Sending the wrong message on concussions

NFL players

Commentary by Dr. Hunt Batjer

The gladiator roar has left football.

The crushing hit that once drew a crescendo of cheers and fist-pumps from fans now brings entire stadiums to eerie silence.

The American public realizes the dire circumstances when a player lays motionless after a spear-heading tackle. Brain trauma is the signature sports injury of the 21st century – an issue that resonates among tens of millions of fans and players across the country, from youth football to the NFL and other sports.

As a neurosurgeon who spent eight years co-chairing the NFL committee that developed the league’s concussion protocol and recommended rules changes to improve safety, I’ve seen increased awareness to the dangers of on-field concussions. Yet we still do not have effective policies in place to assure that players are protected.

In December, Houston Texans quarterback Tom Savage was allowed to return to the field following a hit that left him trembling. He eventually left the game and was listed with a concussion. The NFL subsequently revised its concussion protocol, adding more guidelines to determine how and when potentially injured players need to be examined.

But it’s important that the wrong message not be sent to fans and parents. A more conservative approach is needed that errs on the side of player safety. 

Some changes in recent years have led to notable improvements, from instituting penalties for head-targeting hits to moving the kickoff line up 5 yards to the 35-yard line. Concussions during kickoff returns dropped 43 percent in the season after that change was enacted.

The league has also added neurotrauma consultants to sidelines and athletic trainers in a replay booth to spot potential injuries.

Dr. Hunt Batjer is Chair of Neurosurgery at UT Southwestern Medical Center's Peter O'Donnell Brain Institute and past Co-Chair of the NFL's Head, Neck and Spine Committee.

More broadly, our committee worked with Jeff Miller, Senior Vice President for Health and Safety at the NFL, to get the Zachery Lystedt law passed in all 50 states, which requires that youth athletes and parents be informed about the seriousness of brain and spine injuries, and that any player suspected of having a concussive injury be removed from play or practice immediately.

Still, the NFL needs additional rules that will take the head out of the game and stronger penalties and fines for improper hits. In my view, all injuries involving suspicious helmet-involved impact that result in a stoppage of play should require that the player be evaluated in the locker room, not on the sideline where exams are somewhat superficial.  

The league’s concussion protocol can only work if the guidelines that dictate how players are evaluated and potentially removed from a game are based solely on best medical practices, not political factors.

We owe it to our children and grandchildren to make sports safer. Exercise and organized athletics are vital to healthy living and are critical in battling our nation’s real epidemic, which is obesity.

Even in football-crazed Texas, work is underway to track and reduce brain injuries. UT Southwestern Medical Center is working with the state’s athletic governing body to assess the prevalence of concussions in high school and junior high school sports. Nationally, the U.S. Centers for Disease Control and Prevention is interested in creating a massive database for the same purpose.

But this will take time. In the shorter term, it is imperative that a system be in place to ensure that concussed players are identified quickly and removed from play to prevent potentially devastating brain damage. In a young person, whose brain has not fully developed, the consequences can be catastrophic. 

NFL fans are watching – not just to see who wins the Super Bowl, but for leadership to make the sport safe for all participants. The future of our athletes and the sport itself depend on it.

Dr. Hunt Batjer is Chair of Neurosurgery at UT Southwestern Medical Center’s Peter O’Donnell Brain Institute and past Co-Chair of the NFL’s Head, Neck and Spine Committee. This column was published by the Houston Chronicle, Charlotte Observer and Fort Worth Star-Telegram.