Tuesday, October 15, 2013

League of Denial offers a devastating look at concussions in the NFL

Head Games

Posted by Karl Brenkert on Tue, Oct 15, 2013 at 3:04 PM

If you consider yourself a football fan, and I know that you do, you need to watch the PBS Frontline documentary League of Denial: The NFL's Concussion Crisis which aired last Tuesday. It's based on the book of the same name by the Fainaru brothers.

Who are the Fainaru brothers, you ask? Steve Fainaru won a Pulitzer Prize in 2008 for his work as a war correspondent in Iraq while his brother Mark Fainaru-Wada is best known for breaking the Barry Bonds BALCO story. In League of Denial, the two brothers tell the story of the discovery of the degenerative brain disease known as chronic traumatic encephalopathy (CTE) and the lengths to which the National Football League has gone to deny, deflect, and destroy anyone who attempts to link the disease with playing football.

The disease was first discovered in the brain of Mike Webster, the Hall of Fame center for the Pittsburgh Steelers from 1974 to 1990. Webster died in 2002 at the age of 50. Prior to his death, Webster won a settlement from the NFL's Retirement Board in 1999 that acknowledged that playing football was the cause of his early onset dementia and confusion. After his death, an obscure Nigerian-born medical examiner in Pittsburgh, Dr. Bennet Omalu, examined Webster's brain during the autopsy and became the first to discover CTE. He published his work in the scientific journal Neurosurgery in 2005 and set off a reaction from the NFL that U.S. Congresswoman Linda Sanchez likened to Big Tobacco during a Congressional hearing on the subject in 2009.

The NFL knew they had a problem with concussions as far back as 1994. Back then, they set up the Mild Traumatic Brain Injury (MTBI) committee to "investigate" the problem with concussions. They appointed the Jets team doctor, Dr. Elliot Pellman, to head the committee despite the fact that he was trained as a rheumatologist and had no experience with brain injury. At the time, NFL Commissioner Paul Tagliabue said of concussions, "The problem is a journalist issue." The focus of the committee seemed less directed toward actually evaluating the scientific evidence than in refuting it.

While the American Academy of Neurology was warning of the dangers of concussions, the MTBI committee began publishing articles in the early 2000s which recommended that players who were knocked out could safely be sent back into the same game and even claimed that NFL players were less susceptible to concussions than the general public. In fact, though the documentary doesn't mention it, Dr. Pellman, as Jets team doctor, cleared Wayne Chrebet to go back into a game against the Giants after he was knocked out cold. Chrebet retired in 2005 due to repeated concussions and today wakes up and "just hopes for [one of] the good days" as he told The New York Times in 2011.

By the time Dr. Omalu published his discovery in 2005, the MTBI had published 16 junk science articles downplaying the link between concussions and lingering neurological problems. They immediately attacked Omalu's discovery as "voodoo" and publicly called on him to retract his paper. But the genie could not be put back into the bottle. The scientific evidence continued to mount.

NFL legends Dave Duerson and Junior Seau committed suicide by shooting themselves in the chest so that their brains could be studied. Both were diagnosed with CTE. CTE has been discovered in 45 of 46 NFL players examined to date. It has been discovered in college players and in players as young as high schoolers. In perhaps the most damning testimony presented in the documentary, Dr. Omalu tells of a conversation he had with an NFL doctor. "If 10 percent of the mothers in this country would begin to perceive football as a dangerous sport," he was told, "that is the end of football."

To this day, the NFL still refuses to acknowledge the link between concussions suffered playing football and CTE despite the NFL's own 2009 study which concluded that retired NFL players are 19 times more likely than the general population to suffer from dementia, Alzheimer's, or other memory related diseases. They claim the medical research suffers from selection bias, that those with no CTE are not yet dead and thus haven't been studied. They blame the use of steroids, alcohol, and other drugs as potential factors. They offer platitudes about "studying the problem" and "making the game safer," but most of their professed concern seems more like public relations.

In 2010, the NFL announced a $30 million donation to the National Institute of Health to study brain injuries. While that is a lot of money to you and me, it amounts to about 30 percent of Joe Flacco's latest contract. Just before the start of the 2013 season, the NFL settled a lawsuit with 4,500 retired players for $765 million but refused to admit any wrongdoing. In the past couple of years they have enacted new rules about hits on defenseless players and put independent physicians responsible for diagnosing concussion symptoms on every sideline. Still, there were 14 percent more diagnosed concussions in 2012 than in 2011. Yesterday, Danny Amendola was knocked out in a game against the Saints and the Colts Dwight Freeney left Monday night's game with a head injury.

We know that football is a dangerous game. Players risk everything from sprained ankles to permanent paralysis. I love big hits as much or more than anyone, but the NFL cannot continue to persist in their current state of denial. We, as NFL consumers, must insist that more be done. The NFL steroid policy is a joke. We are concerned about steroid use in baseball because our hallowed records are falling, but we ignore the prevalence of PEDs in football where our heroes are actually suffering brain damage due to the incredible forces unleashed during collisions. If the NFL hopes to prevent their feared revolt of concerned mothers, they must come clean and devote more resources to the youth game.

If the NFL's response to League of Denial is any indication, they have not yet come to grips with scale of this problem. It's not encouraging that NFL used its leverage with ESPN to get them to remove their name from the joint ESPN/PBS documentary. Trust me, you owe it to yourself to check it out. It's available on the PBS website. It will change the way you view the game.

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