The era of concussion awareness has dramatically transformed the social and legal landscape surrounding the gridiron. Concussions \u2013 traumatic brain injuries \u2013 were hardly part of the public discourse less than a year ago.<\/p>\n
In Dr. Elliot Pellman\u2019s words, they were just \u201can occupational risk.\u201d<\/a> Now, there isn\u2019t a day that goes by that we don\u2019t hear about the long-term effects of concussions.<\/p>\n The scientific information players are equipped with provides them with a decision: should I continue to play football knowing that one day I will probably have dementia or CTE?<\/p>\n The overwhelming answer is yes, and, of course, the majority of middle-aged men would unequivocally risk brain damage for a couple million bucks.<\/p>\n The public\u2019s interest in the concussion discussion was on display this week in the \u201ccontroversy\u201d surrounding Robert Griffin III\u2019s return to play after suffering a \u201cmild concussion.\u201d<\/p>\n Regardless of whether you thought he should have returned or not, the fact that people were talking and arguing about it, shows that we as a society are becoming increasingly aware about the risks of concussions.<\/p>\n Unlike the current players, I\u2019m not so sure the pre-2009 NFL players had an opportunity to make an informed decision about the neurocognitive risks of professional football. Whether this was due to the lack of science or whether the NFL concealed this from the players, will be a question for the jury \u2013 if the concussion lawsuits survive several pre-trial hurdles.<\/p>\n In order to appreciate the differences between professional football now and what it used to be, you don\u2019t have to look back very far.<\/p>\n In the early 1990s, Al Toon was one of the first<\/a> players to retire due to concussions. Similarly, after suffering second-impact syndrome and nearly dying, Merril Hoge was forced into retirement<\/a>. Back then, getting your \u201cbell rung\u201d was handled like a jammed finger \u2013 players played through it because they were not informed that concussive and subconcussive blows could have permanent, neurocognitive effects.<\/p>\n In 1994, then-Commissioner Paul Tagliabue formed the Mild Traumatic Brain Injury Committee with the specific task of studying concussions in professional football. The Committee was led by Dr. Elliot Pellman, a rheumatologist; Dr. David Viano, a biomechanical engineer; and Dr. Ira Casson, a neurologist. Over the next 15 years, the Committee created a series of several controversial studies that refuted the link between concussions and neurodegenerative diseases (e.g. dementia, Alzheimer\u2019s, ALS, CTE). In the Committee\u2019s most controversial study<\/a>, published in Neurosurgery,<\/em> the authors made four conclusions that could, eventually, cost the NFL billions of dollars in the NFL Concussion Litigation.<\/p>\n First, \u201cit can be concluded that mild TBIs in professional football are not serious injuries.\u201d<\/p>\n Second, in regard to the often-times deadly second-impact syndrome the Committee found that \u201c[i]t is possible that this syndrome does not truly exist in this population of athletes.\u201d<\/p>\n Third, in dismissing Dr. Cantu\u2019s various grades of concussions and the necessity to hold concussed players out until they are asymptomatic, the authors found that their study \u201csupports the suggestion that such arbitrary return-to-play guidelines may be too conservative for professional football.<\/p>\n And fourth, \u201c[t]he results of this study indicate that many NFL players can be safely allowed to return to play on the day of the injury after sustaining a mild TBI.\u201d<\/p>\n Shocking, I know.<\/p>\n But, I\u2019ll leave it to the plaintiffs\u2019 lawyers, and their experts, to tear apart these studies in court. In the meantime, I\u2019ll use the NFL\u2019s subsequent remedial conduct to shed some light on its, arguably, flawed pre-2009 approach and how the NFL concussion protocol has evolved into its modern form.<\/p>\n After taking a tongue-lashing by Congress<\/a>, the NFL did a complete about-face.<\/p>\n In December 2009, Roger Goodell sent out a memo<\/a> to all teams summarily stating, a player who has a concussion shall not return to play on the same day. A few weeks later, the NFL\u2019s spokesman, Greg Aiello, told the New York Times,<\/a> \u201cIt\u2019s quite obvious from the medical research that\u2019s been done that concussions can lead to long-term problems.\u201d The NFL also accepted the resignation of the members of The Mild Traumatic Brain Injury Committee<\/a>, and its flawed studies were flushed down the toilet.<\/p>\n Players used to have a say<\/a> in whether they were allowed to return to play. After suffering an obvious concussion, Wayne Chrebet was examined by the Jets\u2019 medical staff<\/a> \u2013 none other than Dr. Pellman \u2013 prior to returning to play. Dr. Pellman told Chrebet on the sidelines, \u201cThis is very important. You can’t lie to me. There’s going to be some controversy about going back to play. This is very important for you, this is very important for your career. Are you okay?”<\/p>\n With a wink and a nod, Chrebet convinced Pellman, and Pellman happily agreed, that he could return. In hindsight, Chrebet said, “It was just stupid, trying to get back out there, just me trying to convince them and myself that everything was all right.”<\/p>\n It\u2019s difficult, and perhaps unfair, to blame players for wanting to return to play. Not only is their job and future earning potential at risk, but they also are not thinking clearly (i.e. temporary dysfunction of the brain<\/a>). This is why the decision is, according to the NFL\u2019s protocol<\/a>, no longer in the player\u2019s hands.<\/p>\n If a player is suspected of having a concussion, he must go through the NFL sideline assessment test<\/a>. Once it is determined that a player has a concussion, the John Madden Rule applies, he must immediately be removed from the field and taken to the locker room where he is examined by the medical staff. And, under no circumstances, is the player allowed to return to play that same day.<\/p>\n Before a player is allowed to return to practice, he must pass daily neurological exams and be cleared by an independent neurologist and the team\u2019s doctor. A great example of the protocol working as advertised involved Matt Cassel and RG3. Both suffered a concussion during Week 5 and were immediately removed from the field. Cassel still had concussion symptoms and therefore was not allowed to play in Week 6. On the other hand, RG3 was asymptomatic, cleared by an independent neurologist, and allowed to return to practice.<\/p>\n This brings me to my final point. There is a clear contrast in the way the NFL handled concussions pre and post-2009. From Day 1 at the Rookie Symposium players are educated about head injuries and the daunting statistics that likely await them in life after the game. Players like Calvin Johnson, who readily admit to playing through concussions<\/a>, appreciate the risk, and rightfully so, have determined that the award (i.e. million-dollar contracts) outweighs the cost of someday suffering from dementia or CTE.<\/p>\n Frankly, I don\u2019t mind Calvin Johnson\u2019s attitude — it likely represents the mindset of the majority of current players. Although Tiki Barber\u2019s recent article<\/a> is well intentioned, I think he completely misses the mark. How is RG3 setting a bad example when the decision to return to play wasn\u2019t up to him? Hell, if the decision were up to RG3, he would have returned to play during the same game \u2013 he still won\u2019t admit<\/a> he had a concussion.<\/p>\n Again, this decision was solely within the control of an independent neurologist and the Redskins. Each individual is different \u2013 blanket guidelines yield to a doctor\u2019s judgment. More importantly, with plaintiffs\u2019 lawyers breathing down the necks of the NFL, no independent neurologist would be willing to place his\/her license on the line if RG3 were not ready to return.<\/p>\n Tiki Barber, without saying it, almost comes across as equating steroids with concussions. If Tiki\u2019s comments were in the context of steroids, they would be spot on. Steroid intake is obviously within an individual\u2019s control, and the cheaters that took it should be chastised for setting a bad example to the youth.<\/p>\n But, professional football players should not be called out for being cleared by a neurologist. Moreover, the inherently violent game of football and the daily brain bashing that comes with it is not a good example for the youth, period, but that argument is a lost cause.<\/p>\n We will never be able to take concussions out of the game. What we can do is continue the dialogue and maybe, just maybe, place some trust in the NFL\u2019s concussion protocol.<\/p>\n No system is perfect and we may, unfortunately, see more incidences where players look concussed but somehow are returned to play. At the end of the day, the fatally flawed system of football\u2019s past has been put to bed, and the new era of professional football — independent neurologists and informed players — is here to stay.<\/p>\n","protected":false},"excerpt":{"rendered":" The era of concussion awareness has dramatically transformed the social and legal landscape surrounding the gridiron. Concussions \u2013 traumatic brain injuries \u2013 were hardly part of the public discourse less than a year ago. In Dr. Elliot Pellman\u2019s words, they were just \u201can occupational risk.\u201d Now, there isn\u2019t a day that goes by that we […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0},"categories":[1],"tags":[98,29,16,101,97,4,100,96,99],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"","_links":{"self":[{"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts\/1194"}],"collection":[{"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1194"}],"version-history":[{"count":6,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts\/1194\/revisions"}],"predecessor-version":[{"id":1564,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=\/wp\/v2\/posts\/1194\/revisions\/1564"}],"wp:attachment":[{"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1194"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1194"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/nflconcussionlitigation.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1194"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}