The Helmet problem: It will never prevent concussions and MTBI
Can football helmets prevent concussions and sub-concussive blows to the head? No!
I can’t get any more direct than that, although I believe there are some ways that the severity of MTBI (mild traumatic brain injuries) can be reduced.
Before I talk about why I think we can do something about this issue, let’s take a walk down memory lane. For my NFL alumni brothers that are experiencing short-term memory loss, don't worry, this history lesson goes way back to a time before we were even born.
The American public has known for over 100 years that playing football can cause traumatic brain injury. All you have to do is look at the headlines and articles in newspapers and other media back at the turn of the century.
Here’s a sampling – along with my comments under each headline:
1902 Dec. 13 – JAMA [Journal of the American Medical Association] declares that football can cause “cerebral injuries resulting in insanity,” or “permanent weaknesses” - Atlanta Constitution
Get that! The most respected medical journal in the United States said that concussions not only cause cerebral injuries, but….. INSANITY too! The term for Dementia and Alzhemier’s disease were not coined until 1906, so they didn't know what to call it yet. I’m not really sure what “permanent weaknesses” means, but it doesn’t sound good.
1903 July 18 - JAMA: brain injury can “damage hidden and important structures” in victims, leading to “future trouble which is too often irreparable” - Dr. W.H. Earles writes for the Journal of the American Medical Association.
Some might say that the injuries were due to the fact that players were still wearing leather helmets - and to a certain degree that might be true - but that all changed in 1903. Read this headline:
1903 Aug. 13 Spalding opens marketing blitz for its “pneumatic” air-cushioned helmet, perfectly timed because of insider help from lead rule maker Walter Camp - the equipment company’s close associate at Yale. Camp has informed Spalding executives about rule maker discussions on helmets for more than a year. Having banned heavy leather equipment, Camp publicly endorses the Spalding helmet as safe and legal while newspapers publish the company’s press releases verbatim. Carlisle coach Pop Warner also benefits from the national publicity, for his leg guard co-marketed with Spalding.
Back in 1978, I was selected to be on the Walter Camp All-American team. I didn’t know much about him, other than the fact that he was called the "Father of American Football" because of all the things he did to modernize the game and promote the game. Some would say that he has a tarnished legacy, because he abetted and defended the violence of football. According to his biographer Richard P. Borkowski, "Camp was instrumental through writing and lecturing in attaching an almost mythical atmosphere of manliness and heroism to the game not previously known in American team sports".
We still look at football in a manly and heroic sense. Players have always been revered for their ability to play with pain and injuries. But even though the new Spalding helmet did help to prevent skull fractures, serious cuts and severe bruising to a players head, it still couldn’t overcome Newton’s third law of physics: “An object in motion continues in motion with the same speed and in the same direction unless acted upon by an unbalanced force.” This law is often called "the law of inertia".
So, when a football player rams his head into another player, the brain inside his cranium moves forward and hits the inner portion of his skull. There is not much that anything on the outside of a player’s head can do to stop the inertia that's happening on the inside of a players head. That’s why they call it a law – except that this one can’t be broken or violated. If you think you can break this law then you are dead wrong and should be taken out to the public square and flogged before the masses. Well, maybe that’s a little harsh, but think about it for a moment. Isaac Newton wrote his laws of motion in 1678, so we should have known for over 300 years that helmets cannot prevent the sub-concussive blows that just about all athletes in contact sports experience.
When Walter Camp said helmets were safe and legal, it was just the beginning of the problem we see to this very day. We began to think that putting a helmet on our head could prevent not only outside injuries of the head – but inside injuries of the brain, as well.
When the first concussion lawsuits were filed against the NFL, all of them talked about the NFL’s alleged attempt to hide the fact that concussions could lead to long term brain damage. But as you can see from the headlines, we have known this for a long time. Many of the lawsuits also named Riddell (Easton-Bell) and the helmets they sell - as a contributing factor to the problem.
People in the helmet producing and the concussion prevention/reduction industry are still claiming that their helmets and their skull caps and their double layer outer shells and their suspension, air, water or other liquid filled inner shells can prevent MTBI. But it all runs counter to the laws of physics.
Mark Kelso, a safety for the Bills from 1986 to 1993, wore an outer-padded helmet as a starter in four Super Bowls and finished with 30 career NFL interceptions.
There are ways to reduce concussions, but the helmets players would have to wear would be a lot bigger than what you see in today’s game. So big, in fact that they couldn’t run with them because they would look like human bobble heads – unable to keep them balanced on their heads.
Let's continue with the headlines:
1903 Sept. 29 Newspaper Sporting sections are replete with reports of football ramming and TBI casualties, especially on elite teams of intense coverage like Yale and Harvard… competent doctors can diagnose concussive conditions through known symptoms, but prognosis and proper treatment remain largely unknown; conservative medicine calls for rest…more doctors are side-lining football players, such as this case at the University of North Carolina: “Capt. [H.M.] Jones unfortunately is out of the game for at least ten days, on account of a head-on collision in a scrimmage a few days ago” reports The Wilmington Semi-Weekly Messenger
They were talking about TBI over 100 years ago, but prognosis and treatment were still a mystery other than sidelining and resting players. Back then, they were keeping players out of games even longer than they did for NFL players from 1920 up to the 1990’s! For most of us it was smelling salts and how many fingers am I holding up that determined if we went back in to play.
The violence and on-field injuries were getting so bad that in 1905 President Roosevelt stepped into the fray and by many accounts, saved the game of football. In the article “The President who saved football” by CNN contributor Bob Greene, he writes “Remember, the NFL did not exist -- the college game was the top level of the sport. Harvard's president, Charles W. Eliot, was leading the charge to abolish football, and it began to look as if he and his allies had a chance of doing just that. To give you an idea of just how seriously the get-rid-of-football movement was being taken, the New York Times ran an editorial expressing concern over "Two Curable Evils" in American life: lynchings and football.”
Even after Roosevelt stepped in, look at what started to happen:
1906 Oct. 26 Football is dropped at Pratt Institute in Brooklyn, where officials cite poor reform and serious injuries, including a player’s suffering TBI symptoms for weeks following a concussion against Princeton.
1906 Jan. 6 A study by Harvard sports doctors finds “concussions of the brain are frequent” in football, with medical opinion divided regarding permanent disease newspapers report.
They were already talking about the possibility of concussions causing a permanent disease 110 years ago!
1906 Jan. 13 JAMA editorializes on the Harvard football study by team surgeons Dr. Edward H. Nichols and Dr. Homer B. Smith, published in Boston Medical and Surgical Journal “We may say at once that their conclusions [Nichols-Smith] are entirely against the game as judged from its medical standpoint. They say that the number, severity and permanence of the injuries which are received are very much greater than is generally credited or believed. They consider a large percentage of the injuries unavoidable, and state that constant medical supervision of the game is a necessity and not a luxury… Perhaps the most serious feature of these accidents is the number of concussions reported. Only two games were played in the entire [Harvard] season in which a case of concussion of the brain did not occur.… When a condition like this develops as the result of an injury, the central nervous system has received a very severe shaking up.” Journal of the American Medical Association, Chicago
These articles go on and on for years - right up to the present day. So, it's hard to say that the NFL was trying to hide this information from the public and football players. Maybe we didn't know "definitively" or "scientifically" that beating our heads against each other could lead to "Insanity," or dementia or Alzheimer's, but we probably should have known there was a risk, based on all media reports.
Now, the insurance companies are starting to do a serious "risk assessment" and may end up walking away from issuing future policies and coverage to pee wee leagues - all the way to the pros. That could be the beginning of the end for football as we know it, because the cost of coverage could end up becoming too expensive for anyone - other than college and NFL football teams. It's important to know that insurance companies not only have to pay the claims of the injured, but they also have to pay the legal defense fees of the lawyers involved in the litigation. Lawyers don't come cheap. The NFL wants the insurance companies to pay all the costs and, as expected, the insurance companies are suing the League to keep that from happening. After the dust settles on that case, the NFL may have a hard time finding an insurance company that will provide them with a "reasonable" premium for coverage and may decide it's cheaper to become self-insured.
It seems like we are back to where we were over 100 years ago when a lot of folks were calling for the elimination of football. We need to get back to the future and solve this problem before it kills the game that millions of Americans love to watch and millions love to play. In fact 265 million male and female players (in addition to 5 million referees and officials) make a grand total of 270 million people (4% of the world's population) who are actively involved in the game of football.
As sad as this my sound, I predict that we will see more and more high schools start dropping their football programs due to lawsuits. It will become a common occurrence due to the “liability” concerns of administrators at schools - and the taxpayers that fund the schools. The charge will be led by the parents of children who have been injured. This will be especially true after more and more court verdicts are rendered, ordering schools to pay millions of dollars to plaintiffs as a result of poor coaching, no medical supervision, no neurological doctors available for quick diagnosis and treatment, unsafe playing conditions, no baseline testing or concussion protocols, and poor equipment.
The poor equipment is where the helmets also come back into the equation. Helmet makers are being sued left and right…. and in the middle too, where their pocketbooks reside.
Most research has already shown that no helmet can protect a player from sub-concussive blows to the head, so we may see the day when helmet companies like Riddell no longer want to make helmets due to the liability concerns. Like the insurance companies, they have also done a risk assessment and more of them may decide that the risk is not worth th reward. This would be especially true if Riddell loses the lawsuit that former NFL players have filed against them and their parent company - the Easton Bell Corporation. Even though the NFL ended their exclusive agreement with Riddell in 2013, almost two-thirds of the players still wear that brand.
It’s hard for me to believe that it has taken over 100 years to really start making significant changes to the game and the gear. Most of the changes came as a result of 5,000 retired NFL players uniting to sue the NFL over concussion injuries. We are on the verge of finalizing the NFL Concussion Settlement (if players stop blocking it) There is a lot of activity going on to make sure that future players don't run into the same problems we did. Through their Head Health Challenge grants, the NFL has been fast at work trying to save the game by promising to pour $100 million into detection of brain injury, equipment design, evaluation and treatment of MTBI and TBI.
The NFL is also trying to make sure that coaches and younger players understand the best way to tackle and thereby avoid a concussion. It’s called their “Heads Up” program.
Even with all of the money and research being poured into these studies, it still comes down to simple physics. Who knows, maybe someone can find the silver bullet that can counteract the law of inertia. Tethering the helmet to the body to create a more effective shock absorber – similar to what race car drivers have done - could be a promising development and a future modification that will be a mandatory piece of equipment.
I have suggested the mandatory use of “specially designed” mouth guards as one way of reducing the severity of MTBI……but no one seems to be listening. I wrote my first article about specialized mouth guards over 6 years ago. If we can’t find a better helmet design and other ways to make the game safer, then headlines like this one from 110 years ago will become all too commonplace in today’s newspapers and media websites.
1906 Jan. 15: Yale families resist football for sons, fearing “brain concussion” and spinal paralysis reports The Brooklyn Daily Eagle
If the helmet disappears from pee wee, Pop Warner, High School, College and the NFL, what happens to the game? Does it disappear too? Not flag football, which more and more parents are turning to, despite the fact that most fathers that experienced concussions in high school, still don't have a problem with their own son playing football at a young age.
Here's another safe prediction: NFL Football will continue to exist far into the future. And why? Well, for one thing, the NFL will probably get into the business of designing and producing its own helmets. I’m surprised they haven’t started down that road already – or maybe they have. The research the NFL is currently conducting on helmet materials and design, could be the precursor to their own helmets. After all, lots of companies make their own helmets, including the US Army, so what’s preventing the NFL from doing the same thing? Oh, by the way, the NFL is conducting their helmet research in conjunction with the US Army. Just a coincidence? I think not.
The other reason the NFL will survive and will be using helmets far into the future is because eventually they will be asking active player’s to waive their right to sue the NFL over future concussion issues. Player's will do this in exchange for the right to play in the NFL, and every helmet they are issued will have a warning notice on it - similar to what the tobacco companies were required to do. It will read: [Using this product can cause mild or traumatic brain injury and other cognitive impairments]
The NFL has already put players on notice by saying that playing football can lead to Chronic Traumatic Encephalopothy.
Players will be asked to assume the risk of working in a dangerous profession. Policemen and firefighters do it every day. It doesn’t mean they shouldn’t be compensated if they get hurt. The NFL has a disability plan and players can file for Workers Compensation. Additionally, for all players that have at least one season in the NFL after 1994, they can apply for the Neurocognitive Disability Benefit, but they better hurry because the ability to apply for that benefit could end on June 30, 2016 unless the filing deadline is extended by the NFLPA and NFL Management - see page 30 of the Disability Plan. If active players are smart, they will not only extend the filing deadline, but they will continue this benefit in the next CBA - when it is renegotiated in 2020. Right now, the benefit ends when a player reaches the age of 55 - when many players are just beginning to feel the effects of cognitive impairment - so the active players may want to look at extending the length of that benefit too, especially when you consider the fact that they are not included in the current NFL Concussion Settlement.
Let me close by saying that my first contract in the NFL was for $50,000 ($30,000 salary with a $20,000 signing bonus) and my final contract was for $100,000. If I was able to play the game today at the same salary, I would do it in a heartbeat. I loved the game and I will always cherish the excitement of putting on a Buffalo Bills uniform and helmet and coming down that tunnel at Rich Stadium to the roar of 80,000 fans. I suppose it’s the closest thing to being a modern day rock star or Roman Gladiator – except we don’t usually die in the arena – thank goodness.
I wouldn’t change anything about my experience as a pro football player. I knew the price I might have to pay. I had 5 knee surgeries and a total reconstruction of my left knee. But it could have been much worse. Daryl Stingly was paralyzed in 1978 – the year before I entered the League - so I also knew there were some major risks.
I know there are a lot of former players that regret their time playing in the NFL, largely because of the serious injuries and cognitive impairments they are now living with. If I were in their shoes (or wheelchairs), I might feel the same way. But, now that the NFL has decided to settle our lawsuits, I’m hoping that the guys who are suffering the most from the consequences of TBI can get monetary awards as soon as possible. That can't happen until the players that are blocking the Settlement drop their appeals. I know the Settlement can never give them back what they have lost, but in some small way I hope they are comforted by this billion dollar payout that will occur over the next 65 years.
Newton discovered the laws of inertia….and now we must apply those laws to saving football. Anyone who loves the game and wants to see it survive, needs to continue to promote the game and push for ways to make it safer without turning into touch football. We should "continue in motion with the same speed and in the same direction" until we can find the answers. We can’t be stopped “unless acted upon by an unbalanced force.”
That unbalanced force are the people that would prefer to see football become a thing of the past.
Although he's a big fan, President Obama probably didn’t help football when he said "I would not let my son play pro football," It's important to point out that Obama said pro football. That's ok, the NFL will never have a shortage of people that want to get paid at least $450,000 a year to play in the NFL. That's as much as the President makes.
Talking about the concussion issue, Obama was right when he said "At this point, there's a little bit of "caveat emptor", these guys, they know what they're doing. They know what they're buying into. It is no longer a secret.”
Actually, it hasn’t been a secret for over 100 years.
