10 steps to make the game safer

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The hardest part about taming today's NFL is that the sport's very foundation is built on violence. The most successful teams intimidate and brutalize their opponents, devouring their will. They understand that X's and O's don't always mean as much as force and ferocity. "The only thing that matters to a lot of guys," said one AFC assistant coach, "is being the baddest [dude] on the field."

The problem is that approach will go only so far in the futuristic version of the NFL. It can lead to fines, suspensions and way more time in front of commissioner Roger Goodell than any player ever would want. So instead of sticking with an old-school approach to the game, how about some new ideas for football? If the league values player safety more than ever -- specifically avoiding concussions and the long-term effects of head trauma -- here are 10 ways to achieve that:

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Charles LeClaire/US PresswireColt McCoy returned to the game after this hit. Should concussed players automatically be made to sit out the next game?

2. Make mouth guards mandatory: For years, a few ex-players representing The Fourth and Goal Foundation -- an advocacy group for retirees -- have been pushing for mandatory mouth guards in the NFL. Players are supposed to wear them all the time, but it's commonly known that everybody isn't following that rule. The complaint: Mouth guards are uncomfortable and interfere with breathing. But impact to the jaw can lead to concussions as easily as blows to the head. Gerald Maher, a dentist who has worked with the New England Patriots for two decades, has long advocated that players need to think more seriously about protecting their jaws while on the field. He's created his own mouth guard, a device that several Patriots players have endorsed and retirees also love. "The New England Patriots use [it] to a man," said former Buffalo Bills safety Jeff Nixon in an ESPN.com story on NFL violence in 2010. "When you get hit in the head, the [jaw] moves in such a way that it can lead to concussions. But the NFL won't make the decision [to make mouth guards mandatory] because doing so would mean they're admitting guilt for not having done so sooner."

ESPN is presenting a weeklong, cross-platform series, "Football at a Crossroads." "Outside the Lines," "SportsCenter," ESPN.com and ESPN The Magazine examine health issues surrounding football at all levels of the sport, from youth football, high school and college football, through semipro and professional football.

THURSDAY

Football is dead. Long live football: Story »

Teams face another financial threat: Story »

Universities lead safety research: Story » and Watch »

10 steps to make the game safer: Story »

Concussion Confidential interactive: Story »

"Outside the Lines," 3 p.m. ET, ESPN

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3. Eliminate kickoffs: New York Giants co-owner John Mara put this on the table in April, so perhaps it is destined to happen. As much as great kickoff returns thrill fans, evidence suggests that disposing of them altogether could lessen the risk of players suffering concussions. When Mara spoke to reporters in April, he said, "the problem is that the concussions come from everywhere -- from the wedge, from the crossing blocks where a guy goes from one side of the field to another, from a full-speed collision between a return guy and a tackler. So there's no one thing that you can do. It's something that we'll continue to watch as closely as possible." Though Mara said there was little interest in eliminating kickoffs at this point, the league's decision to move kickoffs from the 30-yard line to the 35 made a difference. The increased number of touchbacks also led to an overall decrease in concussions, according to Mara, who serves on the league's competition committee. That's more than enough proof that the league might as well start games with one team at its 20-yard line. It wouldn't take long for fans to adjust.

4. Require more equipment: I'm not just talking about making players wear knee and thigh pads again, which is an edict the NFL pushed this offseason. I'm talking about the kind of equipment that literally slows players. The NFL could make the bulky knee braces normally seen on offensive linemen mandatory for all players. It could return to the days when shoulder pads were so bulky that it appeared players could comfortably run through dry wall in them. One aspect of concussions that people tend to overlook is speed. As Nixon, the former Bill, said two years ago, "The league is more dangerous these days. When you have 250-pound men who can run 4.5 [40-yard dash times], you're going to have more violent collisions."

5. Partner with high schools and colleges: The NFL had the right idea when it decided to reach back to high school and college players to prepare them for life after football. The theory offered by Troy Vincent, the league's vice president of player engagement, was that "if you want a better player, you have to touch them earlier." The same holds true when it comes to educating players on the dangers of concussions. The league is spending all this time and effort to teach players a new way of striking each other; wouldn't it be better to start the enlightenment process earlier? So far, the recently launched "Heads Up Football" program -- operated by USA Football -- is backing up this belief. Young kids are learning the importance of keeping their heads up when tackling along with the benefits of properly fitted equipment and effective treatment of concussions. That information is bound to pay huge dividends for those who are fortunate enough to become college players and professionals. While USA Football is at it, it could sell another important message to today's youth that needs to be sold around the league: It's better to be smart than tough. "We have to change the mentality that if you get knocked out of a game, then you're an injury-prone player," Winston said. "You don't always have to tough everything out."

6. Create a licensing board: It feels ironic to hold up boxing as a positive example, but bear with me. Boxers have to face a medical advisory board before they're allowed to step into a ring, and maybe the NFL should think about doing the same. In many ways, it would a logical extension of the NFL sideline concussion exam, which already establishes a cognitive baseline for each player. The league might as well make that test an annual event for each player. It shouldn't just be administered when a player is wobbling to the sideline like a drunken sailor on leave. An approved medical board could re-administer that test every 12 months to check for noticeable changes. If a player's results were drastically declining, he could be required to sit a certain amount of games the following season -- with full pay -- until he's deemed ready to go. That would eliminate concerns about players hiding symptoms from coaches or losing their jobs because they're injury risks. If the league is serious about helping players, it has to put its money where its mouth is.

7. Put independent doctors on the sidelines: The league took a huge step in the right direction when it amended its concussion policy late last season to allow athletic trainers "to monitor play of both teams and provide medical staffs with any relevant information that may assist them in determining the most appropriate evaluation and treatment." Now it would be nice to see an even bigger leap in this area. Currently, those trainers can't diagnose concussions or prescribe treatment, and they have no authority to remove a player from a game. That could change if the NFL were willing to let independent physicians roam the sidelines in a similar capacity, albeit with more power. Players have long believed that team physicians care first and foremost about what's best for the team. If that's actually the case, then the league should let outside doctors decide what's best for the player who has just had his bell rung. The trainers can monitor the player's behavior, but the independent doctor has final say in whether that player is capable of returning to action. As Winston said, "If a guy is falling down as he's walking off the field, it shouldn't be that hard to keep him on the sidelines."

8. Get retirees involved: You ever try telling a 22-year-old millionaire what life might be like in his 50s and 60s? Even the savviest young men have a hard time thinking they might be the next Dave Duerson or Ray Easterling, two retired players who killed themselves after battling long-term problems associated with head trauma. But imagine what kind of impact both players could have had if they'd had open dialogues with current players about their struggles. And maybe such a dialogue would have helped them find ways of coping with their own problems instead of feeling helpless. NFL retirees have been trying too long to connect with a league that hasn't really known how to deal with its issues. Just employing one retiree per team to interact with concussed players could make a little difference, sort of like a sponsor in Alcoholics Anonymous. A concussed player would know that he'd have somebody to talk to candidly about his problems, and the retiree -- preferably one who dealt with concussions during his career -- would have first-hand knowledge of the problems. It might not work in every situation. But compassion would be in greater abundance than it is right now.

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William Perlman/The Star-Ledger/US PresswireWould hits be less ferocious if face masks were softer?

10. Make everybody accountable: The onus for making the game safer should not rest entirely on the players. Coaches have to understand that a defender who doesn't go for a knockout shot on a pass play isn't a wimp and a receiver who can't return from a huge collision isn't a punk. Owners and executives also have to be held responsible. If certain players can't temper their aggressiveness, then the league should start penalizing franchises for failing to keep such players in line. Too many players understand that their jobs depend on playing on the edge. The league has to redefine what that edge is if it wants a more civilized game.

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Jeffri Chadiha

NFL

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Jeffri Chadiha, formerly of Sports Illustrated, is a senior writer for ESPN.com. Chadiha first attended Wyoming on a full football scholarship before injuries led him to transfer to Michigan after two years. He received a Bachelor of Arts degree in communication from Michigan in 1993 before pursuing a career in journalism. Chadiha is also a frequent contributor to ESPN TV.