If baseball was once rightly known as America’s pastime, those days have ended. Today football has risen to the forefront of the American consciousness; the NFL is king. In 2013, the 26 most widely viewed sporting events in the United States were all NFL games, and last year’s Super Bowl attracted 111 million viewers. The average value of an NFL team is a whopping $1.4 billion, compared with a $634 million price tag on average for an NBA team.

NFL Commissioner Roger Goodell has made deals left and right to maximize the value of the league. Goodell’s goal, he told league owners in 2010, is for the league to reach $25 billion in revenue by 2027, but the profitability of the league is threatened by the growing issue of head trauma, which poses an almost existential dilemma for the league by fostering reluctance among parents and young players to participate in the sport.

It seems that for Goodell to continue to attract the most talented athletes to the NFL the league will need to address the problem of multiple concussions and head trauma. Concussions are known to cause chronic traumatic encephalopathy (CTE), a degenerative disease that affects brain function as well as emotional regulation. The NFL has acknowledged that three in ten professional football players will eventually develop symptoms of dementia and Alzheimer’s, but the issue may be even more severe than the league has acknowledged.

In the last 15 years, a string of former NFL players have committed suicide, including Mike Webster, Terry Long, Andre Waters, Junior Seau, and Dave Duerson. Many of them suffered from dementia-like symptoms, from short-term memory loss and confusion to violent mood swings and persistent anxiety. They were all diagnosed postmortem with CTE.

High-profile cases of CTE have raised concerns for coaching staffs and within locker rooms at all levels of football, from the coaching staff for the New York Giants to administrators in the athletics department here at Yale. Steve Conn, associate athletics director of sports publicity at Yale, told the Politic he is “extremely concerned about the safety of the players.”

Many collegiate footballers, who might otherwise have gone on to play professionally, have quit the sport after sustaining multiple or severe concussions. David Ash and Casey Cochran, quarterbacks for Texas and UConn, respectively, both stopped playing this fall due to multiple concussions. Christopher Coyne ’15 quit playing football for Yale in 2011 after sustaining his fifth concussion, three of which were football-related. Yale trainers told him a few months after the concussion occurred that he wouldn’t be returning to the field.

After the last concussion, Coyne said, he “had a lot of academic difficulties. My concentration was completely gone.” During high school, when he sustained injuries, he visited doctor after doctor until someone cleared him to play. Coyne said that he thought about doing that again to get back on the field. “I flirted with the idea of transferring to a Division-3 school to let me play,” Coyne said, explaining that even after Yale prohibited him from playing, he yearned to return to football. “I was entranced with the idea of playing college football. It had been a dream of mine since I was a child. It took me until Christmas to finally give up and accept that this decision was made in my best interest. If I continued to play, it would have been bad news for me and my health.”

Potential future recruits will determine the league’s success in years to come, and the number of NFL recruits could decrease dramatically, Conn said, unless there are big changes in the protection of the athletes. “There’s a trickle-down effect,” he said. “You won’t know it next year or the year after that, but in five or ten years you may see fewer parents letting their kids play football.” Even John Madden, the face (or voice) of football for many Americans, argued last year that kids shouldn’t play tackle football until high school. Critiques from insiders like Madden suggest that the game will have to undergo fundamental changes to reduce danger and maintain popularity.

Possible rule changes might include something along the lines of the bans on headers that have been implemented widely in youth soccer. But the issue can only be fully addressed once awareness of the risks of brain injury has increased. When asked if he would let his own kids play football in middle school, Coyne said he would do so only if the culture of the sport had changed. “I dream of a time when football players recognize the severity of concussions and act appropriately,” he said.

Part of the problem, said Patrick Bellgowan, the program director of the National Institute of Neurological Disorders and Stroke (NINDS), is that “because it’s an invisible injury, people don’t take it as seriously as they should.” Symptoms disappear before the brain has recovered, so it is often difficult to tell when the brain has actually healed, Bellgowan said. Moreover, efforts to reduce concussions are complicated by the problem of underreporting, particularly in collegiate and professional programs. Coyne noted: “Concussions aren’t like a torn ACL. They’re pretty easy to hide. You really can’t regulate it if these guys don’t report [the concussions] themselves.”

Both professional and college programs are funding research on concussion prevention and diagnosis. Ivy League and Big 10 programs alike are working with medical professionals to come up with solutions, Conn said. Furthermore, the NFL recently donated $31 million to brain research by NINDS. Bellgowan told the Politic that money had already been granted to two proposals, one headed by Mount Sinai and the other led by Boston University. The research is attempting to define the characteristics of the neurological changes in the brains of people diagnosed with CTE. Once the properties of CTE have been defined, further research will be funded to apply the information collected in postmortem studies to living subjects.

One of the ultimate goals of this line of research is to create a clear, simple diagnostic test for concussions, ideally something that can be done without the help of medical professionals. “There is no doctor or athletics trainer at kids’ sports games the way there is at the collegiate or professional level,” Bellgowan said. Parents on the sidelines at youth football games could perform a balance test or eye examination, thereby preventing kids with concussions from playing.

Recent changes by the league have had dubious effects on the safety of football players. Beefing up head protection with bigger helmets has made players feel safer, but the players then use the protection to tackle at higher speeds and with more abandon, said Conn. “The helmet is like a weapon itself,” he explained. However, the protective strength of the helmets can’t be lessened now, Conn said, because players are so big and strong and fast that such a change could be extremely dangerous.

In its most recent negotiations with players, the league created a policy that allows players to participate in only one full-contact practice per week. The policy is meant to decrease the total number of head hits accumulated over the course of the season. However, this policy change does not prevent coaches from lengthening and intensifying the full-contact practice in order to comply with the new rule while maintaining players’ exposure to full-contact training.

It is clear that the league is trying to address the issue of mental trauma in its players without altering the game too extensively. The NFL’s efforts are complicated by the fact that the results of most of the concussion research currently being conducted won’t be in for years, and until then, the NFL will have to muddle through without clear data. Once the data is in, the NFL will need to do everything in its power to keep its players, present and future, healthy and concussion-free. The league is too lucrative an enterprise not to change, and as the NFL grows, team owners, with their eyes set on Goodell’s goal of $25 billion in yearly revenue, will likely become increasingly responsive to threats to its success, including concussions.

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