Protecting Against Concussions in Football and Beyond

SEP 09, 2013

This offseason, concussions managed to find their way into the everyday discussion of football.

Chris Gorski

Protecting Against Concussions in Football and Beyond lead image — Concussion study

University of the Fraser Valley via Flickr

(Inside Science) -- Tonight’s pair of Monday night football games will pit Philadelphia against Washington and Houston against San Diego, capping the first week of the new NFL season. After a long offseason, the spotlight is now back on the field.

But this offseason, one type of injury managed to find its way into the everyday discussion that’s usually dominated by talk of free agent signings and fantasy football projections: concussions.

On August 29, both sides involved in a class-action lawsuit filed on behalf of more than 4,200 retired professional football players against the NFL announced a settlement. The NFL will pay about $765 million in medical expenses, brain injury-related compensation and medical research. In the settlement, the league did not admit to any wrongdoing.

As explained in this USA Today story , the lawsuit accused “the league of hiding known risks of concussions for decades to return players to games and protect its image.”

Following the announcement of the settlement, players, commentators, and others have had mixed reactions. Scott Fujita, a recently retired linebacker who played in the NFL for 11 years, wrote in the New York Times that he was happy that the former players who need help will get it now, not after litigation that could have lasted for years. But he also expressed doubts that the progress made in the study of and protection against concussions will continue:

“What will become of concussion management? Do we continue to exercise caution with players who may have sustained a traumatic brain injury? Or, because there is no more looming litigation, are we right back to where things were before Congress held hearings in 2009: get the guy back on the field as soon as possible, at any cost? Let’s hope not.”

On Grantland , Charles P. Pierce was more direct, crafting his outrage and dissatisfaction into a column that compared the NFL to the fertilizer industry, of all things:

"[F]or all its legal merits and for all its practical benefits to many of the plaintiffs and their families, the settlement of the concussion lawsuit is a national tragedy and a moral failure. The NFL had a chance to come clean, to inform the public fully about what it knows and when it knew it, and about what its own research told it about the dangers involved in the product it promotes.”

Regardless of whether the NFL misled players about the consequences of head injuries and impacts, had the lawsuit moved forward through the discovery process and into the courtroom, it promised to make public much of what the league knew, and when they knew it. Now, players and the public may never learn those details, but researchers continue to investigate the subject, sometimes producing conflicting or confusing conclusions.

An article that appeared on a New Yorker blog in April discussed the difficulty of assessing the actual brain damage and the proportion that can be attributed to football, detailing a study published in JAMA Neurology, which showed only “mild” cognitive deficits.

Christopher Randolph, a researcher at Chicago’s Loyola University Medical Center , contends that there is no evidence to support the theory that retired NFL players suffer from a unique cognitive disorder. “The retired NFL players [in his study] basically look like regular patients who have mild cognitive impairment and have never played football,” Randolph said in a statement. Popular Science reported in August that Chris Nowinski, the co-director of the Center for the Study of Traumatic Encephalopathy at the Boston University School of Medicine, called Randolph’s conclusions “preposterous.”

This isn’t just an issue in the U.S. In 2012, an international team, backed by the International Olympic Committee, FIFA, the International Equestrian Federation and the International Rugby Board published a “Consensus Statement on Concussion in Sport” in the British Journal of Sports Medicine. In a statement announcing the publication, the journal’s publisher said:

“Mouthguards and helmets can help ward off other serious head and facial injuries, but there is no good evidence that they can help prevent concussion, and paradoxically, they may even encourage players to take greater risks.”

But that is precisely why it is so important to recognize and treat concussive symptoms promptly, the team wrote in their report.

Regardless of the long-term effects of brain injuries, the short-term effects of concussions are well documented. They can happen after violent collisions, or events that shake the upper body, leaving the brain unable to function normally. Symptoms include headaches and issues with memory, concentration and more.

The debate and research over concussions and their consequences will continue. A new book and PBS documentary are set to be released this fall, both titled “League of Denial,” about “the hidden story of the NFL and brain injuries.”

There’s a new class-action lawsuit, filed recently in Tennessee, as reported by the Birmingham News . These plaintiffs are college players that never went pro.

I’ll continue to follow this issue and share the latest research here on Inside Science Currents.