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NFL: Concussion problem one with little answers

Associated Press
Ask Jacksonville Jaguars running back Maurice Jones-Drew whether he would try to play through a concussion or yank himself from a game, and heíll provide a straightforward answer.
ěHide it,î the NFLís leading rusher said.
ěThe bottom line is: You have to be able to put food on the table. No oneís going to sign or want a guy who canít stay healthy. I know there will be a day when Iím going to have trouble walking. I realize that,î Jones-Drew said. ěBut this is what I signed up for. Injuries are part of the game. If you donít want to get hit, then you shouldnít be playing.î
Other players say they would do the same: Hide it.
In a series of interviews about head injuries with The Associated Press over the last two weeks, 23 of 44 NFL players ó slightly more than half ó said they would try to conceal a possible concussion rather than pull themselves out of a game. Some acknowledged they already have. Players also said they should be better protected from their own instincts: More than two-thirds of the group the AP talked to wants independent neurologists on sidelines during games.
The AP spoke to a cross-section of players ó at least one from each of the 32 NFL teams ó to gauge whether concussion safety and attitudes about head injuries have changed in the past two years of close attention devoted to the issue. The group included 33 starters and 11 reserves; 25 players on offense and 19 on defense; all have played at least three seasons in the NFL.
The players tended to indicate they are more aware of the possible long-term effects of jarring hits to their heads than they once were. In a sign of the sort of progress the league wants, five players said that while they would have tried to conceal a concussion during a game in 2009, now they would seek help.
ěYou look at some of the cases where you see some of the retired players and the issues that theyíre having now, even with some of the guys whoíve passed and had their brains examined ó you see what their brains look like now,î said Washington Redskins linebacker London Fletcher, the NFLís leading tackler. ěThat does play a part in how I think now about it.î
But his teammate, backup fullback Mike Sellers, said heís hidden concussions in the past and would ěhighly doubtî that any player would willingly take himself out of a game.
ěYou want to continue to play. Youíre a competitor. Youíre not going to tell on yourself. There have been times Iíve been dinged, and theyíve taken my helmet from me, and … Iíd snatch my helmet back and get back on the field,î Sellers said. ěA lot of guys wouldnít say anything because a lot of guys wouldnít think anything during the game, until afterward, when they have a headache or they canít remember certain things.î
San Francisco 49ers defensive lineman Justin Smith captured a popular sentiment: Players know of the potential problems, yet would risk further damage.
ěIt doesnít take a rocket scientist to figure out if (you have) a concussion, youíre probably damaging your brain a little bit. Just like if you sprain your wrist a bunch, youíre going to have some wrist problems down the road. Yeah, Iíd still play through it. Itís part of it. Itís part of the game,î Smith said. ěI think if youíre noticeably messed up, yeah, theyíll take you out. But if youíve just got some blurry vision, Iíd say thatís the playerís call. And most guys ó 99 percent of guys in the NFL ó are going to play through it.î
Smith said he sustained one concussion in high school (ěYou donít know who you are,î is how he described it) and another in college (ěWalking around the whole time, but I donít remember anything until six hours laterî).
The NFL likes to say that views about concussions have shifted from simply accepting theyíre part of the sport to doing whatís possible to lessen impacts. Commissioner Roger Goodell talks about ěchanging the culture,î so players donít try to ěwalk it offî after taking hits to the head.
Yet the APís conversations with players showed there is room for more adjustments, which did not surprise Dr. Richard Ellenbogen, co-chairman of the NFLís head, neck and spine committee.
ěThe culture change takes awhile,î Ellenbogen said in a telephone interview. ěWhy would these guys want to go out? They love playing the game. They donít want to leave their team. They want to win. I understand all that. And thatís why we have to be on our toes with coming up with exams that are hard to beat, so to speak.î
New Orleans Saints offensive lineman Zach Strief put it this way: ěWe all grew up with, ëHey, get back in there. You (only) got your bell rung.í And while itís changing now, I think itís going to take time for the mindset to change.î
A few players said theyíd be particularly inclined to hide a concussion if it happened in a playoff game or the Super Bowl. Some said their decision would depend on the severity of a head injury ó but theyíd hide it if they could.
Clearly, there is a stigma associated with leaving the field, no matter the reason. Indeed, one player who said heíd exit a game if he thought he might have a concussion didnít want to be quoted on the subject.
Other findings from the interviews:
óAsked whether the NFL should have independent neurologists at games to examine players and determine if they should be held out because of concussions, 31 players said ěyes,î and 10 said ěno.î Three didnít answer.
ěTheyíve got guys looking at your uniform to make sure youíre wearing the right kind of socks,î St. Louis Rams safety Quintin Mikell said. ěWhy not have somebody there to protect your head? I think we definitely should have that.î
He said heís tried to clear his head and stay on the field ěmany times.î
ěIíll probably pay for it later in my life,î Mikell said, ěbut at the same time, Iíll probably pay for the alcohol that I drank or driving fast cars. Itís one of those things that it just comes with the territory.î
óSpecifically regarding concussions, 28 of the 44 players think playing in the NFL is safer now than in 2009, while 13 think itís the same, and two think itís more dangerous. One wasnít sure. Those who think safety has improved gave credit to the rise in awareness; more fines for illegal hits; this seasonís changes to kickoff rules that have cut down on the number of returns; and the new labor contractís reduction in the amount of contact allowed in practice.
ěWhen I first came into the league, it was like, ëWhatever goes.í It was more of that old-school, just ëbeat-him-upí football. Not wanting to hurt anybody, but show how tough you were. Back in the day, it was like if you come out (of a game) with (a) slight concussion, then you werenít giving it all for your team,î Buffalo Bills linebacker Andra Davis said. ěBut now, theyíre taking that option away from you.î
Davis, a 10th-year veteran who turned 33 on Friday and said heís had a couple of concussions, is one of those whose view on seeking help for such injuries has changed.
ěThe younger me would definitely hide it,î Davis said. ěBut the older me now ó with wife and kids and looking more at life after football ó I would say something about it.î
óAsked whether more can be done to protect players from head injuries, 18 players said ěyes,î and 24 said ěno.î Two did not respond.
Not surprisingly, there were divisions according to position, and players on opposite sides of the ball generally drifted toward opposing views: Those on offense seemed more likely than those on defense to say more can ó and should ó be done to improve safety. Linemen, meanwhile, often complained that there is no way to improve their plight, with the helmet-to-helmet banging that takes place at the snap on play after play. One player described those collisions as ěmicro-episodes that build up over time.î
Nearly three-quarters of the players who told the AP they think safety can improve ó 13 of 18 ó suggested equipment can be improved, too. Helmet technology, mouth guards and chin straps all were mentioned.
Two players suggested more education about concussions is needed.
Dr. Robert Cantu, a senior adviser to Ellenbogenís NFL committee who said he is consulted regularly by the league, insisted that while there has been progress, there is still work to be done.
ěHas there been a culture change overall? I think the answer is, unquestionably, ëyes.í Could there be more done? Yes. Do all the players get it? No. Do they want to get it? No,î said Cantu, a clinical professor of neurosurgery and co-director of the Center for the Study of Traumatic Encephalopathy at Boston University School of Medicine.
CTE is a degenerative disease increasingly found in football players and other athletes who have absorbed repeated blows to the head. It has been linked to memory loss, disorientation, poor decision-making, and depression that can lead to drug use and, as in the case of former Chicago Bears defensive back Dave Duerson, even suicide.
The league distributed informational posters in 2010 to warn about the dangers of head injuries, but Cantu said: ěJust because the posters are in every locker room, itís not mandatory reading. Or people can say they read it but not really have read it.î
ěMore stress needs to be placed ó and I believe this is the players associationís responsibility as much as it is the NFLís ó on the dangers of playing symptomatic with a concussion and more knowledge needs to be imparted on chronic traumatic encephalopathy, which obviously does exist in the NFL. … All of those sub-concussive blows count, and you need to minimize the amount of brain trauma that you take,î Cantu said.
Union spokesman George Atallah declined a request for comment about concussions.
Little-discussed until reporting by The New York Times led to an October 2009 congressional hearing on concussions in the NFL, head injuries are now part of the daily conversation about professional football. On Saturday alone, two starting quarterbacks, Clevelandís Colt McCoy and Arizonaís Kevin Kolb, sat out because of head injuries, while a third, Minnesotaís Christian Ponder, left his teamís game with what his coach called ěconcussionlike symptoms.î
According to data from STATS LLC, from 2000-09, an average of 3.1 NFL players ó and never more than nine in an entire season ó went on injured reserve because of a concussion or head injury. That number rose to 18 last season, and stood at 17 through Week 15 this season.
Similarly, STATS LLC said, over that same 10-year span at the start of the century, an average of 26 NFL players each season were listed on the weekly injury report and missed games because of a concussion or head injury. That number rose to 89 in 2010, and stood at 75 this season through Saturdayís games.
At least eight lawsuits have been filed against the NFL in recent months ó including three within the last week ó by dozens of former players who say they have medical problems related to brain injuries from their time in professional football. The NFLís stance, in part, is that players knew there were risks of injury, and there was no misconduct or liability on the leagueís part.
ěItís a physical sport. Guys are going to get hit in the head. When weíre young, when we start playing this sport, we know what weíre getting into,î Philadelphia Eagles tight end Brent Celek said. ěItís not like, ëOh, Iím going to play this because my headís going to be fine when Iím done playing.í Itís a risk you take playing this game, but I think the league is doing everything in their power to make it as safe as possible.î
The NFL certainly has found itself adjusting on the fly.
One example: After San Diego Chargers offensive lineman Kris Dielman got a concussion but stayed in the lineup in October, then had a seizure on a team flight, the NFL said it would give game officials ěconcussion awareness trainingî so they could keep an eye out for players.
A few players interviewed by the AP mentioned the recent case of Clevelandís McCoy, who has missed two consecutive games after a shot to the helmet from Pittsburgh Steelers linebacker James Harrison. McCoy was not checked for a concussion during the game against Pittsburgh and went back in; Harrison was suspended for a game; starting with this weekís games, the league put certified athletic trainers in booths above the field to watch for injuries. The trainers arenít there to diagnose or prescribe treatment, the NFL said, but are supposed to call down to team medical staffs to alert them there could be a problem.
Some think the league could go further.
ěI donít think itís sufficient. I think itís a great first step,î BUís Cantu said, mentioning a study that showed concussions were noticed more in junior hockey when there was an observer at the rink.
While Cantu, like players interviewed by the AP, is in favor of having independent neurosurgeons at games rather than only team-employed doctors ó something raised as a possibility in 2009 but never done ó NFL committee co-chairman Ellenbogen said the more pressing issue was ěthe ability to see all the players on the field.î
ěTeam doctors are pretty concerned about concussions, and I donít think theyíre people that are going to be bought and sold. … If the real problem is the doctors are being influenced by the coaches, then weíve got to fix that,î said Ellenbogen, chairman of the department of neurological surgery at the University of Washington School of Medicine. ěIf the (playersí union) says, ëWe want independent neurologists,í weíll discuss that. … To be honest with you, we ainít done. When our committee meets with the team physicians after the Super Bowl, everythingís on the table. You think this is the last rendition of what we do? Heck, no. Weíre not done.î
As it is, while the players the AP spoke to tend to feel better about the way concussions are handled now than in 2009, they wonít deny that dangers lurk.
ěYouíre never going to be totally safe from concussions in this game,î Oakland Raiders cornerback Stanford Routt said. ěThis is the only place where you can actually legally assault people.î
óóó
AP Sports Writers Bob Baum, Tim Booth, Tom Canavan, Chris Duncan, Josh Dubow, R.B. Fallstrom, Dave Ginsburg, Fred Goodall, Pat Graham, Will Graves, Stephen Hawkins, George Henry, Chris Jenkins, Joe Kay, Jon Krawczynski, Larry Lage, Mark Long, Rob Maaddi, Michael Marot, Brett Martel, Janie McCauley, Steve Reed, Andrew Seligman, Dave Skretta, Howard Ulman, Teresa M. Walker, Dennis Waszak Jr., John Wawrow, Bernie Wilson, Steven Wine, and Tom Withers contributed to this report.
óóó
Howard Fendrich is on Twitter at http://twitter.com/HowardFendrich
The Associated Press
12/25/11 11:01

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