game, which translates to between 100-150 players each season. Nowinski, who played football at Harvard and then wrestled in the WWE before concussions cut short his career in 2003, believes a more accurate figure would be half the league estimate.
"Everybody in the pros is at risk and some of them, a very significant percentage, are going to develop CTE (chronic traumatic encephalopathy) with an average onset of the disease sometime in his 40s," Nowinski said.
"It's virtually impossible to get without playing a contact sport or repetitive trauma. But it's not just an issue for the few thousand guys who pass through the NFL. It's an issue for the millions of kids who play the game and their parents," he added. "People don't have enough good information to assess the risks. Awareness is nowhere near what it needs to be."
Using brain tissue culled posthumously from retired NFL athletes, researchers have identified six cases of CTE, a disease previously limited in the medical literature almost exclusively to boxers. Nowinski helped widen the scope of study when he convinced Waters' family to allow pieces of his brain to be tested. The hard-hitting former Eagles defensive back committed suicide in 2006 at age 44.
A pathologist at the University of Pittsburgh who examined the sample concluded "the condition of Waters' brain tissue was what would be expected in an 85-year-old man, and there were characteristics of someone being in the early stages of Alzheimer's."
The NFL, initially slow to react to anecdotal reports, has begun making up for lost time. The league convened its first conference on the matter in 2007, bringing together experts from outside the league, instituting mandatory brain baseline testing for each NFL player, standardizing concussion reporting and even announcing a "whistle-blower" hot line enabling players to anonymously report when they feel pressured to return to the field.
"The commissioner's position is clear: medical decisions must override competitive decisions, no matter the situation," NFL spokesman Greg Aiello said.
Four rules were also changed this season to reduce collisions on kickoffs and outlaw blows to the head, neck and shoulders.
"It's always going to be a brutal game played by ultra-competitive guys," said Morey, a member of the union's NFLPA Player Safety and Welfare Committee. "The science regarding concussions is better, we can make better assessments, there's better helmets available.
"But it's still probably safe to say half the concussions go unreported. Some of those same players are also husbands and fathers who are going to have to look after families and play roles in their communities long after their playing days are over," he added. "The culture has to change."