Marquez 1

Gabriel Marquez

Professor Presnell

UWRT 1104

23 April 2019

Concussions in the Game of Football

Throughout the past couple of decades, the topic of traumatic brain injuries and more

specifically the topic of concussions in the game of football has now recently become to emerge

into a major issue that the National Football League (NFL) faces. The NFL has constantly

continued to receive backlash from the media stemming from the 2007 season due to the NFL

not reporting concussion incidence rates from each position. In order to help tackle and resolve

this issue, the NFL has constantly been introducing a variety of measures in order to make the

sport of football as safe as it can possibly be every possible measure being aimed at solving just

one question; how can the quality of football be improved to become a safer sport to play in

order to reduce the amount of concussions that occur as a result of it? Even after such regulation

changes and increased media scrutiny, the lack of available data and statistics suggests the need

for an evaluation of current concussion incidences in football to validate the accuracy of past

reporting and the effectiveness of recent rule changes.

One of the negative consequences that comes as a result of participating and playing such

a violent sport that football is, are the long-term impacts that come from taking repeated blows to

the head. Aaron Yengo-Kahn's article, "Concussions in the National Football League: A Current

Concepts Review," begins by stating about how significant attention has been directed toward

the immediate and long-term effects of sport-related concussions on athletes participating in

 Marquez 2

contact sports, particularly football. As human beings, our brains were not made to withstand

countless blows to the head, but as we see in the game of football, it happens on almost every

play which is a big reason that we have seen the evolution of the football helmet. Although it is

poorly understood, possible long-term neurological consequences of repetitive sports-related

concussions have received increased recognition and attention in recent years. Zachary Kerr's

article, "Nine-Year Risk of Depression Diagnosis Increases with Increasing Self-Reported

Concussions in Retired Professional Football Players," begins by stating about how the members

of the National Football League Retired Players Association responded to a baseline General

Health Survey in 2001 and they also completed a follow-up survey in 2010. Health survey results

published in 2007 revealed that 11.5 percent of players with 1 or 2 concussions believed

concussions had a permanent effect on memory, while 31.1 percent of retirees reporting three or

more concussions held this belief. The long-term cognitive effects of concussion have been

studied predominantly in a cross-sectional manner consisting of surveys of retired NFL players.

Approximately 65% of all respondents self-reported sustaining at least 1 concussion during their

professional careers. Professional football players self-reporting concussions are at greater risk

for having depressive episodes later in life compared with those retired players self-reporting no

concussions. The long-term cognitive effects of concussion have been studied predominantly in a

cross-sectional manner consisting of surveys of retired NFL players.

The N.F.L. has stated that the number of concussions from the 2017 season had been

reduced by 11.3 percent when it was then compared with the 2016 season’s record high

percentage. The reason because of this is believed to be because we are seeing an increase in the

number of players that are now reporting their suspected head injuries. During the 2018 playoffs,

only three players were diagnosed with concussions which was a 70 percent decline from 2017.
 Marquez 3

In 2002-2007, 152 players had repeat concussions and four of the players had three or more head

injuries. During 2002-2007, over half of the players with repeat concussions were removed from

play, and fewer returned immediately. For adolescents and younger adults, sports tend to

contribute to a substantial proportion of traumatic brain injuries (TBI), particularly mild TBI or

concussions within studies of high school and collegiate football players particularly reporting

high concussion rates. The concussion rate among professional football players in the National

Football League (NFL) is also higher than most other sports, with 0.41 concussions per NFL

game with quarterbacks, wide receivers, tight ends, and defensive backs being at the highest risk.

NFL players serve as a useful study unit because of the availability of public data sources. Sport-

related concussions are a significant public health problem, with an estimated 3.8 million

concussions per year occurring in the United States during sport and recreational activities.

Concussions in the National Football League have been a topic of interest now for over two

decades. Over the cumulative twelve-year period of study, 353 of 1200 players experienced a

repeat concussion, with 126 players having three or more concussions and twelve players

sustaining five or more concussions. The odds for a repeat concussion were highest for

quarterbacks and tight ends. Loss of consciousness and medical action were taken and the data

on repeat concussions were analyzed for the twelve years and compared between the two

periods. The study of concussions in the NFL has been limited by lack of recent empirical data,

reliance on self-reported concussion history, and ascertainment bias of brains donated for

autopsy studies. The positions that were most often associated with repeat concussion in 2002-

2007 were the defensive secondary, kicking unit, running back, and linebacker.

The NFL is attempting to make the sport of football a somewhat safer game to play by

enhancing the game through rule changes and adding more on-field personnel because the league
 Marquez 4

has been trying now for years to reduce concussions. Once a wraparound hat made of leather, our

modern helmets that we see today are aimed at softening these repeated blows to the head with

special technology placed within them in order to reduce the movement of the brain within the

head which is what ultimately leads to a concussion. The highest level of football, the National

Football League (NFL), has received significant attention and criticism regarding player

management and safety after mild traumatic brain injury. The highest level of football, the NFL,

has received significant attention and criticism regarding player management and safety after

mild traumatic brain injury. The scientific community, as well as the public, should be cautious

in interpreting the current literature surrounding concussions.

Several review articles have reported data related to concussion in the NFL, but an

adequate review and synthesis of data regarding NFL concussions is currently lacking. Medical

spotters at games are currently pulling more athletes aside to exam them to determine whether or

not they are fit enough to continue playing. Ira Casson's article, "Repeat Concussions in the

National Football League," begins by stating how since 1996, team physicians and athletic

trainers in the National Football League (NFL) have been collecting data on the clinical signs

and symptoms, medical action, and management of concussions to provide a basis for

improvements in player safety. Several review articles have reported data related to concussion

in the NFL, but an adequate review and synthesis of data regarding NFL concussions is currently

lacking.
 Marquez 5

Works Cited

Belson, Ken. “N.F.L. Reports a Decline in Concussions This Season.” The New York Times, The

New York Times, 20 Jan. 2018, www.nytimes.com/2017/01/26/sports/football/nfl-

concussions-decline.html.

Casson, Ira R et al. “Repeat Concussions in the National Football League.” Sports health vol. 3,1

(2011): 11-24. doi:10.1177/1941738110391413

Kerr, Zachary Y, et al. “Nine-Year Risk of Depression Diagnosis Increases With Increasing Self-

Reported Concussions in Retired Professional Football Players.” The American Journal

of Sports Medicine, vol. 40, no. 10, SAGE Publications, Oct. 2012, pp. 2206–12,

doi:10.1177/0363546512456193.

Nathanson, John T et al. “Concussion Incidence in Professional Football: Position-Specific

Analysis With Use of a Novel Metric” Orthopaedic journal of sports medicine vol. 4,1

2325967115622621. 27 Jan. 2016, doi:10.1177/2325967115622621

Yengo-Kahn, Aaron M, et al. “Concussions in the National Football League: A Current Concepts

Review.” The American Journal of Sports Medicine, vol. 44, no. 3, SAGE Publications,

Mar. 2016, pp. 801–11, doi:10.1177/0363546515580313.

Marquez 6