NFL Hits Concussion Issue Head On

ROSEMONT, Ill. -- June 19, 2007— -- In terms of what has come to be expected at past NFL meetings, what will transpire Tuesday in the conference rooms at a hotel near O'Hare Airport figures to be markedly different than any other get-together the league has ever convened.

Just consider some of the esoteric sessions among the more than one dozen agenda items:

Does concussion lead to pugilistic dementia and Alzheimers?

The role of neuropsychological testing in return-to-play decisions.

Multiple concussions: When is enough enough?

For a full day, members of the NFL player health and safety committee, doctors and trainers from each of the 32 franchises, prominent researchers and league administrators will meet in what has been dubbed by some as a "concussion summit."

The meeting, mandated by first-year NFL commissioner Roger Goodell, comes at a time when the league is under fire and under intense scrutiny on several off-field fronts. Among them is the belief in many quarters that players who suffer multiple concussions during their NFL careers experience lifetime effects such as Alzheimers, depression, dementia and other serious ailments.

In truth, the NFL has been conducting research on concussions (or MTBI, mild traumatic brain injuries as they are often called) among its players for 14 years and spent millions on studies.

"The safety of our players is critically important to us," Goodell said at the NFL spring meeting in Nashville last month.

But a number of recent events -- the suicide of former Philadelphia safety Andre Waters at age 44 last November, the February revelation by former New England linebacker Ted Johnson that he suffers from depression and other side effects from multiple concussions, and the deaths of onetime Pittsburgh offensive linemen Justin Strzelczyk and Terry Long after long bouts of depression -- have cast more focus on the subject.

Based on anecdotal evidence, and on studies in which researchers have pored over the brain tissue of former NFL players, it appears there is reason for concern. Under Goodell, there is a heightened sense of awareness and of the potential need to better address the issue.

"This is direct tissue evidence [of the impact of concussions]," Dr. Bennett Omalu, an adjunct professor at the University of Pittsburgh and former pathologist for Allegheny (Pa.) County who has conducted considerable studies on concussions, told the Pittsburgh Post-Gazette. "There's no speculation or interference. It's mounting scientific evidence. It's not about any specific individuals, it's about the truth. … If boxing causes dementia, then why wouldn't football? The force [from a football collision] is often 38 times the gravitational pull on their head. That's been published by the NFL itself."

At the NFL meeting in Nashville last month, Goodell outlined a set of recommendations for concussion management. Based on conclusions from the league's independent committee on MTBI, chaired by Dr. Ira Casson and Dr. David Viano, the recommendations stressed that in all cases, medical decisions always must override competitive considerations. Translation: The health of the player always should supersede how important he might be to his team.

As part of the new standards, Goodell has mandated that every player in the league undergo neuropsychological testing in training camp to determine functional baseline measures for everyone in the NFL. Some of the other recommendations: Evaluation procedures used by different teams will be shared with the medical and training staffs of all franchises. Any decision about when a player can return to the field following treatment for concussion must be made by team medical personnel. Every player must wear his chin strap.

The league is also creating a "whistle blower system" in which anyone anonymously can report an incident in which a doctor is pressured into returning a player to the field, or in which a player is pressured to return. Several players have told ESPN.com that they are skeptical of a "whistle blower" arrangement, because they aren't comfortable that the NFL adequately can protect their confidentiality.

The Tuesday meeting here is not the first such conference for the NFL. There have been at least four other concussion-related conferences sponsored by the league and several that were convened by player agent Leigh Steinberg. What might set this one apart from the earlier conferences is the scope of the agenda, the expertise of the people involved, the inclusion of speakers with dissenting opinions from those of the NFL committee, and the perceived collective resolve to confront the issue.

Said Goodell: "We definitely want to be ahead of the curve here."

Len Pasquarelli is a senior writer with ESPN.com.