TMQ: Wrapping our heads around concussions

Football concussions are in decline – but more needs to be done

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The photograph nearby captures Tua Tagovailoa coming to the sideline just after suffering another concussion, this one in the Bills at Dolphins contest last Thursday. His head coach, Mike McDaniel, embraces him and kisses his forehead.

One of the things shown in this photo is that in men’s athletics, affection has changed very rapidly from frowned on to a norm.

In football it is now common for players to say they “love” their teammates, coaches to say they “love” their players. During the hours after Tagovailoa dropped to the ground with a concussion on national television, surely he received, from NFL peers and athletic celebrities, many texts containing the words I love you.

Photo courtesy Amazon Studios.

In the picture, the coach is not just expressing concern – he is expressing love, of the kind the Greeks called philia, which meant strong friendship that is not eros.

That football players and coaches now profess to love each other – and do so in public – is a hopeful sign regarding our society. For many of the problems we face, love is the only real solution.

We need all the philia we can get. And could use a little agape – the love between Maker and made – as well.

It’s good to know Tua Tagovailoa is loved: we all should be loved. Next, what does his concussion tell us?

This is his fourth documented concussion: one at Alabama when he was a collegian, three in the NFL. (Whether Tagovailoa had concussions in high school or youth play is not known.) Some people are more concussion-prone than others: this may be genetics, may be neck strength, may be bad luck. The issue is unsettled.

Concussions in football are becoming less prevalent, mainly because of changes in how teams practice -- under the old system you got hit more in practices than in games. Better helmets help; new kickoff rules and helmet caps may help too. (Too soon to tell.) Stricter enforcement of the penalty against deliberate helmet-to-helmet contact really helps.

Coming reforms should include elimination of the kickoff (team scored on takes possession at its 25) and elimination of the three- and four-point stances (which cause plays to begin with the linemen’s heads knocking each other).

Let’s take a look at the concussion situation.

In the NFL, concussions are in decline. (The numbers are for documented concussions.) Last season there were 213 NFL concussions, in 2022 were 219. The average for the prior five seasons was 270.

Enforcement of helmet-to-helmet penalties, more awareness of proper tackling form (“see what you hit,” which makes it impossible to lead with the head), and less contact in practice have reduced concussions.

Today in the NFL, full contact practice is prohibited in the offseason, limited during August and restricted to once a week after the regular season begins. Some NFL head coaches voluntarily reduce contact further. Anyone who’s good enough to make an NFL roster is not going to forget how to hit.

Because kickoffs are the most concussion-prone down, it’s hoped the new format will reduce concussions further.

Current numbers work out to an NFL player running a one-in-9 risk of concussion each season.

In 2014, when president, Barack Obama told the New Yorker he thought children should not play tackle football – and they shouldn’t, at least not till middle school – but the pros have been warned and knowingly assume a risk for a nice reward.

NFL players average about $3 million a year in pay, and about half play long enough to qualify for an attractive package of benefits. Would you accept a one-in-9 concussion risk in return for $3 million and a good chance of attractive benefits?

A heart surgeon or law professor might say no. Most Americans, including most college graduates, might say yes. For NFL players the risk-reward ratio is appealing, especially with traumatic brain injury declining, plus better treatment when occurring.

It’s likely today’s players, as they grow old, will exhibit less dementia than shown by the previous generation. 

At the high school level, concussions have declined too but remain at a troubling level.

This space often reminds that nearly all football players in the United States are, legally, children – performing at the prep and youth levels.

There are 500 high school football players for each one NFL gent. While NFL players know the risks and are very well compensated, high school players may not understand the risks and in almost all cases, receive nothing of tangible value.

High school football does teach teamwork and self-discipline, which are important life skills, and can be fun!

My 2015 book The Game’s Not Over has a chapter on research by Dawn Comstock of the Colorado School of Public Health, who estimated that in 2013 there were 148,000 high school football concussions, along with 60,000 youth football concussions. Such figures are shocking – they work out to 400 concussions in children for each one NFL concussion of that period.

Recent estimates -- concussion numbers are fuzzy because reporting requirements are not uniform -- from the American Academy of Pediatrics suggest there is one high school football concussion for each 960 “exposures.” (An exposure in this usage is a practice or game.)

Taking into account 16,000 high school football teams in the United States, and each team member facing about 75 exposures per year, that’s about 1,300 high school football concussions annually, about six times as many as NFL concussions, plus an unknown number of youth concussions.

That’s much better than when Comstock did her research – so the trend is good. But the numbers are still too high.

Get out your electron microscope and try to find the reference to Tua’s concussion on this image of the NFL.com front page the morning after. The NFL’s institutional reaction was – “No big deal.”

Beginning about 15 years ago (in part because somebody calling himself TMQ was pounding the table about concussions on ESPN) football concussion awareness increased.

In response nearly all states, including football-crazed Texas, limited full contact practice hours and two-a-days. In my state, Maryland, two-a-days and full-contact scrimmages are tightly restricted; a contact practice must be followed by a no-contact practice; the infamous Oklahoma Drill is banned (the Oklahoma Drill has players deliberately bashing each other’s heads); monitors are present to make sure coaches don’t cheat.

The result is prep concussions down – but still high. Girls do a lot better than boys academically in high school and college, and the boys are getting hit in the head. Coincidence? (Girls’ and women’s soccer are also concussion-prone.)

Youth football traumatic brain injury is morally repugnant because youth tackle football should be banned. Children below age 13 have no business wearing football helmets and pads. They don’t even learn the sport well. Flag football is safer, and teaches how to be in the right place at the right time.

The arguments are here along with the conclusion, “The single most important thing to know about football is that research conclusively shows tackle football in pads should not be played before age 13.”

That report adds, “Don’t take my word for it, take Archie Manning’s word. He did not allow sons Peyton and Eli to wear pads and helmets till they were 13, and their brains are still sharp enough they can yuk it up for three hours on live national TV during the ManningCast.”

Are some helmets better against concussions? Your writer began pounding that particular table in 2011, when Aaron Rodgers alluded to having a helmet model that reduced his TBI risk, but the Packers refused to say what the helmet was.

Here’s a story which caused me to receive a heated phone call from Disney senior management. If the NFL wanted the question covered up, that’s what Disney wanted too.

Around that year, Virginia Tech started to perform independent testing of helmet quality – first football helmets, then bicycle helmets and others. The goal was five-star safety ratings similar to auto safety ratings.

The Virginia Tech ratings allowed players (and their parents, at the prep level) to review solid data when comparing helmets. And just like it did with cars, five-star safety ratings forced manufacturers to design for safety and promote this as a product feature.

Today across the board, new football helmets are designed with concussion risk in mind. No helmet can eliminate risk – but better models can help.

The latest Virginia Tech ratings are here. Virginia Tech’s index of concussion safety research is here.

The best helmet models, such as the Xenith Orbit Pro, cost about $1,000 each – too much for high school programs. But there are affordable five-star models, including the Schutt Air XP at $220. (Schutt is the most common helmet in high school football).

Patrick Mahomes wears the Vicis Zero2, at $759. Denzel Ward of the Browns said over the summer that because he has sustained several concussions, he has switched to a five-star rated helmet.

The Vicis Zero2, as worn by Patrick Mahomes. (That’s not him in the picture.) Photo courtesy Virginia Tech.

Why doesn’t every NFL player switch to one? Money is no object at the NFL level.

Manufacturers have begun offering position-specific helmets. For instance the top-rated Vicis Zero2 Trench is for linemen.

There’s an equity issue in high school play. Some kids’ parents can afford to buy them a Vicis or Xenith, while other kids must accept whatever reconditioned old hat is in the equipment locker.

Hey donors giving millions to college booster collectives – how about instead buying five-star helmets for your local public high school?

Of helmet caps. This summer they were required for most players at NFL training camps. Players have the option to don them during games. A few, including Jabrill Peppers of the Patriots and Jeremiah Owusu-Koramoah of the Browns, sported a helmet cap on Sunday.

The one worn in NFL camps is called the Guardian Cap. It’s effective but ugly – many players don’t like it for fashion-statement reasons. Coaching lore says: Looks good, plays good.

Northern Illinois wore the SAFR cap during its upset at Notre Dame. Spectators didn’t know the difference.

An alternative is the SAFR cap, which is conformal and painted with the team’s logos and colors. Northern Illinois was wearing SAFR caps when it upset Notre Dame in South Bend. Spectators couldn’t even tell.

Your writer also began pounding the table about helmet caps in 2010, citing the handmade cap that Mark Kelso wore when he played safety for the woe-for-four Buffalo Bills in the Super Bowl. Kelso’s capped helmet is now on display in the Hall of Fame in Canton.

Cap that helmet!

Virginia Tech finds that combining a five-star helmet with a SAFR cap reduces concussion risks by about 75 percent.

A five-star helmet with cap belongs on the head of every player: pro, college, high school. Football world – what are you waiting for?

In other football news, the Lions ran a fake punt from their own 20 – on fourth-and-12! And converted! But, lost the game. 

In Monday Night news, the Eagles staged an epic meltdown at home against Atlanta.

Leading 18-15 with 1:46 to play, Falcons out of times-out, Philadelphia faced third-and-3 on the Atlanta 10. Saquon Barkley dropped a perfectly thrown pass, as if it were a live ferret. Had he simply caught the ball and gone down, Philadelphia would have won. Had the Eagles simply run up the middle for no gain, Philadelphia would have been in great shape.

Instead the incompletion stopped the clock.

The Nesharim took a field goal, rather than running on fourth-and-3. Then the home team let the visitors fly down the field for a touchdown: 70 yards in six plays in about a minute, without a time-out. Atlanta pass blocking was perfect, or, put the other way, Eagles pass rushing was nonexistent. The Eagles’ expensive new defensive backfield seemed to disappear.

Stretching to the beginning of last season, Philadelphia has followed a 10-1 run with a 2-7 run. Ye gods.

As Atlanta took possession, the NFL’s flashy Next Gen Stats predicted with hyper-precision the Falcons had just a 0.7 percent change of winning. Off by about 99.3 percent!

 

Stats of the Week #1 Florida State has opened 0-3. In August the New York Times predicted Florida State would be college football’s best team.

Stats of the Week #2 Josh Allen is 12-2 versus the Dolphins, with a 110 passer rating.

Stats of the Week #3 Stretching back to the start of last season, Jacksonville followed a 8-3 run with a 1-7 run. The Jax loss to Cleveland included the Jaguars staging an announced onside free kick after surrendering a safety.

Stats of the Week #4 In his last two games against defenses coached by Mike Zimmer, tailback Alvin Kamara scored 10 touchdowns.

Stats of the Week #5 To eliminate a pair of long-distance flights the Chargers, who on Sunday played at Panthers, are staying in Charlotte this week to train; then will travel to Pittsburgh to face the Steelers; then fly home.

Stats of the Week #6 South Alabama scored 12 touchdowns and a field goal in defeating lower-division Northwestern State 87-10. The game was shortened by mutual agreement of the coaches.

Stats of the Week #7 Possession results for the Washington Commies against the Jersey/A Giants: field goal, field goal, field goal, half ends, field goal, field goal, field goal, field goal.

Stats of the Week #8 Sean McDermott now has the best regular-season winning percentage (.647) of any active NFL head coach. But, has a losing record in the playoffs.

Stats of the Week #9 Marvin Harrison Jr., rookie wide receiver for Arizona, had two touchdowns and 131 yards receiving in the first quarter versus LA/A.

Stats of the Week #10 Fans of the Bengals, Broncos, Colts, Giants, Jaguars, Panthers, Rams, Ravens and Titans and should fret: 90 percent of NFL teams that open 0-2 do not reach the playoffs.

Well maybe not Cincinnati fans, since the Bengals always start slow. Bonus Stat: Cincinnati is on a 0-5 streak in Week Two.

Sweet Play of the Week. Game scoreless, Buffalo faced fourth-and-3 on the Miami 17. The Bills would go for it, recording a touchdown and setting in motion a walkover on the Marine Mammals’ own field.

Fortune favors the bold! Here’s how it went down.

First, Buffalo head coach Sean McDermott decided to go for it, knowing the Dolphins are a high-scoring team. Josh Allen set his charges, watched the play clock tick down and called time. So maybe the Bills never were going for it, just trying to get Miami to jump offside.

But the field goal unit did not take the field. After the time-out, the offense returned.

Perhaps McDermott said to offensive coordinator Joe Brady, “Do we have a play?” This is an expression football coaches use in pressure situations when what they mean is, “Do we have something installed for this week that no one has seen?”

Perhaps Brady said yes, because the play would turn out boffo. Or maybe Allen made the T gesture because the Dolphins were in the wrong defense for what Buffalo wanted to do.

On the first time around, Miami was in a high Cover 2, meaning a safety “above” the left side of the field, which would turn out to be the playside. The second time Buffalo lined up, Miami had switched to a Cover 3. No safety on the left – the look the Bills wanted.

So perhaps during the interlude McDermott said, “Let’s try the same thing again and see if they change fronts. If they don’t, just take the delay-of-game penalty because it’s still a short field goal.”

Seeing Cover 3, Allen started the cadence. First tailback James Cook shifted to the right. Then speed receiver Curtis Samuel imitated Tyreek Hill with a fast “orbit motion” all the way left then back all the way right. The Dolphins had their eyes on Samuel.

At the snap, Cook ran a “wheel” to the left and – no safety! With only a linebacker to beat, Cook scored a touchdown. Sweet.

Sour Plays of the Week. Leading by 2 with 48 seconds remaining, Cincinnati had Kansas City facing fourth-and-16. The Bengals rushed only three, allowing Patrick Mahomes seven seconds to look for a receiver. That’s a long time in the NFL. No defense can hold coverage on everybody for seven seconds.

The pass hit the receiver’s hands then hit the ground, the game seemingly over. But defensive pass interference was called (the call was correct), changing turnover on downs into first down. You can guess the rest. Sour.  

Sweet ‘N’ Sour Sequence of the Week. Vikings leading the NFC defending champion Niners 3-0, Santa Clara staged a 16-play drive that reached fourth-and-goal on the Minnesota 2. Brock Purdy’s pass feel incomplete. Sour for Santa Clara.

Two snaps later, on a “max protect,” the thrice-recycled Sam Darnold threw a 97-yard touchdown pass to Justin Jefferson, who outran the safeties and got a perfect far-downfield block from the hustling Jalen Nailor. Sweet for Minnesota.

A 14-point swing against the Forty Niners in just three snaps. That’s a Sour Warhead.

Photo courtesy Impact Confections.

Pac-2 Was a Great Name. The Pac-2 picked up four members and now is the Pac-6. The organization has until 2026 to add at least two more colleges or lose its shiny status as a conference. The truncated Pac-6 slate this year includes Yale women’s soccer traveling to Oregon State.

Over in the Power Four, the “Atlantic Coast Conference” now includes Stanford and Cal, which are on the Pacific Coast. In football Cal plays Florida State at Tallahassee, Stanford plays at Syracuse.

Who Cares If a Stacked Team Can Run Up the Score? Oregon leading Oregon Sate 39-14 in the fourth quarter, the Ducks spent an entire possession in an empty-backfield quick snap look, trying to run up the score.

Ranked #3 preseason, Oregon was perceived to lack style points in reaching 2-0 with close victories. Ducks boosters wanted a big win and got it, 49-14.

One of the reasons the NFL is superior to D1 football is that style points don’t matter, only Ws and Ls.

Cover of the new Rams press guide.

HMS Pinafore Comes to the NFL. The Rams now have a “game management coordinator.”

Disclaimer of the Week. Recently yours truly went to a Bank of America branch to complete a minor transaction. Customer service was first rate. “I just have to print out these disclaimers for you,” the banker said. She printed out 48 pages.

What’s $200 Million Among Friends? Two weeks ago TMQ noted the NFL has grown so ginormous, Forbes estimates it would cost $190 billion to acquire the whole league. Please don’t mention this to the Saudi sovereign wealth fund!

For comparison I noted that by market cap the Nordstrom chain, with more the 400 department stores, could be had for $4 billion.

Make that $3.8 billion – the amount descendants of the founder just offered to take the company private. 

In 2009, Stephen Ross bought the Dolphins for $1.5 billion in today’s dollars. Last week he said he was seeking to sell a tranche to investors at a number that values the team at $7 billion.

In My Mind I’m Leaving Carolina. The Panthers benched Bryce Young, number-one choice in the 2023 draft, handing the car keys to vagabond Andy Dalton. 

In what may turn out among the worst trades in NFL annals, odious billionaire David Tepper -- typing OBDT into my AutoCorrect produces “odious billionaire David Tepper,” the same wizard who unloaded Christian McCaffrey for chump change – Carolina gave up two number-ones, two number-twos, D. J. Moore and other draft capital for the chance to draft Young.

The Panthers have not yet finished paying the freight, as they owe the Bears their second-round selection in 2025.

That choice may be high, and as TMQ noted before the 2024 draft, “High second-round picks are valuable in the salary cap era, because the talent pool is about the same as the late first round, but the contract slot is a way more cap-friendly.”

Is Young a bad pick? The Cats are a terrible team led by a terrible owner, and all quarterbacks suddenly become more talented when put into a position to succeed. Think Baker Mayfield! Think Sam Darnold!

Remembering Rebecca Blank. On Saturday the Crimson Tide visited Madison and moved the cheese of Wisconsin.

A few years ago I attended a talk by Rebecca Blank, 1955-2023, then chancellor of the University of Wisconsin. On the day of the talk, the Badgers were undefeated and ranked ahead of the one-loss Crimson Tide.

Blank said, “You have no idea how much fun it is to run a college whose football team has a better record than Alabama.”

Rebecca Blank, 1955-2023. Photo courtesy University of Wisconsin.

The Football Gods Chortled. Bills leading Miami 10-7, on third-and-12 undrafted league-minimum Ty Johnson beat Jalen Ramsey, the NFL’s highest-paid cornerback, for a 33 yard gain to the Dolphins 1, setting up a touchdown.

Best Crowd Reaction. The Hard Rock home crowd booed loudly in the final minute of the first half as the Dolphins did not go tempo and threw short to the middle of the field, as if trying to kill the clock – but, were behind by 17. Miami had to settle for a field goal and did not score again.

Hidden Play of the Week. Hidden plays are ones that do not make highlight reels, but stop or sustain drives.

Three minutes remaining at Kansas City, Cincinnati led by 2. Joe Burrow threw a perfect pass a Cincinnati receiver dropped like a live ferret. The next down was a sack, the Bengals punted and lost on a Kansas City field goal as time expired. Had the ball been caught, Cincinnati would have been in command of the endgame.

Photo by Rohan Chang on Unsplash

An approaching pass as seen by a Cincinnati receiver.

Title Inflation Comes to the Sports Desk. Adam Shefter of ESPN holds the title Senior Insider. Now so does Dianna Russini of The Athletic.

In order for there to be a Senior Insider, must there be a Junior Insider. Perhaps: Associate Insider.

BOLO of the Week. All units, all units, be on the lookout for Lamar Jackson – the version of him that won the 2023 NFL MVP. Since Jackson took the MVP, the Baltimore Ravens are 0-3.

Soon She’ll Have an NIL Deal to Endorse Particle Beam Weapons. Raygun, scorned at the Olympics, now is the world’s top-ranked b-girl.

The avant-garde artist always is initially rejected by the Parisian bourgeoisie. Just ask Igor Stravinsky!

Photo courtesy NBC Sports.

Working Class People Know the Value of Money. Buffalo Bills fans have a tradition of donating to the charities of injured players. When Lamar Jackson was injured in a playoff contest at Buffalo, Bills fans donated about $400,000 to his charity, which provides school supplies to underprivileged children. When Damar Hamlin nearly died on the field at Cincinnati, $10 million worth of charitable donations came in (in that case from all over the country).

As of Saturday, Buffalo fans donated $50,000 to Tua Tagovailoa’s foundation, which last year supported victims of the Maui wildfire. (Tua grew up in Hawaii.) Expect the total given to the Tua foundation to rise.

This is both a sign of good will and speaks well of Buffalo, New York. The city is not San Francisco or Denver, rolling in wealth. It’s a working class town where families must hustle to get by. That working-class people give to express warm feelings for others is an auspicious sign for society.

Deion Sanders not only once again wore dark glasses at a night game, he switched to dark mirror glasses for the press conference afterward.

Lend Me a Tight End! TMQ contends: Don’t lend me a tenor, lend me a tight end! Traditionally seen as extra blockers, in a modern pass-wacky offense the tight end can be the matchup problem no defense has an answer for.

In the season’s first contest, Baltimore at Kansas City, both opened with double tight end sets.

A generation ago an NFL club kept two tight ends on the roster. This season Tennessee and Cincinnati had five tight ends on the opening-day varsity, while the Broncos, Cardinals, Chargers, Commies, Dolphins and Seahawks were among teams to keep four. That may change as early-season rosters often are in flux.

It's clear every NFL head coach is looking for the next Travis Kelce. But then so is every female pop star!

The Football Gods Chortled. Near the Jersey/A goal line, Washington lined up so as to go for it on fourth-and-1. The Commies ran multiple shifts, trying to get the G-Persons to jump offside. Instead Washington jumped offside.

Best 99-Yard Drive. Taking possession at their own 1 yard line in the third quarter versus Minnesota, the Niners went 99 yards in 12 plays for a touchdown.

It’s not just a Green Wave, it’s an angry Green Wave. Photo courtesy Tulane University.

Excuse for a Photo. Tulane’s Dorian Williams, a linebacker, made several big plays in the Bills at Dolphins game. I mention that strictly to have a reason to show Tulane’s colorful football helmet, which depicts an angry wave.

Why Tactics Matter. University of Washington trailed Washington State 24-19 with a minute remaining, faced fourth-and-goal on the Cougars 2 yard line. UDub called an  old-school double option. The quarterback runs wide followed by a pitchman: quarterback either keeps it or flips the ball to the pitchman.

But Washington, ball spotted at a hashmark, ran its wide action to the short side of the field.

College hashmarks are farther apart than NFL hashmarks. In the pros, the hashmarks are 24 yards from the sideline; this tends to make action symmetrical and focused on the field’s center.

In college, hashmarks are 20 yards from the sideline. This means when the ball is spotted at a hashmark there’s a big difference between the short side and the wide side.

For this reason college defensive coordinators speak of a “field cornerback” on the wide side and a “boundary corner” on the short side.

Balled spotted on the right hash, UDub ran the option right – toward the short side. When the quarterback pitched, the pitchman had no place to go: there were a dozen blockers and defenders stumbling around in a small place. Washington State took over on downs and ran out the clock.

That same day Utah State, trailing Utah 28-14, faced fourth-and-5 on the Utah 17 and went for it. Lined up on the right hashmark, Utah State ran wide left – toward the wide side. First down, and Utah State went on to record a touchdown.

Let’s Hope He Protects His Health. One can only wonder what the sports future holds for Tua Tagovailoa.

His newly inked contract contains a spectacular $167 million injury guarantee. But according to Mike Florio of NBC – Florio is a former labor lawyer who knows contract language -- Tagovailoa gets that sum only if he is ruled by physicians incapable of playing. If docs say he could take the field again, and he chooses not to, no guarantees.

NFL transactions columns sometimes say, “Released with injury settlement.” This may be in Tagovailoa’s cards, albeit at a lofty level. It’s a good sign that Mike McDaniel told Tua to think first about his health and his family, not about football.

Whatever Tua may end up holding – and even if the funds come from an insurer, as NFL clubs sometimes purchase policies on stars’ health – will count against the Miami salary cap. Should Roger Goodell exempt the Dolphins from the cap charge, how could he not exempt Denver, Cleveland and other teams that have bad quarterback contracts hanging over their cap amortization? 

Best Clock-Killer Drive. There’s just nothing like a clock-killer winning drive. It’s a football art form.

Kansas leading 20-16, Nevada Las Vegas took over at its 25 with 11:22 remaining in the fourth quarter. The Rebels staged 19-play, 9-minute drive, mostly runs to keep the clock moving.

The possession came down to fourth-and-goal at the Jayhawks 1 with time nearly expired. Sports situations don’t get much better! Touchdown, and UNLV held on in the closing seconds to win.

Next Week. Which NFL team will be next to attempt an announced onside free kick after a safety?

About All Predictions Wrong

In addition to TMQ on Tuesday through the NFL season, there will be an All Predictions Wrong, on an eclectic range of topics, on most Fridays, plus bonus editions depending on news events.

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