Headhunters and the nature of the game

We’ve all seen it. The offense lines up in a 113 - one RB, one TE, three WR. Standard OL, shotgun. The X receiver does a stop-and-go fly pattern, the Y receiver does a hitch and the slot receiver breaks to the weakside at 7 yards. The defense was waiting for it. They were in a 3-4, CBs on the primary receivers, SILB on the slot, with help from the safety to his right if the TE tries to block or if the RB comes back far enough to receive a pitch-out. When the slot receiver appeared to be the best option, the FS noticed that the QB, despite untold hours of practice, didn’t look him off, as the slot receiver reached out for the ball and it touched his hands. The SILB converged on him and was there in time for the tackle. But the safety had an open shot at an unprotected WR, and although he would later say that he was trying to hit the receiver in the back, the impact of his helmet into the back of the helmet of the receiver caused an entire stadium to go suddenly silent. Neither got up at first, and trainers from both benches grabbed the equipment they wanted to hold the least, and dashed over to the supine bodies of the players. The loss of feeling in the WR’s arms and legs brought an immediate application of a device that was little more than a high-tech ice bag, one that would fit the neck, shoulders and down the back. It slows the swelling in cases of spinal bruising, bruising that can bring permanent paralysis. Two carts were ready on the sidelines.

Cheers emerged when the safety was able to slowly rise, but even with the home crowd, the yells of approval were muted. The opposing player hadn’t moved, and you could see the trainers and team doctor immobilizing his neck and back. The people had seen every angle on the hit several times on the Jumbotron, and there was no doubt that it was helmet to helmet, and even less that it was deliberate. It was obvious that the safety was headhunting - deliberately allowing oneself to hit an opposing player in a way that can take away his day, season, his career, or the use of his body. Every player in the league can tell you who the most common perpetrators are. Up until now, the league has chosen to do little about it. Perhaps it’s time for that to change.

After this past weekend, there were signs - and demands - that indicated the deep need for change. I commented this spring when the offensive lineman’s group at Combine were measured that they were the largest, heaviest, fastest and most agile group of OL ever to attend the event. It’s true in nearly every position. Players are bigger, faster, stronger and more agile than ever, and that means, simply, that they hit harder than ever before. If you’ve ever seen a game from seats close to the impacts, they will cause you to involuntarily flinch when you hear, see and feel them collide. It’s an increasing issue that the NFL has been forced to deal with, much as they were with the concussion issue. This is more broad, but no less vital. As Jeff Legwold wrote this week,

Most of the hits drawing attention are directed at receivers who are trying to catch a pass in the open field in what the league considers a defenseless position. League rules prohibit defensive players from leaving their feet, or “launching” into a defenseless player or leading with the helmet to make contact with another player’s helmet.

Last weekend, both Dunta Robinson and DeSean Jackson were sidelined with concussions after Robinson executed a helmet-to-helmet hit. James Harrison was fined $75,000 because he was a repeat offender. TE Todd Heap took a terrible blow to the head from New England’s Brandon Meriweather that was as cheap a shot as you’ll ever see, whether you’re a Patriots fan or not. Fines, by themselves, are a poor tool to stop this kind of behavior. These are young men, individuals who by training live only in the moment, and they are often extremely well paid. Too often, the amounts involved are nothing more than an evening’s entertainment. That would suggest that a better approach would involve suspensions - there will be human decisions regarding the severity of the violation, but the business of flinging one’s body into a runner or receiver in the hope that the collision will knock them down isn’t tackling. Driving your body into another person so that your helmet comes up under his, isn’t tackling. Tackling will never be fully safe - it’s a very rough sport. But it can be taught properly, wrapping up with the helmet to the side. And, if the NFL is ever serious about the issue, changing how the players tackle, creating time to practice tackling, how they practice tackling and what helmets and equipment the players use are all issues that can be improved. Individuals - and teams, if it comes to that - that don’t follow regulations will be treated like any other offender - fines first, suspensions later, with the possibility of immediate suspension firmly in place for egregious actions. More from Legwold…

“And defensive players, such as Broncos lineman Kevin Vickerson, understand the concern over potential head injuries but also see infractions they consider equally deserving of suspensions occurring on other parts of the field. An example is the chop block, in which an offensive player engages a defender above the waist while another player blocks the defender low, which can easily result in a severe knee or leg injury.

“All the rules are really set up for offense,” Vickerson said. “Rules for going after the quarterback’s knees should be the same for defensive linemen. You’re taking years off a man’s career.”

Vickerson is right. Fans are often confused between the legal cut block, in which the offensive lineman hits the IT band hard with his shoulder (The IT band is that wide strip of connective tissue that goes down the outside of the thigh). That hurts like heck, but it won’t harm you and it won’t end your career). The chop block is illegal, and any line ref will tell you that the league puts a strong emphasis on forbidding and eliminating the chop block. Zone-blocking schemes often run to the cut block but while it’s a hazard of the system, at times there are inadvertent chop blocks. They are usually seen and flagged immediately, so teams and players go to great lengths to avoid the infraction. There’s no attempt to harm another player - it’s just an unpleasant area to be hit.

There is a side of this that happens because of crossing routes. Crossing routes? You bet. If the TE or slot receiver is coming across the field and fails to stop in the ‘soft’ spot beneath or between the zones and tries to run through coverage, perhaps to what he thinks is a better hole, he’s setting himself up for a big hit, and there is certainly a point at which things happen in microseconds and it’s wrong to blame the defender. That’s not what is being talked about. I’ve watched the game for over 5 decades, and you can usually see the difference very easily.

But, really, why the fuss? Aren’t you taking the joy out of the game? No - or rather, perhaps, in part. But it’s a part that won’t really be missed any more than leather helmets are today. The game does on, people and players adapt, and as to why you might choose to do this? Despite the vast sums of money that pass through NFL coffers each year, and the insurance that teams pony up for, artificial knees, ankles, hips and shoulders, around-the-clock medical care for those who are suffering from cognitive disorders, and the sums that other neurological disorders plow through are sobering. While many fans are of the impression that players are given monopoly money salaries, and that is sometimes true, the tax code and the medical bills once they retire can wipe out those kinds of earnings in a short time. For example:

We are not fully sure of the cause of one such condition, known as Central Sensitization Syndrome. It’s a chronic pain and fatigue disorder that affects the spinal nerves, branches and neurotransmitters as well as a series of structures called ‘glia’ in the body. All in all, these are structures and substances that affect your ability to sleep, awaken, feel pain and to have that pain leave when there is not pain stimulus. The problem with CSS is that the pain doesn’t stop. Cases run from mild to severe, and they can and do leave patients in wheelchairs, since normal daily activities can spark yet another pain flare. The pain flares themselves can last for hours or days. Proprioception, or the body’s ability to maintain normal balance, also tends to diminish during these episodes. (It’s also an increasing problem with motor vehicle accidents, usually between 35 and 45 mph. One of the more concerning issues with CSS is that the group who is seeing the fastest rate of growth in this disease is that of young men, 18-45, in some of the best earning years of their lives. If the football player moves to a different career, the CSS can follow them and put them at substantially higher risk of it developing if they experience something as simple as a fender bender, or they may have it when they retire.

Some studies have indicated a connection between the second cervical (neck) vertebra and some of the problems of proprioception. Given the location of that vertebra and the base of the helmet, proper tackling technique is an obvious place to start in reducing the dangers of the game. Some will undoubtedly decry “ruining the ‘nature’ of the game.” Many of those who do will be younger men who have yet to see the realities of the effects of many of these diseases and disorders. Those who have had the experience of treating or living with such circumstances have an obligation to give a more balanced view. You’re not ‘ruining’ football to protect the health, spine and brain functions of people who may honestly not be clear on the real dangers of the sport.

Teaching Tackling Again

Merril Hoge shared his thoughts with The Sporting News...

“The Meriweather play was grotesque and embarrassing. You should not see that on any level. We need to reintroduce how you tackle an opponent. I had the greatest teacher ever in Chuck Noll (former Steelers Coach). He taught that you had to be fundamentally sound when you tackled an opponent. You can still deliver a big time hit and separate the ball from the carrier, but it’s clean and legal. Becoming a projectile and launching your body is what you have to eliminate. Tackling fundamentally sound is safer for both players.”

Hoge has been a part of the game for a long time, as a running back for the Steelers and now as an analyst for ESPN. Over the years, I’ve noticed a tendency for people to substitute launching themselves through the air in the general direction of the ball carrier as tackling. They may try to hit with the side of their body - the ‘body block’ style of tackling. Other players actually try to roll into the lower legs, to take out the feet. It’s frequently met with useless results - ball carriers often just bounce away from it, and if you try it on a WR and your angle or timing is off for the merest of split seconds, you’ll be on SportsCenter all right - as the idiot who couldn’t tackle on the winning TD pass. It’s one thing to miss a tackle because a player outplayed you. It’s something else entirely to watch someone score on Denver because anyone - from Brian Dawkins down to Andre’ Goodman and on to the newest rookies - just flung their bodies instead of actually tackling. It’s lousy form, it’s dangerous as hell, and it’s poor football however you look at it.

All in all, I think that I’d give Champ Bailey the best marks on tackling. Jason Hunter is also talented and was at one point well-drilled on fundamentals. It shows when he gets close to anyone who catches or carries the ball, too. Many of the players with the worst tacking stats also have the worst technique.

I’m all in favor of changing the way that tackling occurs, on every level of football. For every player on a single play in the NFL that launches themselves through the air without control, there are dozens of young fans and players, from playgrounds, through Pop Warner and up through college who try to do the same thing. Many of them suffer the same injuries, and they accumulate over the years. The outcome? Orthopedic surgery, appliances that replace joints, years of inactivity, pills and brutal pain. The average age at death of a professional football player is 57.5 years (I have sen this number rendered anywhere from 54 to 62 years of age, with the most common between 57.5 and 59). How much money would you trade for those realities? Medical bills like that can eat through the biggest retirement fund like a plague of locusts, and the level of pain has no fair price and no value. Back to Legwold’s article…

The NFL is a violent world filled with collisions that excite fans — and, at times, cripple players. In an attempt to severely curtail helmet-to-helmet hits that have resulted in concussions and knocked players out of games, the NFL has ratcheted up enforcement with heavy fines and threats of suspensions. Commissioner Roger Goodell sent out a directive to each team Wednesday about illegal hits to the head and ordered all teams to show a video demonstrating examples of legal and illegal hits. Former Broncos safety John Lynch said the NFL is trying to change the way the game is played.
“I think there needs to be a little more transparency,” Lynch said. “They need to just say they’re trying to change things, that they are trying to change the culture, and that they need to be the standard bearer for youth football and high school football.”

That’s exactly what they need. If youth football has the proper fundamentals drilled in constantly, and sloppy form punished immediately, and this process continues through the pros, this is a problem that can and will be vastly reduced. But if we don’t deal with it properly on the youth level, it won’t be dealt with on any. How many ex-players with limited use of their bodies is that worth?

What are the real risks - and how do they occur? IAOFM reader Dr. Denny Clifford (Ponderosa) was kind enough to chime in…

Medical Consequences of Repetitive Trauma

The brain is an incredibly complex and sensitive organ which houses all the cells that make up who we are - our memories, values, emotions, interests and personality. Evolution has provided a strong bony protection, the skull, to surround this tissue and protect it. Inside the skull, there is a cushion of fluid called cerebrospinal fluid that bathes the entire brain and spinal cord to provide extra shock absorption from trauma. For ordinary life events these protective structures generally work well, as most infants are seen to have bumps on the head that seemingly don’t cause harm. Child abuse such as shaken baby syndrome or actually hitting a child causes irreparable harm in many cases and death in some. When we look at the consequences of actual repetitive trauma in sports such as boxing, MMA or football, we have to change our preconceptions of acceptable damage.  The purpose of boxing is to incapacitate your opponent preferably with a knockout, which is of course a concussion. Concussions result from rapid acceleration and deceleration of the brain inside the skull. The brain is struck at the point of the blow and then sloshes against the skull on the opposite side rendering two injuries, the so-called coup and cont-recoup damage. There is disruption of blood vessels supplying brain tissue, plus variable amounts of bleeding and disruption of normal nerve cell function. In boxing there is a required period of time of usually 6 months minimum before one is allowed to be hit in the head again, to allow healing of the brain. This at least prevents some of the aggravated injuries that seems to amplify the effects of the original damage before the brain has time to repair. In football, 6 months is more than the entire season, and unfortunately players are returned to risk-filled situations much sooner than is ideal.

The brain is composed of neurons which are the cells that transmit information by means of tiny amounts of electricity and release of hundreds of chemicals called neurotransmitters. These neurons are supported by glia cells which nourish, repair, and do many other tasks which are just now being understood by research. There are millions of connections between the neurons that interact through synapses - the connections between the cells where the neurotransmitters and electricity act. After trauma, these connections become nonfunctional in the area of damage for varying periods of time depending on the injury. Imagine that you have a coffee shop several hundred yards from your house that you visit each morning for your cup of latte. You have found a path around the hill that is a shortcut that cuts 10 minutes off the regular walk. This path becomes well worn from use until one day a huge mudslide wipes it out. Now you have to find an alternate route which will take longer. This is what occurs when a concussion disrupts neuronal connections. Sometimes repair occurs and you can take a path similar to before, although it will never be identical. Sometimes no repair occurs and entirely new pathways have to be found. As these events become more frequent and severe, the possibility of repair becomes less and less, and there is permanent impairment with altered brain function and subsequent loss of who you are as a person.

One of the least understood parts of repetitive brain trauma is the individual variation to different levels of severity. What at times looks like a trivial collision can lead to severe consequences and in contrast, what appears to be a severe collision doesn’t result in the expected concussion. What autopsies show conclusively is that athletes exposed to repetitive trauma inevitably begin to accumulate evidence of brain damage called Chronic Traumatic Encephalopathy, or CTE for short. The repeated bruising of brain tissue can’t be repaired back to normal and instead a scar forms which in turn prevents normal neuronal connections from occurring. This major disruption of pathways leads to personality changes, impaired neurotransmitter production and distribution, loss of balance and coordination, and pain. And not just headaches, but deep chronic aching pain which is incapacitating to those who have it. A process called Central Sensitization Syndrome or CSS as Doc Bear has described is a result of impaired ability of the glial cells to repair neurons. Instead a short circuit of sorts develops which enhances pain transmission to the deep parts of the brain. There is no cure for this condition and treatment has been woefully inadequate.

Modern players have well-designed helmets which can blunt the effects of trauma to a certain extent when it is accidental and glancing in nature. Now we see players actually using their helmets as weapons to deliver blows to the head for which no helmet ever will be designed to prevent injury. The physics simply aren’t possible. This last weekend there were hits that could have resulted in death. As a medical practitioner, I was afraid for the players lives - and I’m not being melodramatic. I have seen lesser injuries result in death many times. Will it take a death for us to realize the seriousness of this? Well, there actually have already been deaths from CTE - it’s just that they didn’t occur before our eyes on the playing field. Chris Henry died last year and his death was considered an accident, but his autopsy showed severe CTE in a player still in his twenties. What we will say about the players from this weekend if their careers are over? Maybe James Harrison should consider retirement if he considers his behavior free from blame.

The attitude of players towards concussions needs to continue the transformation started recently with the published medical reports on CTE. Since the injury is largely non-visible and the severity in many cases more subjective, there is an unspoken prejudice that the player just isn’t tough enough. Suck it up and get back on the field, heck everyone gets their bell rung. However, we have ample evidence now that the brain never heals completely and is thus never the same again after a concussion. Scar tissue forms and changes patterns. Fortunately, we have enough redundancy in most brains to compensate and show little outward change. However, too many players are suffering the long-term consequences of CTE which is ruining their lives after football.

We need to applaud the steps the league has taken to diminish unnecessary brain trauma and encourage proper tackling technique to preserve this game we love and the players who deserve a life after football that is free from the consequences of CTE.

This was Roger Goodell’s Memo:

Memo

“One of our most important priorities is protecting our players from needless injury. In recent years, we have emphasized minimizing contact to the head and neck, especially where a defenseless player is involved. It is clear to me that further action is required to emphasize the importance of teaching safe and controlled techniques, and of playing within the rules. It is incumbent on all of us to support the rules we have in place to protect players.”

Message

“One of our highest priorities is player safety. We all know that football is a tough game that includes hard contact. But that carries with it an obligation to do all that we can to protect all players from unnecessary injury caused by dangerous techniques from those who play outside the rules. The video shown today shows what kind of hits are against the rules, but also makes clear that you can play a hard, physical game within the rules. Violations of the playing rules that unreasonably put the safety of another player in jeopardy have no place in the game, and that is especially true in the case of hits to the head and neck. Accordingly, from this point forward, you should be clear on the following points:

1. Players are expected to play within the rules. Those who do not will face increased discipline, including suspensions, starting with the first offense.

2. Coaches are expected to teach playing within the rules. Failure to do so will subject both the coach and the employing club to discipline.

3. Game officials have been directed to emphasize protecting players from illegal and dangerous hits, and particularly from hits to the head and neck. In appropriate cases, they have the authority to eject players from a game.

Conclusion

The swift violence of the modern game of pro football is still at constant danger of permanently harming those who make their livings that way - even if people like Mike Klis, who predicted the end of pro football this week, are totally off-base on their dark view of the future of the game. Retired wide receivers can hardly handle an ink pen, since their fingers have been broken so often that they stick out in different directions. Running backs talk about when they will get artificial knees, rather than whether they will. Players count their concussions in well over a baker’s dozen and shrug when asked what they will do if they come down with a cognitive disorder.

“Well, if it does, I won’t know so I can’t really let it bother me,” said one. Even more sadly, such individuals do have moments when their thoughts clear for a few moments like the parting of clouds, and the fear and horror that they often experience then is far more sad than gruesome. The problems with chronic pain lead many to drug addiction, and by the time a player retires after a long career, many are already using painkillers daily, experiencing some degree of cognitive loss and/or beginning to deal with the impossible balance between pain control and addiction.

You can’t make football safe - that’s in opposition to the nature of the game. At the same time, you can make it substantially safer without changing the game any more than continuing to improve helmet and safety equipment, monitoring cognitive issues as a normal part of a career, and forcing teams to begin at the grade school and Pop Warner levels with a much more heavily-sustained emphasis on proper tackling technique.

It would be a start.

Learn to laugh at yourself. You will be ceaselessly amused. - Sri Gary Olsen

You can reach Doc at .(JavaScript must be enabled to view this email address) or follow him on Twitter @alloverfatman

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