Author: Vernon Gambetta

This editorial in today’s New York Times caught my eye. I have been thinking all fall about writing a blog on the concussion issue in football and the bigger picture of football (football) injuries. January 3, 2010 EDITORIAL Dangerous Game The National Football League seems finally to have emerged from its cocoon of denial about the devastating long-term effects of concussions on professional football players. In November, it announced that players with concussions could not return to the field without the blessing of an independent brain-injury expert. It has also agreed to support research by its most vocal critics. This is a huge change by an industry (which professional football is) that has long resented criticism and resisted the evidence. It is a tribute to relentless pressure for change from the House Judiciary Committee, which last year blistered league officials for not taking the problem seriously, and will resume hearings on the subject this month. It is also a tribute to the Center for the Study of Traumatic Encephalopathy at Boston University. By studying the brains of deceased football players, the center found evidence of damage commonly associated with boxers who suffered repeated blows to the head — damage that manifests itself in depression, erratic behavior, cognitive decline and, eventually, dementia. The N.F.L. has now said it will donate $1 million to the center. The Boston data was reinforced by stories in the press of former football players, who have begun to suffer cognitive problems and memory loss in their 40s and 50s. Together they should prompt a re-evaluation of everything about the game, including the equipment, medical procedures and the rules of contact on the field. All of this is to the good. But it will take more than new rules, or new corroborating evidence, to change a macho culture in which coaches and TV announcers seem to value vicious “hits” above all else, and players are mocked or presumed soft for sitting out with injuries. Players and their families need to be warned in plain language about the risks involved. Officials at all levels — high school, college and the pros — must revisit the rules of contact to limit often deliberate blows to the head. And coaches must be sensitized to the dangers of such injuries and be measured not only by their won-lost records but by how they treat their players. I would like to frame this with some personal experiences. I played football through one game of my senior year in college. That was a long time ago as evidence by the fact that I played offensive line at weights that varied between 187 and 205 pounds. Helmet fit consisted of a quick question – What’s your hat size and the equipment man threw you a helmet and you put it on and played. As I look back on on it it was not fun. There are many practices that I just can’t remember. The attitude was you got dinged, just suck it up. Despite all the progress we have made in training methods and sports medicine deep down among football coaches that is still the attitude. It seems the if you cant see the injury there is no injury. All that being said, it is a dangerous game, more dangerous now than 45 years ago because of rules changes, artificial turf and significantly bigger and overall faster players. But nobody is forcing anyone to play the game. At every level the players are choosing to play.  You accept the risk. That being the case can we minimize risk without changing the fundamental nature of the game? The answer is absolutely yes. Lets look at some possible solutions:  Start with the body – Is bigger better? Impose weight limits based on body composition.  Equipment has become a weapon. Impose strict helmet fit rules at every level.  The surface – Artificial surfaces significantly speed up the game resulting in higher speed collisions, therefore greater potential for injury. Not sure what can be done here.  Skill – Teach players how to tackle, NOT HIT.   The rules – Change them. Ho head slaps in the line. Offensive lineman cannot extend their arms. Limited substitution, similar to rugby league where a team is allowed only a certain number of substitutions per half. That would eliminate fresh players hitting tired players; also you would see weights drop on average ten to fifteen percent. These are just a some thoughts form an interested observer who would like to see the game survive and the players be healthy. I do think it would be interesting to see a study comparing concussions in rugby league and union to American football. In both those sports the season are significantly longer and there are no helmets. Maybe concussions are the 800 pound gorilla in the room there also. In my brief time around rugby it does not seem to be as big a problem. Football may be a dangerous game, but a few small changes can significantly reduce risk.