Concussions and the NFL: Getting Out Before Getting Hit

Is this the beginning of the end? Chris Borland just quit football after a rookie year that was so surprisingly good that it astonished the guys on the Grantland Football Podcast week after week.

This is probably not the beginning of the end of football, but it is probably the start of athletes choosing to get out and perhaps choosing other sports.  We may soon see a migration of folks who could have been football players to other sports where the concussion risk is either less or unknown.

Given his great first year, Borland is definitely choosing health over money as he would get paid big bucks if he kept up last year's performance.  I admire him for making a very difficult choice.  There is no way this was an easy decision.  Indeed, choosing not to get hit is the brave choice. 

Update: the fan reaction is surprisingly supportive.   Given that his team just lost another key linebacker, Pat Willis, the loss of Borland is going to cause significant problems for the 49ers.  Yet the early reactions support the decision.  Very interesting indeed.

Concussions for Kids update

The bad news on the sports scene is that soccer seems to tolerate unrepentant multidimensional a-holes like Suarez of Uruguay.  The good news is that people are taking concussions far more seriously than a few years ago.*  The major kids hospital in Ottawa, CHEO, just came out with standards for parents and coaches and doctors to treat kids with concussions. 

It contains some common sense and then some.  So, the obvious "err on the side of caution" if you think a kid might have a concussion should have been something that does not need saying, but it does.  More striking are the recommendations for dealing with kids who have been concussed--especially much less screen time.  The idea is that if the brain takes a hit, it needs not only to recover without any subsequent physical shocks, it also needs to really rest--so cut down on video games, computer time and all the rest.  Rest means rest apparently. 

The most unsurprising part of the study--in Canada, the plurality (but not majority) of concussion patients received their injuries via hockey.  I am sure that in the US it is football and then probably soccer (especially for girls).  I think we have turned the corner on taking this stuff seriously, but we definitely have much room to improve.  I fully expect kids football to change seriously or die out in the near future.  Hockey?  That ain't going nowhere, but better treatment, perhaps new rules and better equipment might be in order.  

*  I blogged a lot about concussions when I first started Spewing, but have not as much lately. 

Cognition Day At The Spew: Making War on The War On Mythology

Speaking of cognition, how about those concussions?  I was surprised (although I should not have been) when I was in a bookstore while in the US last week.  On the same book display as the PBS documentary-related book on concussions were books entitled "The War on Football."  The book apparently argues that there are folks attacking football with lousy science--that the concussion problem is over-stated and under-scienced.

Given this morning's theme of confirmation bias, I pretty much refused to take seriously this argument.  I did keep up with the concussion story for quite some time (mostly the Alan Schwartz pieces in the NYT) with many Spews about it.  So, I was definitely motivated to be biased against a book that fought back against the semi-new consensus that concussions in football (and other sports) is a serious, serious problem.

My second gut reaction was to dismiss the book because I hate, hate, hate, the phrase "The War on ...."  If you want me to dismiss or ignore something, just put that in the title.  There is no War on Christmas, for instance, despite the best efforts of some folks to argue otherwise.  Perhaps I am biased since "the War on" seems to be more of a right-wing kind of thing.  Indeed, hitting the link to this author's site indicates that author, Daniel Flynn, writes right-wing books with troll-baiting titles like Why the Left Hates America.  So, now I am really disposed against taking this argument seriously.  The Deadspin coverage is pretty fair, I think, to Flynn's argument.  In the end, it is skeptical about the moral wonderful-ness of football, which seems to be a key to Flynn's perspective.

Anyhow, is there a war on football?  What would a war on football look like?  I do believe there is now more serious criticism of football and the dangers it presents to those who play it.  Is this a "war"?  This gets to the heart of the matter--calling science that raises questions and suggests reforms as a war may be good rhetoric for mobilizing the defenders but really is just a call for more ignorance. 

Yes, I get it that this may be what Flynn is trying to do--mobilize the defenders--but a "War on Football" is just deceptive and ultimately silly.  Revealing that concussions produced by ordinary football, especially practices, is not a war but the product of science and journalism.  A war is when people shoot guns in an organized manner.  Or at least use coercion.  Thus far, I have not seen much coercion in the football concussion effort--just folks seeking to understand whether there is causation that goes with correlation and whether the correlations hold up. 

Until someone really uses coercion in this or in any other area where there is a supposed W"ar On", my cognitive biases are going to direct my eyes and buy book buying dollars elsewhere.

Denial Is Nothing New to the NFL

This piece does an excellent job of showing how the NFL denied, denied, denied that concussions were a huge problem.  The bits and pieces here sound like cigarette companies denying the science of cancer research.  So much conflict of interest between team doctors and the players. 

 2010 - In March, the NFL creates a new committee to study concussions, distancing itself from Pellman and Ira Casson. Prominent neurologists Dr. H. Hunt Batjer and Dr. Richard G. Ellenbogen are appointed as co-chairs. Batjer says the following about the MBTI: "We all had issues with some of the methodologies... the inherent conflict of interest... that was not acceptable by any modern standards or not acceptable to us."

 It is not time for the players to have player doctors on the sideline--it is way, way, way over due.  And I do think that much of the talk (not action) that the NFL is spitting out these days is only of the cover your ass variety.  Force the players to wear the best helmets--there is no way so many helmets should be flying off every week.  Forget the talk about an 18 game season.  Do not return players to the field if they are seriously hurt (like RGIII).  This really is not rocket science. 

We talk about bubbles all the time, like an education bubble.  But what if the NFL is just one big bubble ready to pop?  What happens to the game if the players cannot get hit in the head?  Just wondering.

Our Gladiators

Funny coincidence: I just started playing a free gladiator game on my iPad and this piece on the NFL came out.  Oy.  I had written a fair amount here on the concussion problem (here, here, and here as examples), so I do think that Goodell was right to punish the bounty-hunters, but wrong on his scheduling obsessions.  The previous bargaining effort had an 18 game season as a focal point despite the fact that the NFL was facing a serious problem with the danger of the game with 16 regular season games.

Last season saw numerous players losing significant playing time due to concussions although others managed to stay on the field longer than they should have.  And now we have Thursday games throughout the season.  Whitlock is right that the talk about concussions and the reality of the schedules suggests just a bit more than naked hypocrisy.  The lawsuits that will hit the NFL will be most problematic, and I do start to wonder again whether I should watch football tomorrow. 

This story does convince me not to watch on Thursdays.

Concussions and Kid's Football

Very interesting study.  Not enough has been done thus far.


Clear lesson--football practices are as dangerous as the games.

Would moving back to touch football make a difference?  I don't know, but I do know that the coaches here in this story may not be that typical.  Other coaches may be a bit more into competition and a bit less into protecting the kids.

I am glad my daughter is into ultimate and not football, more so now than ever.

Concussions: The More Things Change

I watched enough games this year to see that the new concussion rules for the NFL were observed sometimes but not always.  There would be times where a player clearly took a major hit to the head and then came back into the game. 

More evidence: this story.  The San Diego Chargers essentially ended Kris Dielman's career.  Well done.  You would think by now that the on-going snowball of lawsuits might make a difference.  Of course not.  And with the owners still pushing for an 18-game season, the concussion problem is clearly not being taken that seriously.  I am at the stage of giving the NFL one more season, and if I see players continue to be sent back in after sustaining concussion, I may stop watching.  It will not affect the NFL, but I will feel less complicit nonetheless.

Concussions and Hockey

I have posted on and off over the past few years about the concussion problem in football.  Of course, football is not the only sport that has this problem.  Hockey faces the same crisis, especially when its star of the moment, Sidney Crosby, has been sidelined by a concussion for more than half a season.  Ken Dryden, the former goalie great of the Canadiens, has a great piece at Grantland.com* about what needs to be done, at least as a start.

*  With this piece, Bill Simmons's little empire starts making a big dent behind the silly stories of pop culture and Red Sox collapses. 

The question Dryden raises now is whether the commissioner of hockey, Gary Bettman, will do what it takes.  Roger Goodell of the NFL has been mixed at best.  Changes in the kickoff rules are good, but how about requiring the safest possible helmets?  And how about getting the media folks to change their coverage and focus less on the hardest hits?  The game of football is great without focusing so much on the collisions.  I do think football has been making progress, with stories of guys going for the right kind of tackles.  But much more progress can and should be made.  Especially since the NFL sets the example for all other forms of football (college, high school, and younger).

Head Games

Check out the Bill Simmons podcast with Chris Nowinski.  Nowinski is a former athlete and pro wrestler now working on the concussion problem.  Bill and Chris do a nice job of discussing the issues, including whether one should let their kids play football.  The comparison between the smoking industry's decades of denial and the NFL's initial attempts to do the same is pretty striking.  And the league still wants to add two games to the season.

I am glad that my daughter does not do competitive cheer-leading nor does she play soccer much (heading the ball a lot as a kid is probably not a great idea).  When we ski, we wear helmets.  We only go into the trees where it s not very steep, so that we can control our speed. 

I have been concussed a few times, I think (I never thought to keep track plus, as the current discussions suggest, it is not always clear what counts).  Clearly the time when I ran into a tree in the main quad at Oberlin chasing a frisbee (we were just tossing the disk).  Perhaps banging my head when falling on a hard ski surface. I never played football with pads (just informal games).  I don't think I ever banged my head playing ultimate, although I am sure I will feel my ankle, wrist, knee, and hand injuries when I am old.

We will be facing some significant changes in some of our sports.  Just this week, Air Canada (which is currently delaying my return to Montreal) has told the National Hockey League, whom it supports with its advertising, that the sport may be too violent to continue to support:

"We are contacting you to voice our concern over [the] incident involving Max Pacioretty and Zdeno Chara at the Bell Centre in Montreal," wrote Denis Vandal, Air Canada's director of marketing and communication, according to the Ottawa Sun. "This is following several other incidents involving career-threatening and life-threatening headshots in the NHL recently. From a corporate social responsibility standpoint, it is becoming increasingly difficult to associate our brand with sports events which could lead to serious and irresponsible accidents; action must be taken by the NHL before we are encountered with a fatality.
"Unless the NHL takes immediate action with serious suspension to the players in question to curtail these life-threatening injuries, Air Canada will withdraw its sponsorship of hockey."

This is stunning as hockey is the national glue of Canada, and Air Canada is the national airline.  To have a business think about disassociating itself with the most watched, most beloved and most integral sport in its primary area of operations is pretty amazing.  Even though my flight is delayed, I may be falling in love with Air Canada.

The Hits Keep on Coming

The concussion saga continues, with a suicide by an ex-player: Dave Duerson.  In his suicide note, he asked that his brain be studied, and then he shot himself in the heart.

Sitting with his mother on the deck of his father’s building Monday night, Tregg Duerson sobbed. “He was looking for an answer,” Tregg said. “And he was hoping to be a part of an answer.”

Puts it all into perspective.  The NFL is trying to lengthen the season to 18 games but refuses to require the players to wear the most protective helmets.  Keep on following Alan Schwarz's stories in the NYT.  

NFL: Alan Schwarz Is Out There

The NFL should just give it up.  They pushed Toyota into dropping part of an ad because it showed football players (not NFL players) colliding and referred to how Toyota research on car collisions is being shared with those working on concussions in sports.  But this illustration seemed too much for the NFL which used to glorify such big hits and has been inconsistent in the playoffs in penalizing such hits.  So, NFL exerted its market power as its games provide heaps of audience for car ads.

As Schwarz points out, the contention that football is just one of many sports where concussions occur is true but also silly:

Brian McCarthy, a spokesman for the N.F.L., said: “We felt it was unfair to single out a particular sport. Concussions aren’t just a football issue.”
The N.F.L. is correct that concussions are an issue in other sports. According to researchers at Nationwide Children’s Hospital in Columbus, Ohio, high school football players report about 100,000 concussions per year. The second through ninth-ranked sports combined reach 110,000.

The NFL should realize that they cannot cover up the concussion problem.  There has been some new openness and improved policies but lots of resistance as well.  Schwarz is going to make sure that resistance is futile.  Nice to see journalism having a bit of an edge and not so much he said she said.

Media Can Make a Difference

It seems pretty clear that Senator Udall's concern about helmet producers' claims about concussions is due to the coverage provided by Alan Schwarz's series of articles, so it is only fair that Schwarz write about the Senator.

“Athletes, coaches and parents today are increasingly aware of the danger of concussion, and this awareness influences decisions about buying new and reconditioned football helmets,” wrote Udall, who last month initiated an inquiry into football helmets by the Consumer Product Safety Commission. “Athletes who have already suffered a concussion — as well as their coaches and parents — may be particularly susceptible to misleading marketing claims about helmet safety.”

The helmet maker in question now is all eager to be transparent.  Funny how often that happens so late in the game.

Anyhow, Schwarz has fun citing himself (a game not just for academics):

As parents and coaches have become increasingly worried about protection against concussions, claims by helmet manufacturers — often embellished by local sales representatives — have come under unprecedented scrutiny. An investigation by The New York Times, published in October, highlighted misinformation as well as lapses in helmet-testing protocol. Udall’s letter focused on helmet-company advertising.

 Insert suitable metaphor here of helmet-maker taking a blow to the head.

If You Cannot Count on the NFL

To Set a good example, then it makes sense to start at the other end.  For football to continue to exist in something like its present state, changes need to happen to reduce, but not eliminate, risks.

So Hosea runs camps that focus on one skill — tackling with your head up instead of down, and away from contact — and gives individual instruction to players in and around Los Angeles. As football careens through its dark cloud of head injuries, Hosea sees himself as saving more than the players’ ability to walk and think. He sees it as saving the sport, one youngster at a time. 

Training players at an early age might lead to fewer NFL players complaining that the new rules go against years of training and experience.

Of course, the first step should have been mandatory safer helmets.  Aaron Rogers of the Green Bay Packers is returning this week after a concussion which he helped cause by not sliding on a run, and the coverage all mentioned his silly-looking but safer helmet.  All of the players should be wearing helmets with padding on the outside--they would be less dangerous as weapons and more protective.  Inevitable for this to happen but not necessarily soon. 

But training to tackle more safely is also overdue:

“When a kid gets paralyzed or dies, it’s not an accident — the injuries happen because people never teach kids how to tackle the right way,” Hosea told about 20 rapt campers before a session this month. “Everyone’s talking about head injury awareness, awareness, awareness. What are you going to do about it? It drives me absolutely crazy. It’s time for this to stop!” 

 Attitudes are only beginning to change:

“A lot of youth coaches have no idea how to teach tackling — they say to just put a helmet in the numbers or light the other guy up,” said Jeff Leets, whose seventh-grade son, Zack, is a defensive end and devoted Hosea pupil from nearby Torrance. “They have the caveman element and don’t want to be told their way is wrong or that their way is unsafe. Or they simply don’t know. It’s sad — you’ve got babies in your hands, man.”

 What is clear?  We need more Bobby Hosea's, willing to teach a better way, and we need more coaches willing to listen and learn.  Otherwise, football's future might be dim.

At the Start of a Cultural Revolution

When do norms change?  When do we start viewing stuff through new lenses?  We need others to start the process, educating us about what was wrong with the old way of doing things.  In this NYT story, Chris Collinsworth is part of leading edge of the cultural revolution in football--that concussions are no longer a joke, and that illegal hits to the head should no longer be celebrated.  While Alan Schwartz and others have run heaps of stories about the damage that concussions are doing to our athletes, this only gets transmitted to the fans via the commentators.  "Collinsworth’s language and tone can be less overt, evident only when juxtaposed with that of other announcers...."

Collinsworth said that he handles head-injury issues as he does primarily because his job is to explain what is happening on the field.But he did cite other influences: The fact that some of his old Cincinnati Bengals teammates are having severe neurological problems in their 50s; Austin at Notre Dame and Jac in high school; and, most of all, all those youngsters in the Fort Thomas Junior Football League in Kentucky.

So, he understands it is not just about the big guys on TV, but that these guys are the ones shaping the expectations.  There is still much to do, even if we accept that the sport will always be dangerous--it is stunning that we do not have serious standards/requirements about helmets.  Teams, schools, and leagues continue to dodge such responsible efforts because doing nothing is actually less likely to produce liability than doing something.  And there are still retrograde announcers covering professional and collegiate sports, as the article notes.

What makes Collinsworth really worth listening to?  He sees the tradeoffs clearly:

“You try to teach toughness and to hit hard, and also say to be safe and don’t hurt anybody — there’s a contradiction there,” Collinsworth said. “The very fundamental question for the long road is, Do you want your kids playing football? That’s the scary question, especially for the N.F.L. I think we’re talking about the survival of the game to some extent.”

Military Takes Concussions Seriously

As I am traveling, I got to see a USA Today story about the new US military policy on concussions.  We are now taking soldiers, marines, sailors, and air folks (not so much) out of duty if they have a concussion.  With the bombs bursting in air and all, this is not an insignificant number of folks.  Should help generate better understanding of concussions.  But entire units might have to be pulled off the line after a major battle with close artillery/air support, right?  The article cites a retired general about the tradeoffs between readiness and caring for the troops.  I guess the numbers are small enough (although plenty of troops affected) that this is not that severe a problem---we are not losing entire units to the concussion doctors. 

Still, with better equipment and medical care, brain injuries are becoming a much bigger part of the post-combat health challenge.  This is good news in some ways--folks are surviving that would not have done so 10, 20, 50 years ago.  But the explosiveness of the new generations of IEDs (improvised bombs) also plays a role here. 

This story combined with the effort to cut suicides in the army reveals that these wars are more than just about KIA--the toll is high and getting higher still.

Limited Progress on Concussions

Alan Schwarz continues his excellent work on the concussion and football story.  This time, he focuses on the helmet industry, and we are not surprised to find that there is little regulation here. Much needs to be changed, like how teams practice, how the media covers the big hits, but helmets would seem to be a logical first step, especially for the kids.  No brainer, really (pardon the pun).  Much progress on awareness the past year or so, in large part to Schwarz.  Still much room for improvement on everything else. 

The story is pretty disturbing as some companies will just wait for new standards and see that as acceptable, while standards-setter is waiting, apparently, for a perfect understanding before moving forward, that a tradeoff between skull fractures and concussions (which may or may not exist) is an excuse for doing nothing now.

Art Chou, vice president of Rawlings, agreed: “We’re not in the standards-making business. We make equipment focused on standards given to us.” Chou also serves on the Nocsae board.

Oy!  This is juxtaposed with other companies that say they are on the cutting edge on this but might be making exaggerated claims, such as Ridelll.  I think I would buy the exaggerator's helmet rather than one from the complacent companies. 

Along with Riddell, the company most emphasizing concussion safety is Xenith, whose X1 model is making inroads among high schools, colleges and the N.F.L. The X1 features a radical new design: air-filled shock absorbers that attempt to withstand a wider range of forces than traditional foam. Xenith’s founder and president, the former Harvard quarterback Vin Ferrara, said the Nocsae standard had discouraged innovation among other companies and was “wholly inadequate” for modern football.

This is where government should play a role--that regulation is required when the market does not operate so well.  Especially when the ignorance is vast:

The fact that helmets are held to no standard regarding concussions surprised almost every one of dozens of people interviewed for this article, from coaches and parents to doctors and league officials. Even one member of the Nocsae board, Grant Teaff — who represents the American Football Coaches Association — said he was unaware of it.

 When we ponder who is doing the regulating, this kind of news should not surprise us, but does nonetheless:

Nocsae’s annual budget of about $1.7 million is funded mostly by sporting-goods manufacturers whose products bear the Nocsae seal of approval. The largest share of that comes from football helmet makers and reconditioners.

 Lovely.  No wonder no progress is being made.  My curiosity is thus satisfied.  No more info is required to figure out why we have no concussion standards for football helmets.  Makes me glad that my kid does not play football--I can understand why we have cheap and crappy helmets and why we will be stuck with them for the near future.