The Concussion Lawsuit

[Guiness]

As usual pbmax, you've got it about right. I got a little turned around when you said to insert Tab A into Slot B, but I think I've got it.

My gut feel, and I think what the findings will be, is that the league purposely turned a blind eye to where they knew there was a problem. I doubt very much that anyone would claim due diligence was done by the league looking into the problem. They took advantage of the player's machismo, the ingrained pride in 'playing hurt' that was so much part of the league.

I wonder how it all adds up. I, like pbmax, ND72 and a couple of others around here, have been carried off the field/ice/hill a few times. Was taught to bring down an RB by putting my helmet between his knees. Landed in the hospital once because I was keeping the headaches to a dull roar with Tylenol 3's. That was all before my 20th, and until recently hadn't thought about it much at all.

[pbmax]

Never had one that bad. Basically buzzing and fuzzy thinking or underwater sensation. Might have sat out a few plays. Not real common for me. However, in retrospect, the most amazing thing is the different reaction to different injuries. I was once playing an O lineman on the scout team and got an inadvertent punch in on our starting Guard. He nearly collapsed losing his lunch.

Later in the drill, he got me back. Same punch, forearm shiver to the breadbasket. Makes you not want to continue to practice and everyone understands.

But getting a shot to the head? Makes you angry that you can't think clearly and stubborn as a mule. Its embarrassing for some reason. Almost the complete reverse. Don't play on the bum ankle until you can walk it off. But head injury? I am fine dammit!

[pbmax]

Another salvo, this one from OSHA, which is apparently called NIOSH now. Players live longer than rest of male pop.

http://www.cbssports.com/nfl/blog/mike-freeman/18992637/government-study-nfl-players-living-longer-than-general-population

[sharpe1027]

Interesting find pbmax.

My concern is the tendency to take a 20/20 hindsight view of these matters. If, as some have suggested, the NFL knew enough beforehand and still didn't act then they should be held accountable. That being said, the foremost experts don't understand some of even the most basic aspects of the human brain. The type of stuff Guiness refers to certain happened, but not necessarily with all the knowledge of the potential consequences, which more is being learned about as we speak.

I am not saying the NFL is blameless, but we should be cautious against assuming individual NFL executives, coaches and trainers were negligently or intentionally exposing players to risks, whether they existed or not. This is especially true for risks that are only now being found out.

[pbmax]

Well, I think Hoge's lawsuit was a bit of a watershed moment. There is always a disconnect between what the trainer says you can do and what the doctor would prefer you to do. And depending on the Doc, the trainer might have more experience in rehab, though the Doctor knows more about the underlying issues.

Hoge's lawsuit exposed the fact that the League, both its Doctors and trainers, were completely out of date with its treatment of concussions according to the best practices of the time (90s). As I said earlier, I suspect it is a human failing to not have treated players with concussions better before this lawsuit. But it was a systemic failure not to improve the treatment after losing the Hoge case. Hoge was prattling on about baselines and recovery times long before Goodell enacted them.

The fear now is that the Hoge knowledge will become the new finish line. As you say, a lot is still unknown. I would hope the League and players spend some significant money researching those unknowns.

[sharpe1027]

That makes a lot of sense. I just hesitate to make assumptions based upon technical details when I have so little knowledge and understanding beyond broad generalizations. This is especially true when there is a clear financial motive on each side. You can find an expert to say just about anything if you pay enough so I don't know enough about the strength of Hoge's contentions.

[Pugger]

Another salvo, this one from OSHA, which is apparently called NIOSH now. Players live longer than rest of male pop.

http://www.cbssports.com/nfl/blog/mi...ral-population

It would be interesting if this study included retirees from other sports. Could it be these guys are living longer because they are athletes and in better physical condition than the general population?

[Deputy Nutz]

A couple of things need to be done to clean up concussions in the NFL but the bottom line is that they are unavoidable. Concussions have been around for ever, but the way we preceive them has drastically changed since I was playing high school footbal 15 years ago. If you missed practice on Monday and Tuesday because you got a concussion on Friday night, you were considered soft, or weak. It was rare that players missed more than a day or two of practice after getting a concussion.

I got a concussion my Sophomore year during a JV game on Thursday and then suited up Friday night and played during the varsity game. I was diagnosed with a concussion from an actual doctor. Why my parents allowed it to happen is beyond me, probably because I felt fine the next day, went to class, went to walk throughs and supposedly I felt fine. They allowed it to happen because concussion in the 1990s were still considered a minor injury in the world of athletics.

So those of you that are cutting on the players for the lawsuit don't have a real understanding of the way concussions were perceived in the past. Doctors, trainers, and coaches didn't put any concern into concussions, the only time head injuries were considered serious was when someone got knocked out.

Now that there is proof of the long term effects of concussion, teams and the NFL are taking it into account. It doesn't just start in the NFL, college football needs to change, high school football needs to change.

1. Coaches need to demand technique and proper tackling at all levels. kids stop practicing the fundamentals of tackling in college, and with the lack of padded practices in the NFL it is a wonder if they ever practice and teach the fundamentals of tackling. Because it isn't just the hits that cause concussions, it is the constant hits that rattles the brain over and over again. It is going to be unavoidable, but once proper tackling is committed to muscle memory, there will be a lot less tackles that are caused by leading with the helmet.

2. The NFL needs to enforce the players to use the equipment the way it is supposed to be used. Helmets need to be fit properly, and players need to use their chin straps appropriately, no more cloth chin straps like the one Rodgers wears and the one that Favre wore. Double and triple snaps them, no more single snaps. The NFL needs to also enforce the use of the latest and safest equipment.

3. College football needs to change. Student athletes need to be student athletes and should meet the same requirement of entrance to a university as the regular student population. Crazy idea, but what this will do is make the sport less athletic, less speed, and less size means less head injuries.

4. Astro turf is mostly gone, but if most fields are going synthetic then they need to come up with surface that offers more cushion to soften the whiplash effect when players heads bang off the turf.

[pbmax]

1. Coaches need to demand technique and proper tackling at all levels. kids stop practicing the fundamentals of tackling in college, and with the lack of padded practices in the NFL it is a wonder if they ever practice and teach the fundamentals of tackling. Because it isn't just the hits that cause concussions, it is the constant hits that rattles the brain over and over again. It is going to be unavoidable, but once proper tackling is committed to muscle memory, there will be a lot less tackles that are caused by leading with the helmet.

A plus 1 to item 1.

Also, don't believe the hype about concussion preventing mouthguards. There are a half dozen reasons why wearing a mouth guard is important, but concussion prevention is still a largely unproven claim. Those guards do absorb force, but the force is also transferred elsewhere in your head. Whether that is a good thing or not is still a matter of debate.'

Basically, avoidance is still better than trusting equipment to prevent it. And stop tackling with your head. Don't be Chuck Cecil.

High Schools should reverse the rules on outlawing the A-11 offense. Increasing spacing on the LOS might help alot on the repeated hits for lineman. The NFL should commit some ex NFL DCs to help develop defenses to counter it, which is why it was banned in the first place.

[woodbuck27]

http://www.cbc.ca/sports/football/nfl/story/2012/05/10/sp-nfl-concussion-lawsuit-art-monk.html

More than 60 former NFLers file concussion lawsuit in L.A.

Joining 100's of others.

The Associated Press

Posted: May 10, 2012 10:02 PM ET

Last Updated: May 10, 2012 10:01 PM ET

"More than 1,000 former NFL players are suing the league across the country, saying not enough was done to inform players about the dangers of concussions in the past, and not enough is done to take care of them today.

The league has said any allegation that the league intentionally sought to mislead players is without merit." fr. LINK

[pbmax]

Congressional Hearing: http://www.nytimes.com/2009/10/29/sp...%202009&st=cse

New Committee: http://www.nytimes.com/2010/03/17/sp...ncussions.html

The Mild Traumatic Brain Injury Committee was formed in 1994. I had forgotten it was around that long. If anyone remembers the impetus for its formation, please post it.

More germane to the topic is the role of two members who were both ousted after NFL testimony to Congress in 2009. That was the hearing that started everything you have read since about rules changes and lawsuits. Less than a year after that testimony, the Committee had two new chairman and a new name: Head, Neck and Spine Medical Panel. None of the Doctors on the Committee were present to testify, despite an apparent invitation.

Of particular interest is the once co-Chairman of the committee was Dr. Elliot Pellman. Pellman is/was a Jets' team doctor (one of the criticisms of the panel was that it was run by those on NFL payrolls). Two of Pellman's most prominent patients were Al Toon and Wayne Chrebet. Each suffered from serious post-concussion effects that ended their careers. Outside of the signature on his paycheck, Pellman was controversial because as "primary author of many of the league’s 13 papers published in the journal Neurosurgery from 2003 to 2006 that made statements or recommended policies at odds with outside research findings and medical opinion." (the New Committee article)

The second person ousted after the hearing (there were a total of three who left and the new committee heads were given the authority to change the rest of the membership) was Dr. Ira Casson. Casson took heat at the meeting for his role in a study of retired players that was criticized by outside experts as improperly designed. He also denied that any definitive link had been established between concussions suffered in football and the damage and dementia that had been discovered by Pathologists starting in 2002.

[pbmax]

Pellman and the Jets, specifically Chrebet and Coles: http://www.nytimes.com/2007/12/22/sp...yndrome&st=cse

One of the articles Pellman wrote maintained that a player who had been knocked unconscious during a game could be safely reinserted into the same game. This practice was banned by Goodell in 2007. Gene Upshaw makes an appearance too, when its recalled he resisted the idea that concussions while playing can affect a player later in life.

[pbmax]

http://articles.chicagotribune.com/2000-07-22/sports/0007220191_1_hoge-concussions-brain-damage

Hoge's lawsuit, a summary of its conclusion anyway. It might have been appealed, don't have those details.

The proximate cause of his lawsuit was a concussion suffered in Aug of 1994. He had another in October of the same year and retired after that. He maintained that had he been properly advised of his condition and the symptoms of its after effects, he might have taken a longer period to recover and been able to resume playing.

Is it anti-ironic that Hoge's suit was actually predicated on how to recover better so one could play longer? It also helps elucidate why Hoge disputes the notion of long term damage if the initial injury is treated properly.

Now what I need is a date for the formation and of Committee.

[pbmax]

Forgot this one. One of the studies the Committee did on concussions effects overlooked a few data points, such as actual player neuropsychological exams. The ESPN Magazine piece also points to a rash of concussions suffered by Troy Aikman and Steve Young, among others, as the impetus for the committee to be formed. The article also touches on the possible sources of error when the NFL studies, showing both no long term effects and no heightened risk of reinjury, contradicted other studies. The NFL studies focused on recently active players and there could be other variables such as age, equipment and medical care.

Committee changes: http://sports.espn.go.com/nfl/news/story?id=2844041

Doctor Yes, Elliot Pellman: http://sports.espn.go.com/nfl/news/story?id=2636795

An October story in ESPN The Magazine detailed how committee researchers didn't include hundreds of neuropsychological tests conducted on NFL players when studying the effects of concussions on the results of such tests. In response, the committee has gone back to team doctors and consultants whose data was not included and asked them for test results.

This effort, however, has not borne fruit. The committee has not received new data, according to one of its members.

"I didn't send anything back," said one former team consultant. "Why now? It's ridiculous. I talked about it with colleagues of mine who are in the same situation, and we were like, 'Now they're trying to acquire the data -- after they've published [their findings].'"

[pbmax]

Hoge's initial verdict was overturned (quite possibly on evidence ruled inadmissible during the trial that he received an insurance payout and an injury settlement). Hoge's suit was a malpractice case against the Bear's team doctor. Still not sure of final disposition or if the verdict or award damage was the subject of the reversal.

Dr. Pellman is a rheumatologist who attended medical school in Guadalajara, Mexico. He had lied about having a medical degree from SUNY Stone Brook. Pellman would seem to be a prime candidate to feel beholden to the team and the League for his lofty position. He was co-chair, Casson held the other chair, but he was member the NFL referred inquiries to. One more example of why the NFLPA should have every player checked out independently by unaffiliated Doctors.

One colleague recounted Pellman's own words about his approach (dates of quotes very unclear):

when he started out, he often professed ignorance about the subject in question. "I would hear him say things in speeches like, 'I don't know much about concussions, I learn from my players,' and, 'We as a field don't know much about concussions,' and it used to bother me," says one doctor. "We knew what to do about concussions, but he was acting like it was new ground."