"Get up. Walk it off."
That's the frequent mentality of athletes facing injuries across the wide spectrum of contact sports. But former football players and safety advocates told Congress that dismissing a concussion as "getting your bell rung" or "clock cleaned" creates a public health risk and necessitates review by the National Football League and Congress.
Amid growing concerns that the NFL has created a culture of hard hits and machismo where players do not report injuries to team doctors, NFL Commissioner Roger Goodell faced tough questioning before the House Judiciary Committee today over the NFL's efforts to protect players from head injuries.
Today's hearing was scheduled after the NFL announced in September the results of an internal study performed by the University of Michigan. The study revealed that players who suffered from head injuries are susceptible to much higher rates of dementia and cognitive disabilities.
Since taking over as commissioner in 2006, Goodell said that no other single issue has demanded more of his energy and attention than player safety, but refused to draw a connection between hard hits on the gridiron and brain diseases suffered by players later in life.
"We know that concussions are a serious matter, and that they will require special attention and treatment," Goodell said. "Medical considerations must always come first. Decisions regarding treatment of player with concussions, and when they can resume play must be made by doctors and doctors alone."
But Gay Culverhouse, the daughter of former Tampa Bay Buccaneers owner Hugh Culverhouse, told the committee that team physicians are not looking out for the best interests of the players.
"The team doctor dresses as a coach on the sidelines," Culverhouse said. "He is not an independent advocate for the player. The players get to a point where they refuse to tell the team doctor that they have suffered a concussion. They do not self report because they know there's a backup player sitting on the bench, ready to take their position."
Dr. Robert Cantu, co-director of Boston University's Center for the Study of Traumatic Encephalopathy, said repetitive concussive hits to the head lead to a brain disease known as chronic traumatic encephalopathy (CTE).
"There's no doubt that these injuries lead to an incurable neurodegenerative disease called CTE, which causes serious progressive impairments in cognition, emotion and behavior control -- even full-blown dementia," Cantu testified.
Rep. Bill Pascrell Jr., D-N.J., who is co-chairman of the Congressional Brain Injury Task Force, compared football players suffering from CTE with soldiers returning from Iraq and Afghanistan with traumatic brain Injury.
"The same way that we have gained greater understanding in research from the brain injuries of our soldiers, we should also take this opportunity to learn from the injuries of professional athletes," Pascrell said.
Pascrell cited statistics from the Center for Disease Control and Prevention that estimate 3.8 million concussions related to sports occur each year and added that those athletes who suffer a concussion are four to six times more likely to sustain a second concussion.
Cantu agreed, testifying that the risk extends beyond the NFL and affects football players at all levels and athletes in a variety of sports.