Like any contact sport, there is a seemingly inextricable tie between football and concussions. Now, it is widely known that repeated concussions are not safe or healthy, however, that was not always the case. For a long time, the effects of concussions and sub-concussive impacts were not apparent. There were many questions surrounding concussions in sports during the 1990s and the National Football League (NFL) received a lot of attention. The NFL commissioner at the time, Paul Tagliabue, created the Mild Traumatic Brain Injury (MTBI) committee, initially to investigate concussions and, later, to determine whether repeated concussions had long-term effects. The committee consisted of individuals with little experience and/or close connections to the NFL. With a multi-part study published in the journal Neurosurgery, the committee ultimately decided that, despite evidence of Chronic Traumatic Encephalopathy (CTE) and other cognitive issues, concussions did not have dangerous long-term effects. The NFL misled the public and endangered its own players by stating that repeated concussions have little to no long-term impact because that was not the truth. Recently, a study was published by Boston University in which 110 out of 111 former NFL players suffered from some level of CTE, clearly indicating that long-term side effects do indeed exsist. The NFL is responsible for all damages, due to mild traumatic brain injuries, sustained by its players because of the league’s dishonest and disingenuous handling as well as denial of the concussion crisis.
While the NFL did create a committee to study the effects of concussions, the committee consisted of professionals not qualified to analyze such data. The committee was led by rheumatologist Dr. Elliot Pellman (Gove). Dr. Pellman served as spokesperson and lead author of 9 of the 13 articles published in Neurosurgery, despite his incompetence to study or analyze MTBIs (Gove). Rheumatologists study and treat arthritis, rheumatism and other disorders involving joints, ligaments, and muscles and play absolutely no role in the treatment of concussions or education surrounding the matter. Therefore, Dr. Pellman was not qualified to analyze or study concussions to the extent which the committee had him do. The NFL, aware of Dr. Pellman’s qualifications still hired him to head the committee. By choosing an individual with lackluster qualities to lead such an important team, the NFL indicated how little importance it placed on concussion research as well as its choice to weigh its reputation over the safety of its players. Furthermore, neither of the other leading doctors on the committee, Dr. Casson and Dr. Viano, were neuropathologists or neurologists (Diehl). Therefore, none of the leading doctors doing research and working with the data from the study were capable to analyze the data properly. A neuropsychologist or neuropathologist, both doctors qualified to analyze the data because of their experience with and knowledge about the brain, would be much more prepared and able to provide an accurate analysis of the data. The NFL’s failure to construct a sufficiently qualified team to work on the committee highlights its lack of interest in the cause and ultimate responsibility for the player’s injuries.
The authors of the studies in Neurosurgery also had strong and obvious ties to the league, making them a biased and dishonest choice to research concussions in the NFL. The committee chairman, Dr. Pellman, repeatedly emphasized that the group aimed to produce “independent” and “meticulous” research (Schwarz). However, most of the 12 members were associated, in some way, with NFL teams (Schwarz). Nearly half of the committee consisted of team doctors for the league (League of Denial). For example, Dr. Pellman, the leading doctor for many of the articles, was the team doctor for the New York Jets, an NFL team (Gove). Team doctors are hired by the NFL, so putting them on the study makes the research not independent from league in any way and the league’s claim that the research was independent was completely false. Since the committee was made up predominantly of people with relationships to the NFL, it had incentives to formulate a conclusion in favor of the league and its protocols and handling of concussions. As most of the members were employed in some form by the NFL, their futures were essentially in the hands of the league. If the research published was not beneficial to the NFL, they could easily be demoted from their position. Likewise, if the research published was beneficial to the league, it is entirely conceivable that the committee members would be promoted or recompensed in some way for their findings. The NFL would lose exorbitant amounts of money if it was found that their industry was responsible for severe brain damage. As an anonymous official in the NFL said to Dr. Omalu, “If 10% of mothers in this country would begin to perceive football as a dangerous sport, that is the end of this sport” (League of Denial). The NFL did everything in its power, including forming a biased committee, to prevent the truth from being revealed and the sport being perceived as dangerous because it did not want to lose money or tarnish its reputation. The committee’s findings should not be trusted because it consisted of people with close ties to the league and motivation to produce conclusions favorable to the NFL. Just as people do not go to close friends or family with medical degrees for an important medical opinion, the NFL should not have gone to their own employees for medical advice. The NFL clearly deceived the public because it claimed that the data was completely independent and unbiased, when, in reality, the members of the committee had close ties to the league as well as strong inducements to side in favor of the league.
Even after receiving warnings about the dangerous long-term effects of MTBIs, the NFL purposefully published erroneous data to deceive the public and protect its reputation. Records of interactions between reviewers of the study and the committee show that many reviewers tried to stop the papers from being published but authors merely brushed aside their criticism (Schwarz). One reviewer even wrote that “Many of the management of concussion suggestions are inappropriate and not founded on facts,” while another said the committee’s assertion that the league was handling concussions too cautiously was not proved and was therefore potentially dangerous (Schwarz). The league was informed of fallacies in its data and unsupported conclusions, indicating that the NFL and committee knew about the errors present in the study. However, the committee proceeded to publish the study and make recommendations based upon the fabricated data. The NFL is responsible for the players’ injuries because it knowingly made unsupported safety recommendations and claims that concussions did not have long-term dangers instead of basing their research and conclusions on real, unaltered data. In addition, Dr. Omalu, the neuropathologist who discovered CTE in Mike Webster’s brain published his findings in Neurosurgery. He was expecting a positive response from the NFL and committee because he thought that the league genuinely cared about and wanted to improve player and concussion safety. However, after publishing the paper, he was attacked by the committee. It demanded that the article be retracted, saying that his research was “completely wrong.” (Intimidate). The committee also claimed in a letter written to the journal that Omalu’s statements were “based on a complete misunderstanding of the relevant medical literature on chronic traumatic encephalopathy of boxers” (League of Denial). The committee attacked Omalu and made allegations that his data was wrong when in fact there were no errors in his data or analysis of said data. Furthermore, the NFL claimed that, in regards to Webster, “there [was] no known history of brain trauma inside of professional football” (Intimidate). However, in 1999, the NFL retirement board determined that Webster was eligible for disability benefits because the repeated blows to his head had left him “totally and permanently disabled” (Fainaru, NFL Board). The committee’s critique of Omalu’s work was completely hypocritical and false. The NFL itself had admitted that Webster suffered from brain damage due to his repeated impacts, yet said that Omalu was wrong for making the same conclusion indicating that the league was trying to suppress the truth. The NFL published false information and denied having any knowledge of long term effects of repeated brain injuries, even though the league was warned by multiple professionals of the danger. The NFL’s failure to act on their knowledge created unnecessary and preventable danger for the players, making the NFL responsible for the damages players suffered from concussions and other MTBIs.
The committee created by the NFL had dishonest intentions as the data published in Neurosurgery was incomplete but advertised as being complete. The committee claimed that the study was based on complete accounting of all concussions diagnosed by team physicians from 1996 – 2001. However, more than 100 diagnosed concussions were left out of the study and the missing concussions accounted for more than 10% of the total concussions used in the study (Schwarz). Dr. Elliot Pellman, a leading figure on the committee, had even treated Wayne Chrebet for two concussions that were left out of the database (Gove). Dr. Pellman was incovertibly aware of at least two of the concussions omitted from the database, yet did nothing about it, indicating that concussions were left out on purpose and the committee strategically manipulated the data to make it appear favorable to the league. Furthermore, the Dallas Cowboys did not have a single concussion listed in the database, even though NFL injury and media reports indicate Troy Aikman sustained four concussions during the time period encompassed in the study (Decoding). Since many of the omitted injuries were included in the injury report, the NFL was aware of the concussions yet failed to include them in its allegedly complete data. The NFL’s failure to include concussions that it was undoubtedly aware of in the study indicates that the NFL actively removed the concussions and manipulated the data to make it more favorable to itself. The study repeatedly emphasized that the data was complete and one paper even said that “It was understood that any player with a recognized symptom of head injury, no matter how minor, should be included in the study,” (Schwarz) however, it is clear that the data was not complete. 100 missing concussions cannot be attributed to human error or a simple mistake. Instead, the missing concussions were intentionally omitted from the study to protect the league’s reputation and prevent the truth from being revealed. The committee also calculated the rate of concussions per game using incomplete data (Schwarz). As a result, the rate of concussions appeared lower than it actually was. The NFL then used the inaccurate rate of concussions to draw other conclusions and make other recommendations, ignoring the fact that the data was fundamentally fallacious. In addition, many players who received multiple concussions were not included when the NFL analyzed the effects of more than one concussion (Schwarz). Subsequently, the effects of multiple concussions were not studied to an appropriate extent. One of the main goals of the study was to determine whether or not serious, long-term damages occurred with repeated concussions, yet the study failed to determine or study this. The committee did not accurately analyze the impacts of multiple concussions because many of the data points involving repeated concussions were left out of the analysis and conclusion of the data. Therefore, no real conclusions about the effects, or lack thereof, of multiple concussions could be drawn from the results of the study. However, the committee still made claims that there were no long-term dangers of multiple concussions, neglecting to mention or take into account the fact that very few players with multiple concussions were included in the study. The NFL left many key details, such as the fact that the data was heavily modified or that the conclusions it was making had very little basis to made in the first place, out of the study. The NFL deceived the public by using false and manipulated data to draw conclusions and thus is responsible for the damages players face from concussions.
Based on the erroneous and falsified data, the NFL ultimately made changes that were not beneficial because they were based on the committee’s inaccurate data. Prior to the 2011 season, the NFL changed rules for kickoffs to increase the safety of returners. The NFL made this change even though the NFL’s research committee classified kickoff returners as “low risk” for brain injuries (Gove). In the 1996-2001 study, 4.2 percent of kickoff returners suffered a concussion, which is relatively low (Casson). For comparison, 11.9 percent of wide receivers suffered a concussion (Casson). The aforementioned rule change was an implied admission by the NFL that the concussion crisis was real and that the problems former players were having were indeed due to repeated head injuries. In addition, the rule change also exemplifies the NFL’s reluctance to actually implement beneficial changes. As stated previously, the position being protected was already classified as a “low risk” for brain injuries, so changing this rule was neither necessary nor helpful. Furthermore, this rule change highlights how the NFL did not take the concussion crisis seriously. The NFL thought implementing a simple rule change would silence the public and make it seem as if the league was improving the situation when, in reality, it did absolutely nothing of substance.
The NFL did not effectively or safely enforce appropriate return-to-play protocols and allowed players to resume playing when they should not have been able to participate in such high risk activity. According to the American Medical Society for Sports Medicine, there should be no same day return-to-play for players diagnosed with a concussion (Harmon). Furthermore, athletes even suspected of having a concussion also may not return to play that same day (Herring). Players must be seen by a qualified medical professional before returning to play and those diagnosed with a concussion must follow strict return to play protocols before being allowed to play. Strict return to play protocols exist for a reason; it is dangerous to return to football, or any other activity with a risk of an MTBI, before being completely healed. It is dangerous to return to play because of the possibility of second impact syndrome (SIS), which occurs when an athlete receives another concussion in close proximity to their original injury, until a qualified medical professional has deemed it safe to return to play. SIS can have devastating effects on an athlete, including death. In addition to SIS, players have a higher incidence of repeat concussions if they are not completely healed before returning to play. Players also are likely to exacerbate their existing symptoms, experience a longer recovery time and are more likely to develop post-concussion syndrome if they return to play too soon. Although protocols have become stricter and more standardized in recent years, it was known, even in 1996, that returning to play immediately was not safe and yet the NFL allowed players to reenter the game immediately following a head injury. In the study from 1996-2001, 16.5% of players with diagnosed concussions returned to game immediately (Decoding). 16.5 percent is a significant amount of players returning to play immediately following a concussion and a significant amount of players in danger of potentially catastrophic effects. It is clear that the NFL did not follow standard protocols, thus endangering its players and exposing them to unnecessary and preventable risk. In addition, the NFL used the committee’s erroneous findings to create return-to-play guidelines despite criticism from the scientific and medical community (Gove). The data was incomplete and inherently false, so the protocols created with the data were obviously inaccurate as well. Creating safe return to play protocols is critical in the prevention and management of concussions and the NFL failed to do so. The NFL did not take the necessary steps to protect its players, therefore it is responsible for the damages resulting from concussions.
Although head injuries are an inherent risk from playing football, the reverberations that NFL players have suffered are significantly more severe than could ever be expected. Assumption of risk is an argument commonly used in cases regarding injured athletes because most sports have an acknowledged danger involved. Injuries happen rather frequently and if an athlete was able to sue everytime they got injured, sporting teams, both amateur and professional, would run out of money quickly. In a sport like football, there is a high assumption of risk. No athlete goes into the NFL with the notion that it is a safe sport; after all, the logo of Sunday Night Football is an animation of helmets knocking together. However, when athletes are experiencing severe issues because of the large number of repeated concussive and subconcussive impacts received in their career, the argument of assumption of risk is not enough to protect the NFL. As stated by sports agent Leigh Steinberg at a concussion summit in Marina Del Ray, California, “It's one thing to go out and play football and understand that when you turn 40, you can bend over to pick up your child and have aches and pains. It's another thing to bend down and not be able to identify that child” (Diehl). This is a sad reality for many former NFL players; their memory and daily life have been notably compromised. Mike Webster is a prime example of a star football player whose life changed completely due to the massive number of repeated impacts. His forehead had skin built up from the continuous pounding of his head, he had severe memory issues, would glue his teeth into his mouth and would even have people use a stun gun to put him to sleep (League of Denial). Webster was no longer himself, his mental and physical state deteriorated considerably and he became dependent on drugs, like Ritalin, to live his daily life (Fainaru). It is clear that Webster suffered greatly due to the large number of repeated impacts sustained in his career. He went from a star football player to a completely broken man in a matter of a few years. Head injuries are an inherent risk from playing football but the long-term damages ensuing from repeated sub-concussive and concussive impacts are not to be expected. It is reasonable to expect to be concussed multiple times, but it is not reasonable to expect or understand that there is a good chance of developing Alzheimer’s, CTE, severe memory loss or other side effects of repeated impacts. Mike Webster did not enter the NFL knowing that there was a significant risk of becoming extremely disabled as a result of his profession. The repercussions that he, and many other NFL players, suffered are significantly more severe than could ever be expected. Therefore, the argument of assumption of risk does not hold or protect the NFL.
The CTE study done by Boston University (BU) exemplifies how severe and deadly the results of repeated concussive and sub-concussive hits in football can be. The study found CTE in 110 out of 111, or 99 percent of, brains of former NFL players (Moran). It is important to note that the study was not random and did not have a control group. In addition, selection bias was present as the families of the players or the players themselves noticed symptoms of CTE and donated their brains (Moran). However, 110 former NFL players diagnosed with CTE still represents a significant and striking number of players with issues stemming from football. There are undoubtedly countless more players who are suffering or have suffered from CTE and related issues. It is obvious that the NFL does indeed have a concussion crisis and that the claims of there being no long-term brain damage resulting from concussions were blatantly false.
While football has been the focus of the “concussion crisis,” the issue is not isolated to professional football. More and more information is being discovered in relation to concussions in other sports, including professional hockey. For example, former National Hockey League player, Jeff Parker, who died in September, was just diagnosed with severe CTE. In addition, there is a movement to ban tackle football for children under 14 in an effort to reduce the number of subconcussive impacts people have in their lifetime because CTE has been linked to such impacts. It is imperative that changes be made because as the number of children involved in sports like football, soccer, lacrosse and other contact spots continues to increase and the age of children able to participate decreases, the number of subconcussive hits and risk for CTE will also increase. While there is no real way to stop all concussions, it is clear that changes need to be made in the NFL and across the sporting world. However, these changes are only possible once the governing bodies stop putting their own reputation and money before their players’ safety. The NFL is a clear example of a league who has put themselves, its reputation and its money before their players. The league ignored its players’ health and safety because instead of implementing rule changes or admitting that long term consequences of concussions exist, it manipulated data and created an inappropriate and unqualified committee to conclude that concussions have no lasting effects. The NFL is responsible for damages players sustained from MTBIs because the league handled the concussion crisis in a dishonest and disingenuous manner.