When Oakland plays the Chiefs in Kansas City this weekend, Raiders' All Pro linebacker Bill Romanowski will be watching the game on television at his home in Northern California.
Romanowski is finished for the season, and perhaps forever, because of repeated concussions — at least 10 — in his 16-year pro career. He wants to play again, but after his latest concussion earlier this season, doctors told Romanowski his history makes him more susceptible and another could cause critical damage.
"It's definitely scary," said Romanowski, watching a Raiders game in his living room. "In no way would I ever want to put the rest of my life in jeopardy."
Romanowski is hardly alone. A newly released NFL study counted 900 concussions in the league between 1996 and 2001.
Concussions were a subject league officials, coaches and trainers long avoided discussing. Players, perhaps because there was no physical evidence of an injury, like a broken bone, often did not take concussions seriously.
But officials became concerned with the forced retirement in 1992 of Jets star wide receiver Al Toon, as the NFL faced an epidemic of concussions. That concern was reinforced when marquee players like Troy Aikmen and Steve Young also retired after multiple concussions.
The NFL study, published in Neurosurgery magazine, was led by Dr. Elliott Pellman, who is also the Jets' team physician.
Pellman said the injury is just as severe as any with physical evidence. And he said the best way to understand is to imagine the brain as a Jell-O mold. "If you bang that Jell-O mold," he said, you see that long after the blow "the Jell-O is just jiggling around, that's probably what's going on with a player's brain."
The study is only the first step in examining the concussion problem. It found that most concussions occurred when one player delivered a hit to the side of the head of another and when the player hit was either standing still or moving slowly. And the hits that cause concussions are surprisingly strong: They packed an average 980-pound force; Computer analysis likened the impact to a head-on car crash at 25 mph; The force was 98 times that of gravity.
Change in Helmet Design
The analysis was conducted with the help of Biokinetics Inc., which used videotape from two angles of nearly 200 concussions. That has led the league's principal helmet manufacturer to make some long overdue changes in design.
"Traditional football helmets," said Thad Ide, director of research and development for Riddell, "have mostly fitting padding, nothing that's really made to reduce the impact in the sides of the face."
Riddell has developed a new helmet worn this season by 300 pro and college players, which more fully covers the jaw and contains padding to better absorb the shock of a hit.
But Pellman says a critical concern remains and is part of an ongoing study: post-concussion syndrome. It is commonly manifested by migraines, dizziness, malaise and mood swings and can linger for days, weeks or months.
"We want some way of predicting who is at risk for post-concussion syndrome. How could you predict whether they were at risk to prevent them from getting injured?" said Pellman.
Bigger Risks in Multiple Injuries
And there is great risk if a player suffers a second direct or indirect blow to the brain when post-concussion syndrome is still present. That could lead to rapid brain swelling and even death.