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Head Trauma in Football: A Special Report

Can football change? Will the sport become safer? How are concussions impacting the game‘s future? Introducing an in-depth series where we tackle those questions, starting at high schools and continuing into college and the NFL

Three years ago today, I sat in the office of Massachusetts neuropathologist Ann McKee, who studies the brains of deceased former football players to discover the effects of repetitive brain trauma. She showed me slides of cross-sections of brains of former NFL players with evidence of chronic traumatic encephalopathy (CTE). This was five days after Rutgers player Eric LeGrand was paralyzed after a big hit in a college game, and four days after frightening blows by pro players James Harrison, Brandon Meriweather and Dunta Robinson. “I wonder,’’ McKee said that day. “Can we make it more of an Indy 500 and less of a demolition derby?”

The race is on to see if football can change—and so far, after three years, the effort is there on all levels. With the emphasis on the head trauma issue evident all over football and society, The MMQBwill spend this week publishing a series of stories taking the temperature of people across America—high school coaches and players, parents of players, medical experts and current and former pro players—about the game.

What you’ll read on our site this week:

  • The MMQBpolled high-school coaches, parents and players in 49 states over the past two weeks, and dispatched our reporters to games in Lawrenceville, Ga., Brookville, Kans., and Indiana, Pa., to learn if the head-trauma issue is more than a bump in the road of football’s future. It is.
  • Jenny Vrentas on helmet manufacturers using innovative methods to produce smarter models while not knowing if players will even wear them; plus, how far can technology go in lessening the impacts that lead to concussions? Later in the week, Vrentas writes about what football will be like in 10 years.
  • Can football change? Will the sport become safer? How are concussions impacting the game’s future?

    Introducing an in-depth series where we tackle those questions, starting at high schools and continuing into college and the NFL. Read the entire series.

    Robert Klemko on current NFL players coping with the new rules and fine system designed to lessen the number and severity of blows to the head.
  • Our regular columnists: Don Banks (What price football?), Jim Trotter (on a former player who needs a separate room in his house as a refuge when effects from concussions are severe), Andrew Brandt (on lingering helmet and concussion issues), Richard Deitsch (on the tightrope TV networks walk when reporting on head trauma), and Andy Staples (on college-prospect concussions being the new scarlet letter in NFL scouting).
  • Current player Richard Sherman, a regular columnist for us, on the effects of playing in the concussion era.
  • Former player Nate Jackson, with a must-read perspective on the residue of years as a player: I am depressed and suicidal thoughts, like raindrops, come down from the sky on seemingly sunny afternoons. Is this science, or the realization that my life peaked in my twenties? I have no skills other than football and no idea what else to do. And the incongruity of knowing he’d play again if a team picked up the phone and asked him.
  • One current high school coach sticking up for football. One current high school coach questioning why he’s sending in boys to play a violent game.

What’s been eye-opening to discover is the trickle-down effect from the NFL to youth football. As the pro league emphasizes safety more and more, so do high schools around America. High school parents and coaches and players noticed the league recently agreed to a $765-million settlement with former players who sued the NFL for hiding the effects of brain trauma. Some saw the black eye from the journalistically bruising “League of Denial” book and documentary.

Coaches are concerned; 41 of 49 polled said they have modified training techniques because of increased education about concussions and head trauma. Parents are concerned; 62 of 96 parents polled said they worried about football impacting their son’s health later in life. Young players, like their professional counterparts, showed they have to be protected from themselves. When Klemko, on his road trip to Kansas, asked Smith Center High  quarterback Kody Molzahn if he has ever hidden a concussion from coach or parents, Molzahn said after a pause: “Yes I have, to be honest. I just love the game of football and I don’t want to stop playing.”

That school in Kansas doesn’t have an athletic trainer at many of its games. Smith Center shares a trainer from Kearney, Neb.—82 miles away—with 11 other high schools in Nebraska and Kansas. So the head coaches at those schools, who have taken a one-hour online course to educate themselves about head trauma, have to monitor players who take a blow to the head. Meanwhile, at larger schools in more populated areas, medical staff is everywhere. Our Emily Kaplan reports from a game at Archer (Ga.) High School that five trainers or medical personnel were on hand at one game.

And the numbers of the game are worrisome in some places. Our Andy DeGory reports from his old high school in Indiana, Pa., that more boys are signed up for lacrosse—a four-year-old sport at Indiana High—than football. Sounds sacrilegious for western Pennsylvania, where Dan Marino and Darrelle Revis prepped. "Much more than 10 years ago, or even five years ago,” a lacrosse program backer, David Zimmerman, said, “if you’re an adult and you use your brain for a living, and you think your kids are going to use their brains to make a living, you’re going to think twice about whether or not they should be playing football.”

Teaching young players the proper tackling techniques is one way to help limit the types of hits that can cause head injuries. (Pouya Dianat/Special to Sports Illustrated)

Teaching young players the proper tackling techniques is one way to help limit the types of hits that can cause head injuries. (Pouya Dianat/Special to Sports Illustrated)

Several high school coaches emphasized the NFL teaching new tackling techniques, such as “Heads Up Football,” which teaches coaches to train kids to tackle with heads up—instead of using the helmet as a battering ram. Said Middlebury Union (Vt.) coach Dennis Smith: “In any drills we're doing—whether it be fundamental drills at the beginning of practices, especially defensive practices—we're always stressing head up. You have to be able to see what you're tackling. And I tell the kids, ‘If you are a head ducker, you will not participate.’ Especially on the defensive side of the ball, because I'm worried for their safety.”

Said Brandon (Miss.) High coach Brad Peterson: “We always start the year, whether spring or fall, with walking through the proper techniques of tackling. I always start the year by making the players read with me the warning sticker that’s on the back of each helmet, and then we discuss what it says. We talk about the importance of letting the coaches and/or trainers know if they have any symptoms of a concussion.’’

I was impressed reading the responses of the 49 coaches. Clearly they get it—they’re on the front lines trying to be sure they fill the roles of smart surrogates to high school players. Most love football, not just for the sport but for the lessons it can teach. The coach of E.O. Smith High in Storrs, Conn., Jody Minotti, said he knows he can’t prevent every concussion, but he trains his players to minimize the risks. “We do less contact throughout the week and we teach proper tackling,’’ said Minotti. “We preach in practice all of the time, ‘Bite the ball. Bite the ball.’ That means keep your head up and don’t ever lead with your helmet. We film tackling, we talk about tackling whenever we’re watching film.

“You know, I think football is a great game. I think a lot of skills are learned through football that you can’t learn through other opportunities, whether that’s in another sport or in the classroom. I think that the more coaches learn about concussions, the more coaches learn about how to tackle properly, the more coaches learn about how to help kind of guide the players in the direction of correct technique. I think the game of football should continue. I’m a big fan of football. I love it. I grew up playing football. It taught me a lot of skills that I wouldn’t have learned in other phases of life.”

That, over and over, is what we heard from those charged with preparing teenagers to play a rough game. But now, the coaches have to be on the lookout for kids who may have been concussed, adding another layer to their jobs. Last week, two parents of a player in Taylorville, Ill., were discussing the undue risks some kids take to play.

“Other kids go in [with concussions],’’ Regina Wilderman said. “We know.”

“Because they’re afraid of losing their spot on the team,’’ said Larry Wilderman.

“I know parents—I won’t name names—that tell their kids not to come out,’’ Regina said. “We’re just the opposite. It doesn’t matter. This is nothing compared to the rest of your life.’’

If coaches don’t take the time to understand this is of huge importance,"Duncan Shackelford said, "then I think the sport of football is going to slowly die.

The game, several high school coaches think, is at a tipping point. “We are the future of the NFL,’’ said Duncan Shackelford, head coach at Chugiak High in Eagle River, Alaska. “In high school in general, we feed the colleges that feed the pros. If coaches don’t take the time to understand this is of huge importance and don’t take the time to change old techniques, then I think the sport of football is going to slowly die.”


Don't miss the mailbag on Page 2, where Peter King answers readers’ questions about Jay Cutler's long-term future in Chicago and why Andrew Luck can't be judged on stats.

This week, please take time to read our report. And respond. Email us:

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. Next week, we’ll run your reactions, your thoughts, your praise, your criticism.

I think football will survive the storm. Too many love it; it’s the cornerstone of too many communities in America. High school games on fall Friday nights, college games on Saturdays, the pros on Sunday. But the clarion call is out: The game must be made safer, continually, if parents are to send their kids to play years into the future. I hope we can all learn something here, by providing a mirror to what the game is now, and where it’s headed.

The Chicago Bears expect Jay Cutler to be out at least four weeks after the quarterback tore his groin muscle in Sunday's loss to the Washington Redskins. (Patrick Smith/Getty Images)

The Chicago Bears expect Jay Cutler to be out at least four weeks after the quarterback tore his groin muscle in Sunday's loss to the Washington Redskins. (Patrick Smith/Getty Images)

TOUGH DECISION FOR BEARS.I think the real Jay Cutler story from Sunday may be how the offense kept right on chugging along after his departure. People will be quick to write off the Bears, but the offense was fine with McCown back there, the defense was the problem. If the offense keeps playing at a high level with Jay on the sidelines, I don’t see how Phil Emery can justify giving No. 6 a big contract in the offseason. Especially with what is appearing to be a real old defense also in need of a scheme change, the money needs to be flowing to that side of the ball.

—Sgt Joseph K. Atherton, Norfolk, Va.

This is a very interesting question. I believe in the next three years, there will be somewhere between 15 and 20 draft-eligible quarterbacks with first-round grades. If you are a man who trusts his personnel judgment, and Emery does, you might say that it would be smarter to draft one of the bright quarterback prospects and pay him a fraction of what Cutler would cost over the next four or five years. I think Bears fans who would call you mistaken for suggesting Chicago should give up on Cutler are not seeing the full story the way you are. And I’m not suggesting they should give up on Cutler. I am suggesting it is worth considering.

BIG MONEY QUESTION.Your article on Peyton Manning’s return to Indy got me wondering: is winning the Super Bowl (statistically) a young man’s game? Tom Brady and Ben Roethlisberger got their rings early, but it seems like early success leads to big salaries, then worse surrounding casts, then at best deep playoff runs but no more championships. Does the data agree? Does a big QB payday make it harder for a team to win the big one?


Good question, one to bookmark for a deeper dive down the road. But one thing to mention: Early success, either by winning a Super Bowl or by putting up great numbers, leads to huge salaries. Matt Ryan has won a bunch of games and accumulated very good stats, but hasn’t won a Super Bowl. Now he is being paid with the highest-paid players in the game. So, I don’t think that making huge money exclusively means that you have to win the Super Bowl. 

HESTER A HOFER?For years, I’ve believed that when (and if) the Hall of Fame inducts a special teamer, it should be Steve Tasker.  Now, I’m beginning to wonder if that special teamer shouldn’t be Devin Hester. His 19 return TDs are more impressive than Deion Sanders, since he didn’t have the benefit of interception returns being included.  Does Hester merit serious discussion in the voting room when he becomes eligible?

—Marvin L. Longabaugh, Navasota, Texas

Absolutely. He has been the best player in his era at a very important task. I’m not sure I’ll be in the room when his candidacy is debated, but I would consider him strongly. I do feel, however, that we will have one or more special-teamers elected in the next few years. That’s my hope, anyway. And I hope it starts with Tasker. 


Got a question for Peter? Send it to and it might be included in next Tuesday's mailbag.


Love the column, but how can you include Geno's pick-six in what you didn't like about Week 7, but no one else's? I get that it was a huge blow to the Jets who were driving, but how was it any worse than Brady's pick-six at the start of the third quarter that brought the Jets back into the game? This doesn't even reflect the fact that Jay Cutler, Ryan Tannenhill, and Sam Bradford all threw pick-sixes Sunday. Any reason to include the one QB who won and not the four who lost besides an anti-Jets bias (although I'm surprised they made your Fine 15 this week)?


As I wrote, Geno took the snap, stared at the receiver, saw him covered closely, and threw the ball anyway. It was a huge mistake. Just because the Jets came back to win doesn’t mean the play was insignificant. I didn’t see the same error by Brady when he threw the ball. Brady, I thought, did have a poor game. 

LET'S LOOK AT THE RATINGS.Peter, I'd like to hear your thoughts on how so many of us (myself included) can think Andrew Luck is one of the best QBs in the NFL, yet after seven games his QB rating is about as mediocre as it can be: 91.3. That ranks 15th in the NFL, just a few decimal points above the mid-point, more than 30 points below league leader, Peyton Manning. It's easy to just dismiss the formula as being flawed, but is it? 


Quarterback rating has some value, but it's not foolproof. It weighs interceptions far too heavily, and doesn’t weigh at all performances at different times of the game, such as in the fourth quarter. I wouldn’t consider quarterback rating as a tremendously important factor in the quality of a quarterback’s play. How, for instance, can Luck’s nine fourth-quarter comebacks not be a major factor in determining his worth? I believe they are. I do use quarterback rating as one measure. But it’s not the only one.