Walkthrough: Concussions

by Mike Tanier

I get asked about concussions and CTEs a lot, both by friends and by people seeking my on-record, expert opinion. I have no expertise in this field whatsoever, and I rarely feel comfortable talking about such sensitive issues.

Still, I have to say something, and I suppose I have to think something. So here is my official position statement on concussions in the NFL.

1. It is ridiculous to take a "zero-tolerance" stance toward concussions in sports. It is appropriate, and for decision makers should be mandatory, to take a zero-tolerance stance toward dangerous behaviors and bad preventative-diagnostic-treatment practices.

2. While the NFL’s response to the medical field’s evolving understanding of concussions and CTEs has drawn criticism, some of the response is probably justified. The league is addressing the issue, from a variety of angles, in a somewhat proactive way. Rule changes, stiff penalties for rough or premeditated hits, and changes in post-concussion evaluation and recuperative practices are all steps in the right direction, and the league appears serious about taking further steps.

3. Concussion prevention and post-concussion treatment each involve a variety of policies and procedures. These include: rule changes; equipment modifications or changes; stepped-up enforcement of rules against dangerous behaviors, by players, coaches, and franchises; better diagnostic practices; better treatment practices; and post-career support services, in addition to some other things I have not thought of.

Considering the complexity and multi-dimensionality of the issue, it is unrealistic to think of concussions and CTEs as a "solvable" problem. It is better to think of it as "manageable." Furthermore, judging the NFL’s response to any one of these issues in isolation is not particularly informative. The NFL’s effort to manage concussion-related problems is best judged holistically.

4. The NFL cannot prevent a concussion which occurred 20 years ago. It should also not be held accountable for the society-wide attitude that existed 20 years ago which generally held that an athlete with a concussion "had his bell rung" and should be ready to play after some Gatorade and smelling salts. The NFL can increase its outreach to retired players, through the NFLPA or other channels, and can assist at-risk veterans with counseling (personal, emotional, career) and other programs. The NFL does a little of this, and I believe they can do more, but we have to accept that these would be "close the barn door" services to a degree, at least in the short term.

5. The NFL is in a position to send unequivocal messages to the college and prep levels about the dangers of concussions and CTEs, and sending those messages is more important than anything else the NFL does on this matter. That is why the harsh penalties the league handed down to the Saints organization and players were justified, in my opinion.

Particularly at the prep level, attitudes are often slow to change. There are still high school coaches who say things like "we didn’t have any mamby-pamby concussion rules in our day," and these coaches remain employed because there are parents and community members who believe that asking a child to shake off a head injury teaches them "toughness." This attitude must be annihilated, for the sake of thousands of children who will play high school football but will never come close to the NFL.

The topic of prep and youth football safety is currently being debated, and it is more complex than anything the NFL can deal with (and, as it involves everything from pediatrics to school law, far too complex for television talking heads to prattle about). The NFL is doing its part by setting a tone on two very noticeable points: installing post-concussion diagnostic procedures which, while in need of improvement, are better than "how many fingers am I holding up," and cracking down not just on illegal hits, but the kind of angry-coach rhetoric that encourages unsafe procedures.

6. The most obvious problem the NFL faces right now is the knowing circumvention of the existing rules: apparent head injuries that are redefined as shoulder injuries, the Colt McCoy incident, and so on. Independent neurologists may help solve these problems. Stiffer fines and/or suspensions for organizations which flaunt the existing rules should also be enforced.

7. The medical profession’s understanding of CTEs is still evolving. The NFL’s response is still evolving. Our attitudes and perceptions toward these matters are still evolving. Expecting instant results, or more illogically, retroactive results, is counterproductive, as is sensationalizing what is already a serious problem. It is our job as writers to become as informed as possible while acknowledging how uninformed we still are, and for "generalists" like me to recognize the limits of our knowledge on these issues. As fans, you owe it to yourselves to be patient with things like bad on-field calls while the NFL tries to figure these issues out.

8. There is a tendency among many of us in the media to adopt an arch, hypercritical, "one concussion is one too many" stance on this issue. Some of us sneer at every NFL initiative to prevent concussions as "lip service" or a "public relations" move by an entity with no regard whatsoever for the health of its employees. Others take to Twitter minutes after a tragic event, climb onto our soapboxes, and use the untimely loss of a beloved player as an opportunity to promote our particular brand of enlightenment on this issue. We assume a concussion after every big hit, then accuse the team of covering up the concussion, based on zero evidence (other than an instant replay) and zero medical knowledge. We sometimes speak out of compassion or concern, but sometimes we speak out of cynicism or in the name of self-promotion, and at times we ourselves cannot tell which is which.

We are not performing a service to anyone when we behave in this matter. We become like Helen Lovejoy shouting "think of the children!" Concussions and CTEs are medical issues, with social and economic overtones, that are best approached analytically, critically, and skeptically. I ask my colleagues to make themselves part of the solution. Respect the scope and importance of this issue by not turning it into a 140-character bon mot.

9. I sincerely believe that in 20 years, we will be watching and enjoying football, and that concussions and post-concussion symptoms will be manageable medical problems that we have learned to avoid in many cases and treat responsibly in the others. American football used to have problems with severe spinal injuries and on-field deaths, first at the turn of the 20th century and later before World War II. Rule, equipment, and attitude changes have made these tragic events rare. Concussions will never be quite as rare, but I believe long-term concussion symptoms will come to be contained as medical knowledge grows and football practices evolve.

10. For the record, my children have shown no interest in the sport, and I would be more likely to dissuade them because of the sport’s intense time commitments on young people than because of fear of concussions. (Nine-year-olds should not practice for two hours per night, five nights per week, at the start of a school year.) I have witnessed terrifying collisions on high school fields, and have also seen hundreds of young boys use football to enhance their self-esteem, community pride, and character, in addition to their ability to run fast and hit hard. Banning football or restricting our young people from the sport is not the solution. Becoming smarter, safer, and saner is the solution.

That’s that. Now, please, let’s play some football.

Or at least watch a movie.

Assemble

Two random thoughts on The Avengers movie.

First, is Stark Towers located on the footprint of NFL headquarters in Manhattan? It is hard to tell the exact address with all of the explosions and action all around it. Oh, wait, spoiler alert: The Avengers contains a lot of explosions and action in New York. Sorry about that.

The Chrysler Tower is clearly seen out Tony Stark’s window in many shots. Chrysler Tower is at 46th and Lexington, on the East Side. NFL Headquarters is on Park Avenue near 48th Street, just a few blocks away. I have never been in Roger Goodell’s office, but I can imagine him having a view of the Chrysler Tower spire. And a red-and-gold battle suit.

During a battle sequence, Tony Stark clearly says that he is getting chased by villains down Park Avenue. Stark Towers appears in a wide shot a few seconds later. That settles it: in the Marvel universe, Iron Man is also commissioner of the NFL.

Actually, I think the production designers stuck Stark Towers on the footprint of the Met Life building, which is just also just a few blocks from Chrysler Tower. If my memory serves me correctly, some earlier shots show Stark Tower very close to the East River. That cannot be right: Marvel fans know that is not Stark Towers, but Four Freedoms Plaza. I may have to go watch the movie again, and write the ticket price off as a research expense.

Second, and Twitter followers know that I have grown slightly obsessed about this: did anyone notice the really, really archaic dirty word Joss Whedon slipped past the censors during one of Loki’s speeches? He calls Black Widow a "mewling quim." Woah! Queen Victoria just fainted. That Q-word was the C-word for several hundred years, and may still be in some parts of the world, so I am sorry for writing it as if it is still super-naughty in your corner of the English-speaking world.

It is not a big deal here in the United States. A cuss word just isn’t a cuss word if no one in the audience knows what it means. I just wanted to mention it so you guys can discuss it if you do not want to talk concussions (and who does?), and if it becomes a major topic of discussions on The View next week, you heard it here first.

Buccaneers Top Five Running Backs

1. James Wilder

Wilder’s 407 carries in 1984 still rank as the third highest single-season total in history. ( Larry Johnson and Jamal Anderson rank first and second). Wilder also caught 85 passes that year; if we assume he was targeted about 100 total times, then he was involved in 48 percent of the Bucs’ offensive plays that year.

Curse of 370 notwithstanding, Wilder managed a 1,300 yard season in 1985 before trailing off, though he really did start trailing off in 1985. Wilder started the 1985 season with four games of 100 or more yards, three of them on 26 or 27 carries, the fourth on 22. Soon, the 24-for-49 and 26-for-49 stats lines began to mix with 14-for-13 catastrophes, though Wilder still mixed in some productive games and was a force near the goal line.

Despite obvious diminishing returns, Leeman Bennett and the Bucs refused to use a change-up back of any kind. Steve Young finished second on the team with 233 rushing yards (in five games) in 1985, and veteran fullback Ron Springs was third with 16 carries for 54 yards. The Bucs were a one-back offense in the truest sense of the term. They were also terrible. Forcing poor Wilder to hammer into the line 26 times for a two-win team was just bonkers, though Wilder was probably happy to do it.

Wilder’s wheels stared to fall off in 1986. He missed two early-season games, then got knocked out early in a third, then missed the final two games. In between, he managed a 24-for-130 Thanksgiving effort that probably represents the only full-game memory most fans my age have of Wilder. That game was not in keeping with his 1986 efforts, because he typically carried 10-20 times by that point, but it was an otherwise accurate slice of his career: he got worked like a mule (nine catches to boot), and the Bucs lost 38-17. Springs was still the change-up back, though really Wilder’s per-game carries only dipped because the Bucs were always getting beaten 31-7, 38-7, or 35-14.

The Bucs finally got Wilder some help in the form of Jeff Smith, then Lars Tate; the team obviously had trouble identifying decent running backs other than Wilder and an ex-Cowboys fullback. Wilder hung around for several seasons as a useful fullback and receiver-back. He would have had a better career with a better team, or with a few less 30-touch games.

2. Warrick Dunn

Dunn finished second in receiving DYAR among running backs with 227 DYAR in 1999. His DVOA was all over the place during his Bucs years, but then so were his raw numbers. He averaged 2.8 yards per carry in 2001, 3.2 yards per carry in 1999. Complementary backs like Dunn often have up-and-down careers; a change-up back who doesn’t break a run longer than 21 yards and gets saddled with six-carry, three-yard games is going to have a statistically poor year, even if he is the same guy who gained 1,500 total yards the previous year.

We never think of Dunn as inconsistent, though, because he is so consistent as a human being.

3. Mike Alstott

Alstott was almost undoubtedly the worst NFL player to be able to boast six Pro Bowl berths and three All-Pro selections since the merger. Alstott kept making the Pro Bowl as a "fullback" even though he was more of a change-up back. As a running back, DVOA was rarely impressed by his rushing or 7.5 yard per catch receiving average. Alstott’s Success Rates were all over the place –- he went from 39 percent to 54 percent in one year -– which is not good for the guy who is supposed to move the chains.

Alstott was not a bad player, of course, and he had a long career as a guy who could help out up the middle, at the goal line, or on a screen. But between the Pro Bowls, Chris Berman sound effects, and gritty white guy persona, he runs the risk of being incredibly overrated. If an Alstott for Hall of Fame bandwagon starts rolling, please shoot paintballs at it.

4. Michael Pittman

Excitingly ordinary all-purpose back who was just good enough at everything to be a cog in the Jon Gruden machine in 2002.

5. Cadillac Williams

Cadillac was never able to overcome injuries and achieve his potential, but he settled into a role as a useful backup for several years.

Errict Rhett grinded out two 1,000 yard seasons in 1994 and 1995. As you might expect from a back averaging 3.6 yards per carry, Rhett generated negative DVOAs in his best years. He was a grinder who should have gotten less than 332 carries in his best seasons. Ricky Bell was another grinder -- the Bucs famously chose him ahead of Tony Dorsett in the 1977 draft. After a pair of injury-marred seasons, he flashed his potential with a 1,263 yard season for a 10-6 team in 1979, but that was the high-water mark of a disappointing career, and Bell died tragically of heart failure a few years later.

LeGarrette Blount appears to be following in the footsteps of players like Cadillac and Rhett. Chances are that Doug Martin will replace him before he cracks the top five. Any back that has three 1,000-yard seasons for a competitive Buccaneers teams will have an argument for joining Wilder and Dunn at the top of this list.

Don’t worry, folks: the NFC West Top 5 Running Back lists will be far better!