I was knocked out in a football game playing against Sevier County.
It was November 1984, Harriman was the homecoming opponent at Sevier County, and it was unusually cold. I was blocking downfield for Scott Mason’s long (took him forever) touchdown run and I was hit in the left temple. I woke up looking at the sky and thinking “Wow, those sure are tall lights.”
I admired the texture of the grass, came to understand I was cold and still somewhere in Sevier County, located my mouthpiece, and staggered to the sideline. And I went back in on the next series.
Under today’s rules, I would be out for likely a week or more. But the only rule on concussions was if you could stand, you could play. Toughen up, it’s football. “Quit killin’ the grass.”
The focus on concussions in recent years has brought to the forefront the consequences of repeated blows to the head and “concussions” - even as we still do not understand the exact process occurring in the brain.
A term commonly used now is traumatic brain injury (TBI). TBI describes the injury that occurs from repeated blows to the head resulting in impaired cognitive function and reasoning, memory loss, depression and other symptoms that profoundly reduce the quality of life for the players. The physical evidence of this damage has been seen in the autopsies of players who have donated their brains to science - some at a heartbreaking young age.
An enormous challenge is measuring the level of injury a player has. Some symptoms are observed, but most are self reported by the athlete. If, however, the athlete does not report any symptoms, then he will continue to play.
There are some tests now that can be given and compared to preseason performances, yet it seems as if measuring concussions is a lot like measuring how in love someone is - yep, they’re acting goofy and different, but how much of that is real?
It is probably easier to study the mysteries of the microscope and telescope than it is to measure a person’s thoughts, desires, motivation and pain. The mind is more infinite than the finite infiniteness of space.
Because of this evidence, recent high profile deaths and litigation, football will change. (Soccer will soon follow.) It is inevitable. Even the most ardent football fans and coaches I talk to will admit it privately under low hushed tones. In ten years, football won’t look anything like it does now.
But football has been there before. In 1905 football was a brutal sport blamed for 19 player deaths. President Teddy Roosevelt, a man who loved the outdoors and competition, weighed in threatening to kill the sport if it didn’t change. Football modified the rules and was allowed to continue.
The rules will now change again.
In a recent opinion article in the Journal of the American Medical Association (JAMA), Dr. Paul Auerbach, and emergency physician, former football coach and collegiate football player, offered and assessment and proposed rules change for football. He noted the recent trend in concussion research show that the cumulative total of hits, not necessarily that one big hit, is the underlying problem of TBI.
He proposed six rule changes for all levels of football: First, no “down linemen” for any play. Linemen will stand and oppose each other without blows firing off on each play (it will look sort of like Baptists dancing. I am Baptist so I can say that).
Second, no tackling or striking an opponent with the top portion of the helmet. First offense is a 15 year penalty and the second is an ejection. That is a challenging for officials to call as real time football can be very fast.
Third, no forearms to the head at the line of scrimmage or when tacking. Same penalties.
Fourth, no more that two days of full contact practice for any player per week.
Fifth, any player with suspected concussion is out a minimum of four weeks with a progressive return after that.
And sixth, any coach who allows an athlete to play in a game with concussion will be suspended for the next three games.
He also stated there should be no tackling at any level prior to high school football.
These changes face hurdles, the largest one being measuring concussions. A new blood test seems to be emerging from research, but that is a long way from reality.
Given that most everything we do now is measured digitally, I would suspect a type of motion sensor will eventually come to the market to measure the number and intensity of hits a player has during his entire career. His “Impact Eligibility” will become another factor in playing time and years of playing. Not wearing it will be grounds for dismissal much like radiation badges in nuclear plants.
Money, though, is the power that will prevail in this decision. Pro-football, college, and now even high schools have advertising and sponsors for ads, equipment, stadiums and broadcasts who would resist change. One major lawsuit could cause insurance rates to skyrocket and high schools and college would have no choice but to change.
So when you watch the college and high school football games this Thanksgiving weekend, keep in mind that the touch football game in the family’s backyard might be a foreshadowing of where football is metamorphosing. The evidence simply can no longer be ignored.
Eric J. Littleton, M.D. (@DrEricLittleton) is a musician and Family Physician in Sevierville, TN. Topics covered are general in nature and should not be used to change medical treatments and/or plans without first discussing with your physician. Send questions to askdrlittleton@gmail.com
