Third and Long

The NFL gets off easy on head injuries, but we all have progress to make.

Goodell1The ripples generated by “League of Denial,” which premiered last night, resemble that of a pebble in the ocean. As usual, PBS’s Frontline produced an excellent documentary. But also as usual, the NFL has won the short-term battle, sweeping its long-term problems under the rug.

“League of Denial” is the story of the NFL’s relationship with the degenerative brain condition called Chronic Traumatic Encephalopathy, or CTE. It’s been a cold, distant relationship for decades, but the disease is now staring the league straight in the face.

Spoiler Alert (but not really): the documentary makes clear that there is a pattern of former NFL players who exhibit loss of memory or cognitive ability and whose brains after death demonstrate the presence of CTE. It also powerfully outlines the systematic denial that the league has pursued since anyone began raising concerns.

The research on CTE suffers from two valid criticisms. The first is that the sample size is still under 100, which is relatively small. Researchers know that a small sample size makes for a shaky foundation for causal claims (such as “playing football leads to CTE”). Second is the issue of selection bias (jargon for the idea that only the families who suspect their late relatives of having suffered trauma would donate the brains for research, so of course the hit rate of CTE in the examined brains is high—quoted in the film as being 45 of 46 cases). However, some heartbreaking cases of youths who exhibited no signs of cognitive impairment but whose brains showed advanced signs of CTE in postmortem exams are helping dispel that concern.

There are clear good guys and bad guys who emerge through “League of Denial.” The good guys include the journalists and scientists doing honest work in pursuit of unanswered questions. Former college player Chris Nowinski deserves a special mention for his hard work in partnership with Dr. Ann McKee at Boston University. The bad guys, unsurprisingly, are those out to protect the popularity and image of football. Former NFL commissioner Paul Tagliabue appears far more nefarious than he ever did while in office. Several members of his handpicked (and euphemistically named) Mild Brain Traumatic Injury committee, including a former chair named Ira Casson, demonstrate overwhelming hubris and narcissism in interviews.

Strangely, the documentary leaves three individuals in unclear good/bad light. One is Bennet Omalu, the Pittsburgh coroner whose work sparked the CTE research in the early 1990s. He’s mostly a sympathetic figure, but after exiting the story he reemerges in a shady way to the kerfuffle over the brain of Junior Seau. The second is Leigh Steinberg, the famous agent who was very much part of the system of disregarding brain trauma but eventually saw the light (he recounts a post-concussion conversation with Troy Aikman that would be comical if it weren’t so distressing).

The other, importantly, is current NFL commissioner Roger Goodell. He is depicted as a full-blooded company man, deeply committed to growing the brand and profitability of the league (in which pursuit he has largely succeeded). His reputation as commissioner is largely as a hard-nosed purist, unafraid to levy fines and suspensions for on- or off-field transgressions. However, Goodell is clearly not the strategic thinker that Tagliabue was. He has slowly acquiesced to the emerging science supporting the connection of football to CTE. But he still carries the image of the former right hand man who has ascended to the godfather’s seat.

Reactions to the film were fleeting. ESPN posted links to excerpts—two videos totaling less than nine minutes—of “League of Denial” to its homepage at the time of the broadcast. Those clips never climbed above halfway up the page, though, and now they are gone. You can still see these videos on the ESPN football page if you scroll down far enough.

The case against the NFL owes a great deal to the reporting of Alan Schwarzof the New York Times. Schwarz appears throughout the documentary to describe conversations he had with league officials—including its spokesman, Greg Aiello, who recognized the effects of repeated concussions in 2009. One story even involved the handoff of an academic research paper, complete with the steakhouse setting and manila envelope (as if anyone walking by is going to say, “Hey, what’s the null hypothesis under examination here?”).

It was Aiello’s admission that put the NFL on the defensive. But even when on its heels, the league is able to overpower its critics. ESPN, which makes billions of dollars annually from its relationship with football, curiously backed out of its partnership with Frontline just weeks before the film’s premiere. Then the league settled a massive lawsuit filed by former players for $765 million, or what it makes in profit in just a couple weeks each season. Goodell’s position is that the issue of former players’ injuries is closed, and we can all move forward promoting safety in our beloved game. At the end of “League of Denial,” we are left to simply rage in a sense of injustice and helplessness.

That brings us to the rest of us. Fans are complicit in the dominance of the NFL that enables its blindness to the truth. We pack the stadiums and bars on Sundays, or pay exorbitant amounts to drown ourselves in satellite coverage of every game. It may only be a side effect of our passion for football that the NFL has the leverage that it does. After all, we are not primarily supporters of the 30-odd rich guys who own franchises or the NFL front office, but rather of our favorite teams and players whose on-field accomplishments entertain us each week. But there are reforms that can be achieved from the bottom up in this scene.

Elementary school-age kids across the country suit up to play football every week, trying to emulate their favorite players—players who use their over-padded bodies as projectiles because they don’t actually know how to tackle anymore, but who want to make it onto SportsCenter on Monday morning.

One option is to take the tackling out of junior football. This falls short on two counts: first, that only half of the players on the field are actually tackling anyone. Linemen, as “League of Denial” emphasizes, take some of the worst head shots in the course of their work along the line of scrimmage. Second, moving away from tackling does not solve the fundamental problem that the perceived goal of football is to damage or injure one’s opponents, as opposed to advancing the ball toward the end zone. Basic skills training has been the expense of the flashy, fast modern game.

Surely, if every parent in America saw “League of Denial,” the ranks of children playing junior football would migrate to other sports. However, there are changes that can benefit both the game and the health of players that can begin at the grassroots level. Knowledgable, patient coaching and parenting can preserve America’s most popular sport while making advances in player safety that leave the NFL in the dust.

Note: this article appeared on Medium on October 9, 2013.

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