BEFORE THE RECENT NFL showdown between Dallas and San Francisco, Troy Aikman and Steve Young joked with their agent that the contest ought to be dubbed the ""Concussion Bowl.'' The two superstar quarterbacks have suffered at least a dozen between them. And that's just counting the ones where ""we were carted off,'' Young told the agent, Leigh Steinberg. But it was no laughing matter early in the game when 49er Kevin Greene sacked Aikman, driving Troy's helmet into the turf. Aikman lay there briefly, then wobbled to his feet, stunned. ""I watched with a sinking feeling in the pit of my stomach,'' says Steinberg.
He wasn't alone. While both Young and The Acheman survived the game without serious injury, that sinking, sickening feeling has been going around the league. The NFL, with its unique combination of sophisticated strategies and primitive combat, remains an American passion. But, too often, it has also become a sour saga of debilitating head injuries caused by bigger, faster, better-conditioned players colliding on what are often, thanks to the advent of artificial turf, muscle-hard surfaces. In recent years three NFL veterans have quit the game after multiple concussions. And the career of San Diego Chargers quarterback Stan Humphreys is now imperiled after his fourth concussion in less than two years. Steve Young admitted to reporters last week that he was shaken after watching replays of Humphreys's most recent injury. ""I saw his eyes, and I was scared for him,'' Young said. Three weeks after he was thrown to the ground, Humphreys still has occasional headaches and serious problems with insomnia. ""Everybody connected with football understands that players may have to live with aches and pains when they bend over to pick up their child,'' says Steinberg. ""It's another matter not to remember the child's name.''
Remarkably little is known about concussions. Put simply, they're blows to the brain that cause some temporary impairment. The NFL's own study committee has a working definition that runs to a full page and lists dozens of symptoms including headache, nausea, dizziness, loss of appetite and ringing in the ears. ""We've increased sensitivity to the issue within the league,'' says Dr. Elliot Pelman, the New York Jets team physician who heads the committee. ""No one talks about "dings' anymore. We've legitimized the word "concussion' inside the NFL.'' That's an important change. Once, the macho climate of the NFL demanded euphemistic talk of a player's ""seeing stars'' or getting his ""bell rung''; nothing earned a player more respect than his willingness to play ""hurt'' or ""with pain.''
Between 100 and 120 concussions are now reported to the league each season, or approximately one every two to three games. The league has already invested $1.5 million in its committee as well as pioneering research on brain injuries. And recent rule changes --banning helmet tackling against defenseless quarterbacks and receivers, for example--have been modest steps in the right direction. ""We take this problem seriously,'' says NFL spokesman Greg Aiello. ""But we're always balancing it against the essential nature of the game, which is based on hitting and physical contact.''
The players all wear helmets, but those were designed to prevent skull fractures, not concussions. Julie Nimmons, CEO of the Schutt Sports Group, which manufactures helmets, says combating concussions would likely require some new device that permits no reverberation of the cranium against the helmet. No such device or, indeed, any radical change in the helmet is on the horizon. In fact, over the past couple of decades, the changes in the helmet have only been incremental, making it lighter, more shock-absorbent and snugger.
One reason for the status quo is that litigation--product-liability lawsuits stemming from football injuries--has become a primary concern of manufacturers. Runaway legal costs are a major reason that their numbers have dwindled from 18 in 1970 to just two today. ""They're in gridlock,'' says Pelman. ""They're so busy stocking the treasury for litigation that there's no money available for research and development.'' And they are loath to experiment and risk defending major design changes with uncertain science before a lay jury. ""We think we're making the best possible helmet, given what we know,'' says Dan Kult, director of technology at Riddell Inc., which makes the official NFL helmet. ""But what we don't truly understand is how concussions occur.''
Indeed, a football player can suffer a concussion without absorbing any direct impact to his head; any blow to the body that snaps the head can cause one. NOCSAE, a nonprofit corporation that sets safety standards for athletic equipment, is funding research to try to develop a microchip that can be attached to a player's skull during a game. The goal is to garner the first truly accurate information on the kinds of violent impact the head sustains during actual play.
Obviously, concussions are not confined to football. Many sports or recreational activities--from hockey to horseback riding, from skateboarding to skiing--run considerable risk of brain injuries. NFL players long ago decided to accept a certain amount of risk to play the game and reap its considerable rewards. But the NFL and those who promote it may have to reconsider how much risk is appropriate and whether they can continue to celebrate the most dangerous and destructive elements in the game. There are a host of new proposals, from further restricting hits on quarterbacks to suspending players guilty of repeated roughing penalties. And neurosurgeons could be required on the sidelines to ensure quick expert attention.
The NFL's nightmare is having a group of punch-drunk players on public display. Multiple brain injuries, even so-called ""mild'' concussions, may have deleterious long-term effects. ""No doctor can tell them absolutely how many concussions represent a major risk,'' Steinberg, the agent, says. ""But players need to know they may be playing Russian roulette with their future health.'' And, as he's the first to admit, not even Steinberg can negotiate a fair contract for that game.