Written & Researched by Kamya Patel
Often described as a national pastime, American football has developed into one of the largest sports industries in the United States and beyond. According to recent estimates, the National Football League is currently valued at $3.48 billion. Years ago, however, the NFL became subject to a negative spotlight as portrayed in “League of Denial: The NFL’s Concussion Crisis,” a two-hour documentary in which “FRONTLINE reveals the hidden story of the NFL and brain injuries.” In particular, the documentary depicts the lives of post-retirement football players, the research of multiple neuroscience experts, and the NFL’s long-term denial of the connection between football and brain disease. Additionally, a variety of interviews and testimonials come to the surface, revealing all sides of the situation, including the science behind the damaged brains of football players.
The brain that sparked the NFL’s concussion crisis was that of Mike “Iron Mike” Webster, a member of the Pro Football Hall of Fame and one of the Pittsburgh Steelers. After his death at the age of 50, Webster’s autopsy revealed that along with his deteriorating body, his brain had chronic traumatic encephalopathy or CTE, a disease never previously seen in football players. CTE is essentially a progressive neurodegenerative disease where tau protein depositions are found in specific areas of the brain. The primary cause is repetitive brain trauma, a common occurrence in football, that changes the behavior of tau protein and forces it to destroy brain cells. Some of the resulting symptoms include mood swings, memory loss, confusion, anxiety, and even depression and suicidal thoughts. Even though not everyone with a history of concussions and head injuries is susceptible to CTE, research does show that many football players of all ages have developed the chronic disease. Plus, the lack of a cure or highly effective treatments makes it almost impossible to recover from or diagnose the disease before death. Nevertheless, the revelation of CTE in Webster’s brain was the first step to not only learning more about the disease but also holding the NFL accountable for its part in hiding the truth about football’s effect on players’ brains.
When the concussion crisis did reach NFL headquarters in New York City in the mid-90s, commissioner Paul Tagliabue immediately blamed the so-called exaggerated concerns on pack journalism, describing the issue as one related to media, not sports. Tagliabue also chose to create the Mild Traumatic Brain Injury Committee, appointing New York Jets team doctor and rheumatologist Elliot Pellman as the head. Surprisingly, Pellman had no experience studying neuroscience or brain trauma and he did not believe concussions were a major problem for athletes or the NFL. When the MTBI committee eventually published 16 papers that simply suggested the NFL’s definitive denials and pushed off the league’s day of reckoning, medical examiner and pathologist Dr. Bennet Omalu made his discovery of CTE in Webster’s brain and submitted a scientific paper on the case to the journal Neurosurgery. Very quickly, the MTBI committee targeted Omalu’s research by publicly discrediting his work and asking him to retract the study. When he examined the brain of Terry Long, a former NFL player for the Steelers who had committed suicide by drinking anti-freeze, Omalu found the same signs of CTE and published another paper. This time, the MTBI committee “insinuated [he] was not practicing medicine, [he] was practicing voodoo. Voodoo!” (Omalu). For the NFL, maintaining the public’s positive opinion of football was important for good business and an even better reputation. In September 2006, Tagliabue was succeeded by Paul Goodell as NFL commissioner and he replaced Pellman with neurologist Dr. Ira Casson. Like those who had preceded him, Casson continuously denied any link between football and the various brain disorders found in NFL players, nicknaming himself “Dr. No.”
At the NFL summit in the summer of 2007, the league invited team doctors, trainers, and some outside scientists except Dr. Omalu, who was represented by former Steelers team doctor and neurosurgeon Julian Bailes. He used Omalu’s research on the brains of Mike Webster, Terry Long, Andre Waters, and Justin Strzelczyk to deliver one clear message: football could cause permanent brain damage, including CTE. Although Bailes’ message was met with little acceptance and much skepticism, Goodell and Casson were at the center of the increasing belief that there is a relationship between football and neurodegenerative disease, making it harder for them to downplay the concussion controversy.
Eventually, neuropathologist Dr. Ann McKee partnered with former wrestler Chris Nowinski and neuropsychologist Robert Stern to examine the brains of football players with the first being Tom McHale, a Cornell alumnus and former Tampa Bay Buccaneer. McKee found tau protein within McHale’s brain and she, Nowinski, and Lisa McHale (Tom’s wife) decided to display the new findings at a press conference in Tampa Bay before the 2009 Super Bowl. Soon after her trip to Tampa, Casson invited McKee to present the data at the NFL headquarters, and amongst other reasons, she was criticized for not being able to answer two questions: did football cause CTE and how many players had it? Around the same time, New York Times reporter Alan Schwarz received access to internal NFL research that contained evidence of a higher rate of memory-related disorders amongst NFL players than ordinary citizens. Now, the concussion crisis was national news and the NFL continued its denials by classifying the evidence as flawed research. Similarly, at a Judiciary Committee congressional hearing, NFL commissioner Goodell neither confirmed nor denied his support of the theory that concussions mentally hurt football players, stating, “...the medical experts would know better than I would…” in order to justify his response. Also, at the hearing, the NFL’s denial was compared to the attitude of tobacco companies, forcing Goodell to create new rules regarding how athletes are treated for concussions as a form of damage control.
In this new era of change, NFL spokesman Greg Aiello directly acknowledged a connection between brain disease and playing football. Plus, the NFL donated a million dollars to Boston University as well as provided McKee with brains for research. In her ongoing research, she came across a unique case, perhaps even more shocking than Mike Webster, Terry Long, or Tom McHale. Hard-hitting lineman Owen Thomas without a history of concussions committed suicide at 21 years old and unexpectedly, McKee found CTE in approximately 20 regions in his frontal lobe and suspected the cause may have been everyday sub-concussive hits. Later, McKee was analyzing the brain of Eric Pelly, a mere 18-year-old high school student who passed away 10 days after his fourth concussion, and discovered small regions with evidence of CTE. Her colleague, neurosurgeon Robert Cantu expressed his opinion: no one under 14 years of age should play tackle football. Then, the apparent suicide of linebacker Junior Seau became another version of a familiar story: former NFL star retires, his life falls apart, sudden death, and CTE is the culprit. This time, Omalu had the opportunity to observe Seau’s brain but the NFL’s intervention in the matter meant the brain was sent to the National Institutes of Health; the final verdict from the NIH was national news: Seau’s brain had visible signs of CTE. Consequently, the NFL donated $30 million to the NIH to study sports injuries and later paid $765 million to over 4,500 retired players to resolve a dangerous lawsuit. Still, several questions and controversies remained.
Considering Goodell’s interview prior to the 2013 Super Bowl, the NFL’s acknowledgment of a link between football and drain damage was a one-time thing. There was no admission of guilt from the NFL or no recognition that football genuinely caused prolonged brain disorders. Therefore, the solution to this possibly never-ending crisis lies in the hands of researchers and medical experts. It is of utmost importance that knowledgeable professionals, such as athletic trainers and sports coaches, educate the players on all aspects of their health, including protective equipment, safety protocols, injuries, medical resources, etc. Furthermore, focusing on the serious threats posed by mild or severe head trauma as well as learning to play in a manner that limits forceful head-to-head contact is a valid step for the prevention of chronic traumatic encephalopathy. After all, football and the NFL are not disappearing anytime soon.
“League of Denial: The NFL’s Concussion Crisis - Transcript.” FRONTLINE, www.pbs.org/wgbh/frontline/film/league-of-denial/transcript/.