Chris Borland and the Future of Head Injuries

I suppose I'm late to this story. It was big last week, and now we've moved on. When Chris Borland retired from the NFL after a successful rookie season, I didn't have to write about it, because everyone was talking about it already, and what I believed, many people were already saying. Why speak when you've got nothing to add to the conversation?

But now, Borland is drifting toward the back page, or perhaps off the page entirely. And I'd like us to keep considering this uncomfortable topic a while longer.

Chris Borland was born in late 1990, the day after Christmas. He grew up in Ohio, a multi-sport athlete, then attended the University of Wisconsin, where he played football and track and field. As a football player, he was Big Ten Rookie of the Year in 2009 and Big Ten Defensive Player of the Year in 2013. The San Francisco 49ers selected him in the third round of the 2014 NFL Draft.

Borland began the year as a reserve, backing up all-pro linebackers NaVorro Bowman and Patrick Willis. After both starters got injured, Borland entered the starting lineup beginning in Week 7. He played brilliantly. Borland led the 49ers in tackles, intercepted two passes, and sacked Peyton Manning. In Week 15, Borland suffered a season-ending ankle injury.

So Borland had excellent statistics ... even though he only played half the season. Literally, he started eight games out of 16. Every week, we saw a rising star. In his first start, Borland led the team in tackles and sacked Manning. The next game, he made 15 solo tackles. Fifteen! Then 11. The next game "only" 9 tackles, but with 2 INTs, including the game-clinching interception. On it went ... he had two more games with double-digit solo tackles, and in only half a season's work, he ranked 12th in the NFL in tackles and finished fourth in Defensive Rookie of the Year voting.

When Willis retired after the season, Borland was poised to take his place in the starting lineup. Except that a week later, Borland himself hung up the cleats, citing concerns about the long-term effects of football injuries.

There are a number of long-term medical conditions associated with football. Joint and back problems can limit players' mobility. Chronic pain puts some at risk of drug addiction. But the most worrisome, and one not properly understood for years, is head injury. Dementia pugilistica was first identified nearly a century ago. "Punch-drunk" was the term. An ex-boxer having trouble might be referred to as "punchy." Today, we call it Chronic Traumatic Encephalopathy, or CTE. Parkinson's disease is a separate disorder, also associated with blows to the head. There is not yet a consensus on whether ALS — sometimes called Lou Gehrig's Disease — is brought on by head trauma. CTE is associated with memory loss, depression, difficulty concentrating, and more.

I'm a fan of mixed martial arts. And the contrast between MMA's approach to head injuries, and football's approach, is staggering. A guy gets knocked out in a fight, and the athletic commission puts him on a 45-day (or longer) no-contact list. A football player gets knocked out, and he's usually playing seven days later, sometimes even returning to the same game.

This isn't some bleeding-heart issue, and it's not a new concern. In his 1996 book All Madden, Hall of Fame coach and broadcaster John Madden expressed grave concern about head injuries:

"Just a little concussion, some teams like to say. But there's no such thing as a little concussion ... If a guy hurts his knee or his shoulder, nobody laughs about it. But a guy with a concussion, ho ho, he's just had his bell rung. He doesn't even know where he is. He doesn't even know what day it is. When the team doctor holds up two fingers in front of the guy's face, he's saying, "How many fingers do you see?" Some people think that's funny. But if you're the guy trying to focus on those two fingers, it's not funny.

"In boxing ... athletic commissions have a rule that if a boxer is knocked out ... he's automatically suspended from fighting there for thirty days, sometimes sixty days. In football, if a guy is knocked out in the first half, you sometimes hear his team talking about maybe he'll be back for the second half."

Madden goes on to discuss specific cases like Troy Aikman (who has a frightening story told in the Fainaru brothers book and PBS documentary League of Denial) and Merril Hoge, who temporarily stopped breathing after one of his concussions. Madden's book came out almost 20 years ago, and he's hardly a soft touch. If John Madden is worried about player health, everyone should be worried.

Chris Borland was worried. I don't blame him. I'm disappointed he won't play any more, because he was a great talent. But I hope his retirement raises awareness inside and outside the league about the long-term risks of playing in the NFL.

* * *

Football is my favorite sport. It has always been my favorite sport, and it will probably always be my favorite sport. I grew up with football, I played football in college, I became a sportswriter because I loved football. Even in the offseason, most of my articles are about the NFL.

I don't want people to stop playing football. I don't want them to stop tackling, or blocking, or diving for that last yard. I just want to enjoy the game with a clean conscience. I believe — and maybe I'm wrong — but I believe that tackle football can be played reasonably safely with regard to life-altering injuries.

The NFL, over the past few years, has introduced a number of new policies to control the problem of head injuries and CTE. Unfortunately, the league's efforts to this point seem motivated by politics and public relations more than genuine concern for player safety. Some of the new measures are cosmetic, some are poorly considered, some are simply insufficient, and none of them are evenly enforced.

I believe there are simple solutions that would dramatically reduce the problem of head injuries, and it's merely a matter of putting those policies into practice. In theory, the NFL has a concussion-monitoring program, to prevent players who suffer head trauma from returning to the game before they are cleared by a neurologist. This system hasn't been working. Players routinely return to the field, after suffering concussions so obvious I can diagnose them from my couch. That has to stop. It is outrageous that the league can't get this right. More than that, it is unethical and sickening. If the league's existing concussion policy were simply enforced, I'd feel a lot better about the direction this thing was going.

In a sad way, I actually am pleased that more players are retiring early in response to head trauma. Borland's retirement was preemptive rather than reactionary, but even that underscores the benefits of player education. Give the players and their families information, to help them make better decisions. If some of these guys had retired after the second concussion, maybe their lives would have unfolded differently.

What I'd like to see in the immediate future is:

1. Qualified, independent doctors on hand to diagnose and respond to head injuries. I don't want the team physician deciding whether players are okay, and I don't want players talking their way back onto the field after a head injury. We saw progress in 2014, but not nearly enough. We should be able to get this right, every time.

2. Better understanding and enforcement of existing statutes. There are good rules on the books, that could help control the problems of CTE. They aren't being enforced consistently.

3. Better protective gear, especially helmets and mouth-guards. I'd also like to see stricter policy on players actually using the mouth-guards.

4. Rule tweaks to better facilitate player safety. I don't believe radical changes to the premise of tackle football are necessary, but there are steps we can take to make the game safer. I also believe, and I've expressed this many times, that the league needs to do a better job of protecting clean play. When the line blurs, and players start getting in trouble for clean hits, it's hard for players and coaches to know what to do, and it reduces the disincentives against dangerous plays. Make the rules clear and enforce them consistently.

4b. Better officials. Referees have a tremendously difficult job, and for the most part they do it well. But if the NFL believes head injuries are a serious problem, it needs to train referees to better understand legal and illegal hits. Officials who fail to properly understand and enforce the protocols must be replaced.

5. Much better player education, at all levels, of the risks associated with head trauma. Information is the most vital piece of this: players and their families, and everyone who's in a position to help them make decisions about the future, need to understand the long-term health risks associated with head trauma.

None of those measures would dramatically alter the game of football, and none of them would be a major expense for a league as successful as the NFL. I'm not a doctor or a scientist, so perhaps I'm misunderstanding the issues. But I've gone out of my way to learn about these issues, and I've written about them many times. I believe the NFL can do better, and I believe the league needs to do better. But most of all, I believe we need to keep talking about this. Chris Borland did something unusual, and I don't want it to be a one-week story. This matters a great deal.

Leave a Comment

Featured Site