The NFL has issued new initiatives regarding head trauma which include independent medical evaluations, evaluations of playing rules and equipment, safer practice guidelines and public service messages, an important moment in the evolution of this percolating "concussion issue".
The initiatives originate from recent events including:
(1) Congressional hearings where both NFL Commissioner Goodell and NFLPA Director DeMaurice Smith were treated with some disdain and put on the defensive -even being compared to the tobacco industry - due to what Congress perceived as apathy towards the issue rather than activity;
(2) An NFL-commissioned study showed greater incidence of brain injury and memory loss for former NFL players than the rest of the population;
(3) A rsurvey of NFL players showed evidence of players feeling pressure, whether internal or external, to "play through" concussions; and
(4) A number of high-profile players experiencing concussions including Brian Westbrook (two), Clinton Portis and the two starting quarterbacks in last year's Super Bowl, Kurt Warner and Ben Roethlisberger.
Here are some comments about the new developments:
Protecting Players From Themselves
There is a need to empower the team's medical staff, both in-house and now independent, to make decisions about the player separate and apart from the interests of the football operation. That need is being addressed.
Players are not concerned about dementia many years later; they are concerned about the next practice, the next game, the next paycheck, and the next contract. These measures are a step towards protecting players from their natural instinct of wanting to play. One can only wonder how many players have been "dinged" but failed to report it for fear of losing ground on making or staying on the team.
Co-chairs of the NFL committee on concussions resign
The doctors previously leading the efforts on concussion research -- Drs. Ira Casson and David Viano - were asked to resign, as it was time for a change.
The NFL did not like being put on the hot seat in front of Congress and the NFLPA did not like the perception - whether real or perceived - that these doctors were ignoring or discrediting research on long-term effects of head injuries.
With the sweeping new changes and goals, it was time to move on to new medical leaders blessed by both the league the union.
Reduction of off-season contact
A committee of coaches is analyzing the safety issue in the offseason and training camp. Ironically, John Madden - know for his "Pow", "Kaboom" and "Bang" descriptions of NFL contact -- is chairing the committee.
This is a much-needed measure that will be a chip in the bargaining process as well. A longstanding irritant to the former NFLPA Executive Director Gene Upshaw was the amount of off-season contact work by the teams. As Upshaw used to tell me when he made his team visits, coaches sit around in the offseason with nothing to do and can't help themselves from having players go out and hit each other.
Trimming the amount of contact in the offseason months will be measure embraced by the NFLPA and their constituency. The league is being very strategic here in throwing out an olive branch before getting down to the hard and substantive items for discussion.
The sustained impact of two-a-day practices in the early part of training camp prior to the season may be the most damaging time of the year for head trauma.
After a six-month offseason, an immediate ramp-up to live hitting occurs in repeated blasts day after day in late July and early August to get players in "hitting shape" as no amount offseason conditioning can simulate live collisions.
One can only wonder how many players have "played through" some sort of concussive event during this period in order to make the team against the odds.
Still many questions to be asked, answered
Despite the list of items the NFL has released as measures to improve the problem, there are certainly more questions than answers at this point.
The independent doctors are in place for about half the teams at this time. Meanwhile, there do not appear to be any strict guidelines for how they are going to be used and long to keep a player out and for what level of head trauma. Obviously, players respond differently and many will want to play, saying they are fine and experiencing no symptoms.
Should there be a minimum period of time where a player suffering a concussion should sit out? Is it a week, two, three? Would Warner and Roethlisberger - who are both reportedly going to play -- be ordered to sit out with the new guidelines?
And what if a player does pass tests that show he has returned to his baseline function? Should be allowed to play? Or should there be another week or two added to recovery beyond baseline?
And what exactly is a mild concussion? To me, that is a concussion that happens to someone else.
NFL taking too much blame?
The NFL is obviously concerned about this issue and is doing the right thing with these guidelines. Indeed, by the time the NFL gets its players, they have been playing football for over a decade, some starting at age 7 or 8 playing tackle in pads. Whatever head trauma they may develop later in life is only due in part, and maybe in small part, to their days in the NFL. According to the Center for the Study of Traumatic Encephalopathy, people under the age of 18 play 95% of the football in this country.
Having said that, the NFL is the beacon in this country for all things football. The more that can be done, the better for all levels of the sport as they all look up to the model of the National Football League.
The best news of all is that we are asking these questions and awareness has been raised. Now if we could only do something about the sensationalism of bone-jarring collisions, including the opening animated sequence of Monday Night Football showing helmets crashing into each other and blowing up. Pardon the pun, but we should use our heads on things like that.