The League

Dr. Matthew Prowler
Resident Psychiatrist

Dr. Matthew Prowler

Resident Psychiatrist at The Hospital of the University of Pennsylvania

More to be done


In recent years, a spotlight has shone brightly on the epidemic of head injuries in the NFL. Responding to the reality of the serious, long-term effects of traumatic brain injury, the NFL changed its concussion treatment policy.

And yet the problem has never seemed more present.

A review of the NFL injury report quickly displays the pattern. Going into week 5, there were five listed NFL players with concussions, and going into week 6, another five (with only one overlapping player). Then week 6 saw several crushing helmet-to-helmet hits, with three new concussions already confirmed and likely more to be formally announced in the coming days. In a two-week period, that makes at least 12 concussions.

The NFL's vice president of football operations announced today that the league may make immediate rule changes and start suspending players for such hits -- a harder-punishment-will-soften-the-blows-theory.

The NFL's policy changes of 2009 were also a step in the right direction. There is an expanded list of symptoms, such as memory loss, headache, and imbalance that, if demonstrated on the sidelines, would preclude a player's return to the field. But these must be strictly adhered to over any players' "put me in coach" protestations.

The policy further states that a player "should not be considered for return-to-football activities until he is fully asymptomatic, both at rest and after exertion," and after evaluations from both team and independently consulting physicians. Again, this undoubtedly represents a positive and progressive step.

But a study in the November 2009 issue of the journal Neurosurgery, examined the effect of a 'symptom-free waiting period' on clinical outcome and risk of repeat injury after sport-related concussions.

The findings suggested that observing a "symptom-free" period post-injury was not an intrinsic factor in preventing repeat concussions. However, of those that did have repeat concussions, 80% occurred within 10 days of the initial injury.

This finding could have implications for the NFL. A minimum rest period, and not just being symptom-free, should become enforced management policy.

To its credit, the NFL is no longer ignoring this problem. But as long as hard hits are part of the fabric of the game, a mark by which players' toughness is measured, one rule change will not be enough. As much as fans might protest, a game change is what any good doctor would order.

By Dr. Matthew Prowler  |  October 19, 2010; 12:30 AM ET  | Category:  Concussions , Dr. Matthew Prowler , NFL , NFL Rules , Roger Goodell Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   StumbleUpon   Technorati  
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Posted from another story...
I see as always the NFL itself gets a free pass from posters.
What about the field turf?
It's a good chance that the attempts to save money by introducing yet another "too hard to be safe" playing surface is a much a cause as anything else.

Plus, far too many players don't wear bigger, lower-hanging,chin-protecting facemasks. Everyone including far too many d-linemen wear running back cages. Ray Lewis, Brian Urlacher and London Fletcher represent the last generation of LBs that wear LB cages. Lavar Arrington was the 1st player I can recall that started wearing a RB cage-he wore it at Penn State and with the Skins'. To my suprise,so did other LBs and DLs.

The QBs of the league almost never wear the 3-bar cages that Marino, Cunningham, and Bledsoe once wore. Eli Manning is one good hit from a concussion-look at his cage, it only covers his nose.

Look at the supposed shoulder pads-they never reach down past the ball of the biceps anymore, now combine that with a cheap, hard playing surface and Voila!-more shoulder/upper body injuries or so it would seem. So many players are so vain, they must show off those tatoos, even at the expense of protecting their shoulders.

Now look at the uniform pants, far too many RBs,WRs and DBs don't wear any leg padding-so when they fall on the ground, where is all that kinetic energy that isn't absorbed by the cheap playing surface supposed to go? That's right, back into their bodies. Everyone likes to point out how bigger,stronger,faster, better trained and conditioned the players are, so why so many hamstring/soft tissue injuries? Well, without any pads to diffuse some of the energy, it goes right through their legs with their muscles being the shock absorbers. I know, they're trying to be as swift and quick as possible, but it comes with more injury risk. Maurice Jones-Drew complained after a pre-season game last year that the opponent was purposefully trying to hurt him,but he didn't have any thigh pads on.

So in a league that supposedly cares so much about "safety", the shortcuts players take to try to gain just a little more quickness should be taken into account in all conversations concerning it.

I just finished watching the Titans/Jaguars on MNF and I'm struck by how close RB Chris Johnson's dreads push his face is to his cage, he doesn't have even in inch of separation-all it's going to take is one good shot to his face and he'll either have a broken jaw, nose or a concussion.
We must also take into account a media that overdoes every newsstory. The sensationalism around this story almost certainly guarantees that another rule change, which of course, ruins the game even more for a core fan such as myself.

I'm souring on the NFL more and more because of the whining, crying, legislating, and handwringing.

As another poster wrote, at some point in time everyone involved knows it's a calculated risk-same as boxing.

Posted by: ArmchairGM | October 19, 2010 3:08 AM

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