Sunday, April 24, 2016


By Ronald T. Fox

The following is a re-worked version  of my April 20th response to Phronesis reader Vito D'Albora. It is based on some new information I found that is relevant to the points I wanted to make.  I changed the title to more closely reflect my thesis.   My apologies if much of this is what many of you previously read.  Stay tuned for more on the NFL's despicable behavior over the brain injury issue; tomorrow I will post a comment I received from a former NFL player.

The original D'Albora comment:

Thanks for your well thought out article. I heard a report on NPR that youth participation in football is down by almost 20%. My son has said that he will not let his boys play football.  On the other hand football is so ingrained in the American culture that people will actually watch the NFL combine and a NFL pre-season game will draw more viewers than a MLB playoff game!

My re-formulated response:

I fully understand how deeply ingrained football is in American popular culture. Further revelations about the risks of permanent brain damage are unlikely to diminish the popularity of the game. As long as fans continue to value "big hits" and tough-guy players who shake off injuries, players remain addicted to the huge money they can make, and the NFL persist in prioritizing its bottom line, we can expect neurological risks to be accepted by most fans, players, and league executives. This doesn't mean, however, that the game can't be made safer and the league can't do more to provide medical treatment for players with traumatic brain injuries. An NFL player shouldn't leave the game knowing that there's a three in 10 chance he will develop Chronic Traumatic Encephalopathy (CTE), which he will have to face mostly on his own.  Below I offer some suggestions of changes I would like to see implemented.  

For one thing, coaches at the amateur football level should be required to teach tackling the old fashioned way: by wrapping arms around the ball carrier’s chest. Leading with the head, or target the opponent’s head, is when most head injuries occur. It should be discouraged throughout all amateur football.  You'd be surprised how many youth football coaches do not teach proper tackling.

At the professional level, penalties for head hits should be stiffened. Instead of assessing a 15-yard penalty, how about ejecting a player from the game and suspending him without pay for the next game? Repeated offenses should bring longer suspensions.

Much more research needs to be done to better understand the science of head trauma, especially the causes and consequences of CTE. The NFL now funds honest concussion-related research, but this needs to be increased. Perhaps the greatest scientific challenge is to find a way to detect CTE in living players. This would shed light on why some players get CTE while others don’t, which would help in the formulation of strategies to prevent the onset of the disease, or at least minimize its more horrific effects. Increasing its support for brain research would indicate that the NFL is seriously interested in finding answers to the many unanswered questions surrounding CTE. Frankly I’m skeptical given the league’s long history of denial, evasion and obfuscation.  Is it prepared to fund costly therapies? There’s good reason to be skeptical.

The NFL also needs to be more supportive of players showing CTE-related symptoms. Financial settlements, like the NFL’s potential $1 billion plan to settle thousands of lawsuits by former players, is not enough. Monetary compensation should be extended to future as well as former players, an extension glaringly missing in the settlement agreement recently upheld by a federal appeals court. With the NFL estimating that nearly one-third of its active players could develop Alzheimer’s disease or moderate dementia as a result of playing football, it is shameful that future players are not included in settlement provisions. Also, while the settlement grants up to $4 billion for prior deaths involving CTE, it does not include players who died after April of 2015. Absurd!

More troubling to me, is that the NFL has no program to support the treatment of all retired players who suffer brain injuries caused by repeated head collisions. Former players who do not qualify for the NFL's disability or benefits system because they don't qualify under strict NFL rules (they must have played at least three games in three different seasons) must try to get coverage through the workers' compensation system.  This leaves them at the mercy of insurance companies notorious for denying workers' compensation claims, especially when they involve the brain, for which there are no treatment guidelines, and might warrant a long-term fiduciary obligation.

In a just world, the NFL would guarantee all its players medical coverage for injuries they suffered as a player. Unfortunately we don’t live in a just world. Because of gaps in the NFL's benefits system, and restrictive state rules on workers' compensation, former players who need extended treatment usually are unable to access any system of coverage.  They are thus obliged to pay for their own medical care, unless they can win coverage through litigation against their team's insurance carrier. This mandates a costly and lengthy legal process with no guarantee of success. NFL teams and insurance behemoths have very deep pockets, which usually enables them to outlast even the most determined of plaintiffs.

The NFL’s negligence on the long-term effects of head trauma reminds me of how the military has responded to the post traumatic stress disorder problem: first denying the phenomenon exists, later questioning whether it’s necessarily combat-caused, even suggesting many soldiers are faking it, and, when evidence of the problem became irrefutable, offering a too little, too late response.

American football is a violent game and players will always be at risk of injury. Every player understands and accepts this. What is not easy to accept is the possibility—or perhaps the likelihood—that a player will incur permanent brain damage that will seriously impair his quality of life in retirement. I believe the NFL has within its power to minimize this possibility—if it only had the will.

Your son's decision to not allow his boys to play football makes sense. With growing evidence that young, developing brains are especially vulnerable to lasting neurological damage from head collisions, including those that are sub-concussive, he’s probably making a wise decision. Is playing youth football really worth the risk? What does a young person gain from it? Oh yes, I’ve heard the bromides about football building teamwork, discipline, a competitive spirit, and turning boys into men (whatever that means), but as one who watched a lot of youth football, I saw little of these virtues on display. Instead, I witnessed field rants, cheap hits, hateful slurs, and way too much “me-firstism.” I’ve seen all too many coaches teach young players that winning is the only thing that matters, whatever it takes, including violating or bending the rules and purposely hurting an opponent. For many kids, these dispositions remain with them throughout their lives.

I’ve also witnessed far too many parents ruining the fun of playing by putting too much pressure on their kids to be “the best”--not the best they can be, but better than anyone else. This can leave psychological scars when the well-planned striving doesn’t materialize.

To be sure, not all young players emerge worse for the football wear; some do learn valuable life lessons that help them become good, productive citizens when they grow up. On balance, I have to say, however, I think the bad of youth football outweighs the good.  Have them play other sports.

While retired NFL players have taken the point in confronting the league about the CTE problem and post-career medical coverage for head injuries, current players have been generally silent.  Perhaps they think they're invincible, but really their passivity stems mostly from monetary considerations. Not only are they muted by the lure of fat contracts enabled by the growing popularity of the game, which they fear could be jeopardized by tighter safety rules, players also understand that workers' compensation premiums come out of the portion of NFL revenues allocated to active players.  Every dollar teams spend for workers' comp. insurance is a dollar taken away from current players.

The only clue we get that active players are concerned about the possibility of brain damage is when a player retires prematurely.  Active player silence is unfortunate. The league is not going to get serious about concussion-related injuries until current players demand it.

Clearly they are not ready to take such a step, at least not collectively. But, as we learn more about the horrors of CTE this situation may change. Every time we hear of the tragic death of a CTE-ravaged star player like Mike Webster, Junior Seau, Frank Gifford, or Kenny Stabler, or hear of the slow slide into dementia of a Tony Dorsett or a Brett Favre, we get one step closer to the time players will stand up and say, in the immortal words of Howard Beale in Network: “I’m mad as hell and I’m not going to take this anymore.” I hope this time becomes sooner than later.


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