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Football is becoming safer, but perception of danger remains.

Nov 17, 2017

Americans have become obsessed with concussions, and with good reason. But for medical professionals, it’s a double-edged sword: people are interested, but they also have more misinformation.

For example, concussions last only a week or two, while smaller, more frequent hits can result in chronic traumatic encephalopathy, or CTE – but the two are often lumped together.

I learned about all kinds of brain injuries when I coauthored a book with ESPN’s John Saunders. One day he stood up, blacked out, and hit his head on a tile floor, which gave him a serious brain injury, and all that goes with it. He had a splitting headache for nine months, he spent six weeks in a hospital re-learning how to walk, regaining the most basic skills, and restoring something called “impulse control.”

In one test, John had to stick ten pegs into ten holes. If you were working slowly and carefully, you’d need about 20 seconds. It took Saunders six minutes. His IQ had dropped from a 154 to 102.

In another test, Saunders was supposed to push a button whenever he saw the letter ‘A’ pop up on the screen. He was mildly insulted by the silliness of this exercise, until he started the test, and realized he could not stop himself from pushing the button whenever any letter appeared, even though he knew he was not supposed to.

This lack of “impulse control” can create serious problems in the real world, where victims often end up making horrible decisions. The governors that regulate such behavior are gone. They don’t have any brakes. It can even lead to suicide, which doctors believe is often an impulsive decision.

John recovered, regaining what he’d lost, and even the headache went away. But not everyone is so lucky.

The damage concussions, CTE, and closed head injuries can do hasn’t changed, but our focus on them has, especially after two former NFL players committed suicide by shooting themselves in the chest to preserve their brains for study. In both cases, scientists discovered severe CTE.

As tragic as that is, it doesn’t mean a kid playing football today is doomed to a similar fate. For starters, the current generation of former players in their 50s and 60s will likely be the most damaged, because they played through two-a-day practices, often on astroturf fields, when we called concussions “getting your bell rung,” and laughed them off.

That’s the generation we see aging now, so it’s hard to believe things will be better for the next one. But they will be, because most of those poor conditions have been removed, and they’ve added better equipment, better rules, and better medical care to make everyone safer. They can make it safer still by eliminating hitting for grade school players, limiting it for high school, college, and pro players, and monitoring players more closely.

One of the best monitors out there is Dr. Jeffrey Kutcher, an international expert on sports neurology. He notes that NFL players as a group do not die sooner than others, but actually live longer, and the risk of concussions in football is not much greater than it is in soccer.

But the question is not only whether football is safe enough to play. It’s whether parents think it’s safe. Because even if football becomes safer than checkers, if parents don’t believe it, they won’t let their kids play. And once a critical mass of kids decide to play something else, those who want to play won’t be able to find any teams.

Football has two problems: the risk of brain injury, and the perception of that risk. The sport is finally doing a very good job on the first problem – and a horrible job on the second.

John U. Bacon is the author of eight books on sports and business. His current book, Playing Hurt: My Journey from Despair to Hope, coauthored with John Saunders, is his fifth New York Times bestseller.