Concussions - Part 2

Every football player wants to leave the game on his own terms. John Elway danced off the field into retirement after a second consecutive Super Bowl victory. Such a glorious exit is rare.

Players like Wayne Chrebet who've suffered multiple concussions eventually face a choice. They can keep playing, risking permanent brain damage and an abrupt end to their careers, or walk away before the next concussion with their health mostly intact but their careers somewhat unfulfilled. It's not an easy decision, not for competitive athletes who realize they get only a few years to play NFL football before spending the rest of their lives doing something else on Sundays.

The NFL's new standards on treating concussions are designed to bring clarity to what has been a gray area, to prevent the Chrebet's and Al Toon's from wobbling into retirement in the fog of post-concussion syndrome. In some cases, the standards may protect players from themselves.

Take Pro Bowl middle linebacker Antonio Pierce. He vowed to play for the Giants against the Detroit Lions Nov. 18 despite nagging "little headaches" from a concussion suffered the previous week.

"If I ain't totally broke and I can play and run, I should be out there, and I think I will be," Pierce after missing a second straight day of practice. Pierce refused to say whether the medical staff had cleared him to practice, noting that he had cleared himself to work out.

Legislating when a player may play raises tough ethical and medical issues, according to Dr. Arno H. Fried, chairman of the Department of Neurosurgery at Hackensack University Medical Center in Bergen County, New Jersey in an interview with Jets Confidential.

"To some extent, you are dealing with people in a profession and informed consent is a part of our medical system. What are the risks? What are the benefits? And then people choose to do what they feel is best in their lives," said Dr. Fried.

"I think they have to get good medical advice. It's also a matter of informed consent. A person to some extent has a right to know the risks and the benefits and make his own decision," he added.

Dr. Fried says the Academy of Neurology has established sound guidelines for dealing with players during a season. Concussions are broken down into three categories, from Grade 1, which is the most common but also the most difficult to recognize because it does not involve loss of consciousness, to Grade 3, which is the most severe. A Grade 3 concussion involves loss of consciousness either briefly (seconds) or prolonged (minutes).

According to Academy of Neurology, after a brief Grade 3 concussion the athlete should be withheld from play until asymptomatic for one week at rest and with exertion. After a prolonged Grade 3 concussion, the athlete should be withheld from play for two weeks at rest and with exertion. Following a second Grade 3 concussion, the athlete should be withheld from play for a minimum of one asymptomatic month.

Dr. Fried said a third severe concussion within two months should result in a player sitting out the rest of the season. "Any good doctor is going to be able to look past the social issues, the entertainment issues, and treat it on a medical basis.

"The extension of that question is when do you retire? I don't think there are good guidelines for that," he added.

Should Trent Green retire? Zach Thomas? Should the NFL have a role in determining whether they should push it any further?

"Maybe all players should have to sign some sort of memorandum of understanding," suggested Dr. Fried. "If there's ever a gray zone case they understand that if they go back to play they may suffer irreparable brain damage."

The league, its teams and players haven't solved the concussion dilemma, but at long last have started to directly address it. Moreover, as scientists learn more about the lasting effects of brain trauma, the league may accordingly adjust its standards.

The questions raised by Dr. Fried and other experts in his field are complex and NFL will always be a violent league. We should have arrived at a day, however, when players don't needlessly endanger their health for a few more moments of glory on the field.

Martin DiCaro is an award-winning reporter for New Jersey 101.5.

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