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Great article. I'd also highly recommend the movie Crash Reel, which is also about TBIs. It should be mandatory viewing for any student who wants to play football, snowboard, bike race, etc.
I am totally crushed by this. Last season I felt guilty every time I watched a football game though I enjoyed it anyway. I used the tortured justification that many people suffer tragic, difficult lives of mental illness without the fame and fortune that comes with being a football player. That the suffering is a horrible thing but perhaps increased awareness will lead to rules changes and better player safety (I suspect the complex helmets and padding are actually the cause of brutality and concussions in football because the players use the padding as a weapon and as justification to go to physical extremes they would not dare try without their armor). But the moral weight of teenagers and twenty somethings who will never have the economic advantages that come with a professional career, and who are supposedly in college to begin the productive part of their life where they grow as human beings, are suffering in exactly the same way while the NCAA and its Universities profit from it is too much.
I'm not sure helmets and padding are the driving issues here-aren't a lot of cases of CTE caused by sub concussive hits? Like linemen who hit each other on plays and have their brains rattled around? I'm not sure what can be done to ameliorate that, other than turning football into flag football.
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I often wonder if football could be played without pads like rugby. And yes I do think the damage done to linemen can be attributed to helmets because when you have a helmet you have a false sense of security that you can smash your head into another person or another person's helmet without injury. I suspect without helmets players would make active attempts to keep their heads out of harms way as much as possible.
> And yes I do think the damage done to linemen can be attributed to helmets

I don't. In all eras of football -- including the eras before pads and helmets -- the close-in part has been the most damaging and seen the most fatalities (especially before elaborate protective gear.) Rule changes designed to spread the game out specifically for the purposes of safety have reduced that overall, but the linemen are still in the worst of what remains.

> And yes I do think the damage done to linemen can be attributed to helmets

No doubt they would -- and did -- but "as much as possible" is unlikely to be enough to offset the increased consequences when it is not possible.

Its not like we haven't had football without, or with less effective, helmets.

The hits are big and regularly concussive because of the pace of the game. It's very short bursts of activity with lots of rest in between, resulting in enormous players with much explosive power. If there were less than a minute between every play, you simply wouldn't get the huge hits. The players would have to be smaller and trained for more endurance at the expense of power.

The existence of special teams and having separate players for offense and defense also contributes to the problem. If the players were forced to play the whole game they simply couldn't be the wrecking balls they are now.

Ooh, I like this idea- cut rosters down to 25 or so. Game becomes less about specific physical abnormality and there's more money to spread among fewer players.
Not a bad start. But have you seen the size of regular rugby players? They still specialize from the looks of it, and even the "small/fast" players are 6ft+ and above average in weight and build.
Still a 300+ lbs professional rugby player is very rare, a 300+ lbs NFL lineman is basically the norm.
Concussions are a serious issue being discussed in Rugby - estimates are that 1% of players will suffer from early onset dementia. Maybe more than the differences in protective gear, the reduced incidence of concussions in rugby are likely due to differences in tackling techniques - Ruby requires a wrap-up technique which results in players leading with the shoulder and not the head since they have to wrap their arms around the opponent and bring them to the ground.
(I suspect the complex helmets and padding are actually the cause of brutality and concussions in football because the players use the padding as a weapon and as justification to go to physical extremes they would not dare try without their armor)

I suspect that helmets and padding are the reason we don't see more deaths at all levels of play.

Watch some Rugby and get back to us on that one. Same basic mechanics (tackling, diving, etc), but done with more caution because they aren't armored tanks.
Exactly! As I stated in the other thread off this comment, I wonder what American football would look like without padding like rugby.
While not as bad as American Football, rugby is still pretty bad - my son plays rugby at U16 level and the level of injuries you see are pretty striking - broken bones aren't exactly uncommon.

Still rugby is a great game and he loves it and I love watching him play.

[Scrums are the really scary bit of rugby as of the risks to players necks - fortunately he is a No 8. not a prop!].

The thing is everyone knows these sports are brutal and can lead to broken bones. It's concussions that are of a larger concern.
Concussions are of larger concern largely because we've reduced the problem of one particular kind of broken bone (to wit, the skull -- which was a fairly serious problem in football) to a more manageable level with protective gear.

I don't think reducing the impact of concussions by returning to the age of deaths by brain injuries from broken skulls is a way forward.

Its really a totally different kind of hit though. Rugby tackles tend to be at sharp angles or from behind while football is often heads up direct or nearly so. But even so, studies seem to show that its the constant impacts from blocking on the line, something rugby doesn't allow, that is a large contributor to the mental problems developed later in life.

Honestly I think facemasks are the biggest problem with the equipment and contributing to problems with it.

American fotoball linemen's only job is to run into other linemen. There is no strategy that has them handling the football save trick plays. If you think removing pads will magically make the game safer because Rugby doesn't have pads, maybe you should watch some American football and get back to us. It's less about the pads and more about the strategy of the game.
> I suspect that helmets and padding are the reason we don't see more deaths at all levels of play.

Given the fact that we have a history of both no helmets/padding and less or less effective effective helmets and padding with much higher death rates, I think that's fairly clear.

Football was pretty brutal in the leather-helmet day. There was a series of deaths in college games that led schools and the government to consider abolishing it, and ended in reforms (no "flying wedge" was one). Even after that, football was hard on the body, and a lot of players lived out their post-football days in steady pain. I believe that a major reason that we are noticing the brain problems now is that American men are living longer than they did fifty years ago. A man who is grouchy and eccentric in his fifties and dies of a heart attack at sixty isn't much noticed. But it is hard not to notice a guy who progresses in his sixties from eccentricity to dementia, and lives another twenty years a fog.
My (I believe) great-grandfather was on the Yale football team during their famed flying wedge days and back when the leather helmets were their only protection. As far as my memory of our family records can remember, he died in his early fifties / late forties of some brain related complications I can't recall at the moment. What I remember very well, however, is that the doctors of the day attributed the complications that caused his death to his time playing football on the Yale football team.

I have no idea if the same conclusions would be drawn by doctors today today, but I thought it is an interesting anecdote to share nonetheless.

> suspect the complex helmets and padding are actually the cause of brutality and concussions in football

They aren't the cause of brutality, but they probably are the cause, in a way, of concussions and lots of the cumulative damage -- but still an improvement over not having them. Specifically, the modern "complex helmets" are a direct result of a past crisis in fatal brain injuries in football, peaking in the 1960s, and directly reduced them, you probably wouldn't have so many people surviving with brain injuries during football when instead they were dying from much more serious brain injuries.

So it's similar to what happened following the adoption of metal helmets over cloth hats in WW1; injuries increased significantly because immediately attributable casualties decreased. The helmets stopped soldiers from dying but didn't deter them from risky behavior.

I wonder what the brain damage rates of players of a game like rugby are?

We moved to Central Florida in 1977. The Bucs were so new they had yet to win. I would wear my Dave Pear #76 jersey to Junior High.

I couple of years ago my cousin was complaining to my unsympathetic Bucs' fan ears about his team's [Orioles or Senators, I can't remember] losing streak. I googled up Dave Pear to out suffering fan him in prose much like this here.

Don't let your kids play football. Never.

https://en.m.wikipedia.org/wiki/Dave_Pear

It's no surprise we are seeing fewer kids playing at the K-12 level as parents just don't want to take the risk. I don't blame them. Wouldn't want my son doing it either. Who wants to push their child on career path where there are good odds you retire in your 30's with brain damage?

Increasingly I am thinking that football is one of those things that people a hundred years in the future are going to think we were totally crazy for ever popularizing, sort of like how today we think gladiator fights were horribly barbaric. I don't know that better equipment and rule changes can solve everything.

>>> I don't know that better equipment and rule changes can solve everything.

Doesn't matter how good the equipment is, it's your body which is handicapped from the outset. It's because your brain floats in the cerebrospinal fluid, there's no way to effectively "anchor" your brain from crashing around in your head during concussions and hard hits.

Anybody playing contact sports is at risk, and even sports you don't think of as contact sports are at risk as well. Baseball's not considered a contact sport, but you see concussions there all the time. The problem in all of these sports is the players are getting bigger and the sport is moving faster. I still remember Wayne Gretzky talking about how we finally decided to retire. He was talking with his father, who asked him if he was going to play one more year. This was his response:

"Dad, I can't compete anymore. The players are getting bigger and faster every year." when Wayne retired, he was 6' and 185lbs. \

The AVERAGE hockey player nowadays is closer to 6'3" and is well over 200lbs. The LA Kings famously had a line where all three of their forwards were 6'3" and weighed 220lbs the year they won the Stanley Cup in 2012.

Take a look at their roster - they only had 4 guys under 6': http://www.hockey-reference.com/teams/LAK/2012.html

Gretzky retired in 98-99. It did take 15 years, but NHL hockey implemented rules to make the game less brutal and it seems to be working. Players crashing into each other head first is not an inherent part of the game like it is with American football. Sure concussions occur, but it's got to be a fraction of what happens in football.

http://www.wsj.com/articles/professional-hockey-has-become-a...

"Much of the decline can be attributed to fewer players going to the box for the game’s more violent infractions. Charging, boarding, roughing and cross-checking are being called at the lowest rates since 2001-02, according to Stats. It seems that the NHL’s plan to crack down on violent penalties this season is working."

I agree and would also add that the increased speed of the game has lessened the amount of bad injuries. Goons have pretty much been eliminated and there' only room for really skilled guys - which means a lot less hard checking and chippie play.

Although the occasional rivalry game will produce more hitting and hard checking. You can see the Wild v. Avalanche this past week or the Flyers v. Penguins last month which included a ton of PM's and four fights - a rare occurrence these days.

I expect that at the college and NFL level, we'll see the demographics shift even more to minorities. If your only ticket out of a bad neighborhood is the NBA and NFL, (realistic or not) then you'll take/ignore the risks. The amount of money involved in football from college to NFL is simply astounding, and it's hard to see it being disrupted, especially when it relies upon a labor pool of young men who aren't the best at evaluating risk.
Football is by far my favorite sport. Unfortunately, it's just not worth the long-term injuries it causes to a large percentage of those who play it beyond high school (and some before even that level).
Do you play in pads for recreation?
Football players = modern gladiators.

One can say other competitive sports are like that too. Maybe the military as well. But American Football is especially bad for a popular sport. It very violent. Permanent brain damage is a common side-effects of playing for years.

Americans love it though. One can make a parallel in general on how our society is inherently more violent than other Western countries. American football is just one of the facets of that.

It is also interesting perhaps how this gets played vis-a-vis the "save the children" rhetoric. We've seen article about free range kids' parents getting harassed by police. How everyone is talking about how special the children are how they should be protected. And then, pretty much the same people, turn around and either send their son to play football or watch and cheer as others run around the field butting into each other head first at full speed.

"Most never made a dime off the game." The article lost credibility for me there. You may think the majority of NFL players don't get paid enough for what they do, but I'm pretty sure no one is playing for free.
" Most of those players are not famous. Most never made a dime off the game. They are relatively anonymous men who played the sport in college and only later, for some reason or another, have found themselves struggling in life."

College players aren't paid. Most college players never make it to a professional paying level.

https://www.ncaa.org/sites/default/files/Probability-of-goin...

The quote was made in the context of NFL players. (At least that's how I read it)

Still, even though college players aren't paid with money, they still receive compensation (scholarships, financial aid, free tutors, etc). To indicate that they receive no financial compensation is inaccurate, I think.

The article wasn't clear, but I think you've misread it:

"Most never made a dime off the game. They are relatively anonymous men who played the sport in college and only later, for some reason or another, have found themselves struggling in life.

Just like their N.F.L. counterparts, Hoffman and those former college players have been left to wonder: Did football do this?"

The author meant to distinguish Hoffman et al frmo NFL players, who are at least famous and well paid for their troubles.

Also, the Hoffman did not say the players never received "financial compensation". Hoffman said they never made a dime off the game, which is profit. (He's also speaking loosely, as the use of the idiomatic phrase suggests)

Don't they play for free while in high school and college? I'm not too familiar with American sports. But it sounds like this could have been avoided entirely if there wasn't such a huge and obsessive push to get kids on the track to "big time NFL stardom" from high school onwards.
Football is seen as a path to free college tuition. An NCAA Division I football team has [last I checked] 85 full grants in aid and a DII program 65. These are in addition to whatever schools use from their academic scholarship pool to attract athletes. With the rising cost of tuition, room, and board, playing college football can easily work out to more than $100,000 of economic benefit.

Some parents see football as a path to education. In fairness, for many it may be among the most likely options.

Here, take this free college education in exchange for playing football... so that when you get dementia, you'll have something of value to forget forever.
The education most NCAA football players receive is pathetic. If you look at the time spent practicing, lifting, attending meetings, traveling, actually playing, the idea that they're learning much else is readily apparent. No wonder most NFL players end up bankrupt shortly after their careers end.
I'd rather have bad knees than a bad brain.
One thing that I think can help is greater emphasis to get Steriods/HGH/Testosterone out of the game. Grew up in Miami, which is a hotbed for highschool football and I recall that Steriod usage was rampant back in the 80's. Players are bigger, stronger, faster because of the use of these performance enhancing drugs and there is no control whatsoever at the highschool level.
Ive seen this suggested before and it seems counterintuitive at first, but get rid of helmets. Get the game back to something resembling rugby. Hard helmets give a false sense of security.
this may reduce the long term occurrence of dementia/permanent brain damage, but it will most certainly increase the occurrence of immediate death unless the rules of the game are changed considerably.