Update May 29, 2014: President Obama is hosting a summit Thursday to address ways to reduce concussions and brain injuries in youth sports, which send nearly a quarter million children and young adults to emergency rooms each year, according to the White House. Last November, America Tonight headed to the University of Nebraska to check out one of the most promising products in this field, which researchers and coaches hope could transform concussion treatment for young athletes.
LINCOLN, Neb. – Steven Thomas and Derrius Bell’s football lives ran parallel paths:
They both started playing before the age of 9.
Thomas and Bell, with reputations as hard-hitting defensive backs, earned scholarships at Brigham Young and Southern Methodist, respectively.
During the course of their high school and college careers, each believes he suffered at least four concussions.
The effects of their most-recent concussions forced Thomas and Bell to retire from college football within the past four years.
The final play of Thomas’ college career lasted all of three seconds. In the first quarter of BYU’s September 2010 game against Florida State, Thomas saw the Seminoles’ running back Ty Jones run up the middle of the field untouched. Thomas, an undersized free safety with a knack for being a punishing tackler, knew he had to take out Jones’ legs. Thomas had made similar tackles more times than he could remember. What he couldn’t anticipate was Jones’ left knee hitting him in the sweet spot of his helmet, knocking him unconscious.
(Editor's Note: In the video below, start at the 0:50 mark.You will see the hit at the 0:54 mark.)
In the days after the game, Thomas felt terrible. His follow-up head tests weren’t even close to matching the baseline concussion results he had done in the preseason. Headaches were constant and his mood swings were unpredictable. The coaches excused him from having to attend class for two weeks.
“I just sat at home,” Thomas says. “I didn’t even go to football practice or meetings. I did nothing.”
A year earlier, Bell suffered what he believes to have been three concussions in a matter of five plays. Coaches had talked to Bell about his reckless tackling technique in the past. In September 2009, Bell blacked out after a helmet-to-helmet hit with UAB’s fullback, causing a tingling sensation running from his neck to his fingertips. He walked to the sidelines, telling his teammates about how he felt like he had been on the turf for two weeks instead of two seconds. He didn’t alert SMU trainers about his believed concussion.
A couple plays later, SMU was back on defense and so was Bell. The play called for Bell to blitz UAB’s quarterback. But when UAB’s fullback delivered a blindside hit to Bell, the SMU cornerback was sent to a hospital to make sure he wasn’t paralyzed.
Still feeling constant headaches and having a hard time sleeping, Bell returned three weeks later for SMU’s annual rivalry game against Texas Christian University. After hitting TCU’s running back Ryan Christian, Bell felt slow and not in his normal state of mind. Bell’s career ended that day with him being helped off the field.
“I remember my teammates telling me how good of a hit it was,” Bell says, adding that his teammates told him he was slurring and speaking slowly during a halftime speech he attempted to give. “But honestly, I can’t remember the exact moment of the hit.”
Thomas and Bell would both retire within a month of their last concussions. Their stories are prime examples of college football players who’ve recently had to step away from the game due to one or more concussions. Since 2010, at least 12 players from BCS programs have taken medical retirements due to a concussion. The most recent might have come Monday when LSU Coach Les Miles announced that guard Josh Williford’s second concussion in a year, which reportedly left him unconscious for five minutes during a recent practice, will keep him as a "student coach" instead of a player.
It has been 80 years since the NCAA first publicly acknowledged the dangers of concussions. In 1933, the NCAA’s Medical Handbook for Schools and Colleges stated that, “the seriousness of [concussions] is often overlooked.” Another passage noted that concussions “should not be regarded lightly,” and any player who experiences concussion symptoms for more than 48 hours “should not be permitted to compete for 21 days or longer, if at all.”
Calls to implement a standard concussion treatment policy to be used by all of its member institutions -- making the NCAA liable for the health and safety of their student-athletes -- are getting louder. Hours before the college football season’s kickoff, the NFL settled its own concussion lawsuit filed by nearly 4,500 former players to the tune of $756 million. In the concussion era, NCAA athletic programs have been hot and cold about implementing measures for concussion treatment. A 2010 internal survey from the NCAA found that 50 percent of schools polled didn’t require a concussed athlete to see a physician. Almost half of the schools surveyed would return an athlete to the game after he or she suffered a concussion. Return-to-play guidelines following concussions, another suggestion from the NCAA to member institutions, haven’t been a priority either. The same survey found that 39 percent of schools lacked return-to-play guidelines.
The concussion debate has largely focused on what’s wrong, but what is working and what’s missing from the conversation? America Tonight headed to the University of Nebraska for what could be the next big thing in concussion care.
Moving The Dial Forward
The future of concussion care in college football will be located behind the concessions area.
Construction workers with drills, hammers and wheelbarrows pass through what will be the main rotunda of the $63.5 million expansion of the east side of Memorial Stadium at the University of Nebraska. Lincoln, Neb., is built around the campus and Saturdays in the fall. The sleepiness of the town in the summertime evaporates come Labor Day Weekend inside Memorial Stadium, with a home sellout streak going on more than 50 years.
Wearing a red hardhat through the messy construction site, Dennis Molfese understands that researchers like him face an uphill climb when it comes to the concussion question.
“Do I have any answers? No,” he says. “Do I have guesses? Yes.”
But those guesses for the most-effective ways to identify and treat concussions in college football players are methodical and studied – and come with significant financial support.
“We’ve got a lot of people’s future lives dependent on all this,” says Molfese, calmly.
As part of the expansion project, the university has created the Center for Brain, Biology and Behavior. The crown jewel of CB3 is the functional MRI (fMRI) device – a $3 million scanner that will help Nebraska trainers and coaches identify in 10 minutes whether a player has suffered a concussion. Last month, NCAA Chief Medical Officer Brian Hainline praised Molfese’s work, telling the Associated Press that Nebraska’s fMRI is “going to move the dial forward.”
“There’s a huge need for products like this that will help us objectively identify a concussion immediately,” says Christopher Nowinski, co-founder and executive director of the Sports Legacy Institute, which studies brain trauma in athletes.
The device itself is an electrode-covered mesh cap, which looks like a layer of loose headgear that a medieval knight might have worn. But the sophistication of the device is the real fashion statement. Soaked in saline, the 256-sensor cap is placed on a player’s head and provides biomarkers, which are disruptions in the blood that spark the release of certain chemicals within the brain. Putting the cap on takes all of 10 seconds, a process “that comes straight out of a classic science-fiction movie,” says Vicki Liu, a 19-year-old biochemistry major who volunteers at CB3.
Walking past several construction workers focused on a concessions stand, Molfese makes a left into the room that will house fMRI. Most of the time, fans will not be aware that behind the stand where they’re buying a bag of popcorn or a hot dog will be one of the most groundbreaking concussion treatments in college sports.
The use of the fMRI would be a departure from some of the more common concussion baseline tests used by a number of college programs, including the King Devick and the SCAT3. While the tests can be effective when administered properly, they offer no indication for what the long-term damage might be for the player.
“They work pretty well for a day or two after the concussion and most symptoms tend to disappear pretty quickly,” says Molfese, “but we don’t know with those tests if there is more severe damage that the tests simply aren’t measuring, or if there is a prolonged recovery time. I’ve had players here and other places say, ‘You know, I know you know the tests say I’m doing fine, but I just don’t feel right.’”
When Molfese arrived at Nebraska in early 2010, acquiring an fMRI was a priority. Tom Osborne, the legendary coach-turned-athletic director, got wind of Molfese’s interest in concussions, and what was supposed to be a five-minute talk turned into 45-minute discussion on Molfese’s concussion research. With Nebraska’s pending move to the Big Ten Conference, Osborne, who led the Huskers to three national championships as head coach, mentioned how the stadium expansion would allow for Molfese and his team to do their research. Days later, Prem Paul, vice chancellor for research and economic development, called Molfese.
“[Prem] said, ‘You know that space we were talking about, in giving you that 2,000 square feet?’” Molfese recalls. “And I said, ‘Yeah.’ He said, ‘Well, what if we had a different space?’ And I’m thinking, ‘Oh my god, it’s a bait and switch.’ And he said, ‘Yeah, athletics wants to give you 25,000 square feet.’”
Walking across the catwalk on the east side of the stadium, Molfese smiles as he makes light of the stable bridge between athletics and academics.
“Of all the research that’s going on in athletics from the academic side, athletics is saying this is No. 1,” he says.
Before turning to psychology, Molfese, 67, planned on being a Catholic priest. Forty-five years later, Molfese reports to President Obama and Congress as part of the National Academy of Sciences Institute of Medicine Committee on Sports-Related Concussions in Youth and leads the Big Ten-Ivy League concussion research collaboration that’s studying sports-related brain injuries. On one corner of his desk are a couple of Dr. Seuss books. But there’s more to the books: They are used for a side project that has him working with children from low-income families that are at high risk for developing a learning disability.
Even with the prospect of Molfese’s fMRI on the horizon, there remains some doubt as to how much technology, as well as the current guidelines implemented by the universities, can help change the tough-guy culture among college football players. When University of Texas running back Tre' Newton retired in 2010 due to multiple concussions, one of his teammates who had also suffered a concussion that same season said that nothing would stop him from playing football. "I support Tre' but for me personally, I'd die on that field,” Newton’s teammate told The Dallas Morning News. This season, a former Pac-12 player who took a medical retirement due to concussions last year will be a walk-on player at Abilene Christian University.
“The culture has to change,” says Art Maerlender, co-leader of the Big Ten-Ivy League partnership. “The culture is saying, ‘tough it out, don’t tell anyone.’ Until that changes, the policies will have marginal success.”
Yet, the concussion issue in college athletics is as complicated as ever, and comes at the height of the NCAA’s financial successes following conference realignment and newly inked nine-figure TV contracts with partners such as ESPN. In January, President Obama told The New Republic that the NCAA needed to do more to protect its college football players who suffer concussions. Last month, the concussion lawsuit filed by former football player Adrian Arrington against the NCAA in 2011 sought class-action status, alleging that the NCAA failed to protect its student-athletes. Congress has taken notice, too. Earlier this month, the House of Representatives introduced the NCAA Accountability Act, a piece of legislation that would require all member institutions to perform baseline concussion tests on student-athletes and guarantee four-year scholarships that could not be revoked.
As the new season kicks off, new data shows that a culture change is still a ways off. In a survey of 92 players who responded anonymously, ESPN The Magazine recently found that 33 percent of players polled have lied about suffering a concussion. “It’s pretty easy to get away with it,” a current SEC player said, “you just stay away from the team doctors.”
“These guys have to report the symptoms,” says Gillian Hotz, director of the Concussion Program at the University of Miami. “I think it’s great we have these fancy pieces of technology coming out, but the players have to understand that they have to tell us how they’re feeling.”
Thomas and Bell know that now. Thomas, who lives in San Diego and works as a project engineer at a landscaping company, is now at peace in being away from the game. He still has bad days, mostly involving pounding headaches and a compressed neck and vertebrae.
“One less hit maybe would have saved me one concussion and I wouldn’t have had to step away,” Thomas says.
Bell has remained around football, but in a coaching capacity. As part of SMU’s defensive quality-control unit, Bell breaks down game film of SMU’s opponents. Times were hard when he had to walk away, often in denial that he wasn’t going to take another snap. Now, he spreads the message of awareness to the players. Still, he wonders what his football life would have been if Molfese’s technology had been available to him, and other college players who’ve had to retire.
“If I had some information like that, then I would have definitely made better decisions,” Bell says.