02.01.14

Super Bowl Special: Tackling a Concussion Crisis

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454334349.jpg?w=340&h=226&crop=1This Sunday the nation’s attention will turn to football as the Denver Broncos and the Seattle Seahawks face-off in the undisputed champion of yearly sporting events – the Super Bowl.  Like most, I am an avid football fan.  But, as a public health advocate, I struggle with the severe and sometimes fatal health risks that football players face each time they step on the field. Because behind the media hype, pre-game trash-talk and touchdown receptions, there is growing concern over the dangers of concussion-related injuries in football.

In 2011 – following a Frontline exposé that revealed that subconcussive impacts contribute to neurodegenerative diseases – thousands of former NFL players brought a lawsuit against the NFL claiming that league officials knowingly suppressed research about the link between traumatic brain injury and professional football. Earlier this month, a federal judge rejected the proposed $765 million settlement between the players and the NFL, citing concerns that the settlement might be insufficient to cover all of the players’ medical expenses.

The risk of concussions in football is not confined to the professional level: there is mounting evidence of the impact of concussions on youth football. According to the Centers for Disease Control and Prevention, emergency rooms treat approximately 173,000  sports and recreation-related mild traumatic brain injuries every year, including concussions, among children and adolescents.  Football players experience roughly half of the concussions suffered in high school sports each year. 

With superstars like Troy Aikman and Brett Favre joining a chorus of players acknowledging that concussions have left them with a range of debilitating symptoms, parents are reconsidering their children’s recreational choices. In November, the nation’s largest youth football program, Pop Warner, reported a 9.5 percent drop in participation between 2010 and 2012 – the largest two-year decline since the organization began keeping statistics. Although many factors may contribute to this decline, Pop Warner’s chief medical officer cited concerns about head injuries as “the number one cause” of the decline.

The NFL has begun a number of initiatives to try to tackle the concussion crisis. Since 2012, the NFL has partnered with USA Football to promote its “Heads Up Football” program that teaches safer tackling techniques and recently instituted a controversial head-lowering penalty intended to reduce concussions. The NFL has also contributed millions of dollars to support research on new imaging technologies and to improve treatments for mild traumatic brain injury. 

Federal and state laws can also play a critical role in protecting athletes. With the exception of Mississippi, every state has passed legislation intended to protect young athletes from the dangers of concussions and sports-related injuries. Most state concussion laws require athletes who are believed to have a concussion to be removed from play immediately and prohibit athletes from returning to play or practice before at least 24 hours and only with permission from a health care professional. Sen. Robert Menendez (D-NJ) and Rep. Bill Pascrell (D-NJ) have introduced a federal proposal to mandate national concussion guidelines and provide funding to implement the guidelines in school sports programs nationwide. This proposal was recently endorsed by the NFL.

Perhaps the biggest challenge that football will need to overcome will be a “culture of resistance” in a highly competitive game where players often refuse to acknowledge their weakness. According to a recent ESPN survey, for example, 85 percent of NFL players polled said they would play in the Super Bowl even if they had a concussion. And Denver Broncos wide receiver, Wes Welker, who has missed several games this season due to concussion symptoms, said he’d play in Sunday’s game even if doctors advised against it. Unfortunately, young players have adopted the same attitude: youth agree that “the game and team are more important than their individual health and that they may play through a concussion to avoid letting down their teammates, coaches, school and parents.”

In order to successfully navigate football’s concussion crisis, it is clear that more research is required. The Institute of Medicine recently highlighted the significant gaps in concussion research that make it difficult for coaches, parents and physicians to properly prevent, diagnose and treat concussions. The Institute reported an acute need for youth-specific data to develop age-specific recommendations and rules. Better research – and the monitoring and evaluation of existing policies – will be critical as state and federal policymakers look for ways to effectively reduce concussions.

As we gather with friends and family on Sunday to cheer on our favorite team during the big game (or even just to watch the halftime show), let us not forget the risk that each player puts themselves in and the importance of protecting their health on and off the field. 

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The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.

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