The Tip of the Iceberg

When we think of concussions, we think of the “big hit” that leaves a player dazed or unconscious, and it’s true that a single concussion, or series of concussions, can result in a traumatic brain injury. But medical science is also increasingly pointing to the accumulation of undramatic subconcussive hits as a major risk for potential brain disease. Players who exhibit no immediate symptoms may still be at risk for serious health problems. Concussions can take days, weeks, or even longer to heal.

Concussions are not limited to professional sports. According to the U.S. Centers for Disease Control and Prevention (CDC) as many as 3.8 million concussions occur each year at all levels of sport.

Pittsburgh Steelers quarterback Terry Bradshaw is kicked in the head while being sacked by an unidentified Cincinnati Bengals player.

Concussion Timeline

1906

The Intercollegiate Athletic Association of the United States (now the NCAA) is founded as a result of President Theodore Roosevelt’s efforts to reform safety standards in college athletics. Among its central tenets is the pledge to “protect young people from the dangerous and exploitive athletics practices of the time.”

1952

The New England Journal of Medicine publishes a study of traumatic injuries in college sports. The study concludes that student-athletes who suffer three concussions should no longer be allowed to play body-contact sports.

1984

In December, the American Medical Association (AMA) formally calls for a ban on boxing. An AMA study of active and retired boxers finds 87 percent show definite signs of brain damage.

1994

Dallas Cowboys quarterback Troy Aikman suffers a high-profile concussion during the NFC Championship Game. After the game, Aikman does not know where he is and has no recollection of playing. He plays in the Super Bowl a week later.

2002

Former Pittsburgh Steeler Mike Webster dies of a suspected heart attack. His autopsy is conducted by forensic pathologist Dr. Bennet Omalu. Omalu diagnoses Webster with Chronic Traumatic Encephalopathy (CTE), and three years later publishes a landmark paper on the subject.

2006

The NFL’s Mild Traumatic Brain Injury Committee criticizes Bennet Omalu’s published findings and demands a retraction.

2009

Washington State enacts the Zackery Lystedt Law, becoming the first state in the nation to enact a comprehensive youth sports concussion safety law.

2010

The NCAA adopts a Concussion Management Policy that requires member schools to develop a concussion management plan for the 2010-2011 school year. However, the NCAA’s director of enforcement, Chris Strobel, acknowledges the organization has no intention of enforcing the policy.

2011

The first concussion lawsuit is filed against the NFL (since consolidated). The NHL institutes a new concussion policy. The policy requires players with a suspected concussion to be examined by a physician in a quiet room.

2014

The NCAA settles a class action lawsuit by creating a $70 million fund to diagnose potential brain trauma in thousands of current and former players. Football, ice hockey, soccer, basketball, wrestling, field hockey, and lacrosse are covered under the agreement.

2015

The NFL brain bank reports 87 out of 91 examined former players have tested positive for CTE.

The Case that Changed Everything

The NFL Concussion Litigation

Despite the NFL’s attempt to dismiss the suit on the basis of federal employment preemption, in 2014, U.S. District Judge Anita Brody preliminarily approved a $765 million settlement (both sides estimated damages close to $1 billion, but the fund is expected to earn interest over its 65- year lifespan). The case revealed the estimates of the NFL’s own actuaries, who reported that they expected almost a third of retired players to develop long-term cognitive problems, and at notably younger ages than the general population.

National Football League Commissioner Roger Goodell testified before the House Judiciary Committee about football brain injuries on Capitol Hill October 28, 2009, in Washington, D.C. (istockphoto.com/EdStock)

“They’re forced to care now because it’s politically correct to care. Lawsuits make you care.”

Former Pittsburgh Steelers' quarterback Terry Bradshaw

In the States

In 2010, only 10 states had laws addressing traumatic brain injuries in youth sports. Since Washington State enacted the Zackery Lystedt law in 2009, every state and the District of Columbia has enacted some form of a “When In Doubt, Sit Them Out” law.

01Only one state has any enforcement mechanism for its concussion management laws.

05Only 5 states mandate medical personnel to be present at games involving collisions.

06Only 6 states require parents be notified of their child’s traumatic brain injury.

31Just 31 states require concussion training for coaches.

Concussion Stories

Stories that have shaped legislation and research

Mike Webster

In 1997, the same year he was named to the Pro Football Hall of Fame, Webster had been homeless for three years and was beset by health problems. By 2002, Webster was dead at the age of 50. The autopsy was performed by Dr. Bennet Omalu, a forensic pathologist at the University of Pittsburgh, who found evidence of Chronic Traumatic Encephalopathy, or CTE, in Webster’s brain.

Eric Lindros

Philadelphia Flyers star center Eric Lindros retired after a series of concussions in 2007. Lindros was injured by an elbow to the head in March of 2000 and continued to play despite headaches, nausea, and memory loss. He would later say he felt pressured to keep playing, saying he wouldn’t take himself out of a game but hoped the team would.

Hugo Lloris

In 2013, English Premier League goalkeeper Hugo Lloris, was knocked out by another player. Medical staff initially signaled for Lloris’ replacement, but when he angrily insisted he could play on, they acquiesced and allowed him to continue. The medical staff and team manager came under heavy fire for allowing Lloris to continue.


“Nobody told me anything about my concussion. Nobody told me about the signs and symptoms and what to be aware of.”

Merril Hoge, former NFL player and current football analyst for ESPN

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