Earlier this year the National Football League’s new “public service” website, nflhealthandsafety.com, posted a buffoonish demonstration by the Pittsburgh Steelers’ neurosurgeon, one of the marketing masterminds of “ImPACT concussion management,” of how to do a two-minute test of a player who seemingly sustained a head injury. See “Comedy Central: NFL’s PR Video of Dr. Joseph Maroon Conducting the Perfect Neurological Exam,” June 20, https://concussioninc.net/?p=4122.
More recently, nflhealthandsafety has added “Ellenbogen on Concussions,” a brief presentation by Dr. Richard Ellenbogen, the co-chair of the league concussion policy committee. See http://nflhealthandsafety.com/2011/07/13/dr-ellenbogen-on-concussions/.
The Ellenbogen video is not buffoonish. It has useful information, but its message is muddled. One of the plaintiffs in the new lawsuit against the NFL, alleging a cover-up of past research, has described Ellenbogen as well intentioned (see “Former San Francisco 49er George Visger Comments on Today’s Article at Beyond Chron,” June 24, https://concussioninc.net/?p=4146). As I see it, the problem is that Ellenbogen serves two masters – one of whom, unfortunately, is NFL Commissioner Roger Goodell.
I have two main observations on the Ellenbogen video:
1. It is in direct conflict with Maroon’s. Ellenbogen emphasizes taking your time in an on-field evaluation of an injured player; Maroon, with no disclaimers, emphasizes how fast you can do such an evaluation (“efficiently and expeditiously” is his assonance). These two positions are not reconcilable. Will Ellenbogen use his authority to remove and disavow Maroon’s video? I will ask Ellenbogen and report back.
2. Ellenbogen’s “first principle” is unassailably correct: “tailor approach to level of athletic play.” But this principle is undercut by the overall topic, which is a guide on returning athletes to play after they suffer concussions.
We all get it that NFL return-to-play protocols are being tightened up (except, of course, when they aren’t). The question Mom and Pop Football urgently want to hear the experts discuss, however, is not how to manage Johnny Gridiron’s second concussion. It is whether they should be exposing their precious bundle of shoulder pads to a possible first concussion and to scores, hundreds, or thousands of lethal subconcussive blows. In short, is the sport of football a viable activity at all for youngsters? That would be the most fundamental “tailoring of the approach to level of athletic play.”
Now, no one expects Richard Ellenbogen, speaking on an NFL website, to trash his client. But rather than handing down education about baseline neurological testing for little squirts – a concept both flawed overall and, specifically, impossible to reproduce at the amateur level – he should be making the broadest and most professionally responsible disclaimer of all: that everything he says on behalf of the league about return-to-play applies only to those so dedicated to football that they are willing to play Russian roulette with their mental health. Failure even to acknowledge the existence of a controversy on this crucial point exposes his lack of independence.