Next step: NFL takes deeper look into concussions of possible draft picks at combine
By Michael Marot, APThursday, February 25, 2010
NFL combine puts more emphasis on concussions
INDIANAPOLIS — The focus on head injuries in pro football is turning to this year’s potential draft picks.
For the first time, all 329 invited players at this week’s NFL scouting combine will be given a baseline brain activity exam — called the ImPACT test — and will likely face more grilling than previous classes did about their concussion histories. Those implementing the changes call it smart football.
“We’re testing everybody, not just at-risk athletes who have had more than one concussion,” said Dr. Art Rettig, an orthopedic surgeon at Methodist Sports Medicine in Indianapolis, which runs the medical part of the combine. “Everybody will have this ImPACT test so they will have a baseline, and whatever team they end up with will be sent that baseline information.”
That hasn’t been standard operating procedure in past years, though all 32 teams individually now use similar tests on their own. Doctors compare pre-injury and post-injury answers to determine whether a player can safely return from a head injury.
By testing everyone at the combine, the league will have a more standardized way of evaluating players and potentially collecting data about repeated hits to the head.
It’s the latest step in a movement that started to gain momentum last season, particularly after a study for the league by researchers at the University of Michigan found retired players may have a higher-than-normal rate of Alzheimer’s disease and other memory problems.
The league has since adopted stricter policies on allowing players to return to the field after big collisions. Lawmakers in Congress and state legislatures also have jumped into the discussion, and the NCAA is considering additional ways to reduce head injuries in football.
On Wednesday, the league’s competition committee heard presentations about helmet designs that could reduce the risk of head injuries. No decisions are expected before next month’s owner’s meeting.
“We have to admit, this is a tough game, a violent game, a collision game,” said John Madden, a Hall of Fame coach, former television analyst and now a consultant to the NFL. “How do we make it safer? We have to educate players and coaches and trainers, equipment is another way and rules changes are another way. But it can’t be just any one of those things. It has to be all of them together.”
The message seems to be getting through.
On Friday, the NFL Players Association will hold its second Player Safety and Welfare Summit in Indy, an all-day event that gives manufacturers a platform to discuss products and services to make the game safer. Later that evening, team doctors will have their annual scientific meeting to discuss better treatments for players. Part of the discussion, Rettig said, will focus on head injuries.
Rettig, the Colts team physician, and other doctors will spend four days poking and prodding players to make sure teams are investing in athletes with a clean bill of health — and that goes beyond brain trauma. After Bears defensive end Gaines Adams died in January from a heart attack, there is also renewed interest in cardiology issues.
“Invariably we have one or two players that are found to have (medical) conditions that are not reported, that are life-threatening in some cases,” Colts president Bill Polian said.
But all players could face new rounds of questioning during the 15-minute team interviews.
Traditionally, decision-makers such as Polian and Minnesota’s Rick Spielman have used the allotted time to measure football aptitude, whether it’s through questions and answers or psychological tests.
This year, the expanded discussions may include head injuries.
“You may talk about it a little bit more if a guy had a concussion history coming out of college, that you may want to dab into that a little bit deeper just to make sure,” Spielman said this week.
The question: How many of the answers will be the whole truth?
NFL prospects have a vested interest in making it through the evaluation process without any red flags, which could send them skidding down the draft board and cost them millions.
“That’s always an issue not only with concussions but with all injuries, trying to improve status by minimizing other injuries,” Rettig said. “I think that’s one area where the ImPACT test will help us. The ImPACT might pick up the problems.”
Tags: Athlete Health, Indiana, Indianapolis, North America, Sports, Sports Medicine, United States
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March 16, 2010: 2:18 pm
Hi, this comment is for the author and the commenter Steve. I am a risk management student at Temple University and am writing a thesis on liability issues in the NFL. If you have anymore information on this and other issues I would like to discuss some of them with you, and get your permission to possibly quote you as a source. I am looking for professional opinions on some matters, as well as general information. Any help you could offer would be greatly appreciated. I can be reached at jlatham27@temple.edu. |
 steve |
February 27, 2010: 9:25 pm
Why doesn’t the NFL mandated the mouth guard. If the NFLPA doesn’t know the answer to that question then they don’t need to be representing players. Although there is a current study being conducted by the Center for the Study of Traumatic Encepholopathy, it could be decades before the research can provide any definitive results. The Center is looking at the brains of deceased NFL football players to study Chronic Traumatic Encephalopathy (CTE), a progressive degenerative disease of the brain, found in athletes (and others) with a history of repetitive concussions. The study is a very important first step and it should be noted that boxing studies have already made the link between concussions and CTE, but the most important question we should be asking is: Why do concussions that cause CTE occur and how can we prevent them from happening? Moreover, why do most of the brain bank subjects have it manifest in the medial temporal lobe, or just behind the ear? Some suggest it’s because the bone at the skull-base – where the end of the jawbone rests – is paper thin and just millimeters away from the medial temporal lobe and that when the jawbone gets hit and hammers at that paper thin area during collisions involving the head and jaw area, it produces concussions. A key brain stem lives behind the jaw, and controls many functions of the body. Normally a dime sized cartilage disk (meniscus) at the end of the jawbone protects the bone from traumatizing this paper thin area. Patients who have had multiple concussion have been found to have damaged or a slipped “meniscus”, thus opening the jawbone to a hammering effect, exacerbating the mild events of dizziness, the sensation of seeing stars, facial numbness and concussion. This “hammering effect” can be reduced and therefore help in the prevention of concussions by one simple piece of equipment…….a corrective mouth guard! In 2006, Indianapolis Colt players had over twenty concussions, a little better than the NFL average of 16. That same year the New England Patriots reported just (2) two. The difference between the two teams? Most of the Patriot players were evaluated prior to the season and fit with the Maher mouth guard. The two Patriot players that had concussions were not wearing the Maher mouth gaurd, but once fitted, these players returned to play with no problem of recurrence. The New England Patriots medical records will show that by using this concussion protocol, they have the lowest concussion rate annually, as reported in a peer reviewed American Academy of Orofacial Pain paper. Congresssman John Conyers has specifically asked Roger Goodell to turn over these records. There is no word on whether this has happened. The NFL is reluctant to discuss mouth guards because until now, researchers have had very little understanding of how they can be linked to concussions. Conventional mouth guards are made by taking an upper impression of the teeth, but they only protect the teeth and do not address any TMJ (Temporal Mandibular Joint) issues. All prior mouth guard research has been devoid of a consistent TMJ element and that is why no previous mouth guard research has ever shown a reduction in concussions in humans, only arbitrary results. One very big problem with the NFL research is that they used crash test dummies and since crash test dummies are not equipped with jaw joints, their research method was questionable from the very beginning. The NFL funded researcher, Elliott Pellman, looked at injuries that took place from 1996 to 2001, but chose to study only those concussion-causing hits that researchers could re-enact from watching video. As a result, the committee analyzed 25 concussions out of a total of 787 that team doctors and athletic trainers reported over that period, and didn’t find one case in which a player suffered a concussion while striking another player. Here is an article about Dr. Pellman: ESPN Dr. Gerald J. Maher, the developer of the Maher mouth gaurd said that the NFL study threw out the majority of concussions that a helmet would be unable to protect against. He also said that the helmet can’t protect the jaw, in fact, the chin strap compounds the problem. The NFL helmet research consisted of approximately fourteen studies at a cost of $7 Million dollars – funded equally by the Owners and the Players Union – and was specifically conducted to assist in the development of the Riddell “Revolution” Helmet. That’s a lot of money to help in the design and development of a product sold by a private company. It is interesting to note that the NFL’s initial 2001 research on the majority of concussions showed a need for jaw stabilization. The following statement was from a Riddell official as reported in the Pittsburgh Tribune Review: “The helmet was designed to protect players from concussions but also provides the best jaw protection available on a football helmet.” The Revolution Helmet was made after a study came to the surprising conclusion that 70 percent of players’ concussions occurred from blows to the jaw or side of the head. If Pellman’s research had focused on the origin of jaw concussion, or the majority of concussions, not just those focused on helmet improvements, then the direction of the research might have been very different. Unfortunately, the NFL appears to have steered the research toward a lucrative series of redundant studies that minimized the effects of concussion and overstated the effectiveness of the new helmet design. Chris Nowinski and Dr. Robert Cantu from the CSTE publicly criticized this as a “marketing” piece that stated the new Riddell Revolution helmet reduced concussions by 30%. Many feel it is a complete fabrication for the purpose of selling the helmets. The NFL did not do its due diligence to protect its players from the most common type of concussion force, a blow to the jaw. Instead, Dr. Pellman steered the study toward a series of misleading, highly questionable studies that resulted in a boon for Riddell’s stock and has not reduced the concussion rate one bit. This whole debacle has been reckless and self destructive to the NFL’s research reputation. At Fourth & Goal, we are not in the business of endorsing products used by active players, but we’ll make an exception in this case because the Maher mouth guard is the only one that has any data on human research, history of use in the NFL and an American Dental Association approved fitting evaluation and protocol. This small piece of “mandatory” equipment could save the NFL from a long line of active and retired players applying for NFL Disability. It will cost the league nothing to provide this protective gear for their players, because most insurance will cover the cost and many current players are using it today. You would think that the liability issue alone would force the NFL and the NFL Players Association to make these specialized mouth guards mandatory equipment, but, then again, that might look like an admission of guilt for allowing this travesty to go on for as long as it has. It’s a shame that “retired” NFL players have to plead with the NFL and the NFL Players Association to protect the active players. Maybe it’s because retired players have experienced the crippling effects of concussions and we don’t want to see history repeat itself and add to the body count. Something needs to be done today, not twenty years from now. The Union must take action to reduce and prevent concussions. Active players cannot be co-conspirators in their own demise and the NFLPA cannot allow them the opportunity to do so. It’s the Union’s job to ensure the safety of its members and that is why a mouth guard mandate and preseason jaw evaluations should come from the NFL Players Association, not the League. |
Joseph Latham