The NFL announced yesterday that it plans to spend another $100 million on concussion research and the development of new technology, including potentially safer helmets. The announcement comes four months after a congressional investigation concluded that the league improperly influenced a major government research study on football and brain disease. It also comes less than a week after reigning MVP Cam Newton took multiple vicious hits to the head in the season opener.
Given the NFL’s long history of mishandling the concussion issue, it’s fair to wonder whether this move is a legitimate step forward or a knee-jerk reaction that’s meant to save face. The truth is probably somewhere in between, and a look back through the history of head trauma in football can help explain why.
While football has been around since the mid-1800s, helmets weren’t widely used until the early 1900s, and the NFL didn’t make them mandatory until 1943. According to Dr. Robert Cantu, a senior advisor to the NFL Head, Neck and Spine Committee, the sport of football first came under fire in 1905. There had been 18 football-related deaths and 156 catastrophic injuries during the previous year, and most were due to skull fractures and intracranial hemorrhages resulting from the lack of helmets. Rule changes to the sport and the creation of the NCAA eventually resolved the immediate crisis, but it was the future development of helmets that would end up making the biggest difference.
With the rising popularity of helmets in the 1920s and 1930s, equipment manufacturers gradually worked to improve the design. Plastic helmets began to replace leather ones in 1940. The first modern facemasks were developed in 1955. And in the 1970s, manufacturers started to include the air-filled cushions that you can see inside helmets today. As the sport became more dangerous, the NFL was forced to tweak its rules and develop clear equipment guidelines along the way. But while the equipment improved and skull fractures in football disappeared, the more complicated consequences of head trauma were yet to be discovered.
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It wasn’t until 2002 that Nigerian-American physician Bennet Omalu identified the first known case of chronic traumatic encephalopathy (CTE) in a former football player. Omalu, who was the subject of the recent film Concussion, published his findings in 2005 and called for further study. Instead of embracing his research, the NFL dismissed Omalu’s claims for years and attempted to discredit him. The league didn’t admit that concussions could have long-term effects until a New York Times interview in 2009, and it wasn’t until March of this year that they acknowledged the link between football concussions and CTE.
Unlike the skull fractures and cranial hemorrhages that used to exist in football, the nature of CTE allowed the NFL some deniability. While skull fractures in the early 20th century were the clear effect of blunt force trauma, CTE in football is usually caused by repeated blows to the head over a long period of time. As a result, CTE can’t be diagnosed immediately, and symptoms often don’t show up until many years later. That allowed the NFL to deny that football was the cause.
To be fair, since admitting that concussions can have long-term effects, the NFL has rolled out a number of initiatives to try to protect players and to support concussion research. The league tightened its concussion guidelines at the end of 2009, and they instituted the concussion protocol in 2013. That same year, they partnered with GE and Under Armour to create the “Head Health Challenge,” a series of open competitions that resulted in the invention of many innovative materials and technologies that could improve the diagnosis and prevention of brain injury.
On top of that, the NFL committed $30 million to concussion research in 2012, part of an “unrestricted gift” to the National Institutes of Health (NIH). They also reached a $1 billion dollar settlement with thousands of retired players in 2014, thereby ending a huge class action lawsuit. Still, most of these developments were the result of extreme outside pressure, and the money dished out by the league had some strings attached.
One of the key aspects of the concussion settlement was that the NFL admitted no wrongdoing. Worse yet, a congressional investigation earlier this year found that the league tried to steer the NIH study away from one of its critics and toward a doctor with NFL ties, a practice that clearly violated NIH policy and would have compromised the integrity of the study. And when it comes to on-field diagnosis, there are still questions as to whether the concussion protocol is being used enough.
One of the most egregious examples of the failure of the concussion protocol occurred last November. In a tight game versus the Baltimore Ravens, St. Louis Rams quarterback Case Keenum hit the turf hard in the final minutes, grabbing his head and staying on the ground for several seconds. Despite clearly appearing concussed, Keenum wasn’t evaluated and never even left the field. Although NFL Commissioner Roger Goodell admitted that it was a violation of the concussion protocol in an interview with Matt Lauer, which aired on Today earlier this week, there are still serious concerns that teams aren’t always following the protocol.
In the season opener Sunday, the Carolina Panthers quarterback Newton sustained several hits to the head, but he never left the game to get tested for a concussion. It’s unclear whether Newton actually suffered a concussion, but he was clearly in pain after taking a big blow to the head on the final drive of the game. As with Keenum’s situation, the outcome of the game was still in question, making Newton’s presence on the field important for his team. The NFL could still discipline the Panthers for breaching the protocol, but no punishment has been handed down as of this writing.
When it comes to professional football, all the parties involved have their own agendas. Teams want to win games and the NFL wants to attract viewers, and both of those things have historically trumped player safety. An individual team isn’t likely to increase its usage of the concussion protocol unless the NFL enforces it in a way that resonates with the organization. While the Panthers were reluctant to evaluate their star quarterback for a concussion when the game was on the line, they might have been more inclined to do so if the alternative was, say, a loss of draft picks.
The NFL itself has also been slow to make lasting changes, and the league’s troubling mismanagement of concussions in the past certainly casts some shade over this new $100 million initiative. The damning congressional findings from earlier this year suggest that the league is at least partially doing this as a PR move. But just like football’s first head trauma scandal in 1905, it seems that something good is coming out of it, and that’s still worth celebrating. After all, sometimes the most progress is made during the greatest times of crisis.