Could the NFL ever be safe for players’ brains?

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This was an unprecedented year in research highlighting the dangers of head injuries to football players, striking the NFL and raising questions about the future of the league. 

In an attempt to improve players’ overall safety and prevent injuries, the NFL has implemented nearly 50 rule changes in the past 15 years, with the most recent ones geared at protecting the head and neck. 

However, even with added safety precautions the rate of concussions per season has not seen a consistent drop and even rose 58 percent in 2015 – the highest number in four years of record-keeping. 

Added pressure has been put on the league from players and their families who believe the NFL has enabled head trauma by knowingly dismissing previous research that revealed the damaging effects on the brain.  

There is no way to know if the game can ever be safe while maintaining the essence of what it is, which is the question on players’, officials’ and fans’ minds as experts try to grapple with a league that averages 243 reported concussions per season.   

Daily Mail Online broke down what we know about the rules thus far, future options being explored and how impossible that question may be to answer.

The NFL has made 47 new rule changes since 2002 with the aim to reduce injury and increase overall player safety, though statistics have shown little has improved the concussion rate 

The NFL has made 47 new rule changes since 2002 with the aim to reduce injury and increase overall player safety, though statistics have shown little has improved the concussion rate 

The NFL has made 47 new rule changes since 2002 with the aim to reduce injury and increase overall player safety, though statistics have shown little has improved the concussion rate 

The history of football and brain injury  

Groundbreaking new research revealed a degenerative brain disease called CTE in 99 percent of former players whose brains were examined after death.

The study published in July was the largest of its kind that spotted CTE in 110 of 111 brains.

Chronic traumatic encephalopathy (CTE) is a degenerative brain disease caused by repeated hits to the head that result in confusion, depression, dementia, aggression and suicidal thoughts.

Though the new research brought the disease into the public eye, doctors have been finding CTE in dead players’ brains for more than a decade but the findings have been repeatedly dismissed by the NFL.

The first case of CTE in football players was discovered in 2002 by Dr Bennet Omalu who examined former player Mike Webster’s brain, who suffered from mental and mood disorders.

After Dr Omalu diagnosed several other players with the disease, he published his findings in 2005. 

That same year the NFL’s Mild Traumatic Brain Injury Committee said that returning to play after sustaining a concussion ‘does not involve significant risk of a second injury either in the same game or during the season.’

It wasn’t until last year, after a swell of research showed the damaging effects football has on the brain and the 2015 movie Concussion which starred Will Smith as Dr Omalu, that the NFL acknowledged the connection between football and CTE.

Thousands of lawsuits have been filed against the league by former players and their families for the NFL’s handling of concussion-related injuries, wrongful death and negligence. 

WHAT IS CTE? 

Chronic traumatic encephalopathy (CTE) is a degenerative brain disease that is caused by repeated hits to the head. 

Over time, these hard impacts result in confusion, depression and eventually dementia.

There has been several retired football players who have come forward with brain diseases.

They are attributing their condition to playing football and the hits they took. 

More than 1,800 former athletes and military veterans have pledged to donate their brains to the Concussion Legacy Foundation for CTE research.

CTE was usually associated with boxing before former NFL players began revealing their conditions.  

The NFL paid billions of dollars in settlements while they continued to dispute and reject the evidence of football’s long-term impacts on the brain.

Between 2009 and 2015, there were a total of 10,577 regular-season injuries. 

Of those injuries, 1,113 were regular-season concussions.

Cleared by teams’ medical staff, players were often sent back into the game with a concussion.

Facing pressure to protect its players, the multi-billion dollar NFL implemented a concussion protocol in 2009 that it continues to adjust each season. 

In 2016 the league added a rule to their protocol that said teams would face fines of $100,000 or more if they failed to take players out of the games after sustaining a concussion.

However, even in the current season hard hits to players such as Cam Newton of the Carolina Panthers and Tom Savage of the Houston Texans who both returned to play, made viewers skeptical of how effective the protocol really is.

The Seattle Seahawks became the first team in the NFL to be fined for not following the concussion protocol after quarterback Russel Wilson suffered a hard hit to the chin and was tested in the medical tent on the sideline for just seconds before returning to play.

The team was fined $100,000, the maximum punishment for a first-time offense. In addition to the fine, the Seahawks’ coaching and medical staffs will be required to attend remedial training regarding concussion protocol.    

Experts believe there are far more concussions than are reported due to players wanting to continue to play. 

Biomedical researcher Stefan Duma told Daily Mail Online: ‘We use a number of 10 to one. We think that for every concussion that is diagnosed, there are 10 that are not diagnosed. We think it’s that prevalent.’

Earlier this year Gisele Bundchen, the wife of Patriot’s quarterback Tom Brady claimed that her husband had experienced a concussion during the 2016 season – none of which were ever reported. 

Hernandez's brain was examined after he killed himself in his jail cell while serving a life sentence for murder. His family sued the NFL claiming it knew of the dangers of football

Hernandez's brain was examined after he killed himself in his jail cell while serving a life sentence for murder. His family sued the NFL claiming it knew of the dangers of football

Hernandez’s brain was examined after he killed himself in his jail cell while serving a life sentence for murder. His family sued the NFL claiming it knew of the dangers of football

A post-mortem brain scan shows the severe damage to Aaron Hernandez's brain from years of head trauma while playing football. It was the most-severe case of CTE ever reported 

A post-mortem brain scan shows the severe damage to Aaron Hernandez's brain from years of head trauma while playing football. It was the most-severe case of CTE ever reported 

A post-mortem brain scan shows the severe damage to Aaron Hernandez’s brain from years of head trauma while playing football. It was the most-severe case of CTE ever reported 

Who are the former players with CTE?

The most popular case of CTE that brought the condition to light came after the suicide of New England Patriots running back Aaron Hernandez.

Hernandez was serving a life sentence for murder when he killed himself in his jail cell earlier this year.

A brain examination done in September found that Hernandez suffered from the most-severe form of the disease ever reported, though the Patriot’s postseason injury reports showed that during his three seasons he was only listed with a concussion once.

Despite that injury, Hernandez played that week, making seven receptions as the Patriots beat the Baltimore Ravens, 23-20, in the AFC Championship game on January 22, 2012. 

Hernandez’s family members have sued the NFL claiming the league hid the dangers of football.

The suit states: ‘By the time Aaron entered the NFL in 2010, defendants were fully aware of the damage that could be inflicted from repetitive impact injuries and failed to disclose, treat or protect him from the dangers of such damage.’

This family is just one the many that speculate that CTE is behind their love ones’ erratic behavior, mental issues and suicides, sparking wrongful death lawsuits.

Junior Seau was found with a gunshot wound to his chest and exams revealed he had CTE

Junior Seau was found with a gunshot wound to his chest and exams revealed he had CTE

Dave Duerson committed suicide in 2011 and left a suicide note that said he wanted his brain to be examined. Tests revealed he suffered from CTE

Dave Duerson committed suicide in 2011 and left a suicide note that said he wanted his brain to be examined. Tests revealed he suffered from CTE

Junior Seau (left) and Dave Duerson (right) both were former players who committed suicide by shooting themselves in the chest. Brain examinations revealed they had CTE 

Former New Orleans Saint Steve Gleason has been diagnosed with ALS

Former New Orleans Saint Steve Gleason has been diagnosed with ALS

Mark Gastineau, who played 10 seasons with the New York Jets, has been diagnosed with crippling brain conditions such as Alzheimer's, Parkinson's and dementia believed to be caused by years of constant blows to the head

Mark Gastineau, who played 10 seasons with the New York Jets, has been diagnosed with crippling brain conditions such as Alzheimer's, Parkinson's and dementia believed to be caused by years of constant blows to the head

Former New Orleans Saint Steve Gleason has been diagnosed with ALS while former New York Jet Mark Gastineau has Alzheimer’s, Parkinson’s and dementia – all believed to be tied to years of blows to the head in the game 

Former Chicago Bears defensive back Dave Duerson shot himself aged 50 after reportedly suffering years of cognitive and motor issues. 

He purposely pointed the gun to his chest instead of his heads when he took his own life in 2011, leaving a suicide note that said he wanted his brain to be examined by scientists.

‘Please, see that my brain is given to the NFL’s brain bank,’ the note read. 

Duerson was later found to have CTE. 

He played from 1983 to 1993 – before many of the new safety rules were put in place to protect the head and at a time when research was slim on the long-term effects the impact of football can have on the brain.

A year after Duerson’s death, former player Junior Seau was found dead with a gunshot wound to his chest. 

The 20-year football veteran’s brain examination also revealed he had CTE.

Though CTE can only be diagnosed after death, former players have come forward convinced they suffer from the neurodegenerative disease. 

Earlier this month former NFL star Larry Johnson spoke out and said he has demons in his head that almost pushed him to jump off a roof – blaming years of repeated blows to the head which he believes have resulted in CTE.

He added that he suffers memory loss and cannot remember two full seasons of his time in the NFL. 

Johnson has a history of violent behavior including six arrests, five of which were assault charges against women. 

Other former players including Mark Gastineau, who played 10 seasons with the New York Jets, have been diagnosed with crippling brain conditions such as Alzheimer’s, Parkinson’s and dementia while former New Orleans Saint Steve Gleason has been diagnosed with ALS. 

All of these conditions are believed to be tied to years of constant blows to the head.

These are just a few cases of the hundreds of football players, both dead and alive, who have been diagnosed with traumatic brain injury or show signs of CTE.

In 2010 the NFL implemented a rule that declares the ball dead the moment a runner's helmet comes completely off

In 2010 the NFL implemented a rule that declares the ball dead the moment a runner's helmet comes completely off

In 2010 the NFL implemented a rule that declares the ball dead the moment a runner’s helmet comes completely off

How it has changed: NFL safety rules then and now 

The NFL has come a long way from the days when players were allowed to grab their opponents’ facemasks, player substitutions were prohibited and communication from the sideline was not allowed.

It didn’t take much research to determine that those actions were unsafe and as injuries increased, new rules were implemented and amendments were made to improve old ones. 

2016-2017 NFL SAFETY RULE CHANGES  

2017 

  • Prohibits crackback blocks by a backfield player in motion, even if he is not more than two yards outside the tackle when the ball is snapped.
  • Gives a receiver running a pass route defenseless player protection.
  • Prohibits a player who is off the line of scrimmage from running and jumping over the line of scrimmage in an attempt to block a field goal attempt.
  • Reduces the length of preseason and regular-season overtime periods to 10 minutes.

2016

  • Rules prohibiting chop blocks are extended to include running plays, making all instances of chop blocks illegal.
  • Rules prohibiting horse collar tackles are extended to include when a defender grabs the jersey at the nameplate or above and pulls a runner toward the ground.

According to the NFL operations website: ‘The custodians of the game not only have protected its integrity, but also have revised its playing rules to make the contests fairer, safer and more entertaining.’

Since 2002, 47 safety rules have been adopted.

The 2017 season’s rule changes had a greater emphasis on head and neck injuries than 2016, especially high velocity collisions.

One of this year’s most significant changes meant to protect head and neck injury came with prohibiting crackback blocks.

A crackback block involves an offensive player – typically a wide receiver – blindsiding a defender who is focused on the ball in the backfield.

New York sports medicine physician Dr Clifford Stark told Daily Mail Online: ‘That rule clearly protects players from high-force collisions that can cause severe head/neck and other injuries.’ 

An increasing number of rules also protect the person committing the foul instead of rules only intended to protect those on whom the foul is committed, such as the 2017 rule prohibiting defenders from jumping over the line of scrimmage on field goals. 

‘It is a good example of a rule that protects the player who would be committing the foul, including serious head and neck injuries due to landing awkwardly after a high leap when jumping over players,’ said Dr Stark.

He also suggests that this year’s rule change that reduces the length of overtime periods from 12 to 10 minutes protects against injuries related to fatigue.   

Last year horse collar tackling, the maneuver in which a defender tackles another player by grabbing the inside of an opponent’s shoulder pads, was made illegal.  

The 2010 season saw several key rule changes including the rule that states: ‘All “defenseless players” are protected from blows to the head delivered by an opponent’s helmet, forearm, or shoulder.’

The purple area in this image shows the kinetic energy that spreads across a football player¿s helmet and into the brain when head-to-head contact is made

The purple area in this image shows the kinetic energy that spreads across a football player¿s helmet and into the brain when head-to-head contact is made

The purple area in this image shows the kinetic energy that spreads across a football player’s helmet and into the brain when head-to-head contact is made

The NFL’s reported concussions over five seasons 

Preseason and regular-season practices plus games

2012 – 261

2013 – 229

2014 – 206

2015 – 275

2016 – 244

Players are considered ‘defenseless’ when they are in the act of or just after throwing a pass and are attempting to catch a pass.

While kickers, punters and quarterbacks were previously protected from helmet-to-helmet hits, this rule was extended to protect them from blows to the head delivered by other parts of their opponents’ body. 

‘Defenseless player protection is very important- it protects against serious head and neck injuries that can result from forcible collisions using the crown of the helmet,’ according to Dr Stark. 

Other rule changes made that year declares the ball dead the moment a runner’s helmet comes completely off. 

While the new rules were meant to protect players head and neck, the 2015 concussion rate rose 58 percent making it the highest number in four years of record keeping. 

This raises concerns that perhaps the increasing numbers are due to teams and players getting better at spotting and reporting concussions, rather than there being more head injuries.

The future of NFL rules 

The rise in head injuries has shaken not only players and their families, but moved a prominent ESPN college football commentator to resign. 

Ed Cunningham, a former NFL player, resigned citing that he no longer wanted a job enabling a sport that creates long-term brain injuries.

A rule that was thought to be put in place earlier this year on automatic ejections for players who commit ‘egregious hits to the head’ was never implemented. 

This season when Bears linebacker Danny Trevathan knocked out Packers receiver Davante Adams with an illegal helmet-to-helmet hit, fans argues that Trevathan should be have been ejected from the game according to the new rule. 

However, an NFL spokesman informed Pro Football Talk that the rule was not approved nor adopted. 

This came as a surprise after NFL Media reported that the ‘rule on automatic ejections for egregious hits to the head was approved’. 

Analysts speculate that this rule will be implemented for the 2018 season.

On September 28, 2017 Packers receiver Davante Adams was knocked out after an illegal helmet-to-helmet hit, though the player who committed the foul was not ejected from the game 

On September 28, 2017 Packers receiver Davante Adams was knocked out after an illegal helmet-to-helmet hit, though the player who committed the foul was not ejected from the game 

On September 28, 2017 Packers receiver Davante Adams was knocked out after an illegal helmet-to-helmet hit, though the player who committed the foul was not ejected from the game 

Studies have shown that the best way to reduce head injury is to limit the amount of contact during practices.

Stefen Duma, professor at Virginia Tech, started the Virginia Tech Helmet Lab where he conducts sport-specific impact testing on helmets in youth sports.

His research used helmets designed with censors to find that 75 percent of impacts to the head happen during practice.

Duma has also encouraged teams to eliminate two-a-day practices during training camp as well as reducing the number of full-contact practices. 

‘A lot of these schools, even at Virginia Tech, will go a whole week without practicing in pads between games, depending on where it is in the season. So there’s just not that old school notion that you have to beat everybody up at every practice and it’s making the game a lot safer,’ Duma said. 

This is similar to this year’s rule changes in the Canadian Football League. 

In September, the league barred players from making hits during regular-season practices.

While they still wear helmets, they no longer wear shoulder pads and other protective gear in practices.

No professional league had eliminated padded full-contact practices and this change was not entirely welcomed by coaches and general managers. 

However, the league commissioner, also a former player, stood by the changes for the sake of players’ safety.  

The NFL has also cut back on the number of practices where players are fully geared and making hits, though not nearly as drastically as the CFL. 

A study using helmets equipped with censors revealed that 75 percent of impacts to the head happen during practice

A study using helmets equipped with censors revealed that 75 percent of impacts to the head happen during practice

A study using helmets equipped with censors revealed that 75 percent of impacts to the head happen during practice

Some experts have pointed to the helmet as the best bet at protecting players’ head and neck from injury.

While others protest that adopting rugby rules of going without helmets would stop players from hitting with their heads altogether. 

The helmet has gone from being made of leather to including lining that absorbs energy and new research is constantly being conducted to find the best form of protection.

Last year the former manufacturer of NFL helmets, Riddell, was sued by about 100 former players who say the company made false claims about its helmets’ ability to protect against concussions.

This year VICIS, a helmet manufacturing company was contracted to design new helmet, the ZERO1, that claims to protect players better than the current shells. 

In regards to future rule changes Dr Stark said: ‘Many of these head injuries that we are trying to prevent are cumulative in nature and the effects are often not seen until many years or even decades later- chronic traumatic encephalopathy (CTE), for example.’

He said prevention is key and suggests implementing a tracking system throughout the season on each player, so that repeat offenders of fouls that involve forcible hits to the head are suspended from games.

Duma is working to create a censor to go in a player’s ear to measure hits throughout a game, similar to what Dr Stark is referring to.

‘It looks like a hearing aid and that collects all the data. We use that with our varsity lacrosse. We instrument them for a season to measure how many head impacts they have, how hard they are, what the injury risk is associated with that,’ said Duma. 

As the upcoming seasons of American football appear questionable in the wake of eye-opening research, some say new rules will change the game altogether.

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