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America’s great mid-winter festival has just concluded. As the nation focused on the Super Bowl, football has been on America’s mind in a different way. The top-grossing movie Concussion has many of us thinking more about X-rays than x’s and o’s.  It featured the tragic story of Pittsburgh Steeler center Mike Webster’s decline into depression and dementia, but also brought back into my hippocampus (the seat of memory) a host of other tragedies—from Hall of Fame linebacker Junior Seau’s suicide to the diagnosis of brain disease for former player and broadcaster Frank Gifford.  And all of this on the heels of the NCAA’s recent $75 million settlement of a class action lawsuit on, you guessed it, concussions.

As portrayed in the movie, Webster’s autopsy led to the discovery of a previously unidentified brain disease, chronic traumatic encephalopathy (CTE).  This is the condition which also afflicted Gifford and, we now know, a host of other deceased players.  A recent Veterans Affairs report found that 87 of 91 deceased NFL players studied suffered from CTE.  These recent findings led Chris Borland, one of the league’s top rookies, to walk away from a $3 million dollar contract with the 49ers after just one season.

I googled football concussions last night and got 24 million responses in .38 seconds.  Googling football steroids — a decade after that was the top issue — still gets more than a million responses.  And last week, there was a report out that says one in four college athletes experiences some form of depression.  Not surprisingly, the new NCAA Sports Science Institute announced last month that the number one safety issue for intercollegiate athletics isn't steroids or depression, it’s concussions.

Here's the bad news--we are only beginning to understand what a brain baseline is — which is step one in diagnosing and treating concussions.  And here’s the really bad news — NCAA Chief Medical Director Brian Hamline says that we do not have even a definition of neuro-biological recovery.  We cannot really tell yet if and when a student-athlete is healed from a concussion — and that is even if we are lucky enough to have his/her baseline on file in the first place.

Those of us responsible for the well being of college student-athletes (I serve on the NCAA Division III Presidents Council) are considering how we can best protect those student-athletes competing in football (and other sports) from head trauma. The NCAA has produced a series of guidelines to deal with concussions and its recent $75 million lawsuit settlement will provide for increased testing, diagnosis and future research.

But more needs to be done, especially the adoption of preventive measures. At last month’s NCAA national convention, I was part of a successful floor fight to defeat a proposal to expand spring practice for Division III football programs. This was a common sense step to limit student-athletes’ exposure to head trauma.

There are a number of other common sense measures that ought to be reviewed at all levels of football.  The elimination of kickoffs (the single most dangerous play perhaps in all of sports) would be a good place to start; better enforcement of the NCAA’s own guidelines for reducing head trauma should also be a priority; limiting contact in practices and reducing the distance (velocity) at which drills are conducted are both measures that should be universally adopted (especially given the dramatically increased size and speed of today’s athletes).

The culture of the game also needs to undergo a sea change — a coaching change that will encourage players to self-report potential head injuries without fear it will affect how they are perceived and a teaching change that will focus young players on technique (hit’em smart) instead of intent (hit’em hard).

Practicing on occasion without helmets is, counter intuitively, another means to reduce head trauma. The University of New Hampshire introduced this practice in the belief that players would instinctively modify their blocking and tackling techniques to avoid any head contact. By season’s end, players in game situations recorded 30 percent fewer head blows.  It is worth noting here that improving the design of helmets has yet to offer a panacea. There is no protection against the sudden acceleration and deceleration of the head, which The Week magazine recently noted “can cause the brain to slosh around inside the skull like the yolk inside a vigorously shaken eggshell. When the brain is compressed against the skull by this sudden stopping and starting, neurons are damaged — and they never recover.”

Head trauma is both qualitatively and quantitatively the biggest challenge to the future of football.  Yet, football faced a similar moment at the turn of the last century. There were 18 deaths in college football in 1905, when safety rules were non-existent, and broken necks ended lives in an instant.  The game had to change.  It did and it thrived.  In today’s crisis we are confronted with the kind of slow-motion death that characterizes CTE, and those numbers could run into the thousands.

My father played semi-pro football back in the day, and he coached youth football for 30 years. All eight brothers in our family played the game on our fields all over this state; four made it onto the college gridiron; two won league championships; one has a national championship ring.  I played the game myself for many years (and spent another decade playing rugby here and in Ireland). I thoroughly enjoyed the physicality and camaraderie of the game.  I still enjoy the game tremendously. But I care about student-athletes — their futures — more.

Sport is meant to provide formative experiences that enhance the lives and prospects of its young participants, not damage or limit them. It is the job of all of us — parents, coaches, administrators, and fans — to protect our athletes. To do that, the game must change again.

Tom Foley is president of Mount Aloysius College in Cresson, Pa., and serves on the NCAA Division III Presidents Council 

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