The NFL's Response to Brain Trauma: A Brief History

Checking the claim that the league always made sure players "knew the risks"

mike webster funeral 615 ap.jpg
The casket bearing the body of former Pittsburgh Steelers center Mike Webster in a Pittsburgh funeral home Friday, Sept. 27, 2002. (AP Photo/Keith Srakocic)

We've spent quite a bit of time discussing the NFL and head trauma. One rather constant claim is that the NFL has always been always been straight about head trauma and that players "knew the risks."  I think it's helpful to weigh that claim against the actual history. Here is one rendition of that history.

1992 - Al Toon suffers his fifth reported concussion in six seasons. Asked if he will retire Toon says, he's "not thinking about retirement right now." 

A week later Toon retires saying, "I feel better sitting still than moving around. I get real tired. Things I normally help with around the house, I can't."

1994 - The NFL establishes the Mild Traumatic Brain Injury committee. Rheumatologist Elliot Pellman is installed as its chair. "Concussions are part of the profession, an occupational risk," rheumatologist  Pellman tells Sports Illustrated. He says that a football player is "like a steelworker who goes up 100 stories, or a soldier."

Pellman continues--"Veterans clear more quickly than rookies...They can unscramble their brains a little faster, maybe because they're not afraid after being dinged. A rookie won't know what's happened to him and will be a little panicky. The veterans almost expect the dings. You have to watch them, though, because vets will try to fool you. They memorize the answers. They'll run off the field staring at the scoreboard."

1995 - The Jets try to improve Boomer Esiason's recovery time from a concussion by employing what the Times calls a "innovative but unproved form of biofeedback therapy." The Jets team physician explains the treatment as  "having a head filled with marbles knocked around after a hit. The biofeedback is trying to put them back in the same order." The Jets team physician admits that they have no controls to show whether the treatment is effective. The Jets team physician is Elliot Pellman.

1997 - The American Academy of Neurology establishes guidelines for concussed athletes returning to play. The guidelines recommend holding athletes who suffer a Grade 3 concussion (loss of consciousness) be taken "withheld from play until asymptomatic for 1 week at rest and with exertion."

2000 - The NFL rejects these guidelines. ''We don't know whether being knocked out briefly is any more dangerous than having amnesia and not being knocked out,'' says neurologist Mark R. Lovell. ''We see people all the time that get knocked out briefly and have no symptoms,'' he added. ''Others get elbowed, go back to the bench and say, 'Where am I?' ''

Lovell is a consultant for NFL and the NHL.

2002 - Hall of Fame Pittsburgh Steeler center Mike Webster dies. Towards the end of his life Webster was living out a pick-up truck, using a Taser to ease back pain, and applying Super Glue to his teeth. 

2003 - In a game against the New York Giants, Kurt Warner suffers a concussion. Confusion ensues over the medical chain of command. Warner's coach, Mike Martz, says that the team doctor cleared Warner to play. The doctor, Bernard T. Garfinkel, agrees. But asked why Warner was allowed to play even though he "had trouble deciphering plays," Garfinkel says, "That's a coaching decision, not a medical decision."

Warner leaves Giant stadium in an ambulance.

"I would say it's not the coach; it's ultimately the physician's decision," says Pellman. "But you can't have a hard and fast protocol, because the injury is all over the place."

2003 - Wayne Chrebet suffers a concussion in a November game against the Giants. The following discussion between Pellman and Chrebet takes place:

"There's going to be some controversy about you going back to play." Elliot Pellman looks Wayne Chrebet in the eye in the fourth quarter of a tight game, Jets vs. Giants on Nov. 2, 2003, at the Meadowlands. 

A knee to the back of the head knocked Chrebet stone-cold unconscious a quarter earlier, and now the Jets' team doctor is putting the wideout through a series of mental tests. Pellman knows Chrebet has suffered a concussion, but the player is performing adequately on standard memory exercises. 

"This is very important for you," the portly physician tells the local hero, as was later reported in the New York Daily News. "This is very important for your career." 

Then he asks, "Are you okay?" 

When Chrebet replies, "I'm fine," Pellman sends him back in.

2004 - In September, former Steelers offensive linemen Justin Strzelczyk leads the police on a high speed chase through central New York, colliding at 90 MPH with a tractor trailer. The trailer explodes, killing Strzelcyzyk instantly. 

Neuropathologist Bennet Omalu later finds evidence of CTE in Strzelczyk's brain. Dr Ronald Hamilton of the University of Pittsburgh confirms Omalu's assessment: "If I didn't know anything about this case and I looked at the slides, I would have asked, 'Was this patient a boxer?'"

2005 - In January, Pellman and MTBI publish their seventh in a series of research papers on concussions, concluding, in part, "Return to play does not involve a significant risk of a second injury either in the same game or during the season."

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Ta-Nehisi Coates is a national correspondent at The Atlantic, where he writes about culture, politics, and social issues. He is the author of the memoir The Beautiful Struggle.

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