Friday, January 31, 2014
HEADS UP - FOOTBALL'S FUTURE IN A NEW LIGHT
THE FUTURE OF FOOTBALL AND ITS
PLACE IN OUR CULTURE
THE GAME CAN BE MADE SAFER BUT AT WHAT EXPENSE?
RATIONAL ARGUMENTS VERSUS OVERBLOWN RHETORIC
TAGS: NFL HEAD TRAUMA, NFLPA CLASS ACTION SUITS, NATURE OF THE GAME,
NFL CONCUSSIONS AND SUB-CONCUSSIVE TRAUMA,
CTE, NEURAPOTHY, LONG TERM HEALTH EFFECTS,
BRAIN EFFECTS BEGIN BEFORE A PLAYER GOES “PRO”,
NEUROPATHOLOGY AND HISTIOPATHIC STUDIES,
RISKS AND REWARDS,
THE LURE OF MONEY
(Friday January 31, 2014 “Football Boulevard”, NYC) The National Football league is a brand worth upwards of $9 billion dollars annually. It is more profitable than many Fortune 500 companies but remains a privately held entity. Each of its 32 teams is private owned franchises except for the Green Bay Packers who are partially supported by the public, most notably by their fan base in Green Bay Wisconsin. The NFL brand transcends our national borders and has been rapidly gaining popularity internationally in countries from England to Japan. There has been much discussion at the NFL headquarters just a few blocks from here about expanding the League by fielding foreign teams.
In every sense the NFL has been a juggernaut generating wider and wider appeal, raking in greater revenue and marketing merchandise, owning a cable television network while standing atop the “sports-ertainment” landscape as the penultimate professional spectator sport in America. The raw numbers speak for themselves. Over the last 25 years the NFL and its franchised teams have enjoyed revenues that have grown at a near exponential rate of growth. As far as the “economy” of the NFL is concerned, it is solid, solvent and a true powerhouse wielding tremendous influence throughout American athletics at every level. It is a business model that is difficult to replicate. Professional football is a worldwide phenomenon that has left all the other professional sports leagues in the United States in the dust. However, it is not without a budding strain of controversy.
HEADS AND SHOULDERS ABOVE THE REST
The collegiate footballer who actually earns a slot on a NFL team roster is a rare, elite athlete. These young men possess athletic prowess, a combination of size, speed, strength and overall athleticism that elevates them to breathe the rarified air of the professional footballer. Approximately one tenth of one percent of the collegiate footballers playing on FBS teams will even have a chance of making an NFL squad. The completion is fierce as it is brutal. Football has historically celebrated the type of controlled violence that can simultaneously mesmerize and terrify. The speed of the game is not fully captured by television cameras, the forces of impacts, tackles, blocking and rushing can only be appreciated from the sidelines.
The professional football player today has been trained, coached, educated and conditioned in such a way that would have seemed impossible even 30 years ago. Most of those pros who played in the 1960’s and 1970’s would likely not even make a “practice squad’ in today’s NFL. The fact of the matter is that significant advances in physiology, nutrition, strength and speed training, kinesiology and sports medicine have helped create with a young man with a hefty dose of “God-given” ability into the elite athletes we watch on Sundays in the Fall. Of course virtually every NFLer has played college football most at the highest level of competition. But their road to professional fame, fortune and glory begins long before they ever step foot on a college campus or receive a recruiting letter from a big time collegiate powerhouse.
DIAMONDS IN THE ROUGH
In today’s world once a young boy demonstrates a particularly high degree of athletic prowess, what will be a years long process of conditioning and training begins. Boys at increasingly younger and younger ages are now being identified by some parents and coaches and at the still tender ages of 7, 8 and 9 years old are already being groomed to climb the steep ladder to the next level of competition. This practice that has evolved into something of a cottage industry with highly specialized coaching, position clinics and conditioning programs has raised concerns about the long term health effects of such raising a young child in such a regimented structure. Certainly parents of young football players are not alone in this practice. Some of our “amateur” Olympic athletes such a female gymnasts begin rigorous years of training hoping to gain a highly coveted spot on the Olympic team. Several longitudinal medical studies have yielded troubling results ascribed to this process. Many of these young female gymnasts suffer developmental problems from chronic musculoskeletal conditions to the delayed onset of menses. Some young amateur athletes, reach their peak performance level and have seen their best days before their sweet sixteenth birthday. We are familiar with some of the young faces with beaming smiles adorning boxes of Wheaties only to drift away into obscurity often plagued with long term health issues.
But those youngsters who participate in Olympic events represent a miniscule number compared to youngsters who participate in organized sports from an early age, through high school and hopefully into college. Not every child has access to gymnastic centers, swimming pools with high diving boards or ice skating rinks. But, most kids have Pop Warner football leagues, basketball courts, Little League baseball fields and playgrounds in their neighborhoods where they first begin to develop the skills that may vault them into the stratosphere of their chosen sport. In far too many cases the parents are to blame. They see a gifted child as a ticket to glory that may have eluded them when they were younger (and probably less gifted) or simply as a potential “meal ticket” once their child “goes pro”.
Professional football is unique in some important ways from other professional Leagues. While a major league baseball team can draft an athlete right out of high school and the NBA is allowing younger and younger athletes to declare to go pro, the NFL still maintains a strict policy regarding the eligibility of an athlete to enter the annual draft. This makes sense since football is a vastly different sport requiring a unique skill set and the ranks of collegiate football players are akin to a “farm system”. Major League baseball operates a farm league in which they develop players at a well-paced, well-structured manner. The NFL relies on the “Big Time” collegiate football programs to groom and prepare their prospects. This arrangement works to the NFL’s advantage while often leaving a long trail of broken dreams and broken bodies throughout the NCAA sanctioned university and college ranks.
OUR FOOTBALL CULTURE
Football long ago surpassed baseball as our “national pastime”. Baseball, that sedate, comparatively leisurely game lost its mass appeal as our culture became more in-your-face, less respectful, and semi-addicted to violence of every sort. The game itself has changed as well. Many innovations designed by famous coaches from the seventies and eighties forever altered the way the game is played. Highly potent offenses featuring the forward pass and skilled runs from scrimmage have been designed causing defensive schemes to adjust accordingly. Many if not all of these components of the game as it is played today have demanded more and more of the young men who play it. Every Sunday during the season the audiences are treated to feats of such athleticism that sometimes a series appears more like an acrobatic display than a football game. Each yard gained is hard fought; each receiver blanketed by man or zone coverage while the big men in the trenches engage in gladiatorial battle.
As the game evolved so too did have the athletes and equipment. In an odd twist indicative of the “Laws of Unintended Consequences” as the athletes became better conditioned, bigger, stronger, faster, more nimble yet powerful and as the equipment provided more advanced levels of protection, the game actually became more dangerous. When an NFLer at 6 feet 3 inches weighing 250 pounds of well-developed muscle who can run a forty yard dash in 4.5 seconds clad in the protective padding and helmet that constitutes his full battle regalia sets his sights on a receiver coming across the middle, the collision can be brain rattlingly ferocious. And, with increasing frequency they are just that: concussion causing collisions that can leave both receiver and defender dazed, confused and worse for the wear.
But that is a big part of the attraction; watching men do battle on the gridiron has an almost primal appeal and the harder the hits, the more crushing the tackle or goal line stand, the more we cheer and have another beer. However now, as more and more former NFLers are coming forward about their post playing careers health, some very unsettling developments are causing greater concern in the NFL and NCAA communities as well as on the Pop Warner Junior League and high school levels. As the evidence is mounting regarding the long term effects of playing football on the cognitive and motor functions of ex-players and degenerative processes such as Alzheimer’s and Parkinson’s Disease and, perhaps most disturbingly, Chronic Traumatic Encephalopathy (CTE). The focus on chronic degenerative, progressive, neurological diseases has the NFL, the NFL Players Union, current and former players, their families and lawyers on all sides of the debate each utilizing medical science data that supports their respective positions. As of June 1, 2013, there are more than 4,800 named player-plaintiffs in the 242 concussion-related lawsuits. Including the players’ spouses, there are more than 5,800 plaintiffs, total. There has already been a $725 million settlement for the plaintiffs – the players and their families – but none of the parties are satisfied and neither of them sees this settlement as the end of litigation.
WHAT DID THEY KNOW AND WHEN DID THEY KNOW IT?
Implicit in the $725 million payout is a de facto acknowledgment that the NFL was aware for many years that there is a direct correlation between playing professional football and neurologic disorders later in life. Some legal observers have equated this situation with the successful litigation of “Big Tobacco” wherein scores of former smokers sued the cigarette companies for not fully disclosing the array of health problems related to smoking. Those cases were assembled into several huge class action suits and to this day the tobacco companies are paying for “damages”. It seems more than a bit disingenuous if not hypocritical for life long smokers to blame the makers of cigarettes for their health problems.
What is different about the plaintiffs in the tobacco class action settlements and the plaintiffs contentions in the NFL cases is that there were decades of accumulated empirical medical and scientific data that proved overwhelmingly the correlation of cigarette smoking and certain types of primary lung malignancies, as well as malignant lesions of the lip, mouth and throat, in addition to cardiovascular deficiencies. Those CEO of the big tobacco companies were not only made aware of the potential hazards of using their products but, despite such facts, the irrefutable results of studies they themselves had underwritten, went as far as to design specific marketing strategies to attract younger and younger smokers. All of this condemning information was made public by the prosecuting attorneys and it cast an entirely more ominous shadow over the entirety of subsequent legal proceedings.
The big question now is what did the NFL know about the long term effects of concussions and accumulated sub concussive injuries and, when and how did they acquire such information? At this point such questions remain largely unanswered. However the highly acclaimed PBS investigative documentary series, “Frontline”, has established a timeline tracing the genesis of this debate back to 1994. At that time 20 years ago, then NFL Commissioner Paul Tagliabue was only able to admit to a potential problem with concussions and he formed the Mild Traumatic Brain Injury (MTBI) committee to study the issue.
START AT THE CENTER
The chronology of this debate can be tracked back to the case of Mike Webster, the offensive Center of the Pittsburgh Steelers from their storied Super Bowl winning teams of the late 1970’s. The All Pro Center’s career lasted 17 years. According to his family and several doctors who had treated Mr. Webster for a variety of injuries, ailments and symptoms, within a dozen or so years of his retirement from the NFL he began to exhibit signs of some form of neuropathy. His short term memory was failing; he had profound mood swings, difficulty concentrating aside from the regular “garden variety” type of musculoskeletal troubles that are accepted by former NLF’ers as a fact of life. Webster’s behavior and symptoms increased as did the concern of his family and doctors. At age 50 Mike Webster passed away from a heart attack. His autopsy, most notably, the neuro-histogical examination of sections of his brain revealed troubling findings. On microscopic evaluation of his brain sections there were a pronounced number of areas that showed the presence of residual proteins known to be a result of traumatic head injuries and closely associated with other more common progressive brain diseases that typically strike older people. The proteins that react to a head injury are quickly engulfed by surrounding normal cells if the brain is healthy. Obviously Webster’s brain was anything near “healthy” and his autopsy began the efforts to understand CTE and head injuries of all kinds. Today there are a number of rigorous studies looking into traumatic brain injuries and the effects of cumulative effects of concussions and sub-concussive trauma. So preliminary finding may let the NFL “off the hook”, if you will however, complicity culpability might be much closer to home than has been previously thought.
HEADING FOR TROUBLE
Like several facets of this debate about head injuries and football, the etiology and causative factors being examined seem, in retrospect, to be so obvious that to realize that we have thought otherwise for all these decades is in itself counterintuitive. On so many levels the debate reeks of convolution, ignorance and plain old-fashioned stupidity. The NFL, as sleazy in this regard as some might see it has a good argument in their defense when considering the amount of liability they carry.
By the time the rare athlete that earns a slot on an NFL roster goes pro he has already sustained hundreds if not thousands of significant sub-concussive blows and, perhaps several concussions of a more serious nature. Again, relying solely on incomplete preliminary data, it appears that the younger the age a boy begins playing a full contact sport such as “tackle” football, the higher the likelihood of him developing some form of neuropathy in the future. Parents of youngsters have had to sign insurance waivers and other such documents permitting their sons to play football at the Pop Warner level, in high school and in college. Injuries such as strains and sprains of cartilage and ligaments, fractures and dislocations of bones and joints have always been part of the game and are taken with a grain of salt particularly in today when medical science has made non-invasive surgical repair of certain injuries an out-patient procedure and rehabilitative modalities and techniques have shortened the recovery time from months to weeks in many cases that just years ago would have meant only a remote possibility of rehabbing sufficiently to return to action in less than a year or more.
Given the tender age virtually every professional football player was at the time of his first exposure to the game as a participant, the premise that head trauma sustained only during his NFL career has caused CTE or any other related neuropathology is simply wrong. More accurately it can be asserted that whatever head injuries he incurred as a pro were simply icing on the cake of his already frequently shaken and rattled brain.
By the time a future NFLer is identified, let’s say in high school, and is taken under the tutelage of a coach or coaches, trainers, conditioners and the like, he has suffered any number of head injuries. In the old days such head injuries were commonly referred to as having your “bell rung” and, the antidote often was a small gauze covered ampule of ammonia waved under the nose of the stricken player. The ammonia would suddenly rouse him but had no positive affect whatsoever on the underlying problem; all the inhalation of ammonia did was wake him up. Anyone who has ever strapped on the hip girdle, shoulder, hip, knee and thigh pads and donned a helmet to play football as a youngster knows full well the feeling of having his bell rung. It used to be all the player needed was to “shake it off” and return to play. Now there are strict concussion protocols that must be followed in college and the NFL after a player has suffered an apparent head injury.
This debate has spawned other debates such as what is the appropriate age for young boys to begin playing tackle football? Many parents are seeking a reasonable, informed answer but it may be up to a parent’s common sense and their level of comfortability having a son participate in football as the pre-high school level in particular. Just as a child’s body continues to develop well into the late teen years, the young skull bones and brain are not yet fully developed and significant head trauma during these young years have the potential for doing the most long term damage.
As is so often the case what were meant as new generation protective padding and helmets the donning of which was designed to decrease the severity of hits to the body and head have become the culprits instead. The new rib and back padding worn by quarterbacks, running backs, receivers and most defensive backs have given the sense of false security. The better the equipment the more readily prepared were players to deliver vicious blows and it propel themselves like human projectiles at their targets. Although sports medicine, equipment manufacturers and the ruggedness of highly trained very powerful young players, the incidents of head injuries had continue to escalate over the past 20 years. The disturbing finding from postmortem studies of retired NFL’ers have brought the League, their policies and practices under a level of scrutiny that is most unappealing.
In recent years there have been several suicides committed by high profile retired NFL’ers. One, Dave Duerson, a defensive standout for the Chicago Bears intentionally shot himself in the chest so that his intact brain could be examined by the doctors and researchers laboring in this field. Many more than the thousands who have signed on to several class action suits naming the NFL as the perpetrator are legions more who suffer chronic pain, degenerative joint diseases such as arthritis and all other manner of the ailments and injuries that persist well beyond their playing days.
CHOICES, RISKS AND REWARDS
There are many very dangerous, hazardous professions in America many of which we give little or no thought to as long as we can go about our daily business without undo interruption or inconvenience. Among the occupations with the highest casualty rates as measured in acute injury and chronic exposure to chemicals, toxins and environment causing long term ailments are coal and ore miners, commercial fishermen, oil field/natural gas refinery personnel, long-haul truck drivers, high steel walkers and many more are typically legacy jobs; a coal miner likely had a dad and granddad, uncles and cousins who mined before him or even with him. The same can be said of urban firefighters, police officers, and most of the other construction trades. While these jobs are inherently dangerous they pay well enough to raise a family but, the operative phrase here is “well enough”.
A top draft pick from the ranks of the NCAA collegiate “farm team” into the NFL in this modern day may receive a signing bonus worth millions of dollars and that is before he’s ever played a down in the NFL. The money in professional sports particularly football is measured in astronomical numbers difficult for your average person to get a grasp of. In two weeks hundreds of NFL hopefuls will travel to Indianapolis Indiana for the NFL Combine; a sort of athletic audition where young men can display their athleticism to coaches, general managers and scouts representing all 32 NFL teams. The competition is always brutal. Each participant knows the odds and, if they are concerned about the long term effects of their chosen profession they certainly would not show up at The Combine.
But show up they do; by the hundreds. Some from the big collegiate powerhouses, others from smaller more obscure colleges and some come for a second and third year because they so desperately want to make a team. It can take a long time for an athlete who enjoyed notoriety on campus, TV and in the press to have it all end so suddenly.
For every contender at The Combine there are countless others who would sacrifice anything to be in the position of being evaluated by the NFL teams. Money is a huge determining factor in this equation; the average NFL player lasts just under six years with some not able to make the squad after just three campaigns. If one were to take a poll among miners, truckers, fishermen, loggers or any of the other hazardous jobs in America what they would or would not do for a few million dollars with a large chunk of it up front, there would likely not be a man who’d turn down the chance for a big payday.
Given all these variables it is safe to surmise that the NFL and junior league, high school and college are not going anywhere soon. They are here to stay. No other organization worth an annual revenue of 9 billion dollars is going to close their doors. The League has been tweaking and tuning some of the rules of the game in order to reduce the risks to a vulnerable player such as a QB or a receiver going across the middle defenselessly. Some of the rules have helped but the game will not be the same if too many rules are established and enforced. This past season most of the most severe collisions where a players head contacted another player’s thigh or knee, or a tackler moving so quickly that he was unable to come to a full stop before he leveled someone were incidental; they were not on purpose, they were the result of very fast, big powerful men moving at a high rate of speed doing his job.
It was curious to see a law firm advertising on TV during the Super Bowl broadcasting the message that anyone who has ever played NCAA football and suffered some head trauma to phone their 800 number. This was just a matter of time. With the ultra-powerful NFL trying to fight off the various legal dogs nipping at their heels it was inevitable that some law firm would not take the initiative to bring some of those same legal mongrels to begin the pursuit of the NCAA. Even at the big universities with successful football programs money, a great deal of money is involved. There have been enough scandals over the last two decades to attest to this fact. Certainly the matter of financially compensating college football players has been debated long and hard with no signs of abating. As unpaid students not members of a labor union as the NFL players are, the legal path ahead will be sloppy and slick. Simply the sheer numbers of former NCAA football players is orders of magnitude larger than the entirety of current and retired NFLers. Having that particular commercial air during the single greatest sporting event of the year was odd. Perhaps the network opted to take the money for a 30 second TV ad without the NFL being aware. Anything is possible.
THE WAY FORWARD
President Barack Obama when asked if he had a son would he allow him to play football, unlike most politicians, gave an unambiguous answer stating that he would not allow his son to play football. Parents all over the country are asking this same question to themselves, discussions among spouses and their potential football player have already shrunken the number of young boys playing Pop Warner football. Some of these discussions are not just general airings of the issue; many parents are simply unsure how old their son should be before they allow him to participate.
Just as the growing juvenile musculoskeletal system remains in the developmental phase for much of the teen years, the young brain is still in the process of developing the full complement of neurons and axons, dendrites and synapses, the intricate neural networking of the central nervous system, well into the teen years. Given all the publicity these issues have attracted it is not a surprise that enrollment in Pop Warner leagues has dropped but that does not concern the NCAA or NFL in any real way. There is certainly no paucity of willing youngsters to put on the pads and buckle their chinstrap and entertain dreams of glory on the gridiron.
For their part, the NCAA and NFL have funded initiatives aimed at teaching young boys the fundamentals of the game in the manner most conducive to injury, especially head trauma. Coaches at all levels are being required by their employers be they big time universities or high schools to instruct their student athletes that the game of football itself can be played safely and need not be about causing injury to the opponents. This is well and good in theory but it remains to be seen how it translates onto practice fields all across America this summer.
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