Saturday, October 31, 2009

NFL players, union say they share blame for head injuries

From The New York Times:

WASHINGTON — The helmet sits under glass at the headquarters of the football players union, memorializing the play-at-all-costs warrior who strapped it on every Sunday. Four swaths of duct tape suture the crown. Screws are broken, the enamel is cracked, and two Raiders logos cling for dear life. During his 15 years as an N.F.L. lineman, this was the only helmet Gene Upshaw wore.

Upshaw was immensely proud of this, his associates recalled, from the day he retired through his 25 years running the players union and up until his death in August 2008. That helmet protected him. Kept outside forces away and his inside thoughts intact. One of those thoughts was that playing football had nothing to do with the dementia and cognitive decline so many of his fellow retired players were experiencing — despite outside and even union-financed research that claimed a strong relationship.

“I think we’re just a reflection of society,” he said in a 2007 interview. He added: “I don’t want to take that next leap to say, you know, football caused dementia. I just don’t believe that.”

As a House Judiciary Committee hearing examined football brain injuries Wednesday and strongly criticized the N.F.L. and its concussion committee for their research and approach, lawmakers, players and Upshaw’s successor, DeMaurice Smith, accused the union of lethargy while others sounded alarms. Although all regretted speaking ill of the dead, they said that Upshaw’s reticence at the top stunted progress and awareness below.

“They should have been the first to jump on top of the issue and press the owners to do something about it — they were asleep at the switch,” said Representative Linda T. Sanchez, Democrat of California, who before joining Congress was a top A.F.L.-C.I.O. official in Orange County. “When you’re the person negotiating the working conditions for a unit, you must look at the dangers or potential to cause injury. You’re the designated person to educate members to be aware.”

Tiki Barber, a former Giants running back who was among the players who kept Upshaw in office, added: “The union shares responsibility, too. And us players. Especially since you now see the issues that are arising. I don’t know if they could have been headed off, but at least the discussion would have started earlier.”

Upshaw was often criticized for appearing too genial with the league, but he did support many safety-related rules changes, helmet research and repeated disability-plan improvements for active and retired players. The labor agreement he struck in 2006 was so favorable to the players that the owners soon counted the days until they could opt out of it.

But as a player who wore only that one helmet on Oakland’s offensive line from 1967 through 1981, an era in which concussions were ignored like hangnails, Upshaw — who felt no notable cognitive decline, associates said — simply did not believe that football substantially affected the brain.

Upshaw authorized $172,000 in union grants to finance research by the University of North Carolina’s Center for the Study of Retired Athletes, according to the center’s records. But as the published survey studies from 2004 to 2007 crossed his desk and indicated a substantial link between N.F.L. concussions and later-life risk for depression, Alzheimer’s disease and cognitive impairment, Upshaw consistently played down the findings and did not push the league to act.

Asked about the union’s responsibility to pursue concussion research and warn players of risks, an N.F.L. spokesman highlighted Upshaw’s positive contributions — like support for new concussion guidelines in 2007 — and declined further comment.

Upshaw did hire Dr. Thom Mayer, an emergency and sports-medicine physician, to become the union’s first medical director, in 2001. In an interview Friday, Mayer said that in private conversations, Upshaw cared more about football head injuries than he let on publicly, for reasons Mayer said he never understood. Mayer pointed out how Upshaw kept his pancreatic cancer secret from even those closest to him for months before his death — a sign that he loathed any admission of weakness. It was one area where, as the union’s leader, Upshaw might have retained too much player to be a protector.

“There’s a gladiator mentality that separates the ones who make it to the N.F.L. and stay there,” said Mayer, adding that he began speaking with Upshaw about mounting literature on head injuries in 2006. “Look at how he died — ignoring pain. I mean that charitably. Particularly guys from that era, you just got through it. You just sucked it up. No excuses.”

The union’s questionable approach to concussion-related science continued after Upshaw’s death. Last December, his job still unfilled, a letter on players association letterhead was mailed to every living retiree to say the union was “supporting and endorsing” an N.F.L. study of retired players, “trying to determine if there are possible long-term effects on the brain from playing in the N.F.L.” — implying that the question remained open.

The support and endorsement was given with no participation in devising (and scant knowledge of) the study’s methods, which have since been criticized by members of Congress and outside experts as underpowered and rife with conflicts of interest.

And one month ago, when a union lawyer analyzed data from the 88 Plan, a joint league-union program to reimburse retirees for medical expenses deriving from dementia, mathematical and methodological errors led him to assert that N.F.L. retirees were experiencing dementia at a rate similar to the general population.

Experts in epidemiology, neurology and dementia later said that correcting for those errors resulted in a situation in which football retirees between ages 60 and 89 probably had moderate to severe dementia at four or five times the national rate.

After succeeding Upshaw in March, Smith looked to shift the union’s approach to many issues, including the brain-injury controversy. He successfully requested Mayer to become the union’s first representative on the league’s concussion committee, and assembled a union committee to study the matter independently. He admitted that the players union had been “slow to embrace all of the medical literature” regarding the effects of head trauma. And in his written testimony before the House committee Wednesday, he took a far less conciliatory tone toward the N.F.L.’s handling of outside research.

“The days of denigrating, suppressing, and ignoring the medical findings must come to an end,” said Smith, who played no organized football beyond high school. He added, “Unfortunately, the N.F.L has diminished those studies, urged the suppression of the findings and for years, moved slowly in an area where speed should have been the impetus.”

Members of Congress praised Smith’s remarks but remained skeptical given the union’s past. “The players essentially wasted years by how poorly they responded to this early on,” said Representative Anthony D. Weiner, Democrat of New York.

Sanchez added: “I sincerely hope he’s serious in that effort. The proof will come in the future.”

Several players who followed last week’s hearing said they began to appreciate how they, and not just the league, held responsibility for allowing the situation to evolve as it had. Rick Jones, a former linebacker for the Cleveland Browns and the Baltimore Colts from 1977 to 1983 who now cleans windows in Birmingham, Ala., spread the blame.

“We’re all culpable — players, coaches, owners, doctors,” Jones said. “We all have a hand in it. We didn’t know it. We did not know about brain injuries in my day. But the minute our union knew it was dangerous, it was their job to take care of the guys who were hurting like me, and to keep it from happening to anyone else.”