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Rationalizing the Radical Approach to Concussion Treatment in the NFL versus the NCAA

2012 October 30

A lot of criticism has been levied against the NFL and teams for allowing players, who appear to have concussion symptoms, to return to play too soon. I believe this criticism is a bit much. The NFL has moved light-years ahead of its prior inability to comprehend the severity of concussions and the clear link between repeated blows to the head and neurodegenerative diseases.

The concussion lawsuits have forced the NFL’s hand, and various policies and protocols are in place, which appear to be working. The concussion lawsuits focus on the NFL’s prior actions, not its current stance on concussions. The NFL’s concussion protocol has effectively been taken to its logical extreme; any further requirements will change the characteristics of the game — jeopardizing the future of the sport.

In my opinion, the criticism should be levied against the NCAA and its member institutions for their complete failure to collectively handle concussions. See, Robert Woods and Matt Scott. As my friend Nathan Fenno put it, the NCAA’s failures make the NFL look responsible and conservative.

There are significant differences between professional and college football. Concussions at both levels can, and in all likelihood will, cause permanent brain damage. Nonetheless, the care, legal principles and scrutiny involved should vary between the NCAA and the NFL.

The obvious difference is compensation. NFL players receive lucrative contracts and signing bonuses, and they also have the right to seek significant health benefits – during and after their career.

Obviously, college players don’t get remuneration, and they certainly do not get any neurological health benefits – yet, another travesty.

It should be reasonable to assume that both players (NFL and CFB) understand the consequences of playing when experiencing concussion symptoms. If they don’t by now, that is an utter failure by all institutions involved.

It is clearly not medically advisable to participate in contact sports when suffering concussion or exhibiting concussion symptoms. A symptomatic individual is at a significantly increased risk of experiencing catastrophic brain damage or even death if he is allowed to return to play. This is commonly known as second-impact syndrome.

Teams, as well as the NFLPA, owe a duty to inform their players about these risks. In turn, NFL players owe a responsibility to themselves to report their concussion symptoms. In fact, according to a league source, a player reported concussion symptoms in Week 8, and he was immediately removed from the game. If an NFL player, however, decides to willfully disregard the health risks, he assumes the risk of permanent brain damage.

Just like a firefighter going into a burning building – which is also not medically advisable – risks the threat of death, so too does an NFL player. But they do it because it is their job.

This is neither medically advisable nor role-model worthy. Yet, kids still inspire to be firefighters and NFL players. The idea that returning to play too soon sets a bad example for the youth, rings hollow because watching football, period, is arguably a moral hazard. Watch baseball or tennis if you are concerned football sets a bad example for kids.

Since the inception of professional football, there hasn’t been a single reported death due to second-impact syndrome, although Merril Hoge came very close. Meanwhile, several dozen police officers and firefighters die in the line of duty on an annual basis. Until 2009, an NFL player was regularly returned to play after experiencing a “ding.”

If a catastrophic injury occurs in either profession, the employee or the employee’s family has the right to receive Workers’ Compensation benefits. Now that players are cognizant of the risks involved, Dr. Elliot Pellman’s words finally have merit: concussions and neurodegenerative diseases are an occupational risk. Players experiencing neurodegenerative diseases should seek Workers’ Compensation benefits, as well as benefits under the NFL’s 88 plan.

When you begin to consider the similarities of high-risk professions, it’s easier to rationalize the idea of NFL players remaining in the game after suffering a concussion.

I’ve come to the conclusion that NFL players can, if they so choose, remain in the game after having a concussion. Should they? Of course not. But their contracts incentivize this behavior. Until the players negotiate guaranteed contracts, a gladiator must continue to perform if they believe job security is more important than their long-term health. In exchange for guaranteed contracts, players should give up the right to sue the NFL, teams, doctors and trainers.

Again, remaining in the game is not medically advisable.

Nonetheless, it’s an NFL player’s personal responsibility to make this risk-versus-reward analysis. We can pontificate and scrutinize this decision as much as possible, but in the end, if an NFL player wants to return to play after experiencing concussion symptoms, that is his prerogative.

On the other hand, college players should not be allowed to play after experiencing a concussion or exhibiting concussion symptoms. Colleges, coaches, athletic trainers and doctors owe a duty to remove a player from the field if a concussion is suspected. Although college athletes should understand the risks of not reporting concussions, their risk-versus-reward analysis bears no fruit, because there is simply no reward.

Two of the most egregious examples of this occurred on the concussion plantation this year. Robert Woods and Matt Scott both showed clear sings of concussion symptoms (e.g. vomiting, dizziness, etc.). Unfortunately, all actors involved failed, miserably, and placed two lives at an unnecessary risk of second-impact syndrome.

The media and fans should direct their criticism toward college football. Whenever a student athlete is allowed to return to play after experiencing concussion symptoms, we should scream and shout — calling colleges’ slave masters and hypocrites — because, at the end of the day, who is profiting off the student athletes’ free labor and brain damage? The fat-cat coaches, the conferences, the NCAA and its member institutions. Meanwhile, the student-athletes receive a “free education,” the likelihood of long-term brain damage and a two-percent chance of moving on to the NFL.

At bottom, NFL players have the ability to weigh the risks and balance this against million dollar contracts. College athletes, on the other hand, are not provided with this opportunity. In the new era of football, let the NFL players take on the known, and highly compensated, risks. But tread softly, colleges, for your day of reckoning is near once a high-profile student athlete dies during a televised game. Then maybe, you’ll realize the injustices of the concussion plantation. Perhaps it is time for real leadership, like that shown by President Theodore Roosevelt, when he had a serious concern about the high rate of deaths in football. His leadership led representatives of major football programs to form a Rules Committee, which subsequently transformed into the modern day, cash-cow juggernaut, that is the NCAA.

*This argument is limited to NFL players only. No college, high school, middle school, Pop Warner, or other non-compensated individual should return to play if he/she is suspected of having a concussion. Period!

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