August 24th, 2013- “Momma, I think he’s dead.” That’s what my then 8 year old brother Wyatt frantically ran and told my mom sitting up in the stands. Just moments earlier, my brother Zack, then a senior quarterback and Nebraska Cornhuskers commit, had rolled out to pass during the 4th quarter of an ESPN nationally televised game against the Byrnes Rebels of South Carolina. Unable to find a receiver downfield, he tucked the ball and headed towards the sideline, where he took a hard, but clean hit. As he hit the ground, his head snapped back and bounced hard off of the turf, leaving him lying motionless on the ground. Lights out.
A thousand miles away, sitting on a couch in Norman, Oklahoma, with my teammates, I watched in shock as they loaded my little brother up onto a stretcher, packed him into a helicopter, and airlifted him to a nearby hospital. In but a moment, the concussion crisis had become real to me, penetrating my seemingly invulnerable family and taking my best friend as its victim. In my mind’s eye, concussions aren’t symbolized by a lawsuit, a news story, or a Hollywood movie, but by my little brother lying on the sideline, motionless and unconscious.
I am not a scientist and I will not pretend to be one. I understand that my unique perspective is one of a former student-athlete with a wide range of experiences with concussive issues. If you want an expert analysis on concussions, CTE, or Traumatic Brain Injuries (TBI’s), I am not your guy. But I would be remiss not to glance over the basics of concussions for those of you may know very little about the topic, or have a flawed understanding of the nature of concussions. I have the resources to access such information, both in material and in people.
The problem starts with the definition of a concussion: there isn’t one. One could define it as a “malfunction of the brain,” but that definition is rather ambiguous. Therein lies the problem: we cannot even define exactly what a concussion is. Our head athletic trainer, Scott Anderson, refers to the concussion as “the invisible injury.” This is because you cannot test for a concussion. No MRI result, CT scan, or blood test is ever going to come back “concussion positive” with what we currently know about the issue. What we use to identify a concussion is a range of symptoms, of which there is no minimum or maximum number. Symptoms include, but are not limited to headaches, dizziness, blurred vision, memory loss, nausea, etc. But the presence of symptoms do not guarantee a concussion, just as the absence of symptoms doesn’t ensure that there isn’t a concussion. A person could have multiple symptoms present, but not be concussed, while another individual could not even be showing any symptoms, but have a concussion. The crucial point is how the medical experts detect and interpret the symptoms. As we have seen recently, medical personnel have started to err on the safe side by holding players out who may even have a chance of a concussion. As you can see, there may be more that we don’t know about concussions than that we do know. But that small blurb, as incomprehensive as it may be, should be able to give you a decent understanding of the basics of concussions.
Over the past few years, as national attention has shifted towards the dangers of playing football, every level of the game, from youth leagues to the NFL, has taken significant steps to improve player safety. It is my opinion that many fans of the game do not truly realize how much has been done and is being done in response to increased general safety and concussion concerns.
At the ground level, Heads Up football, a collaboration between the NFL and USA Football, seeks to promote safety in youth football by supplying a variety of training resources for coaches, such as tackling and blocking tutorials, as well as training in how to deal with concussions, heat stroke, and other situations where a child’s health may be compromised. Heads Up even issues an official coaching certificate. If I were a Pop Warner commissioner or a youth football parent, I would absolutely make sure that the coaches that we are entrusting our kids with be qualified, trained, and certified. The techniques, culture, and mentality that kids learn from these coaches are carried over for the rest of their football careers. It is my opinion that, of the three levels (pre-college, college, pro), the first level has the greatest room for improvement, particularly at the youth level (pre-HS).
At the college level, the concussion issue has been tackled from multiple angles. On the field, rules changes and a renewed emphasis on targeting have undoubtedly changed the game. Head to head contact and spearing (dropping the head prior to contact) are punishable by a 15 yard penalty and ejection from the game. While many lovers of football, fan and player alike, have decried these initiatives as erosive to the spirit of the game, they are both necessary and effective. I can assure you that players are acutely aware of the rules and their consequences.
This point can be driven home by a poignant memory from my last game as a Sooner. Several of my teammates and I were engaged in a lively discussion about several opposing players that we did not particularly care for. There was a particular play in the gameplan that was going to set one of us up for a devastating block on this particular player. Even in the midst of flaring testosterone, my teammate remarked, “I’ve gotta make sure I hit him in the chest though. I can’t get ejected.” That comment struck me. I realized that the emphasis on head injuries, targeting, and concussions has indeed trickled down from the administrators and pundits to the coaches and now to the players. Player behavior has been altered, which is the ultimate goal of such regulations.
*While I do support the rule in general, I absolutely reserve my constitutional right to throw a two-year old hissy fit the next time myself or one of my teammates gets ejected for what I believed to be a bogus targeting call. Thank you.*
The aforementioned rule changes are designed specifically to limit concussions and head injuries in football, but there has also been significant concussion management legislation recently passed within the NCAA structure that applies to all sports. Last January, a piece of legislation passed through the NCAA Autonomy sub-structure that was designed to improve concussion management protocol throughout the Power 5 conferences. In a nutshell, this legislation created a 6-member Concussion Safety Committee, which then established minimum standards for concussion management. Each of the 65 schools had to submit their concussion protocols to the committee for approval.
Of personal note: I voted against this piece at the convention. Like others, I did not believe it went far enough. There was a certain provision that myself and others wanted to see added, a provision that would grant unchallengeable autonomous authority to medical providers (athletic trainers, team doctors, etc). In other words, we wanted to make sure that the ONLY people with the authority to make decisions regarding student-athlete health were certified medical professionals. This was to prevent any pressure from coaches, administrators, and even the player himself in making return to play decisions. Unfortunately, that provision didn’t get added. But we did one better. At this past NCAA convention (January 2016), that same provision passed as its own piece of legislation, but it applies to all health issues among student athletes, not just concussions. This is a major victory in student-athlete welfare.
At the professional level, there has also been an increased awareness for concussion safety. As in college, targeting has been emphasized, with punishments ranging from on-field penalties, to ejections, and even to fines and suspensions. Unlike college, a player can be punished for infractions retroactively. Just like college players, NFL players are taking notice and lowering their target area. Some would say that fining players is the most effective punishment, while others would point to players that have accrued incredible sums of fines without appearing to modify their behavior. Also, the NFL has sponsored concussion studies, but some would argue the objectivity of such initiatives.
That is a very basic overview of what is currently being done to improve concussion safety. I didn’t include information from a myriad of concussion studies that I found incredibly interesting because doing so would’ve turned this blog into a book. Up to this point, this piece has been mostly educational/informational. Now, for the good stuff. What are we missing? How do we deal with concussions better?
Overemphasized vs Overlooked
For athletes and fans alike, it is human nature to naturally gravitate towards the flashy plays in sports: the soaring dunks, bone-crushing hits, and incredible home runs. But anyone that knows sports will admit that it is the mundane, unspectacular details that can prove to be integral to the outcome of the game. I believe that we tend to evaluate the concussion issue in a similar way. We focus in on the high-velocity, open-field collisions that bring us to the edge of our seats, sometimes at the expense of some smaller, overlooked pieces of the concussion issue.
Obviously, big hits are a big part of concussions. But they aren’t the only part. Several other aspects deserve the attention of both the policy makers and the public. These include:
- Accumulated impacts- Rather than analyze how a single high velocity impact can affect the brain, what is the effect of the gradual accumulation of “normal” impacts over time? Many football players begin playing at a very young age, and over course of 10+ years of play, we experience thousands of collisions that involve the head and neck.
- Line Play- Most attention falls upon collisions between defenders and ball carriers/pass catchers. In the blocking sense, the emphasis is primarily on “crack back” blocks that leave a defender vulnerable. Though lineman may not be involved in many high velocity impacts, lineman make some sort of head to head contact on nearly every play. This ties into the “accumulation of impacts” point. Offensive and defensive lineman make helmet contact immeasurably more than any other position.
- Lack of enforcement on offensive players- Many people often forget that targeting goes both ways. Personally, I feel like targeting is not called on offensive players nearly enough. The only times I have ever seen an offensive player called for targeting were all blocking penalties. But what about ball carriers? Are they not subject to the same rules as everyone else? Often times, it is in fact the offensive player that initiates helmet contact by lowering his head in an attempt to run a defender over. I have never ever seen a ball carrier flagged for this behavior, and that’s a problem.
- Type of contacts- Concussions are not solely produced by helmet to helmet contacts. Some (like my brother’s) result when the head snaps back and makes impact with the ground. Other head and neck injuries occur when the head collides with a knee (i.e. Seth Russell of Baylor).
These ideas may not be as crucial to reform as others, but they cannot be entirely overlooked.
Threats to the Future
When I attended the CFB National Championship game, I fully experienced for the first time the grand spectacle that is a major college or NFL football game. I visited the ESPN green room, stopped by the massive tailgate party, stuffed my face at the CFB exclusive pre-party, strolled the sidelines for the first half, and then took my place in a luxury suite to watch the game in comfort. Above all else, I realized one thing: football is not going anywhere. What takes place on the field is but a fraction of the intricate production that is a football game. To call it a game doesn’t do it justice. It’s truly an entertainment event. It is my belief that there is too much money and power in football for there to ever be a top-down shutdown. No matter what happens, I do not believe we will ever see a time when either the NFL, the NCAA, or Congress will intervene and say “football is too dangerous to be played.” The threat to the proliferation of football is not from the top level of the hierarchy, but from the bottom level. Youth football participation is what I believe is the best indicator of the future and this is what is most concerning to me. NFL owners, university presidents, and conference commissioners may hold power in the present, but parents, with their attitudes towards the safety of the game, hold the key to the future.
Recently, there has been a lot of negative publicity related to the dangerous nature of football, with a lot of this coming from the attention giving to concussions, CTE, and other long term risks of playing football. But we have not yet fully experienced the deleterious effect of this negative publicity. In 20 years, we are going to have a much better idea of how many mothers and fathers are currently not allowing their children to play football. Farther more, how many of today’s players, who are more sensitive to and aware of the risks than any generation of players before, will not allow their children to follow in their footsteps? Recently, there have been an increasing number of premature retirements, in which many players cite long term health concerns. 49ers linebacker Chris Borland played one year as a starting linebacker, and then abruptly retired. 49ers right tackle Anthony Davis also walked away from the game as well. Jerod Mayo recently retired. Calvin Johnson had several more years in the tank. Players are not waiting until their bodies give out, or until they no longer have a roster spot to move on from the game of football. They are walking away from millions of dollars for the sake of their long-term physical health. This is a harrowing indictment of the possible deleterious effects of football on the body. If their decision-making as parents mirrors their decision-making as players, then we may never see the junior versions of these football greats on the gridiron.
Changing the Culture
I believe that the single greatest growth initiative that we can pursue as a football community is to change the culture on our teams and in our locker rooms. There is only so much we can do rule-wise without completely changing the game. If we truly want to remedy the problem, we must start at the root: the culture. From a young age, we learn that toughness is key to football. I absolutely agree, and anyone that knows my dad or played for him knows that you cannot emerge from his team or his family soft. But soon after internalizing toughness as integral to the game, we begin to equate toughness with hitting.
Toughness=hitting….. and more specifically: hitting with the head.
In a sport birthed in brutality, the most violent of acts, the helmet to helmet collision, becomes instinctually internally celebrated. It is imperative that we break down the connection between toughness and improper hitting that is formed in childhood. Using your head as a weapon is not toughness. It’s blatant stupidity. Toughness is coming off the ball with your pads down and your eyes up, using your hands and hips as weapons to move another man against his will. Toughness is taking on a block with the proper shoulder to force the ball back to your buddy. Toughness is getting driven into the dirt and getting back up the next play to fight again. It’s continuing to play with technique and awareness even at your body’s highest levels of fatigue. Dropping your head and ramming it into an opponent is NOT toughness. Until all players start reevaluating their assumptions about the essence of toughness, we will continue to fight an infuriating battle against deeply rooted cultural norms.
Good coaches realize that leading with the head is in no way advantageous as a football player. There is no technique at any position that requires a player to lower his head and make contact with the crown of his helmet. Proper tackling is not taught this way. Proper blocking is not taught this way. But there are some outdated drills that continue to be practiced in the name of toughness. These are drills that simply have no place in football, drills that increase the risk of improper helmet contact without teaching any functional football skill. I’m talking about Bull-in-the-ring, in which one player stands in the middle of the circle and fends off defenders that run at him and hit him. I’m talking about board drill, where two players line up across from each other and drive each other off the board. When done properly, board drill can be useful. But usually what takes place is in no way applicable to football, for most times the two players put every ounce of their weight on their hands and just fire off as low and hard as possible. Other drills, even our beloved Oklahoma drill, have only intermediate applicability to actual gameplay. Oklahoma drill is different because the goal of the defender is to get off the block and make the tackle, just like during actual gameplay. I won myself a scholarship by displaying my toughness and competitiveness in such drills, and I am not saying they need to be abolished. But unless such drills carry over to the field of play, they are not needed. Hitting for the sake of hitting is not the answer.
At times, true toughness can work against proper concussion care. Toughness does indeed include playing through injury at times. If you haven’t ever played through an injury, I question whether you really even played football. In the fourth quarter against Tennessee, my right leg was all but useless, but there was no way in hell I was leaving that game (it’s not like Baker gave me a choice though). When drawing the line between when you need to come out and when you need to tough it out, I always ask myself a pointed question: Could my back-up do a better job? If so, staying in the game isn’t only injurious to yourself, it’s also detrimental to the team. If the next guy would do a better job, staying in the game isn’t heroic. It’s selfish. But, in the case of the Tennessee game, I felt that, even though I wasn’t very effective physically, my team needed my leadership and composure in order to win the game. Therefore, I stayed in the game.
This mindset challenges our concussion protocol. It is crucial that we recognize that concussions are a completely different category of injury. A concussion isn’t an ankle sprain. It’s not an MCL. Players cannot apply the “tough guy mentality” when dealing with concussive symptoms. We must understand that trying to “tough out” a concussion is to gamble with your long-term mental health. If you think you’re staying in out of loyalty to your teammates, then take yourself out in loyalty to your children.
So where are we now? If you asked me, I would say we are headed in the right direction, though we still have work to do. Awareness is on the rise. Scientific research is being conducted. Gameplay rule changes have occurred. Care and recovery policies have been adopted. What we must remember is that it takes time to see all of these changes begin to take effect, and therefore we must be patient. But this patience cannot be confused with complacency. In order to continue to move forward, there must be a definite sense of urgency among coaches, players, and policy makers at every level of the game. In order to be proactive on this issue, scientific research and culture change must be priorities within all the football realm, not just at the highest levels. We must continue to spread awareness as we seek to adhere to proper standards of concussion care and implement progressive recovery practices.
The formula for the continued success of the sport is simple. Appeal to the parents. Educate the coaches (particularly youth coaches). Protect the players. If we can do those three things from Pop Warner to the NFL, then the sport we know and love will continue to be the greatest sport in the greatest nation in the world.
Thank you for taking the time to read my views on this topic. If you have any questions pertaining to my views/experiences with concussions, don’t hesitate to direct message me on social media. I plan for my next blog topic to be about the compensation of collegiate athletes.