Saturday, February 3, 2007

N.F.L. Culture Makes Issue of Head Injuries Even Murkier

By JOHN BRANCH and ALAN SCHWARZ
New York Times
February 3, 2007

MIAMI, Feb. 2 — Diagnosing a concussion is difficult. But it may be harder to determine just who is at fault for the long-term effects of concussions among N.F.L. players.

A culture of toughness permeates the locker room, encouraging players to fight through pain and stay on the field even as they feel the dizzying effects of a blow to the head. Coaches do little to combat that aura of invincibility, wanting their best players to remain on the field. And doctors and trainers, despite advances in science, still struggle to recognize the severity of the trauma and determine the proper recovery period.

It leaves a murky film over a burgeoning issue for the N.F.L., and there is no consensus on how it should be handled.

“In football, that’s the way it is,” Giants center Shaun O’Hara said. “If it’s not bleeding and it’s not completely broken, rub dirt on it and let’s go. There is that machismo in there, and also the ego from the player’s standpoint that, ‘Hey, I can play through this.’ Obviously it’s the coach’s job. He wants to win. He’s going to try to push the player and get him to play, and he wants to make sure that the injury is legitimate.”

The subject of concussions is being raised with increasing frequency around the N.F.L., particularly as their damaging effects are found in players long after retirement.

The former Patriots linebacker Ted Johnson, who retired in 2005, told The New York Times for an article published Friday that he believed concussions he sustained in the N.F.L. led to his severe depression and addiction to amphetamines. His neurologist, Dr. Robert Cantu, said that Johnson, 34, displayed early signs of Alzheimer’s disease.

Johnson is just the latest former player to wonder whether postcareer ailments are linked to the injuries and medical treatment he received in the N.F.L. In November, the former Eagles player Andre Waters committed suicide, and tests later revealed he had significant brain damage from football-related concussions.

“We have had a concussion committee that has been studying this issue from a medical standpoint, including 12 doctors — five are from the outside and seven from the N.F.L. — that have been looking at this issue and trying to see what it is we can learn about concussions that would be helpful as we go forward,” N.F.L. Commissioner Roger Goodell said during the commissioner’s annual news conference Friday, two days before the Super Bowl.

Upon the committee’s recommendation, which runs counter to most modern medical guidelines, many players who sustain a concussion in games are allowed to return to the game if they appear to have recovered.

Johnson said he returned to the practice field four days after a concussion in August 2002. Despite the recommendation from the Patriots’ trainer that Johnson be protected at practice, Coach Bill Belichick sent Johnson into a high-impact drill, Johnson said.

Johnson, feeling he was being tested and that his job was on the line (N.F.L. contracts are not guaranteed), did as he was told. He hit his head in the next drill, he said, and immediately felt woozy. He finished practice. Weeks later, having missed two preseason games and still feeling lingering effects, he approached Belichick.

“I had to see if you could play,” Belichick said, according to Johnson. Johnson was so angry that he temporarily left the team.

Belichick told The Boston Globe that he remembered the meeting. “If Ted felt so strongly that he didn’t feel he was ready to practice with us, he should have told me,” Belichick said.

He added: “I’m sure in part of that conversation I apologized for things I said or did, as he did for his actions and his emotions following his decision to leave the team. If I made a mistake or hurt Ted in any way, I don’t feel good about that.”

The Patriots’ owner, Robert Kraft, declined to answer questions about the possibility that Belichick, the winning coach in three of the past five Super Bowls, went against the advice of team medical personnel and sent a player with head trauma into high-impact drills.

During his news conference, Goodell was asked if the league would consider taking action against a coach in such a situation. He did not answer directly.

The former Giants linebacker Harry Carson, enshrined in the Pro Football Hall of Fame last year, is one who believes the N.F.L. does not do enough.

“I think the league is in denial, and I think the league will do everything that it can to discredit anyone who associates concussions that are sustained playing on the field with what happens after the game is over,” Carson said. “They have to discredit that, otherwise they might be open to all kinds of lawsuits down the road.”

Many players, past and present, said much of the responsibility fell on the player. They often are reluctant to tell anyone when they feel the effects of a concussion, fearing that it will be construed as a sign of weakness.

Vikings center Matt Birk and Saints tight end Ernie Conwell each said that they had demanded to go back into a game after taking a blow to the head, only to have trainers hide their helmets to keep them on the sideline.

Much of the past focus on concussions has been related to quarterbacks. Troy Aikman, Steve Young and Chris Miller are among those who left the game early in part because of repeated concussions. But other position players take more routine beatings.

“You think Belichick would test his quarterback?” Giants linebacker Antonio Pierce said. “Think he would test Tom Brady or his backup? No. They would be out for weeks. You test a defensive lineman or a linebacker. You’re taught to be so tough and so physical and so mentally tough and all that, that they use that against you whenever you get hurt.”

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