Head trauma awareness up, but many NFL players are tuning it out
When the NFL and the NFL Players Association completed their 10-year labor deal last year, they agreed to commit more than $100 million over its duration to medical research, primarily that of brain injuries.
Since NFL commissioner Roger Goodell was questioned at congressional hearings in 2009 about the league's approach to concussions and whether head injuries in football can be linked to brain disease, the league has toughened its standards and improved its methods for diagnosing and treating concussed players.
There are campaigns by Steelers coach Mike Tomlin about awareness, and even Hall of Fame safety Ronnie Lott is a spokesman for the league's cause.
Concussion awareness has never been greater in the eyes of the NFL. But the win-at-any-cost culture of among most players seemingly still exists.
Despite the potential long-term effects of repeated blows to the head, players are loathe to take themselves out of a game for medical precautions.
• Steelers safety Ryan Clark suffered two concussions in a 15-day span — and didn't miss a game.
• Teammate Troy Polamalu has been diagnosed with “eight or nine” concussions over his career but told “The Dan Patrick Show” during the offseason that he lied about having concussions in the past. “Yes, I have, for sure,” Polamalu said, noting that he has chosen to play injured despite the team's medical staff advising him otherwise.
• Steelers linebacker James Harrison has estimated he had a dozen unreported concussions during his career.
• San Francisco quarterback Alex Smith stayed in the game for several plays after he suffered a concussion against St. Louis two weeks ago.
• The next night, Chicago quarterback Jay Cutler played seven snaps after his concussion.
• Steelers running back Isaac Redman was diagnosed with a concussion during last week's game against Baltimore and said he was “woozy” as late as Tuesday. He passed a concussion test and was on the practice field the next day. He was cleared a day later and will be on field Sunday against the Browns.
• Chicago linebacker Brian Urlacher said recently he would cover up a concussion if it meant staying on the field.
“There's a lot of risk, but there's a lot of reward in (football),” Clark said. “You can provide a great life for your family. You get great relationships. We get paid well. But you know there's going to be some risk to it, especially if you play the way that I play it.”
‘Why would you tell?'
One hundred and 58 players are on the season-ending injured reserve list but only five because of concussions, with the biggest name being Detroit running back Jahvid Best.
Yet there are 14 players on this weekend's injury report with concussions. Five are listed as probable, and two of those are expected to play Sunday and have not missed a game.
Last week, Sporting News released the results of a survey of 103 players from 27 teams that asked whether they would hide concussion symptoms to stay on the field. Fifty-six percent said yes.
Former Steelers running back Willie Parker said it's a similar mentality today as he played from 2004-09.
“For me, it was the team first,” said Parker, who signed with the Steelers as an undrafted rookie free agent and fought to beat out a future Hall of Famer (Jerome Bettis) and a notable free agent signee (Duce Staley). “That's how I looked at it. You don't want to let your brother next to you down.”
Will that mentality change?
“Not if you have any fight in you,” said Parker, who broke a leg toward the end of the 2007 season and never was the same. “You have to have fight in you, hunger in you and that dog in you. If you get a concussion, why would you tell? Why would you say something?”
Pressure to play
Steelers rookie running back Chris Rainey was knocked to the ground by Indianapolis' Jerraud Powers during a preseason game and was forced to undergo a series of sidelines tests.
Rainey returned to the field a quarter later.
He said he probably wouldn't have let on he was hurt had he not been forced to sit, per NFL rules that state a player requiring medical attention on the field must miss at least one play.
“I would have gone to the sideline, shaken my head and gotten ready for another play,” Rainey said.
Even with all the knowledge available about concussions, many players insist they would rather suffer a concussion than a knee injury.
“If it isn't something really serious to the point I can't stand up, I don't see a reason why I would take myself out of the game,” Steelers running back Jonathan Dwyer said.
Urlacher was more blunt.
“A knee injury puts you out for a season. A concussion you may miss a game or two,” Urlacher said. “Huge difference.”
Urlacher, an eight-time Pro Bowler, is established enough not to have to worry about job security if he has to sit out a couple of weeks.
“Me, personally, I wouldn't want to be sitting down,” said Parker, who didn't have that luxury early in his career. “Once you sit down, you let somebody else come in and get their shot, and I am not about to do that.”
Redman, in a three-way battle for playing time with Dwyer and Rashard Mendenhall, disputed that he feels a need to rush back.
“I don't feel pressure at all,” he said. “If I am healthy, I am going to play. I don't feel like I am going to be sitting on the sidelines if I don't get out there in time.”
Some people's symptoms go away quickly and others linger.
“Everybody is different,” said Penguins center Sidney Crosby who missed 101 games after suffering a concussion. “Even when I was skating during the playoffs (in 2011), I was still dealing with dizziness. But some people just don't get symptoms that bad.”
The NFL has a stringent concussion protocol that players must pass before being cleared to play.
The ImPACT test is a computer-based program that measures mental and memory agility in addition to reaction speed and recognition skills. It takes players through various tasks such as word identification, design memory, Xs and Os, distractor tests, symbol matching and color matching, and letter memory.
The NFL mandates players take a baseline test at the beginning of the season so doctors have a comparison for a later date, if needed.
‘A different perspective'
Steelers tackle Max Starks may be in the minority when it comes to concussion awareness.
Starks' wife, Dr. Tiffany Calloway-Starks, is a physiatrist — a nerve, muscle and bone expert who treats injuries or illnesses that affect how a person moves — at UPMC and has worked closely with people suffering traumatic brain injuries.
“I have a different perspective compared to some of the other guys,” Starks said. “It is not about right now but down the line. There are years to go, especially if you plan on playing longer in this league. Quality of life is really an important thing. With all the information out there now, it is hard to say that you are just going to play through it.”
Starks is part of the NFL Players Association's Mackey-White Traumatic Brain Injury committee that was formed to raise awareness of head trauma.
Starks has taken his role on the committee and applied it to his teammates — especially if someone is not disclosing concussion-like symptoms.
“I would really be upset if I found out somebody was withholding that,” Starks said. “A concussion means to me that you are punch drunk and out of it. I had one in college, and I remember sitting through that ImPACT test and not being able to focus. I couldn't imagine playing this level and having those types of symptoms.”
So Starks keeps an eye out when it comes to his teammates, even if that means glaring at them in a meeting.
“If (someone) is sitting in the meeting and rubbing his head and trying to look at the playbook, that it is a dead giveaway,” Starks said. “That is when you have to be a good teammate. I keep an eye out for that. The onus is now on us as teammates as well to report if a guy is symptomatic.”
Starks said he never came across a teammate who withheld concussion-like symptoms with the Steelers.
“In this locker room, it is that important because we had so many guys affected by concussions that you have to take it seriously,” Starks said. “When you have prestigious (Steelers) alumni who had the detrimental effects, you can't take it lightly.”
Mark Kaboly is a staff writer for Trib Total Media. He can be reached at firstname.lastname@example.org.