Football's Brain Drain

By Kyle Rowland on June 22, 2012 at 10:00a

Andrew Sweat was living his dream. After a solid four-year career for Ohio State, Sweat signed a rookie contract with the Cleveland Browns, a team that plays less than three hours from his hometown of Washington, Pa.

Sweat never even put on the fabled brown and orange uniform, though. Instead, he abruptly retired from the game. Chronic injuries were never a major issue for Sweat – passing a physical wasn’t a concern. Sweat’s anxieties were much more serious in the sense of day-to-day living.

He retired because of concussions.

Decades ago, and just years ago, retiring because of a few bell-ringings would have been unprecented. Players would be largely mocked if a weakness was shown. Football was a sport of larger than life barbarians. Seemingly, nothing could keep them down for the count. And, surely, your man card would be revoked if you kowtowed to fears.

“We played real football back then,” former Ohio State running back Pete Johnson said, referring to the days of yesteryear. He played for the Buckeyes in the mid-1970s, when you were tackled to the ground on pavement so hard many believed it was concrete painted green.

Then large-scale cases of dementia, chronic headaches and even suicide began cropping up in former players. At first, the correlation wasn’t noticed. But as the rate of incidents rose, so did the suspicions. Former players from the 1950s, 60s and 70s – when technology and equipment was less than par – were thought to be the focal point of the issue. But players from the 80s, 90s and 2000s crept into the problem as well. Another contributor was the tough-man mystique – players would not stay on the sidelines if they could walk.

“I can remember getting led off the field by my teammates and not remembering it, then getting woken up with smelling salts under my nose, and 20 minutes later I’d be back in the game,” former Ohio State All-American linebacker Ike Kelley said about his NFL career with the Philadelphia Eagles. “Did that affect me? Some people would say, yeah, it has. I’m not going to say it’s overblown or underblown. I’d just say they haven’t done enough research to determine it. Anyone who just blows it off, that’s not factual. There is something to it. We just don’t know how much.”

 A healthy brain (left) conpared to one with CTE. 

Boston University began studying the deaths and determined that chronic traumatic encephalopathy, or CTE for short, played a major part in former players’ dementia, headaches and suicides.

CTE is a progressive degenerative disease. It can only be diagnosed post-mortem. Because of this, former players have begun the act of donating their brains to the cause. Junior Seau’s family became the latest to join the study, donating the eight-time All-Pro’s brain after he committed suicide in May. CTE is found most commonly in people who experience concussions, including military service personnel. Individuals with CTE may experience dementia, aggressive behavior, confusion and depression. The symptoms can come in the short term or long term. While football has garnered the most attention, there are also concerns about other contact sports such as ice hockey, soccer and basketball.

An estimated 300,000 sports-related traumatic brain injuries, most of them concussions, occur annually in the United States, according to the Centers for Disease Control.

An American Journal of Sports Medicine study of the 1975-1982 college football seasons found that concussions were a persistent and regular but relatively infrequent type of injury. A primary reason goes back to the lack of knowledge on concussions during the time frame.

Concussions accounted for 75 percent of head injuries. The study determined that running backs were the most likely offensive position to suffer a concussion, while the secondary positions were the most at risk on defense.

"I didn't get concussions, I gave them," Johnson said.

Sweat, a linebacker, suffered three concussions during his career at Ohio State, including one last season at Purdue. Following his concussion last season, Sweat experienced the tell-tale signs of repeated head trauma.

"I've never been depressed in my life,” said Sweat, who will pursue a law degree. “I'm the most positive person, and I was down. I knew it wasn't me. I couldn't control my thinking. I was not myself. My mind was not there. Some of the thoughts that were out there, I was getting worried about that."

While that experience gave him signals that something serious could be wrong, Sweat brushed it aside during the winter and spring, hired an agent and awaited his NFL future. Not until an accidental bang to the head the day before minicamp did Sweat walk away from his boyhood dream. As fate would have it, Sweat bumped his head in the shower – a Doomsday location for Cleveland – at the Browns’ team hotel. Symptoms he had experienced for months returned, and that’s when Sweat knew it was time to concentrate on something else.

“It scared me," Sweat said. "Football is not worth my health. It's really important to me that I'm able to have a family and a life after football. Football is a great game, but when you have a concussion like that, it's not worth it.”

More and more players, both past, present and future, are figuring that out. Another former Buckeye – Ross Homan – retired last season after suffering a concussion in the preseason, and several NFL players, including former Super Bowl MVP Kurt Warner, have said they wouldn’t let their sons play the very game that consumed their fathers’ lives and deepened their bank accounts.

Could we one day see this in Ohio Stadium?

A lawsuit was brought forth against the NFL from more than a thousand former players, including former Ohio State Buckeye Dave Foley, accusing the NFL of hiding information that linked football-related head trauma to permanent brain injuries.

“The biggest problem I see is back then when the concussions were happening, the equipment wasn’t near as good and the coaching and medical staff really didn’t know how to deal with it,” said Foley, who’s had six operations for a detached retina in the past year. Doctors believe blows to the head led to the eye issue. “They’d ask you how you felt, you’d say I feel OK and they’d send you back in the game. I don’t know the long-range cause – I’m not a medical doctor – but I think it’s been proven that multiple head blows causes brain damage, and if you have brain damage you can do a lot of crazy things, like shoot yourself, and that’s a shame.”

More than a dozen former NFL players who have died in recent years have been diagnosed post-mortem with CTE. Several of those diagnosed committed suicide, including Dave Duerson, who took the step of shooting himself in the chest to preserve his brain. Before he killed himself, Duerson sent a message to family members telling them he wanted his brain donated to the CTE study.

“It bothers me when I hear about guys taking their own lives, Junior Seau being the most recent,” Kelley said. “He was a guy that seemingly had everything going for him. What I have found over the years is certain people can’t make the adjustment to the limelight of the NFL to regular life, so to speak. Did concussions cause that? I don’t know. But I know those guys have a lot of them, especially us guys who played linebacker.

“I think it affects different people in different ways. I have documented, from my days in high school through Ohio State through seven years in Philadelphia, 15 or so concussions. Some people say it’s bothering me, but I don’t seemingly have any cognitive problems. But I do not certain individuals act differently to certain injuries, and I don’t think concussions are any different. When you slam your brain against your skull it can be damaging. They still don’t know the long-term effects. I think the studies going on are good. The longer they go, the more they’re going to find out – yea or nay – on whether it affects everyone all the time.”

This week the Big Ten Conference and Ivy League announced they will co-sponsor a major research study on concussions and other head injuries among major athletes. The two academic heavyweights will combine resources to better understand the injuries from a physical and behavior standpoint, thus improving the well-being of athletes.

“Frankly, this is a unique moment in the history of science,” Dr. Dennis Molfese, Big Ten/CIC Research Collaboration Director and the University of Nebraska Director of the Center for Brain, Biology and Behavior, said. “There is no question that this research program will be greatly strengthened by bringing together in a genuine partnership the outstanding and cutting-edge scientists, athletic trainers and team physicians of both conferences to better understand and reduce as well as treat head injuries.”

Student-athletes who volunteer to be part of the study will be evaluated at different stages of their career – when they enter school, during their careers and after their careers. An assortment of medical personnel - sports medicine specialists, neurologists, neuropsychologists, neurosurgeons, biologists, epidemiologists and other experts – will lead the study.

Last season the Ivy League became the first conference in the country to limit the number of full-contact practices. Pop Warner, the largest football youth organization in the country, implemented rule changes just last week that will drastically reduce the amount of contact allowed during practice.

In 2010, Owen Thomas, a junior lineman for Penn, an Ivy League university, committed suicide. After his brain was studied, it was determined to contain the beginning stages of CTE. Thomas became the youngest person to ever be diagnosed with CTE. Though he never had any documented concussions, Thomas was known as a hard hitter, raising the possibility that he played through concussions and took multiple blows that led to sever head trauma.

Ohio State medical staff personnel closely monitor student-athletes who suffer head injuries. If an athlete is thought to be concussed, doctors will perform the various levels of concussion tests to correctly determine and diagnose the severity of the trauma. They will then be held out of contact until the symptoms have completely subsided, which is determined by passing a series of tests.

“I think concussions are a serious problem and have always been,” Ohio State athletics director Gene Smith told Eleven Warriors. “It is not an overblown issue.

“The most important thing is our team physicians have total authority with decision making on a concussion, not coaches. We have defined procedures to determine when a player can reengage.”

The NFL is a multibillion-dollar business, while college football is in the midst of playoff fueled discussions that could include a TV contract over $1 billion. When you have two business models that are clearly working, making changes to alter the product is rare. Yet, many believe that is exactly what will happen. Some already see football going over a bridge to nowhere.

“Did you watch the Pro Bowl this year,” Foley asked quizzically. “It wasn’t football, and it was a horrible display. I think there has to be some compliments within the rules to still allow the speed and violence but protects people’s heads.

“What really bothers me about it is I think the game itself will have to change in some ways. I hate to take the violence out of the game, but I think in the very near future there will need to be some drastic changes in the equipment or even the rules of the game. That’d probably be good for the everyone, including the game. If you have this game going on and it becomes worse and worse over time, eventually the public is not going to stand for it, either.”

Said Johnson, “You watch the NFL now and guys don’t even tape their hands. When was the last time you saw blood in the NFL? There used to be jerseys covered with blood when we played. I wish I hadn’t played hurt. I’d be walking a lot better.”

Johnson believes the research into concussions is much ado about nothing. In the years immediately prior to the discovery of CTE in former players, the main focus was on the brutality of knee, hip and shoulder injuries suffered in former players. Sports Illustrated even did a cover story on the decline of former stars, such as Johnny Unitas.

“I think it’s part of the NFL’s deal that overshadowed the real problem,” Johnson said. “I don’t know any guys who have dementia, can’t remember things or have headaches. But I know a lot of guys who can’t bend over and put a tee in the ground. Congress started investigating disability in the NFL and they came out with this dementia stuff. I just think it’s a cover and hard to prove. How can you prove it didn’t happen in high school or when you jumped off you bed? I think the real issue is guys who can’t walk.”

College football has already changed dramatically over the past 20 years. The sport went from the days of few bowl games to the Bowl Alliance and the dreaded Bowl Championship Series. The next 20 look like they could undergo even more change. Already, a four-team playoff is on the horizon.

Could Ohio State and Alabama one day square off in the national championship game in New Orleans with flags adorned to their hips? It’s doubtful at this point in time. But don’t rule it out.


Comments Show All Comments

David Sokol's picture

Flag football in Ohio Stadium sounds exciting...

Kyle Rowland's picture

Maybe we can field an 11W team...? 

Denny's picture

A thing I've been wondering as of late, especially after the Ivy/B1G partnership was announced: is there a lot of cross-communication between football TBI research and that going on with military injuries? I'd assume so, researchers being highly collaborative and all, but you never know. I'd be very surprised if major changes to football don't happen in the next ten years or so, as TBI becomes more and more well-known outside of niche academic circles. 


Maestro's picture

I understand a little bit about where Pete Johnson is coming from, but he is ignoring the elephant in the room.  Joint problems are easy to see.  They show up in a limp, or in difficulty getting out of your chair/car, or when you can't reach overhead to put on a shirt.  Brain injuries are more subtle.  All you need to do is look at all the trauma that players from Johnson's era had on their joints and apply that to the brain.  Scary to think about really.

vacuuming sucks

beserkr29's picture

I think it comes down to technique used when playing and how cautious a player is when coming back.  Some of the greatest defensive players ever are still kicking.  Dick Butkus and Deacon Jones, both HOFers, are still doing great, even though both were extraordinarily tough players who played (and hit) extremely hard.  Our own beloved Jack Tatum was very successful in life after football, until diabetes hit him hard.  And, as is so often pointed out, Tatum was one of the most physical players to ever play the game.  Is football a dangerous game?  Absolutely.  Are concussions and CTE serious problems?  Of course.  Technology can help with that, but even more would be done if proper technique in the tackle were preached, in my opinion at least.  Look at rugby.  Nearly as physical, absolutely no padding whatsoever for the players.  Tackles, scrums and the like occur all the time.  And yet, since rugby players are taught fundamental tackling from the word go, there's nary a peep about the kinds of issues the NFL is currently dealing with.  The Junior Seau and Dave Duerson events are horribly tragic and deserve a thorough investigation into prevention of these types of scenarios.  But football's appeal is it's rough and fairly violent nature.  Take that away and the game will become a pale facsimile of what it is now, in terms of fan interest and revenue.  Whether that's a good or bad thing depends on your point of view.

yrro's picture

The frustrating thing is that I'm pretty sure there are solutions that do not involve making football less violent. If we make harsher rules and culture about detecting concussions and allowing proper recovery time and do whatever it takes to change the gear used to dissuade using the helmet as a weapon, I think that would solve the vast majority of the safety issues without making the game into flag football.
I don't know that we need to go back to leaether helmets, but modern science should be able to make something that both protects the face and yet doesn't encourage people to lead with the head. Rugby players don't lead with the head just because they are taught proper form, but because it f'ing hurts!

BrewstersMillions's picture

Man, its tough. There is only so much a helmet can do. As a more extreme example, if someone rides a motorcycle and hits a wall at 45 MPH but wears a helmet, they probably still die. Helmets are going to protect against damage to the structure of the head but at the end of the day, your brain is still rattling around inside of your head. Detection and recovery are more important, in my opinion, than any advances we can make in equipment at this point.

CowCat's picture

Helmets are definitely necessary, but I think they also can encourage players to hit with speeds and forces that they would never use if they weren't wearing a helmet.
Oftentimes protective equipment leads to more risky behavior.
Another example:  Here in the Seattle area many people drive 4WD/AWD cars for traction on the mountain roads ... but far more 4WD/AWD cars get involved in wrecks than 2WD because the drivers think they're immune to the conditions.

"We get paid to score touchdowns, not kick field goals"
-- Urban Meyer

buckeye76BHop's picture

I hope ShadyBuckeye reads this...may be seeing facts will make him and other meat heads see that TBI is a result of multiple concussions and a serious issue.  TBI will push all football programs from Pop Warner all the way to the NFL to change the way players hit.  Too much leading with the head and concussions from improper technique will be some things to change.  Including hitting defenseless players as well as eliminating the kick off will be some ways they'll try to prevent it as well.  Flag football and other suggestions of removing helmets like in the old days will not help anything.  It will take away the essence of what football is.  Make it safer...I'm all for...changing it entirely and making it a joke...I'm not for that what-so-ever. 
The smartest thing GS has ever said besides his press conference after hiring Urban Meyer in November.  “I think concussions are a serious problem and have always been,” Ohio State athletics director Gene Smith told Eleven Warriors. “It is not an overblown issue.
  Hopefully other OSU fans and fans of football in general will see that this is a serious issue.  Andrew Sweat is a hell of a smart man for not hurting himself more and I commend him for his decision.  Go Bucks!

"There's nothing that cleanses your soul like getting the hell kicked out of you."

"I love football. I think it is most wonderful game in world and I despise to lose."

Woody Hayes 1913 - 1987 

hodge's picture

The problem is the fans, we're just as much to blame for the culture of the NFL as its players are.  Remember when Jay Cutler went down in the NFC Championship a year ago?  He was ripped apart by fans, players, and even the media (which is now leading the witch hunt) for not being "tough" enough.  Couple that with our near-masturbatory praise for bone-crushing hits, and you can see why this is such a salient issue.  Things are going to change, and you're right--it will be interesting to see how they make the game safer without simoutaneously castrating it.

BrewstersMillions's picture

Oh man. I was at ground zero for that Hodge. Cutler to this day still has his toughness questioned by meathead Bears fans-Even though around the league he is known as one of the NFL's toughest dudes.
To elaborate. We like to think about this problem in terms of the head to head collisions that occur on a tackle. When a safety leads with his head over the middle or a linebacker leaves his feet or whatever. Yes, that is stuff that can be 'taught' out of the game by forcing guys to lead with their shoulder and wrap\drive. That's the only element affected. You still have offensive and defensive lineman banging their heads against one another (For the record, fundemental line play involves a lot of head to head action). Running backs still 'lower the boom' on guys by dropping their heads, blocks are still thrown with the head as the weapon. The very nature of football REQUIRES the use of the head in more than just tackling. We can have %100 of players tackling with the fundamentals of the best rugby guys out there but you will still have thousands of head to head collisions each and every game because of the very nature of the game. Tackling is just part of it.

smith5568's picture

Well this meat head does not think this is as big an issue as it is being made out to be. I see the "facts", but remember there are "facts" that support a counter-conclusion. I have suffered severe brain trauma but I still agree with Johnson that head injuries are blown out of proportion. They are serious and should be looked into, however I see far more players struggle with joint problems than with depression, dementia, and suicide. 
I take offense to you thinking that anyone who doesn't believe that this is a huge issue is a meat head. 

BrewstersMillions's picture

This topic is the most interesting and fascinating element to football right now. These pieces never get old for me, thank you 11W for keeping up on this stuff. It is important to football-fans and players alike.

spqr2008's picture

Kyle, love the article, and 11W staff, love the beat writer!

Grayskullsession's picture

Look at rubgy. After they banned much of the protective gear, injuries and concussions went way down. Wanna know why? Because the players had to actually use form tackling instead of throwing their body into another person. I promise you if you remove a lot of the protective gear from football the same thing will happen.

"if irony were made of strawberries, we' d all be drinking a lot of smoothies right now."

BrewstersMillions's picture

I agree with you there. Give an NFL player anything to use as a weapon and he will. Hell, I was guilty of it growing up. I broke my forearm in my junior year of high school and had a half cast after a few weeks. I was cleared to play with the cast on, threw a pad over it and I had me a club I used more than I'm proud to admit. The problem the NFL specifically has-they won't ever get rid of the helmet. Its the worlds greatest marketing tool. Its a very interesting conundrum.

M Man's picture

To my 11W friends:
How about we just ban the NFL?  I think that to a great extent, it is the NFL super-humans -- bigger and faster by an order of magnitude, and playing for years longer than just the 4/5 years of collegiate eligibility -- that seem to be the main problem.
I have no particular use for NFL football. 
I'm not sure how I could live without college football.

CowCat's picture

Or, replace the NFL with an alumni league!   Second chances for former TOSU and UM players!
We have an alumni band after all ...

"We get paid to score touchdowns, not kick field goals"
-- Urban Meyer

lamplighter's picture

cleveland already has

timdogdad's picture

the nfl should get extremely serious on dirty helmet to helmet hits. espcially to repeat offenders. if i was roger goddell, i would tell the refs working a steelers game that if james harrison hits someone like he did against colt mccoy, then he's pulled from the game and out for the season.  that's what i would do..  listen carefully..  one helmet to helmet hit, you're done...     

KE's picture

I think this particular train needs to slow down. I remember the 1990s, when every early death of a football player was related in the media to steroid use. Clearly steroid use causes physical problems down the road, and I'm sure that repeated concussions do too. But the jury is still out on thow severe this problem is. I recently read of a study that showed that former NFLers have longer life expectancies than average overall. It's something that needs much further study, and the Big Ten / Ivy project is a great start. But don't go making judgments until the facts are in - anecdotal evidence is not science, and if you know anything about how to interpret scientific studies you know that it take more than a few studies to confirm a hypothesis. Perhaps the role of concussions in long-term health problems will be confirmed. But at present it's not.

Denny's picture

Couple football concussions with TBI data from soldiers coming back from overseas, and there's a lot more than just "anecdotal evidence".
It does take a lot of data and a lot of studies to separate the signal from the noise, and the brain is incredibly complicated -- and longitudinal studies on humans require a lifetime to collect data, limiting the rate of study turnover.
Along your same lines, though: one study saying that NFL players outlive the general population isn't definitive either, especially if the data wasn't normalized for general fitness level or other similar factors. It's all tricky, and hard to parse. But I don't think discounting the notion that concussions are a problem because there's not a ton of data is erring on the right side of caution.


nick_ferguson58's picture

They will never play flag football in Ohio Stadium.  They will just play soccer and lacrosse in a half empty stadium.  Football will become a niche sports and probably will not be sanctioned by the NCAA and as a whole will be much like boxing.  At best it will become a sport with die-hard fans that not a lot of the better athletes choose to play.  Sort of like Hockey or even baseball.  I see it being far worse off then that though in the distant future. 
Personally, I see football dieing a slow death for one of two reasons.
Reason number one is that if lawsuits start winning and hitting the pockets of High Schools, the they will cease to have the sport because of the liability and the risk of litigation.  Also, school insurance policies will go through the roof.  This is a bit unlikely but if it were to happen it would happen very quickly.  One or two lawsuits against a school or even college that win and you could see a cascade of schools dropping football within a few short years.  
Secondly, is the possibility that parents see the danger, whether it be real or perceived, and stop letting their kids play football.  The pipeline of talent that feeds colleges and the NFL slowly starts to dry up as more kids turn their attention to basketball, baseball, soccer, track, and Lax.  Some smaller high schools with small teams are no longer able to field a team at all and even the bigger high schools hurt for numbers.  The product on the field suffers at all levels and tickets and TV revenue decline gradually in the NFL and college.  This further fuels less kids playing and the sport slowly starves.  Eventually it becomes like boxing is today.
This is sad stuff.  I played college football and certainly will encourage my kids to play but I truly believe football will not be what it is today for much longer.  I am 23 and I worry that my grandkids, or maybe kids, will not believe me when I tell them football used to be the most popular sport in America.  Just as kids today dont realize Boxing and Horse racing used to eb the most popular sports a long time ago.  Sad but true. 


BrewstersMillions's picture

Nick, i see your point but I think you seriously under estimate the Death Star that is the NFL. Football is not going anywhere.

CowCat's picture

Maybe I'm an optimist, but ...
I think football can be exciting, physical war of your-best vs. their best without being unnecessarily violent / trashy / stupid.
I don't know of anyone who roots for injuries or helmet-to-helmet collisions (outside of Philadelphia lol) -- There are the slack-jawed fans who live for a bone-crushing hit, but we can do without them too -- Buckeye football is tied to a prestigious academic institution after all.
If the NFL and NCAA put in *drastically* harsher penalties for headhunting, player targeting, piling on, facemasks, etc.  I think all of this will blow over and educated, loyal fans will not miss a thing.   In fact, the game will get a lot better because more great players wlll be on the field more often.
There needs to be a culture change, but the game will still be great.

"We get paid to score touchdowns, not kick field goals"
-- Urban Meyer

nickma71's picture

Yep, learn to tackle rather than "blow up" your opponent and injuries will go down. Sort of like the comment here about how little animal isn't as good as Hawk because he tackles people. Riiiiiiiiiiiight.

CowCat's picture

All that needs to be said was said by Woody and Bo at  0:34 here:
Hard-nosed, disciplined, clean football with respect for the opponent.

"We get paid to score touchdowns, not kick field goals"
-- Urban Meyer