What We Know (and Don’t Know) About Football and Brain Injury

[Brandon Patterson]

Over the past few weeks, I’ve had the opportunity to listen and speak to Dr. Stefan Duma of Virginia Tech and Dr. Jeffrey Barth of the University of Virginia, both of whom are leaders in the field of head injury research.

Here’s some of what they had to say: http://secondlevelfootball.wordpress...-brain-injury/

[br1990]

Over the past few weeks, I’ve had the opportunity to listen and speak to Dr. Stefan Duma of Virginia Tech and Dr. Jeffrey Barth of the University of Virginia, both of whom are leaders in the field of head injury research.

Here’s some of what they had to say: http://secondlevelfootball.wordpress...-brain-injury/

Great read, thanks.

[Brandon Patterson]

Great read, thanks.

Welcome! I hope to follow-up with a look at VT's helmet lab and their programs both at Tech and with local youth leagues--it all depends on if I can get hold of Dr. Duma for a bit.

[Futureman]

The press conference with Seau's mother was heartbreaking.

[Brandon Patterson]

The press conference with Seau's mother was heartbreaking.

Agreed. Heard it in-passing in the locker room and that was enough for me.

[PFHokie]

Thanks for posting. Been thinking about the Seau thing a lot this week and to the draft experts telling us why Washington was stupid to draft a second quarterback (Kirk Cousins). I think that Shanahan is looking towards the day when if you have someone suffer a concussion, you may be looking at a mandatory wait period (3-4 weeks) before that person can return to the field. If RG3 gets concussed during a game, then they are going to need an excellent backup or secondary quarterback or they are going to be in trouble.

With this type of impact to the game, teams are going to look to move to a two quarterback system. The days of your starter taking all the meaningful snaps just may be over as teams try to mitigate the risk to their number 1 guy. I'm not sure how teams will move to this format but it could start with the secondary QB playing every 4th series or in situational substitutions. Whatever path is choosen, in 2013, I could see RG3 playing 75% of the snaps and Cousins getting 25%.

[PFHokie]

Brandon, really liked your article.

[gern]

doesn't take a rocket scientist to figure out that repeatedly running your head into a wall is bad for the brain.

I did think this quote was interesting...
"Interestingly, out of the entire team only about four actual concussions are diagnosed annually, while the rest of VT athletics reports around 26 concussions during the same period."

Lots of things possibly going on here:
(1) #s... 100 FB players versus what, 500 non FB (? no clue here - what's total athletic pop?)
(2) helmets reduce # of measurable concussions (think this is true) but not necessary the accumulation of little ones - yup, dumbing it down to a low cycle fatigue problem so I can relate : )
(3) normalization... FB players/coaches have been engrained to play through "minor concussions" as a sign of manliness ("walk it off", "rub some dirt in it", etc)

and a lot more choices people smarter than me can come up with



Honestly, I can't come up with a reason to not knee jerk about football player health and in that I strongly disagree with those 2 doctors. Just look at the mortality rate for folks, especially OL. Lots of stats out there in terms of average life span for NFL players with numbers of 55-65 thrown out there. That is like 20yrs less than a "normal" person. How much is physical contact, how much drug use (yes, I think this is rampant in NFL), how much is obesity, ... who knows. I do know that training kids in high school playing OL to target 300lbs is unhealthy and that will result in early deaths as most don't lose weight as they age. There are serious problems with the sport that need addressing and when things are out of whack swing back the other way to compensate for decades of neglect:
(1) heart stress tests - these are becoming more common
(2) head injury rest - mandatory pulling players out for the game if they're dinged up, not just a play or two (getting better here but betting having company docs judging ain't best way forward). minimum of 4wks off if suffer an actual concussion (or a meaningful time frame until someone can come up with a scientific date)
(3) no more shots for pain before or during competition (do they still do this?)
etc

[Brandon Patterson]

With this type of impact to the game, teams are going to look to move to a two quarterback system. The days of your starter taking all the meaningful snaps just may be over as teams try to mitigate the risk to their number 1 guy. I'm not sure how teams will move to this format but it could start with the secondary QB playing every 4th series or in situational substitutions. Whatever path is choosen, in 2013, I could see RG3 playing 75% of the snaps and Cousins getting 25%.

I've been thinking about that, too. Football is cyclical enough to where we could see mandatory concussion breaks and resultant platooning essentially devalue players to the point where it makes sense to use them in higher-risk plays. Running the speed option looks a lot better if you got two interchangeable Joes at QB instead of a Peyton Manning and a human interception machine. Or if the penalties for illegal hits got especially severe and frequently applied, baiting defenses into taking head shots (or relying on their timidity to get open) could become a reasonable tactic, especially if you got six similar guys willing to go over the middle for a paycheck.

I'll admit in total it's extreme, but football's all about unintended consequences, and there've been weirder ones. Including a focus on player safety that led to adopting helmets, facemasks, and pads thick enough for players to turn into human missiles, which in turn is probably causing many of these problems.

[Brandon Patterson]

...Honestly, I can't come up with a reason to not knee jerk about football player health...

I agree with almost all of the content of what you're saying, and while I don't want to put words in their mouths, a lot of your general health comments echo in tone and concern what Barth and Duma said regarding brain injury. What you advise is fairly well-thought and informed, so it's the opposite of the reactionary or uninformed action of a knee-jerk response, though you've mischaracterized the doctors' work and views.

Barth in particular was worried about people becoming so concerned with concussions that they'd fall for what he called "charlatanism," which is a nicer word for medical fraud and quackery. We're already seeing this in the supplement business with a host of unregulated, untested concussion supplements. He was also worried about the converse, where people would assume concussions were an overblown hypefest and pay too little attention. Duma cautioned us about unsubstantiated claims regarding mouthpieces reducing head trauma, and about inappropriately applying anecdotal evidence from NFL players to 5 million adults, teens, and kids who play football in a given year.

As to my intent with the phrase, I caution against things like people calling for blind legislation to ban football (a la what was tried with MMA), and also against a completely laissez-faire approach where no one cares about player health. Speaking more to the sad situations that led me to write this article (I'd originally planned only to cover Tech's research on SLF, and on concussions for more science-oriented publications), we should not assume that every NFL vet is a murder/suicide waiting to happen, nor should we assume it's an NFL problem and our college and younger players are safe. I also want to caution against thinking this is a hopeless fight and that our best approach as members of the public is to inure ourselves.

Regarding your recommended compensations, you're advising a fairly conservative approach for head injuries in comparison to what the doctors have already achieved and what they would like to progress to. Barth and Duma both are responsible for the implementation of preventative brain health measures for perfectly healthy players (and butt heads with coaches and owners in doing so), and they are responsible for developing some of the very recovery and monitoring guidelines you theorize about.