Why The NFL's "Concussion Crisis" Isn't Really A Concussion Crisis

Originally published in Bloomberg View.

The biggest NFL story of the week may not have been Jovan Belcher's horrific murder-suicide in Kansas City Mo.,, but the release of a small study in the scientific journal Brain. And we may yet learn that the two are intertwined.

The four-year study looked, posthumously, at the brains of 85 athletes and soldiers. Fifty were former football players, 33 in the National Football League. The study found that the incurable degenerative disease known as CTE—chronic traumatic encephalopathy—is just as likely to be caused by a routine hit to the head as it is by a big, concussive blow.

"This is a disease of total, overall repetitive brain trauma," one of the researchers said.

In other words: Football doesn't have a concussion problem. It has an existential one. By calling it anything else, we are doing the brain-trauma issue a grave disservice.

This isn't necessarily anyone's fault. Early reporting on football's "concussion crisis" was a revelation—particularly Alan Schwarz's 2007 New York Times story linking the suicide of former Philadelphia Eagles safety Andre Waters to brain trauma suffered while playing football. But what exactly had caused the trauma?

At the time nobody knew from CTE. What we did know were concussions. They, clearly, were the smoking gun that had left Waters's brain tissue in tatters—those bell-clanging hits that the NFL had been downplaying for years with language that, in retrospect, seemed Orwellian. ("Concussions are part of the profession, an occupational risk," Elliot Pellman, then the doctor in charge of the league's Mild Traumatic Brain Injury Committee, said in 1994.) They were something the public could understand and would pay attention to.

Thus did football enter its Concussion Era. The phrase may sound damning for the NFL. In fact, it gave the league an out. "If you consider this 'a concussion problem' it seems solvable," says Chris Nowinski, a co-author of the study and a co-director of the Center for the Study of Traumatic Encephalopathy at Boston University School of Medicine. "That's not the truth."

Of course, concussions are part of the problem—but only part. By framing football's head-injury crisis as a concussion crisis, we have understated its severity. Our scope of concern should go beyond observable phenomena.

Calling football's head-trauma crisis a concussion crisis diminished its urgency at lower levels of the game, where players don't hit as hard and concussions are less common. More to the point, it allowed the NFL to treat the crisis as a function of improper tackling, of inadequate rules, of insufficient education, of the behavior of an isolated group of bad actors.

The league could ban helmet-to-helmet contact and move kickoffs to the 35-yard line. It could overhaul its "concussion-management" rules, requiring players experiencing amnesia or poor balance to be removed from a game or practice until the following day. (Just a little dizzy? You're free to return to the field right away.) It could run public-service announcements about the dangers of concussions and issue concussion-awareness pamphlets that begin: "What is a Concussion? It's More Than a ‘Ding.'" It could make examples of players and coaches—like New Orleans Saints coach Sean Payton and a handful of Saints players—for creating what the league said was a slush fund to reward teammates for injuring opponents. (One thing the league still won't do, despite the urgings of the NFL Players Association, is add independent neurological experts to the sidelines of games.)

Most of all, calling the head-injury crisis a concussion crisis made it sound as if it stemmed from how the game is played, not from the game itself. Football is an inherently violent sport in which unremarkable plays can eventually add up to permanent brain damage. That damage, in turn, can result in dementia, depression and destructive behavior.

What is the tipping point? We don't have any idea, because the head-injury crisis is also about a degenerative disease that we have scarcely begun to understand. Renaming this crisis—calling it what it really is—won't solve it. It can, however, get us to think about it in a more helpful way.

I'm not going to speculate about what might have made Jovan Belcher kill the mother of his 3-month-old daughter and then himself. It may very well have had absolutely nothing to do with his years of playing football. I couldn't help but notice, though, one of the first questions asked in the aftermath of the incident: Did he have a history of concussions?

The answer, apparently, is no. The question itself is as good as meaningless.

Jonathan Mahler is a sports columnist for Bloomberg View. A long-time contributor to The New York Times Magazine, he is the author of the best-selling Ladies and Gentlemen, the Bronx Is Burning, The Challenge, and Death Comes to Happy Valley. He's @jonathanmahler on Twitter.