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Offseason Rant No. 1: Unnecessary Head Trauma

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In which the author makes a case for eliminating an entirely gratuitous source of brain trauma.

Karl Walter

I have been known to write the occasional article in the past from a somewhat satirical standpoint, and these articles have sometimes been interpreted as serious before a key phrase tips off most readers to its true nature. This is not one of those articles, although it could easily be mistaken for one, and thus the heads up, as it were.

The NFL has implemented a number of changes in the past few seasons with the avowed purpose of reducing injuries, particularly head injuries. These have been viewed by many with a certain amount of scepticism, which may be unfair. I will admit I am one of the sceptics. My scepticism resides in my belief that the owners and officers of the league are not motivated so much by concern for the players as they are a fear of the tainting of the NFL brand combined with potential massive lawsuits. How else to explain their protection for defenseless receivers and quarterbacks while ignoring the players who are more at risk over the long term—the linemen, running backs, and so on?

But my purpose here isn't to start another fist-shaking exercise at the NFL front office. It is to suggest something which would not impact the game of football in any way and yet would prevent a great deal of avoidable head trauma.

"Sounds good," you say. "Sign me up!" So what's the catch? Well, it would require a culture change among the players and coaches. If enough of them saw the point, though, it should be possible. To what am I referring? The seemingly harmless and collegial practice of head-slapping and/or head butting. Every time I see it I cringe, and I see it a great deal in most games.

Before you think I've completely lost it, let's look at what we now know about head trauma/CTE (Chronic Traumatic Encephalopathy.) These are things even the NFL front office knows, although it took them an amazingly long time to figure them out:

  1. Head trauma is cumulative.
  2. It doesn't require a particularly forceful blow to cause damage.
  3. Any damage is bad. (See Item No. 1.)

First, a couple of reminders as to what constitutes a concussion. (After all, the players themselves are slowly coming to realize there is a stricter standard for injurious head contact than they had long assumed.)

  1. A concussion can occur (and generally does) without loss of consciousness.
  2. The onset of symptoms of a concussion may not occur until many hours after the hit takes place, and not all are evident to the victim.
  3. Although the initial syptoms, if any, (dizziness, fatigue, headache, irritability, and so on,) usually disappear within a few days, the underlying damage doesn't necessarily completely resolve for six to 18 months.
  4. And of course the 65,000,000 million dollar question is whether the damage does ever resolve. Repeated concussions can cause permanent damage, including mild cognitive impairment, CTE, and post-concussion syndrome. The latter is what they used to call shell shock.

One of the most disconcerting things to come out of the new evidence about TBI (Traumatic Brain Injury)/concussions is the cumulative nature of head trauma. Sidney Crosby is an excellent example of the more dramatic form of this. The victim suffers an initial concussion, and before the damage from this concussion has been fully resolved, a second impact occurs. This impact doesn't need to be particularly forceful.

There is an extreme form of this, called Second Impact Syndrome, or SIS. It is quite rare, but since the outcome leads to collapse and death within minutes, that's just as well. Although Crosby didn't curl up and die, it was unclear for quite some time when and if he would ever be able to play hockey again. Jahvid Best, the running back who the Lions traded up to get at the end of the first round in 2010, suffered two concussions in the 2011 season within the space of six weeks or so. He has been unabl to play since—a period of well over a year, as his second concussion came in mid-October of 2011. The Lions finally moved him from the PUP list to IR in the latter part of this season.

But the problem isn't just obvious slobber-knocker hits such as the one Best suffered in college, giving him his first massive concussion. Constant minor hits can also cause damage. This rather counter-intuitive conclusion was reached after studying soccer players. The study was done on adult amateur soccer players, all of whom had played since they were children. Those who most frequently used their heads while playing showed a "significant loss of white matter in parts of their brains involved with memory, attention and the processing of visual information." Only one of the study participants reported ever suffering a concussion, and yet the damage pattern was consistant with that from a traumatic brain injury.

Note these are amateurs. The number of head "hits" they were reporting averaged out to two or three per day. Although it was a small study, the author feels there is "a potential of significant effects on the brain from frequent heading."

And whether the evidence is in on such minor blows as heading a soccer ball, there is no doubt about the accumulation of damage for head injuries as a whole. This has been studied not just in professional sports but in the military. To confine the discussion to football, a study of former professional players has shown a massive increase in depression among players suffering three or more concussions.

So why do I appear to be joining the ranks of Roger Goodell's "No Fun League" in proposing to do away with a harmless and traditional practice among players and coaches? I first begin thinking about this when I read this item from "Wolfley's View from the Sidelines" following the second Ravens game:

On the bus heading for the airport after the game, I happened to be sitting a row ahead of Heath Miller. So I asked Heath how Kelvin Beachum had done. Heath said he played great and then went on to say that during warm-ups Beachum head-butted him so hard that Heath almost crumpled to his knees. Heath said, "I figured he was good to go."

This comment made me really start paying attention to how often players slap each other's helmets or use their own helmeted head to hit the helmet of a teammate. A touchdown catch appears to require head slaps or bumps from any and all surrounding teammates. (The picture heading the article shows Heath Miller being mugged by Ramon Foster and Maurkice Pouncey..) When the player returns to the bench, the coaches start slapping them upside the head. But almost any play considered to be well-done can bring on a volley of head-bumps or slaps.

I realize they are wearing helmets. But as I discovered at a press conference announcing a material designed to reduce head trauma, the helmets most NFL players wear were designed before the effects of concussions were known, and are designed to prevent skull fractures. This is obviously a good thing, but the current helmets do essentially nothing to minimize the effects of impact on the brain.

It may seem silly to worry about a friendly head slap or bump, but my question is, why even take the risk it is adding to the burden playing football places on the player's brain? If you are going to play anything resembling what is currently called "football," there is going to be some amount of unavoidable brain trauma. Why not remove the avoidable forms?

If nothing else, I would hope coaches and parents of children will eliminate this practice at the youth level. It is already clear that children's brains are more easily damaged than even those of young adults.

Perhaps Mike Tomlin's catchphrase "don't hit the head, don't use the head" could be taken one step further: "Don't hit the head, don't use the head, don't congratulate the head." Although I'm sure the silver-tongued Coach T could come up with something more thoughtfully non-rhythmic...