Upside the Head

From the concussions of Eagles DeSean Jackson and Kevin Kolb to the tragic suicide of Penn football star Owen Thomas, Philly has been the epicenter of sports head-injury news. Now, two Penn researchers are poised to put a big dent in the problem

This story became big news, in part because Nowinski knew a 20-something baseball writer, Alan Schwarz, who began his career at Penn, at the Daily Pennsylvanian. Schwarz brought Nowinski to meet an editor at the New York Times, for which he had freelanced, and was pleasantly surprised to be assigned to write a story himself. It ran on page one, and led to a unique job starting in 2007: Schwarz was assigned by the Times to cover sports head injuries all the time. It was an important, uniquely resonant subject, and certainly one the paper’s editors thought might win awards. Many more of Schwarz’s stories made page one.

This was a turning point in the head-injury battle between the NFL and its players, as new NFL president Roger Goodell began the slow process of reforming the league’s posture on veterans’ head injuries and minimizing head-trauma danger on the field. Members of the NFL’s concussion committee—which had all but denied the existence of what was starting to be called chronic traumatic encephalopathy, or CTE—were eventually replaced, largely by long-term critics.

But it was the April 2010 suicide of 21-year-old Penn defensive end Owen Thomas that set the stage for last year’s pile-on of concussion obsession. As the fall 2010 football season approached, Thomas’s brain was autopsied by the group at BU. The results were covered on the front page of the New York Times on September 13th. Thomas’s death immediately became associated worldwide with the small amount of CTE found in his brain, and the theory that this explained why he’d committed suicide went viral. (Few seemed to notice that the autopsy finding, while important in establishing how early repeated blows to the head can cause damage, didn’t prove this was happening to most football players. Nor did it tidily explain the suicide, which could have been the result of another problem altogether: undiagnosed depression.)

It was around this time, just as Steve Galetta and Laura Balcer’s research was drawing pre-publication attention, that politicians became more involved in concussion issues. States passed ambitious laws to raise concussion awareness among student athletes and force better medical care before they could be cleared to play. (Twenty-seven states, including New Jersey, have them; Pennsylvania’s is pending.) But as the NFL, NCAA and high-school seasons dragged on, concussion rates were higher than ever—in part, ironically, because of heightened awareness and better diagnosis. Frustrated legislators, especially rookie senator Tom Udall from New Mexico, started lashing out, as if easy fixes were being ignored. There were calls for “concussion-proof helmets,” which don’t exist; cries to change the way helmets are tested; even proposals to eliminate the three-point stance so linemen wouldn’t clank heads on every play.

After weeks of fear and loathing in the sports head-trauma community, the NFL concussion committee met and agreed there were no easy fixes. Senator Udall shifted his focus to helmet manufacturers, asking the FTC to investigate major ones for over-promising in concussion prevention. Eventually, all the football seasons ended, and the media quieted down. But college, high-school and youth football coaches, as well as players and their parents, were left wondering what to make of all this, and whether there is a way to play football—or any contact sport—safely.

I’M SITTING IN Steve Galetta’s office on the fourth floor of the Gates Building in the labyrinthine HUP complex, talking head trauma with him and Laura Balcer. While Balcer sits quite properly, Galetta slouches in his desk chair, playing absentmindedly with a hard rubber brain.

The results of their King-Devick studies, they say, are still very preliminary. But these two understand something that a lot of people in the concussion world tend to overlook—none of the tests team doctors and athletic trainers have been using for the past decade have been well-studied. The tests are better than nothing, but nobody knows how much better. It’s still unclear how many less obvious concussions they miss.

Gary Dorshimer, team doctor for the Flyers and Eagles—he’s treated most of the famous concussions in modern Philadelphia sports, from Eric Lindros’s on—has always been intrigued by the very subtle vision changes that can help identify less obvious concussions. Players with concussions seem to have a problem with motion: “You can see early on in their recovery—they don’t like being in a car, they put their heads down, don’t want to see the road moving,” he says. “It would be nice if King-Devick could catch that more easily, with something more reproducible.”

But most experts say the only hope of lessening concussions is to change the way younger football players are taught to hit. At the Haverford School, along with participating in the King-Devick testing, coach Michael Murphy is in his second year of a new program to change the way his players tackle. When he was growing up, playing at Quakertown High, he was taught to tackle around the knees. He now realizes you can’t keep your head in a safe position that way. “We’re teaching a kind of tackling that’s more like a bear hug—facing the player, head up, exploding into the hips and chest. And we also want more of a gang tackle, where one guy stops forward motion and others try to strip the ball.”

Murphy is realistic, though. He often hears from other coaches that the goal in a concussion-aware world should be to “take the head completely out of the game.” This prompts a toothy grin from him. “How are we ever gonna eliminate the head from football?” he asks. “You can’t just pop it off and set it over on the sideline.”