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Tuesday, October 27, 2009
Updated: October 30, 4:03 PM ET
Are we at football's tipping point?

By Tim Keown
Page 2

Packers Line
The numbers don't lie -- all that plastic and padding can't stop the head injuries from coming again and again.

The news reports and academic studies are hitting us almost daily. The post-football stories of players who end up doddering and destitute are gradually becoming part of the fabric of the game. The game's toll used to summon an image of Jim Otto's countless knee surgeries, but that's gradually being replaced by the image of a homeless and brain-damaged Mike Webster.

The damage inflicted on the brain by the game of football is no longer a story of folklore and anecdote. It is now a story of science and technology, of reams of data and irrefutable conclusions.

This is an idea NFL would like to refute. The NFL has a long-standing tradition of trying to downgrade evidence to mere speculation. But with numbers that indicate former NFL players are afflicted with premature dementia at a rate many times the rate of the general population, the problem is becoming tougher to dismiss. They can pick apart the methodology in the recent spate of studies -- and one of the surveys relied on responses to phone interviews, which are not always reliable -- but the results are becoming more insistent and damning.

There are obvious reasons for the people who run the NFL to refrain from embracing studies that indicate their players are many times more likely to suffer from early dementia or early onset Alzheimer's. For one, they don't want to end up like the cigarette manufacturers, fighting a bunch of lawsuits about what they knew and when they knew it. Second, they're expecting their own study to be the definitive word on the issue, although it won't be published for several years and is already being questioned by experts who cite conflict of interest and statistical problems. And third, they don't want to lend credence to the idea that the viciousness of their game -- the viciousness that is intrinsic to its appeal -- makes it a breeding ground for 50-year-olds who can't find their way home from walking their dogs.

It's not just an NFL issue. It's a football issue. And here's where it gets interesting.

What if kids stop playing football? Predicting the death of football is a fool's errand, at least in the short term, but that might change as the studies linking the game to head trauma gain traction in the media. The seriousness of the issue, reported vigorously in ESPN The Magazine as far back as 2006, is now common knowledge.

The evidence is piling up, and it is no longer directed solely at the NFL. Chillingly, a New York Times article from last week outlines the possible long-term dangers from playing college and high school football.

If you played or watched high school football, you know the kind of guy who plays full-speed without regard for his body. He leads with his head and delivers hits that make the coaches rewind three or four times every film session. He's the guy whose lack of size or speed keeps him from playing after high school, but he is remembered long after he graduates. Well, it turns out he might also be the guy who ends up with depression or substance-abuse problems that stem from the brain trauma he received by doing all those things that made him a local hero.

In high school, where on-location diagnoses and treatment aren't always available or feasible, concussions can go undetected. Players don't want to be considered weak, they don't want to let their teams down, they don't want to disappoint their coaches -- so often they ignore or deny the buzzing in their heads and stay on the field.

The Times article tells the story of Mike Borich, a former Chicago Bears assistant coach who died at 42 of a drug overdose after a long stretch of depression and substance abuse. He was a wide receiver -- a position not as prone to brain trauma as line or linebacker -- at Western Illinois and never played beyond college.

Borich's brain was examined postmortem by Dr. Ann McKee, an important figure in the quest to uncover the dangers of the game. A researcher at Boston University, McKee told the Times the damage to Borich's brain is not seen in people "living a normal life." She then asks, "What are we doing with our kids? Are we doing enough to protect against their developing this awful disease?"

As the father of two current high school football players, one who will start next year and another who played four years, it's a troubling question. It's also a question that a growing number of parents aren't willing to ask themselves. Instead, they're simply saying no to football for fear their boys will suffer a serious injury to their head or any other number of body parts.

Over the past six years, I've seen a marked decrease in the number of players suiting up for teams in my sons' league. Consequently, teams with fewer players have more two-way players, who are more at risk for injury given the amount of time they spend on the field and increased levels of exhaustion. At the same time, the number of kids playing lacrosse as an alternative -- or simply concentrating on one sport -- has risen dramatically. (Maybe until someone gets around to examining the impact of lacrosse on the brain.) Granted, the league is in an area where lacrosse is an option, but far more good athletes than I can ever remember are choosing to skip football.

How do you weigh risk and reward? It's a question I asked myself as I sat in the emergency room with my 17-year-old for five hours on Friday night. (Six stitches across the chin from a cut suffered on a double-team block where the tackle inadvertently pushed my son's face mask up, exposing his chin, and the tight end drove a helmet into that chin.) The game teaches something that other sports don't. It requires a commitment and self-sacrifice that teaches lessons that prove valuable later in life. More than anything, it teaches you about yourself -- your toughness, your strength, your limits. But there are times when it is scary as hell.

In an article titled "Offensive Play" in the Oct. 19 issue of The New Yorker, writer Malcolm Gladwell draws a comparison between the "gameness" of fighting dogs and the similar qualities valued by NFL teams. As a dog will return to fight repeatedly despite horrific injuries in order to please its owner, so will an NFL player return to the field regardless of pain or injury -- especially concussions.

The article's characters include the fearless McKee, whose voice-in-the-wilderness persistence -- along with her autopsies of more than 1,000 brains -- could be the basis for a movie. It's also thick with science and chronic traumatic encephalopathy, which is common among those who have suffered brain trauma. It turns out CTE is also common among those who play football for good portions of their lives, and it turns brains to mush and can make 50-year-olds think and act like 85-year-olds. It's very frightening, and it has the power to make you reconsider the notion that professional athletes are living the dream. They are now, maybe, but the tradeoff can be a real bitch.

Gladwell describes a program at the University of North Carolina, where Butch Davis has allowed Kevin Guskiewicz and his researchers at the school's Sports Concussion Research Program to study his players during practice in an effort to quantify the impact of the game on the brain. Six sensors are placed inside the helmets of each player on the field, "measuring the force and location of every blow he receives to the head." The results are predictably startling. They show that practices can be as dangerous as the games, and that even smaller hits can lead to damage if there are enough of them.

The article also makes a point that I've been making for years: Kickoffs are the worst. In fact, Gladwell writes, the UNC research program suggests that eliminating kickoffs altogether would be a good first step toward reducing the number of concussions and sub-concussive hits in football. With players getting as much as a 40-yard head start before contact, and with blindside hits happening everywhere, kickoffs are the worst five to 10 seconds in every parent's lives.

It's a fascinating time for those attempting to reach conclusions about the risks posed by such a violent game. The fact that it is such big business tends to get in the way, but now that information is disseminating at a faster pace and to a broader audience, there's one big question on the horizon: Just how much will the pain inflicted on the players eventually hurt the game?

ESPN The Magazine senior writer Tim Keown co-wrote Josh Hamilton's autobiography, "Beyond Belief: Finding the Strength to Come Back," which is available on Amazon.com. Sound off to Tim here.