Are NFL Players Beginning to Value Their Brains More Than the Game?

This offseason, Anthony Davis of the 49ers unexpectedly retired recently at the age of 25, explaining in a letter, "This will be a time to allow my Brain and Body a chance to heal. I know many won't understand my decision, that's OK."

Not many people can relate to a decision that involves walking away from millions of dollars and a successful career. Likewise, not many people can relate to the threat of serious as part of their profession. Davis suffered a concussion in week 11 of the 2014 season and described the injury at the time. "It's scary when your brain's not working the way it's supposed to," he disclosed per ESPN.

Former teammate Chris Borland made a similar decision, for similar reasons, after his rookie year. When he retired, Borland explained via NFL.com, "I just honestly want to do what's best for my health. From what I've researched and what I've experienced, I don't think it is worth the risk." Like Davis, Borland has a history of concussions.

Borland and Davis's decisions are not unique, nor are they new. Former Steelers player Merril Hoge retired from the Bears in 1994 for the same reason. Hoge described his experience, as reported in a 2009 Arrowhead Pride article:

"Here's what people don't know and never see. They take me to the training room where I died. I flat-lined. My heart stopped. As a process of trying to resuscitate me, I started to breath again. They rushed me to the emergency room. I was in ICU for two days. It was after that I was basically trapped in my home for six weeks... I had to learn to read again... There were a lot of cognitive issues that I dealt with that took over two years to overcome."

According to an American Academy of Neurology study, NFL players are four times more likely than the general population to suffer from diseases that affect the brain such as Alzheimer's and ALS. Also, a spate of deceased players brains showed signs of chronic traumatic encephalopathy (CTE), whose symptoms can include dementia, mood changes, confusion, and even suicidal thoughts and actions. The problem is even more insidious and dangerous if you consider that almost 50 percent of athletes who have suffered a concussive blow do not report any symptoms. In the long run, however, those asymptomatic concussions can be devastating. People who suffer from Traumatic Brain Injury (TBI), CTE, and PCS often struggle to live a full and productive life. Problems can range from cognitive impairment and mood disorders to physical pain and impaired motor skills. When you consider the average professional football player receives 900-1500 blows to the head annually, you can begin to understand Borland and Davis' fears.

The first time the NFL recognized the problem of head injuries and attempted to do something about it was In 1994 when then-commissioner Paul Tagliabue created the Mild Traumatic Brain Injury Committee. While this was a good idea in theory, in practice there were questions about its helpfulness. The doctor chosen to chair the league's research arm was Dr. Elliott Pellman, Tagliabue's personal physician, a rheumatologist with no experience in neurology or brain research, according to ESPN. It was later revealed in The New York Times that Pellman had falsely claimed he had a medical degree from the State University of New York at Stony Brook when in reality he attended medical school in Guadalajara, Mexico. This could explain why the NFL's conclusions about brain injury were often very different than those reached by researchers who were not affiliated with the league, a troubling pattern reported in several news outlets throughout the years.

Meanwhile, around this same time there was evidence surfacing that there was a connection between football-related trauma and a devastating brain condition. Former Steelers center Mike Webster died at age 50 in 2002 after a heart attack. He had been suffering from amnesia, depression, dementia, and chronic pain. His autopsy revealed a case of CTE, which rendered his brain functionally similar to someone with Alzheimer's. Forensic pathologist Bennet Omalu said of brains afflicted with CTE, "No brain of a 40- or 50-year old should look like this." Webster's case was the first in a series of troubling findings regarding the brains of former NFL players, and brought the issue of CTE and PCS to the forefront.

In the wake of the NFL's 2013 $765 million settlement in a concussion lawsuit brought by former players suffering from the long-term consequences of repeated head trauma, the league appears to be taking the risks and dangers of brain injuries more seriously. The bar was low, however, since the previous attempt at addressing the issue involved the nepotistic appointment of a physician with no experience in the field of neurology. The 2014 Return to Play Protocol requires sideline assessments and regular monitoring by physicians so that players are not returning to the field prematurely.

Some medical professionals are relieved that such injuries are in the spotlight and that there are increased safeguards in place. Dr. Johnny Benjamin is an orthopedic surgeon who works with athletes and is also on the NFL Accountability and Care Committee which creates policy on medical issues. He told me, "I am happy the message appears to be getting through, and that they're taking concussions and brain health more seriously."

Even with such protocols in place, however, it doesn't take a medical degree to see that players often return to the game in a compromised state, even since the 2014 Return to Play Protocol was implemented. For example, on January 3, 2015 during a game against the Ravens, Ben Roethisberger and Health Miller both returned to the field almost immediately after suffering jarring blows to the head. Though both appeared dazed and wobbly, neither underwent the concussion protocol which generally takes 15 minutes -- or more -- to administer. These are not isolated examples.

Meanwhile other of the Steelers most beloved players have sustained stunning injuries that receive little or no attention after the fact. Analysts and fans alike are almost universally more concerned with joint injuries. In 2013, Le'Veon Bell sustained a blow so hard his body went limp and his helmet flew off. Unlike Roethlisberger and Miller in January of 2015, he did not return to the game, but it was clear even to the layperson that he sustained a major injury.

When players hurt their joints, it can take months and months to return to the playing field. Concussed players return much sooner, even though the impact of head injuries can be more insidious, a silent force that can ambush players after their careers are over. The NFL only reported 111 concussions during the 2014 season, according to the Washington Post. Since nearly half of all concussions are asymptomatic, and other players have returned to the field of play without undergoing the concussion protocol, it is safe to say that the actual number of concussions might be much higher. To make matters worse, even when players experience symptoms, they are unlikely to report their concerns. A report about concussions in sports revealed: "There is still a culture among athletes that resists both the self-reporting of concussions and compliance with appropriate concussion-management plans."

While the NFL is saying that football has never been safer, some players feel otherwise. The recent retirements of Chris Borland and Anthony Davis give fans a glimpse into the sacrifices players make when it comes to their careers. Former Buffalo Bills defensive back Mark Kelso told the Washington Post, "The game is going to suffer until we come up with adequate solutions." Unfortunately, adequate solutions might make the game less appealing to fans who want to see their favorite players on the field at all costs and who also enjoy the violence associated with the game.

Anthony Davis and Chris Borland made the decision to put their physical, cognitive, and emotional health at risk. "Your life is your dream and you have the power to control that dream," Davis wrote in his retirement announcement. "I am simply doing what's best for my body as well as my mental health at this time in my life."

How many other players' dreams involve optimal neurological health after football? How many will follow in the footsteps of Davis and Borland?

Originally published on Behind the Steel Curtain. Reprinted with permission.