Upon further review, many concussions caused by head hitting turf

NEW YORK — In a season in which concussion awareness has been hammered into the public consciousness, and the NFL and commissioner Roger Goodell have focused so publicly on the prevention of head trauma, it seems appropriate that former Detroit Lions tailback Jahvid Best would choose Super Bowl XLVIII week to file suit against the league and helmet manufacturer Riddell for injuries that he says ended his professional career.

Appropriate, since the Super Bowl is the league’s most conspicuous and over-the-top celebration of its game. What better time, after all, for Best — who recently retired after playing in only 22 games in four seasons and joined the coaching staff at his University of California alma mater — to cast an even brighter spotlight on a problem that already has garnered a considerable amount of public scrutiny?

Then again, there is an element of incongruity to the legal action by Best, because it comes at roughly the same time that another, less obvious component of the concussion conundrum gains some traction: concussions precipitated by a player’s head striking the playing surface.

“People think ‘concussion,’ and they immediately picture in their mind one guy hitting another and his head snapping back,” said Atlanta-area attorney Robert Blackmon, who has been involved either as a lawyer or consultant in four concussion-related cases. “That’s not always the case. You don’t have to hit another person, believe me, to (suffer) a concussion. (Playing) surfaces figure into the equation, too. I don't know if it's the ‘dirty little concussion secret’ or not. But it’s true.”

The case of Best — a 2010 first-round draft choice who celebrates his 25th birthday Thursday but has not played in a game since a preseason contest on Aug. 25, 2012 — is a graphic reminder of the ramifications of head trauma. But smack your head hard on the artificial or natural surface of the local high school field some day, and you’ll get all the illustration you need of how it doesn’t always take contact with another animate body to incur a concussion.

The most recent example of a surface-related concussion probably is the injury Kansas City tailback Jamaal Charles sustained on the Chiefs’ first possession of their wild card-round playoff defeat at Indianapolis on Jan. 4. On just his fifth play of the game, Charles gained 7 yards before being stopped by Colts defensive tackle Jeris Pendleton and cornerback Greg Toler.

Charles, a Pro Bowl runner and noted tough guy, was examined on the sideline by the Kansas City medical staff, and the neurotrauma consultant now mandated by the league to be present on each team’s bench. He never returned to the game.

Replays of the run reviewed several times by Al Jazeera indicate some helmet-to-helmet contact from the initial hit by Pendleton. But a bigger problem, later acknowledged by Charles, came when his head impacted the Lucas Oil Stadium artificial surface. Even in slow motion, the impact appears fairly jarring.

“I don’t know exactly when (the concussion) occurred,” said Charles, who has since waffled on whether the injury was technically a concussion. “But I know smacking the turf like that sure didn’t help any.”

League officials and NFL medical experts have confirmed that Charles, no matter his backtracking on the matter, suffered a concussion and was not permitted to return to the game, despite his requests, because of the league’s concussion protocol. And those people have privately conceded to Al Jazeera that the concussion was most likely precipitated by Charles’ head striking the playing surface.

The NFL concussion protocol — developed by the league’s Head, Neck and Spine Committee, essentially as a manual for the diagnosis and management of concussions — specifically cites “contact with the playing surface” as a potential cause for injuries.

Dr. Robert Cantu, one of the nation’s leading neurosurgeons and a concussion expert who has often served as an NFL consultant, recently reaffirmed that playing surfaces can have a role in head injuries. He has included the issue of playing surfaces, and the conditions in which they can contribute to concussions, in several studies.

For their part, players don’t need medical journals or published investigations to conclude that playing surfaces can cause concussions.

Notable, and coming at a fairly inopportune time for the league with the Super Bowl hype gaining momentum, is that U.S. District Judge Anita B. Brody two weeks ago rejected the initial $765 million settlement to which the NFL and attorneys for the plaintiffs agreed in August 2013. It is not known how many of the players filed suit because of trauma resulting from contact with a field surface.

Several former NFL players here for Super Bowl-related festivities, including one-time defenders Derrick Brooks and Sean Gilbert, said they know playing surfaces can cause head injuries.

“Let’s just say I know because I know,” Brooks said, laughing.

Added Gilbert, “It definitely happens. More has to be done, if it can be, to prevent it.”

Back in 2003, Dr. Martyn Shorten, a Ph.D. studying head trauma, wrote, “It is reasonable to believe that a collision between the head and a surface has the same injury potential as a direct impact with another object.”

More than a decade later, that assessment hasn’t been dramatically altered, but the NFL and other groups have adopted measures to reduce the impact.

The NFL, for instance, has mandated that field managers must assess the “hardness” of a playing surface before every game. They do so, in various locations on the field, with one or two kinds of tests, both similar in nature. The field manager drops a weighted device from a fixed height, and an “accelerometer” gauges the amount of time it takes the weight, or “missile,” to stop. A device called a Clegg Impact Tester, or another, an F355, may also be used to create what is known as a Gmax. The NFL and the Penn State Center for Sports Surface Research have generally established a Gmax reading of 100 as the outer limit.

The Gmax readings are relevant for both natural and synthetic surfaces.

Unfortunately, most sports programs below the college level don’t, or can’t afford to, measure the “hardness” of a field with such expensive devices. But parents and age-group leagues are cautioned by Levens to be diligent about field conditions.

“There’s only so much at that level you can do, but people need to keep watch about head injuries, how they occur, what caused them,” Levens said. “Everybody can do more . . . and that probably includes the NFL.”