In April, the whiteboard in Pioneer head coach Jeremy Gold’s office listed a long roster of spring visits by colleges looking for football players. On May 11, Yale and Harvard were coming. On the following days, Penn and Brown. After that, Kenyon College and Princeton.
Eight members of this year’s graduating class will go on to play college football. “It’s a great day for Pioneer football,” Gold told the press.
With that pride and joy now comes a flood of concerns over what happens to a young man’s brain after repeated hits to the head playing football, first in high school, then in college, and then, for a lucky few, under million-dollar contracts in the pros. Dangers to the limbs, necks, and joints have been talked about for decades. Now the major concern is for the players’ brains.
Mel Owens, a linebacker for Bo Schembechler thirty years ago, went on to play ten years with the Los Angeles Rams. He’s now a partner at a California law firm that represents roughly 1,000 former NFL players who’ve filed workers’ compensation claims for injuries from years of on-field collisions. Owens told the New York Times that three-quarters of them report suffering a brain injury while playing pro ball.
Local builder Don “Donnie” Dufek, Jr., also played for Bo. A two-time All-Big Ten defensive back, he went on to play nine years for the Seattle Seahawks. After a hit in one NFL game, he recalls, “I didn’t know where I was, who I was.” It was halftime when he realized, “Oh, I’m in Cleveland. And we’re winning.”
Dufek walks with a slight limp but says his brain feels absolutely fine. Still, he wonders whether his years on the football field punished his mind as well as his body–especially since he read a copy of Christopher Nowinski’s 2009 book Head Games: Football’s Concussion Crisis.
A concussion is an injury to the head that leads to a noticeable impairment in brain function. The mental symptoms usually clear up on their own; the concern now is that concussions may also leave invisible, cumulative damage.
A New Yorker article last fall honed in on Kyle Turley, a former NFL lineman who, at age thirty-four, collapsed in a Nashville bar with symptoms that resembled, with frightening precision, the concussions he suffered on the playing field. Writer Malcolm Gladwell cited even more disturbing stories: “Mike Webster, the longtime Pittsburgh Steeler and one of the greatest players in N.F.L. history, ended his life a recluse, sleeping on the floor of the Pittsburgh Amtrak station. Another former Pittsburgh Steeler, Terry Long, drifted into chaos and killed himself four years ago by drinking antifreeze.”
Gladwell interviewed Boston University neurologist Ann McKee, whose group autopsied the brains of sixteen former football players and found damage resembling Alzheimer’s disease in all of them. If so many players have been hurt so badly, the New Yorker headline asked, “How different are dog fighting and football?”
Pioneer’s coach Gold comes from a football family–his brother Ian played for Michigan and then the Denver Broncos and a cousin is with the Green Bay Packers.
Gold’s players spend long hours in the weight room and endure bruising practices for the chance to star under the lights on Friday night–and, maybe, go on to college or the NFL.
“I always had this dream of being a quarterback,” says Andy Creal, who’s finishing his sophomore year at Pioneer and will be moving up from junior varsity to varsity in the fall. His dad, Mike, was a quarterback and defensive back for Pioneer back in the 1980s. Andy has been playing football since the fifth grade; his freshman year at Pioneer, he quarterbacked his team to an undefeated season and a championship. “Ever since then, I’ve fallen in love with football.”
Creal says he actually likes getting hit, likes feeling sore the morning after a game. But he’s mindful of the game’s dangers. “How you tackle and how you hit–technique–is important,” he says. “Keeping your head up, your neck strong–it’s a big thing. You put your head down, and that’s your career.”
Yet Creal already has suffered two concussions. One happened in the seventh grade on the decisive play of an overtime loss. The second was during the Pioneer JV’s win over Chelsea last October. “I was so in the game I didn’t feel it at the time, so I kept playing,” he recalls. But afterward, “I couldn’t even focus at school.” He had lingering headaches that cleared up only in March, after he took his mother’s advice and tried reflexology and massage.
“My mom’s a wreck,” Creal says. “She wants me to quit. My dad understands. I think he loves watching us play.”
Despite the concern, many older players remain mentally healthy. Don Dufek, Sr., a Michigan fullback from 1948 to 1950 and MVP of the 1951 Rose Bowl, is eighty-one. “His head is clear,” says Don, Jr.
Al Wistert, a Michigan tackle in the 1940s who went on to play nine years with the Philadelphia Eagles, seems fine, too. In a phone interview from his house in Oregon, he says he’s almost ninety and “still going strong.” Wistert says that most of his teammates are gone now, but one he knows well, Johnny Greene, is still “quite sharp. He enjoys life the way I do.”
So why are Wistert and Dufek, Sr. doing fine while much younger players like Kyle Turley, Mike Webster, and Terry Long are suffering from brain damage?
Wistert and Greene played wearing only hardened leather helmets with no face mask. “My nose to this day looks like it has been broken once or twice,” Wistert says. “I lost a few teeth.” Today’s helmets are made of impact-resistant plastic, cushioned with air chambers and protected by face masks. The new helmets cut the number of sudden deaths from head injuries on the football field–but may have made the game less safe in other ways.
“The football helmet has dramatically changed to be more protective of the head,” explains Paul Schmidt, director of training for the U-M football team. “But the consequence of it is as it has become a better protector of the head and the brain, it’s used more as a weapon. So now there is more spearing–leading the tackle with head first. It’s illegal, and it’s rarely called.”
Today’s players also are bigger and faster, so they hit with more force. “Football is a contact sport,” says Schmidt. “People will run into each other. The question is: are there more concussions today? That is hard to answer, because we are much more medically aware of concussions.” But regardless of the number of concussions, he says, the improved helmet “allows the players to be more aggressive” and sustain more minor collisions–and “every time a person gets hit, there is a certain amount of energy that is dissipated into their skull.”
Jeffrey Jentzen, director of autopsy and forensic services at the U-M, played football at Ypsilanti High and as an undergrad at Michigan Tech. “They started talking about this issue of closed head injury in sports about fifteen years ago,” he recalls. “What they’re talking about is the repetitive nature of it–that’s what’s different than just regular head injuries.”
At last year’s annual meeting of the National Association of Medical Examiners, Jentzen saw a presentation by Ann McKee, the researcher featured in Gladwell’s New Yorker article. McKee, who’s affiliated with Boston’s VA Medical Center, showed slides of a football player’s brain displaying protein patterns typically seen in the brains of people with Alzheimer’s–a disease rarely seen in young people. Jentzen says McKee issued “a call for us to be on the lookout for athletes who had developed dementia, and if possible, to recover their brains for study.”
Jentzen is not aware of any football players’ brains being studied at the U-M. But a growing number of athletes, including Kyle Turley, have agreed to donate their brains to the Boston University program. That will eventually provide a much larger sample and permit comparison with a control group.
But getting those results will take years. What can be done for players now?
U-M neurologist Jeffrey Kutcher is a national expert on that question. “I was an athlete, grew up playing hockey, and had a few concussions myself,” Kutcher says. “I became a neurologist because I just love the brain and how it works and all of the complexities of it we don’t know. Because of my interest in athletics I started on the athletic department medical staff with complicated cases, in not just concussions but neurological cases too. I quickly figured out that there was a lot of neurology in sports medicine, but not a lot of neurologists doing it.
“Neurologists, classically, aren’t given the skills you typically need to take care of athletes,” Kutcher explains. “But sports medicine folks don’t have our neurological training either. So I got interested in it, and it sort of became my personal crusade, if you will, to bring the two together and create and organize the field of sports neurology.” He heads the U-M’s Neuro-Sport program, chairs the Sports Neurology section of the American Academy of Neurology, and serves on the NFL committee monitoring head, neck, and spine injuries.
Treating sports concussions is complicated by the fact that athletes don’t want to report an injury that could send them to the sidelines. Recovery, too, is different. “If you have a concussion, for example, the classic neurologist’s thinking was, ‘That will go away after a week, and you’ll be fine,'” says Kutcher. “But that’s when you’re thinking they’ll go back to their regular life….In contact sports you’re returning to that activity that caused the concussion in the first place.”
Kutcher is the neurologist for both the U-M and EMU football teams. If he diagnoses a concussion, he says, that player is done for the day and will stay inactive until “he becomes completely asymptomatic.” Then, once the mental symptoms clear, “you challenge them in a graded fashion” to watch for any recurrence–“stationary bike, jogging, agility drills, weight lifting, non-contact practice, practice, game.” In most cases, recovery takes one to two weeks–but “we don’t put a time frame” on when a player returns. “[Coach Rich] Rodriguez is actually very good about that.”
In January, Kutcher testified at a congressional hearing on head injuries in football–part of what he calls a “crazy” few months of public attention to the problem. “Probably the one media event that started the process was the New York Times article [last September] that talked about the University of Michigan ISR study,” he says. The NFL-funded study asked 1,063 retired players dozens of health-related questions, one of those being whether they had received a diagnosis of “dementia, Alzheimer’s disease, or other memory-related disease.” About 6 percent of respondents said they had–five times the national average.
“It’s been observed for decades that playing football, playing contact sports, getting multiple hits, is a risk factor for possibly lowering one’s cognitive abilities, even leading to a dementing illness,” Kutcher says. “That’s not a new concept. What is new is sort of the level that folks have tried to link the two, [to] say everybody who’s getting hit is going to have a risk of dementia.”
The ISR survey, he says, was not structured to make comparisons with the general population. But “even if you took the NFL players in the study who said ‘we have Alzheimer’s or a memory-related diagnosis’–which could really be anything–that was six percent of them! Even if you accepted that as being true, which is significant, it’s not saying or concluding that everyone’s going to be demented at age forty!”
Kutcher calls the sudden attention to sports concussion “a plus and a minus. It’s a plus because it heightens awareness.” The minus is that “it seems like people really want answers when we can’t give them….There’s very little that you can point to in science and data and say ‘this is why concussion’s bad.'” Even what causes a concussion is unpredictable: “You take a hundred athletes and you give them the same blow to the head,” Kutcher says. “You’re going to get a hundred different responses.
“The fact of the matter is, when it comes to brains, there are a tremendous number of variables that go into whether a brain is going to degenerate, for whatever reason–the genetic makeup of that brain, for example. The physicians and scientists who are involved in this debate, myself included, we all kind of agree it is a subset of people who are at risk.”
But due in part to the media coverage, Kutcher says, “I have athletes who are scared to death. They love to play, but they come in and say, ‘Gosh, Doc, I have a concussion. I don’t know if I should ever play again.’ It’s their first concussion, and they’re a sophomore in high school, and they’re going to be fine. It happens.
“And yet, everybody’s different.” If a player gets concussed more easily or more severely or shows signs of long-term mental impairment, Kutcher says, he may indeed need to give up football: “You have to treat this as an individual injury, not as if everyone has the same thing.”
While Kutcher sees concussions as a medical problem, Ann McKee, the Boston neurologist, sees them as a public health issue.
“Is everyone at risk playing football? I certainly hope not,” she says in a phone interview. “The point is we are finding that in a number of individuals that we’ve studied–actually in all of the brains we have studied so far–we found a chronic neurodegenerative condition…and it’s only been found in individuals who have had repetitive head trauma.
“As far as knowing exactly what it means for everyone playing football, I don’t think we’re there yet. Clearly there are people who have played football who are walking around and appear to be quite intact. So we really don’t know what the prevalence of this disorder is. That’s something we really have to wait for longitudinal case controlled studies [to resolve], and that will take years.”
But, McKee adds, “I think that the magnitude of the problem is such that we can’t wait [for those results]….There’s a problem, and it’s a very significant problem. It’s not something that is benign. It’s ruining people’s lives and causing them to lose their mental capacity at a very young age.
“It’s probably not just the concussions, it’s probably just that day-to-day on the line of scrimmage, subconcussive hits, that end up contributing to this. So the question is: can we change football back to where the head and the helmet aren’t such a key part of the process?
“I am an enormous football fan. I grew up with football. I’m from Wisconsin–it’s like Michigan [in its love of the sport]. I hate to see this game go away. But we also don’t want our players–players that we really admire and like to watch–risking their mental capacity at such a young age.”
McKee’s group is urgently looking for a way to identify the players at greatest risk. Meanwhile, she suggests a “buddy system” where players monitor one another for possible concussions. Huron High football coach Cory Gildersleeve points out that current practice already trains players to use their hands more on the line of scrimmage–“you keep separated, and you’re not getting the head-to-head contact in the trenches.” When tackling, “we teach them to keep the head up, keep the chest up–we talk about biting the ball.”
Schmidt, the U-M trainer, says game officials could help by calling more spearing penalties. And if a player appears to be at high risk, he should be encouraged to quit the sport. About eight years ago, Schmidt says, Michigan did just that with a player who’d had multiple concussions before starting college and suffered more while he was here. “He has since become a physician and actually sent us back a thank-you letter, saying, ‘At the time, I wasn’t mature enough to understand that you were looking out for me. Now that I’m a physician, I understand how the brain works and I want to thank you for looking out for me when I was unable to for myself.'”
Schmidt also notes that football is only one of many sports where players are at risk. “I’m not concerned about the appropriateness of care in the college or professional sports environment,” he says. “I’m way more worried about my daughter who is a freshman in high school. If she gets a concussion [in field hockey practice], does the coach know properly how to take care of it? Is there a certified athletic trainer there? What about the sixth grader who plays soccer every Saturday morning? Who evaluates them when they get hit in the head with the ball?”
Still, few sports are as violent as football. Don Dufek, Jr.–like all of the dozens of former players interviewed for this story–has no regrets about his football career. But after he had retired from the pros, standing on the sidelines at Michigan Stadium, he’d see–and hear–the impact when two players collided at top speed. “It was shocking,” he says.
“It was an entirely different experience seeing and hearing it close up years later from the sideline. And it is a whole other experience sitting twenty rows up, as a spectator, where you can’t hear the hits, where you just see the play. You can separate yourself from the pain of it.”
Offensive lineman Dave Moosman is following in Dufek’s footsteps. In April, the 2010 U-M grad signed as a free agent with the Arizona Cardinals.
“I started playing football in fourth grade,” Moosman recalls. “It was in Memphis, Tennessee. I played all the way through school. I’ve played in the same position for all those years–I’ve been a fat kid all my life.”
As a lineman, “usually the people that I hit are about a foot away from me or less, so there’s no real, traumatic impact,” Moosman says. “Sometimes you get your bell rung, so to speak. Then you get your wits about you, and you keep going….Never have I gotten up and thought that I couldn’t keep going or something was seriously wrong.”
Moosman knows about concussions but doesn’t think he’s ever had one. “I like to think of myself as reasonably intelligent and use fairly good judgment when it comes to common sense,” he says. “If I were feeling nauseous or dizzy or if I was forgetting, I definitely would have said something.”
He’s well aware of football’s dangers. “You’ll see people who come out that have long prolific careers that have little damage to their bodies, either mentally or physically. And then there are people who have very short careers, because they play with little to no regard for their own well-being and just throw their bodies at people. Those are the players that make a name for themselves, but those are the players that just burn out because they have prolonged brain injuries and they keep doing it.”
Moosman wants to be one of the survivors. “I guess one thing I got out of [the concussion debate] was that I realized that there’s more to life than just football. There’s more to life after football–and you should play and live accordingly.”
This article has been edited since it appeared in the June 2010 Ann Arbor Observer. Don Dufek, Jr.’s position was corrected.