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Tuesday, March 6, 2007
Updated: March 7, 5:55 PM ET
Concussions research remains question for NFL

By Peter Keating
ESPN The Magazine

Last week, Elliot Pellman stepped down as head of the NFL's mild traumatic brain injury committee.

This week, concussions experts are asking: Does that move indicate the league will now pursue a fundamentally different direction toward researching and managing concussions? Or will it still be business as usual, just with the controversial Pellman out of the way?

As head of the NFL's mild traumatic brain injury (MTBI) committee since its inception, the gregarious, accessible Pellman fended off criticism of his qualifications for more than a dozen years, including complaints that he is a rheumatologist, not a neurologist or neuropsychologist, and the 2005 revelation that he had exaggerated his academic credentials on his resume. And Pellman always had a genuine knack for aggressively defending the way teams treat injured players. In September 2006, for example, when Tampa Bay Buccaneers quarterback Chris Simms kept playing after rupturing his spleen, Pellman told the New York Times, "I heard some people say, 'Did they allow him to return to play?' In any given football game, everybody has aches and pains. Particularly when you're on the field, your ability to see things is often masked. Things happen in piles. Often, you're left with dealing with things after they happen."

Trent Green
Kansas City Chiefs quarterback Trent Green lies motionless after being tackled by Cincinnati Bengals defensive end Robert Geathers during the third quarter of an NFL football game Sunday, Sept. 10, 2006, in Kansas City, Mo.
But after an ESPN The Magazine story reported last fall that several of the nation's top neurologists and neuropsychologists questioned Pellman's tactics and the committee's research methods, the NFL stopped relying on Pellman's salesmanship. From the time that issue first appeared until his resignation, Pellman didn't make a public comment. And now the league is at a crossroads. Rid of Pellman's penchant for drawing brickbats, the NFL could keep insisting that no concussions policy is the best concussions policy, and continue to allow each of its teams to manage head injuries as it sees fit. Or, with an increasing number of players and former players concerned about the aftereffects of concussions, the league could turn over a new leaf.

There are good reasons to think that nothing much will change. For one thing, Pellman is still on the brain injury committee, still the league's medical liaison and still the New York Jets' team doctor. The NFL won't even admit that questions about Pellman's behavior played a role in his resignation as committee chairman.

For another, the committee's new co-chairs, Ira Casson, a neurologist at Long Island Jewish Medical Center in New Hyde Park, N.Y., and David Viano, a biomechanics consultant in Bloomfield Hills, Mich., have co-authored several of the committee's most controversial papers. For example, five members of the committee, including Pellman, Casson and Viano, wrote in December 2004 that there was "no evidence" in the committee's work of "widespread permanent or cumulative effects of single or multiple MTBIs in professional football players."

In January 2005, Casson and Viano, again with Pellman and two other co-authors, wrote: "Return to play [of NFL players with concussions] does not involve a significant risk of a second injury either in the same game or during the season."

And they're not about to change their minds.

"The scientific process does go on," Casson said in an interview Super Bowl Sunday. "The league is still collecting data. But nothing has happened in the collection of that data that would raise any red flags."

"The cards are being dealt from the same deck," said Chris Nowinski, author of "Head Games: Football's Concussions Crisis."

"The basic problem with the committee is their research," Nowinski said, "and there's no change in its leadership or philosophy on concussions."

On the other hand, NFL commissioner Roger Goodell doesn't have the personal ties to either Pellman or the brain injury committee that former commissioner Paul Tagliabue did. Tagliabue created the committee in 1994 and named Pellman to lead it. Goodell recently has shown a personal interest in the subject of head trauma, asking former NFL player and multiple concussion victim Merril Hoge (also an ESPN analyst) about his experiences. And amid ongoing questions about the committee's research, the suicide of Andre Waters and claims by former Patriot Ted Johnson that coach Bill Belichick ordered him to play with a concussion, Goodell might find it politically impossible simply to leave unchanged the agenda and methods of Casson, Viano and their colleagues.

What's more, the NFL's concussions research is entering a new phase. Until now, the committee has examined only the impact of concussions on active NFL players, while others have studied the long-term effects. For example, a 2003 report by the Center for the Study of Retired Athletes at the University of North Carolina found a connection between multiple concussions and depression among former pro players. A 2005 follow-up to that study found a link between concussions and both brain impairment and Alzheimer's disease among former players. But Pellman and other members of the committee derided that research over the years while insisting they were about to take their own look at the long-term effects of concussions. Now that study is finally about to begin, according to two members of the committee.

"What they need to do is begin their own study, since they're not going to accept or acknowledge our studies of almost 3,000 retired players, and confirm or refute our findings," said Julian Bailes, medical director of the Center for the Study of Retired Athletes and chairman of neurosurgery at the University of West Virginia. "The committee has talked about studying retired players, and it may be able to analyze them in greater detail than we were able to do. They need to have it independently done and verified."

"The litmus test is going to be how they study long-term effects," said Robert Cantu, chief of neurosurgery and director of sports medicine at Emerson Hospital in Concord, Mass. "That's the line in the sand. If they exclusively use their own in-house people, then I would understand why they would do it, but it isn't going to pass the test of honesty."

Bailes, Cantu and other doctors outside the NFL say that if the league wants to forge an effective concussions policy, it should include more independent scientists in its study of long-term effects and allow other researchers to verify its data. And it should take more seriously the emerging consensus that three or more concussions in a pro football career can significantly increase the chances that a player will develop cognitive problems later in life.

"To their credit, the MTBI committee has done its studies on NFL players, but their work has been spun, and its limitations are huge," Cantu said. "Now the chance is there if Goodell wants to change course and do work the NFL and others can be proud of.

"But I don't see it happening. I hope I'm wrong."

When the league moves on studying the long-term effects of concussions, we'll find out if Elliot Pellman was just the NFL's fall guy.

Peter Keating writes about sports business for ESPN The Magazine.