NFL, union try to change culture on concussions

[October 20, 2012]  NEW YORK (AP) -- A high-profile rookie quarterback gets slammed in the side of the head and his Super Bowl-winning coach describes him as "shaken up."

An All-Pro receiver admits to getting "my bell rung pretty good" as being part of the game, and if a player gets concussed, "you've got to keep on playing."

NFL executives want to change the culture of the league -- and all of football -- to reduce head injuries. So far this season, there's evidence it's going to be a tough road.

"The challenge is everywhere and for everyone in the sport," says perennial Pro Bowl defensive back Troy Vincent, now a league executive. "It's a shared responsibility and a personal accountability when you participate in this game, no matter what level.

"A culture change must come on the grass roots level, in Pop Warner, in high schools, in the colleges, and in the NFL. It has to be the parents, the coaches, the players, anyone in charge, so player safety becomes a learned behavior."

League executives seem more apt to claim progress and insist their perspective is not influenced by the 3,500 ex-players suing the NFL for mishandling or ignoring head injuries. Players are more ambivalent, critical of the league yet also giving it credit -- and recognizing they play a risky game.

"I think a lot of that by the NFL is done just to protect their own hides," says Broncos linebacker Keith Brooking, now in his 15th NFL season. "I mean, obviously with the lawsuits and the media attention that concussions are getting currently, it's all about the dollar, it's a smart business move to be proactive in that. But, I mean, in return, what does that equal? It equals taking care of guys more, and as far as the long-term effects, hopefully there will be a difference made as far as our long-term health goes.

"It's positive. But whether it's done from the right initiative I don't know."

The NFL insists its motives are pure, and believes its health and safety policies are working. It cites the thousands of dollars in fines handed out for unsportsmanlike conduct or unnecessary roughness having caused a decline in the number of such hits.

"Guys are going to hit the head of opponents or use their head fewer and fewer times," says Ray Anderson, the NFL's executive vice president of football operations who oversees league discipline for safety issues. "It's definitely encouraging and it's not just occasionally making adjustments, but it's in every game."

Adds Eagles defensive tackle Mike Patterson, currently sidelined after brain surgery: "It is being handled as best as possible. We just know that we've got the NFLPA and you know we've got the NFL as well, so they're going to work it out, make sure things are going to be right for the players, make sure the safety for players is right. ... I mean, we have confidence in what they're doing."

One thing the players' union is doing is requesting that the NFL place independent neurologists on the sidelines of every game and include them as part of the initial concussions examination protocol. For now, when a player shows signs of head trauma, immediate examinations are conducted by team physicians, with the NFL encouraging a conservative, "safety first" approach.

Obvious symptoms of a concussion are listed by the NFL as: loss of consciousness; unresponsiveness; disorientation or an inability to respond appropriately to questions; amnesia; headache, nausea and/or dizziness; abnormal neurological findings; or progressive, persistent or worsening symptoms.

An independent neurologist is generally not at the game and is used to examine a player diagnosed with a concussion to determine when he can return to play.

A major obstacle to a culture change, though, is what one agent calls the players' "gladiator mentality." Calvin Johnson, the Lions' star receiver who got his "bell rung," added that he can't "become afraid to go across the middle."

After Robert Griffin III, Washington's scintillating playmaker, took a hard (but legal) shot to the head and came up woozy, his reaction was straight out of the warrior playbook.

"You want to play and your survival instincts take over," he says, "and it just shows that I care about this team and I didn't want to leave them hanging."

That outlook, and coach Mike Shanahan's use of such an innocuous euphemism to describe Griffin's condition, worry observers inside the league and out.

"We are the NFL and we should be setting the standard for safety and be the symbol for children," says Dr. Thom Mayer, the NFLPA's medical director. "If we are serious about this, having a player say what RG3 said, what symbol does that send to youngsters?"

And, as Vincent emphasized -- supported by current and former players, physicians, even lawmakers -- player safety knows no age limits.

Former NFL running back Merril Hoge, who was forced to retire because of concussion-related problems, calls it "a fallacy" to think there's a trickle-down effect from what the NFL is doing with concussion protocols. He insists a hands-on approach is required on every level, and points out USA Football's Heads-Up Football initiative that has player safety instructors who teach coaches at their leagues and educate parents and players on the proper way of tackling to avoid injuries.

Seahawks fullback Michael Robinson wants all youth coaches to be certified by the NFL.

Steelers linebacker James Harrison, who estimates he has had "double digit" bouts with concussion-like symptoms, believes equipment changes are necessary. He was the first NFL player to wear special, lightweight padding inside his helmet and about 100 other players have joined Harrison.

"If something works, I'm going to use it," he says.

Seattle's Robinson wants to see mouthpieces mandated in the NFL and everywhere else.

Several agents suggest that the players' union establish a network of doctors who examine players as they get ready for the draft and remain available to them throughout their pro careers. In that way, they aren't beholden to teams' medical staffs, eliminating any perceived notions that their health isn't the doctors' first priority.

Dr. Gerard Varlotta of the NYU Medical Center's Department of Orthopedics and Rehabilitative Medicine, works for several agents, regularly examining their players and handling their medical care from the NFL combine right through retirement. He recognizes the players' concerns about priorities.

"There are trends in the NFL where players are injured and their contracts are not fully guaranteed, so it may be better for the team not to treat their injuries," Varlotta says. "A team may cut a player or treat them and be looking at it from a short-term standpoint, and not long term for the benefit of the player."

Union doctor Mayer says he's aware of several physicians who perform such services.

Player agent Joe Linta calls for mandatory health and safety seminars at the league's combine in the winter, its rookie symposium in the spring, and at training camps during the summer.

"Players really need to be on the front lines of education on this," Linta says.

Certainly most beneficial would be getting players to police themselves -- and one another. There are signs it's happening.

"We are seeing a switch in the way players are handling concussions and suspected concussions," says Rich McKay, president of the Atlanta Falcons and co-chairman of the NFL's competition committee, which recommends all rules changes. "A player goes down and we are seeing when he has trouble getting up or there's a problem, other players are pointing to the sideline and telling the coaches to take him out of the game. It's player accountability for each other, and it's a very important part of making that (culture) change."

Still, it's a violent game at the highest level, played by physical specimens who work themselves into a fervor. Their careers are short, their pain thresholds are high, their dedication to each other often immeasurable.

"The doctors, the medical staff," says Chiefs quarterback Matt Cassel, who sustained a concussion earlier this month, "are there to protect you against yourself a lot of times."

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[Associated Press; By BARRY WILNER]

AP Pro Football Writer Arnie Stapleton and Sports Writers Dave Skretta, Tim Booth, John Wawrow, Noah Trister, Joseph White and Will Graves contributed to this story.

Copyright 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.