From his home in Chicago, Ethan Ross can still vividly recall lacing up his cleats before a midseason game against Illinois College five years ago. He remembers stretching and going through warmups like it was yesterday. He remembers his disappointment not to start the game, and the jubilation when he was called in to play.
What the 200 lb. outside linebacker does not remember is one hit, or a series of smaller hits late in the game, or anything for hours thereafter. Days of disorientation and confusion followed the memory loss. Ross spent most of his days after the game asleep, and when he was awake, he was in a daze; the difference between dreams and reality blurred. On the recommendation of Knox’s head trainer, Ross visited a Galesburg neurologist, who just told him to take it easy for a couple of days.
“I wanted to come back, but it became clear quickly that something was very wrong,” said Ross.
Despite the days of rest, he had migraines to the point of blacking out and his other symptoms, including nausea, headaches and impaired cognitive function, did not disappear quickly. His mother, Margaret Ross, hearing something wrong in his voice over the phone, brought him home to the Chicago suburbs, where he saw a concussion specialist.
“I could tell by the tone of his voice and how slowly the words were coming out that something was seriously wrong,” she said. “On the Thursday after the game, we had the conversation on the phone and by Friday morning I was at Knox picking [Ethan] up… He needed to stop playing football immediately. If anything worse happened, it could plague him for the rest of his life. Just one more hit could mean irreversible brain damage.”
After conducting a battery of tests, the doctor concluded Ross had suffered a moderate concussion and had developed post-concussive syndrome, in which the symptoms of a concussion linger for an extended period of time after the initial incident. For Ross, the effects remained for several agonizing months, and he stayed on medication for a year. He alternated between the hypersomnia he experienced in the days after the game to insomnia, was tired no matter the amount of sleep he got, was constantly dizzy and had a sudden inability to retain knowledge he learned in class. His playing days were over, and his school career was suddenly in jeopardy.
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Concussions are a part of the game, claims Derek Mortensen ‘12, a running back for the Prairie Fire for four years. Mortensen, standing at 5-foot-10 and 215 lbs. during his playing days, is of the mind that head injuries are something the media over-hypes and something our nation has grown overprotective about. Mortensen has never been diagnosed with a concussion, though he suspects he’s had a few fly under the radar. More than the hits he’s taken, Mortensen remembers the concussions he’s dealt out.
Once during Mortensen’s 2012 senior campaign, he got the ball on a routine handoff against Beloit. It was a normal carry; Mortensen got the ball in the backfield, shot through a gap, and lowered his shoulder into one of his best friends from high school, Joe Carmody, a defensive lineman for Beloit. Instantly, he laid Carmody on his back. It was immediately clear to Mortensen that he had concussed Carmody.
“You can tell if you’ve hurt someone the instant you do it,” Mortensen said. “They go down too easily. It’s unfortunate to do that to someone, especially one of your best friends, but you pick yourself up and dust yourself off. That’s football.”
For Carmody, whether or not he was concussed was a bit less clear. Carmody remembers the hit, and remembers receiving some helmet-to-helmet contact; he does not, however, remember the next five or so plays thereafter.
“I was just going on instinct,” Carmody said. “I was very out of it. The whole world seemed to slow down, and it was hard to focus. I didn’t read their offense, I didn’t remember what we planned in practice. I just played.”
Had he known he was concussed, Carmody would have come out of the game. But at that point, he wasn’t familiar with what a concussion felt like or meant. During training camp the next season, his senior season, he had a similar collision with similar aftereffects and was removed from practice and diagnosed with a concussion. He suspects he was concussed in that 2012 contest, but isn’t worried about the past. Football is still a major part of his life, and he’s now a tight ends coach at Beloit. For him, the game is inherently risky, but that’s all a part of the package.
“That’s just how football is,” Carmody said. “You pick up injuries here and there that don’t get noticed. Everyone who plays football knows the risks.”
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Researchers at the Department of Veteran Affairs at Boston University studied the brains of 165 individuals who played football in high school, college, or professionally. Of those 165, 131 (or 79 percent) showed signs of chronic traumatic encephalopathy, a degenerative brain disease believed to stem from repetitive head injuries. Ninety-one of those 165 were former NFL players and of those 91, 87 showed signs of CTE.
The results, however, are constantly under scrutiny. On one hand, there are swarms of neurologists directly correlating football and brain injury, such as the BU researchers. The other side of the debate includes Scott Sunderland, head athletic trainer at Knox, who believes the results are not quite as clear-cut as some would make it to be. While he doesn’t deny there is a potential link between football and brain trauma, he noted that there is evidence that shows that CTE numbers are comparable in populations who have not played football.
“Numbers can do what you want” Sunderland said.
Moreover, Sunderland said, rules are being made or amended to make the game more sustainable. Sunderland believes changing rules pertaining to various offenses such as targeting or leading with the head and the officiating crews that enforce such rules are leading the fight to make the game safer. Indeed, in the NFL’s 2015 Health and Safety Report, the league reported that concussions in the regular season have decreased by 35 percent since 2012, a change that was attributed in part to its ban on tackling with the crown of the head. Further, the NFL is implementing new helmet testing, clinical trials to better identify concussions, and the medical timeout, which allows for athletic trainers to alert a referee to call a timeout if they see a player needing attention.
The question, however, remains – is enough being done for players who suffer debilitating injuries on a regular basis? The NFL is attempting to commit itself and to show dedication to player safety, having doled out a $1 billion settlement after over 5,000 players claimed the league hid the risk of concussions; still, many NFL players are of the mind that the league’s response is inadequate. On a more local scale, Sunderland said Knox has no policy in place should a former player present signs of CTE or another comparable illness.
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Perhaps absorbing and even embracing big hits is a normal part of football culture, Ross theorizes; even in his grade school days, he vividly remembers being taught to brush hits off and to suck it up.
“To an extent, it’s a good lesson to learn to brush stuff off,” said Ross. “But that’s not all we learn. We learn to cover things up and move on, which can be very damaging.”
Knox’s Head Football Coach Damon Tomeo, on the other hand, believes risk is inherent in any contact sport, and that it is not specific to football.
“You’re not going to stop driving just because you have a car accident,” Tomeo said. “There’s risk any time you play a sport that involves contact. More than anything else, football teaches players to be better men, better fathers and ultimately to be future leaders. It’s a great game, and the rule changes will help keep it safe and alive.”
Ross agrees, at least in part; football has seen a lot of growth in the last five years in terms of safety. When he got his concussion in the fall of 2010 he believes Sunderland did the best he could but that, like many trainers across the nation, Sunderland simply wasn’t informed about potential concussion damage. Ross maintains that he, like many others, was the victim of a concussion policy that often didn’t give kids the attention they needed until it was too late. Slowly, surely, the policy is changing to be more proactive rather than reactive. Neither Ross nor Mortensen was taught about concussions until high school, but now many coaches in juniors’ football are educating their players on what they’re getting into.
Despite the continued education, injuries in football happen, even in today’s modernized sport. Senior wide receiver Ilir Emini acknowledged the multitude of changes the sport is experiencing, noting in particular the attention that is being paid to helmets, treatment and recovery of concussions. In spite of this, the game, Emini believes, will always have a baseline level of violence. Despite the modernization of equipment and education of coaches and athletic trainers, the physicality and forcefulness inherent in football leaves players exhausted, bruised and, at times, not feeling 100 percent, which often leads to injuries that may go unnoticed, said Emini.
“I believe concussions can go unnoticed at times,” he said, acknowledging the fact that some players can be unaware that they’ve sustained a concussion. Indeed, Emini’s analysis fits in to a larger body of work: A recent study from Harvard and Boston University researchers has found that, despite years of increasing education and public awareness regarding head injuries, college football players report having six suspected concussions and 21 “dings” for every diagnosed concussion.
Sunderland recognizes this as a major problem. He estimates the number of concussions during the last five years to be fewer than the five prior to that, thanks to increased educational systems and rule changes. Still, Sunderland impresses that any one of those 27 dings can significantly alter a playing career, and, moreover, one’s life.
“The phrase I always use is that we aren’t dealing with an ankle here,” Sunderland said. “This is a significant quality of life issue and can sometimes become a life and death issue. For that reason it’s imperative we are honest with one another as an athletic department regarding the tremendous implications of such an injury.”
The researchers conclude that college football players are intentionally playing through the vast majority of potential concussions, a decision that is made due to lack of understanding of the injury, by the culture of their position and by a coach who may not support reporting a concussion. This 27-to-1 ratio elucidates the challenges the sport faces, lost amid a culture that prioritizes the big hit over player safety.
Such research, as well as other work noting the prominence and danger of head injury, Mortensen suggests, may be more applicable at Division I institutions, or in the NFL, which are entirely different beasts than DIII. In DI, form must be perfect and players are among the most physically fit humans on the face of the earth. Mortensen also pointed to the increased size and speed of DI and NFL players as compared to players 20 or 30 years ago. All that size and speed can result in some pretty devastating collisions. Even with that in mind, players and fans of the game, Mortensen maintains, know what the deal is and what the risks are.
Though it may be safer than DI football, Sunderland and Tomeo both agree that Knox football has made positive strides to alleviate head injury as much as possible, having adopted the Ivy League style of practice upon Tomeo’s arrival in 2012. The Ivy League, as prestigious academic conferences across the nation are prone to do, took action early to protect its players’ safety, reducing the number of full contact practices to two a week. This decision was made largely in response to research that indicated that football players pick up more concussions and head injuries during practice than in games. Of course, the real contact happens on Saturdays, when the games are played, and when fans eagerly await the next big hit.
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For Ross, his relationship with football today is bittersweet. He appreciates all the game taught him, but had he known about the concussion issues, he says he would have stopped playing much earlier. Sunderland attributed the American relationship with football to our gladiatorial roots, a sentiment Ross concurred with.
“There’s almost a primal level to football,” said Ross. “With the new rules, the game is becoming safer but also devoid of contact. But there’s going to need to be a certain level of violence to keep the game alive.”
Violence may be all well and good for NFL players, who are being paid millions to put their bodies on the line (though there is debate on this as well), but it hardly seems fair to hold DIII players to the same standards. Only 19 DIII players have made it to the NFL since 1990, only eight of whom have made a career out of football. Ross, meanwhile, had his career plans altered.
“In retrospect, I should have taken the remainder of the year off from school after that game,” said Ross. “I think [the hits] rewired something in my brain. There’s been damage done to the way I think… I wanted to go to Rush for medical school after Knox; football was just a plus.”
Instead of going to Rush Medical College like he wanted to, the effects of the post concussion syndrome forced Ross to transfer from Knox to Loyola University in Chicago, where he could receive more adequate medical care. Football, which was never a part of his long-term plan, ended up dictating his life.
“At the end of the day, you’re at Knox for the education,” Sunderland said. “Head injuries can impact academia in a way few other injuries can… It’s an issue we have to continue to take seriously.”