Running head: THESIS OUTLINE 1 Title: Concussions in the National Football League Introduction Thesis Statement: NFL needs to put in place new initiatives that will prevent, diagnose and treat head traumas because its current commitments to reduce concussions have been on the spotlight as former players have been diagnosed with chronic traumatic encephalopathy, a progressive and deteriorating brain condition set off by recurring head injuries. I. History of concussions in the National Football League A. Common symptoms of concussion i. Imbalance ii. Vision change iii. Loss of consciousness iv. Memory loss and confusion v. Fatigue vi. Malaise B. Concussion protocol process i. Weaknesses of the protocol C. Current prevention initiatives to reduce concussions D. NFL litigation II. III. Statistics on diagnosed NFL concussions New initiatives to prevent concussion A. Implementation of concussion-preventing technologies B. Play Smart Safe Initiative C. Involvement of Scientists in tackling concussions THESIS OUTLINE IV. V. Recovery efforts Conclusion 2 Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE Al Toon was a Pro Bowl wide receiver for the New York Jets from 1985 until his retirement in 1992. Al Toon is also the first ever documented player to retire from what the National Football League (NFL) now calls post-concussion syndrome. All throughout Al Toon’s career he was experiencing what the league was just labeling dings or just being dazed. However, it is now what the league now recognizes as concussions (Pellman, 2003). The Congress of Neurological Surgeons explains that, ‘‘Sports concussion is defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces’’ (McCroy, et al., 2005). Al Toon displayed many symptoms of concussions during his time as a New York Jet. Some of the symptoms are minor, such as, mild headaches to slight dizziness. Towards the end of Al Toon’s career, he began to experience more severe concussion symptoms. These symptoms include severe headaches, depression, intolerance to loud sounds, and malaise (Pellman 2003). It was shortly after Al Toon’s retirement from the NFL that the league began to query about the medical issues that Al Toon and players across the league were experiencing. The NFL Commissioner and several physicians from around the league gathered and realized that they had more questions than answers when it came to concussions. This led to the creation of the NFL Committee on Mild Traumatic Brain Injury in 1994. This committee was comprised of a wide range of personnel. The committee included physicians, athletic trainers, neurosurgeons, and more (Pellman 2003). The symptoms mentioned above that Al Toon suffered during and after his NFL career are common ones among players with concussions. Other Symptoms found in players with concussions include, headaches, nausea, balance problems, sensitivity to light or noise, Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE blurry vision, and malaise (Collins, Lovell, & Mckeag 1999). Often the athletes will either minimize their symptoms and injuries or they will not report an injury at all. The non-reporting of head injuries can be contributed to several factors, players not wanting to be taken out of the game, players thinking heavy blows to the head are a just a part of the game, or players simply do not recognize the symptoms or dangers of playing with a concussion. Many symptoms of concussions are not specific to just concussions, this is another reason that it is important for training staff and health care providers to be able to identify possible signs of head injury or concussions (Putukian 2011). Physical symptoms are not the only way concussions effect players, but mental symptoms also plague players that have suffered concussions especially retired NFL players. Retired NFL athletes are more likely to exhibit signs of depression as opposed to the general population. Retired NFL athletes have also been more prone to report signs of irritability, apathy, and suicidal ideology (Didehbani, et al., 2013). With NFL player’s physical and mental health at risk it is important to indentify and treat players with traumatic head injuries so that the players that suffer from concussions will not also suffer from the long-term effects that concussions present. The National Football League’s concussion protocol consists of a six-step process that each player must go through before being cleared to play or return. This process does not have a specific timetable because each player and concussion is different. As stated in the steps of the NFL's concussion protocol the return to play process is as follows. The first step is to assess each player in the pre- season with a baseline neuropsychological test. Step two, if a player shows any signs of a possible concussion, he must be immediately removed from the game or Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE practice. The third step is a team physician and neurotrauma consultant must review film of the play and conduct a sideline test for any concussion like symptoms. Step four, if suspicion of a concussion continues, the player is escorted back to the locker room for a full examination. Step five, if the player is diagnosed with a concussion, he is out for the remainder of that game or practice. If the player passes the exam, he can return to play, but will be monitored throughout the game. The last step, step six, is when a player has been diagnosed with a concussion, he then has to be cleared by the team and an independent neurologist before he can return to play. The NFL has made great progress in improving its concussion protocol, but the system still has a lot of weaknesses. One of the biggest problems about concussions is that they are not visible. A football player can look fine, but still have a concussion. The common visible signs, such as: speech, muscle control or headaches does not always show (Carroll, 2013). Another problem, the neurotrauma consultant is located at the 25-yard line, away from the team personnel. Rather than acting as an independent expert, he or she can only enter the personnel box and evaluate the players when called over by a team doctor (Carroll, 2013). Lastly, some NFL players try to cheat the pre-season concussion screening. Players will fake reaction time tests by slowing down. By slowing down these tests, it makes it more difficult for team doctors to evaluate for concussions during the season (Bien, 2017). The NFL has made some progress, but there are still loopholes and problems in the NFL’s concussion protocol. The NFL is under a lot of pressure to ensure the safety of players from concussions. Over the past ten years a lot of new rules and regulations have been made to reduce concussions. On the field doctors can now intervene and stop a game if they think a player should be evaluated Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE after a hit. Also, the doctors can keep a player from returning to the field no matter how much the player or coach protests (Sisalvo, 2015). Another new prevention to reduce concussions is new helmet technologies to reduce the severity of collisions. Currently, sensors are being placed inside new helmets to provide data on the frequency and severity of head impacts (Sisalvo, 2015). The NFL has donated millions of dollars to support the research on these new technologies. Another big change the NFL made is in the rules. Players can be directly fined for any head to head contact and if a player is a repeated offender the fine will keep increasing or lead to further disciplinary actions. In 2011 more than 4,500 retired NFL players filed a class-action lawsuit against the NFL. The players accused the NFL of covering up the long-term health dangers caused by football related head injuries to protect the leagues image (Red, 2016). The Supreme Court of the United States declared that the NFL will have to pay nearly 1 billion dollars to the thousands of retirees. Also, the NFL will have to provide care and support for the players and their families that are facing serious neurocognitive injuries. The problem of the settlement is that if an NFL player is diagnosed with chronic traumatic encephalopathy (CTE), after the date of the settlement, he would not be entitled to its benefits (Red, 2016). The current and future players will not have to play at their own risk. Over that past year the NFL concussion rate has slowly decreased. The NFL has reported a decrease in concussions from 2015 to 2016 (275 to 244) in data collected from all preseason and regular-season practices and games (Austin Knoblauch, 2017). In addition, there was an 8.7 percent decrease in in-game concussions from 2015 (183) to 2016 (167) (Knoblauch, 2017). There was an increase of self-reported concussions as well in the past season. Furthermore, Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE researchers have found that athletic trainers and neurotraumatic consultants are taking a stronger approach when requesting examinations of players. Almost 70 percent of the players called for an examination by a doctor are cleared to return to play (Knoblauch, 2017). With the heighted awareness of concussion and its new protocols it seems that the NFL has made the game safer according to the statistics. The NFL can implement various strategies that would help the organization to prevent or reduce the rate of occurrence of the concussions. The first step that the league can take is to implement several technological advances that capitalize on preventing the occurrence of concussions. The first piece of technology that could aid in these efforts is extending padding to the helmets of football players. The padding extension for helmets will make them safe and add their ability to absorb shock in the case of collisions. A specific technology application by Shawn Springs, a former Patriots Cornerback will allow the use of the car seat technology to develop the safer helmets (Abreu, 2016). If the improvement goes through, the NFL can adopt the helmets and make the game safer. Also, mouth guards have always played a central role in the prevention against concussions. However, the current designs have not been able to tame the number of concussions in the NFL which was 233 in 2016 alone. Although technology has not yet enabled the NFL and other concerned parties to estimate the hits that cause concussions, a new technology mouth guard might just be able to do so. A start-up company in Minnesota has designed an improved mouth guard that allows for a real-time alert on possible concussioncausing hits. This new mouth guard might just be the device required in the field to estimate the intensity of hits and seek medical attention before the concussions occur since most of the Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE adverse effects are seen later after the hit (Raguse, 2017). Technological advances like these, if adopted by the NFL, might help in reducing the occurrence of concussions. Another prevention approach to the issue of concussions in NFL could be launching a play-smart safe initiative. The NFL advocates for safety in the game. However, little effort has been dedicated to ensuring that the players implement safety procedure and that they understand how to play safely in the first place. Therefore, investing in advertising campaigns where the players are educated on safe play and avoid injury both for themselves and other players should be stepped up. Although the league advertises new techniques and guidelines to ensure safety, there are no campaigns and training programs on the ground that ensure that players get this training. The organization of a play-smart safe campaign should be such that the league communicates and demonstrates different safety guidelines to the players in all conferences. Therefore, the league can organize for training initiatives whereby facilitators are sent to the individual clubs and engage players in training programs where different techniques are displayed. Techniques that could help the players develop safety in the game could be documented and trained to coaches as well. The training should include sensitization on the issue of concussions, and it could involve the integration of concerned parties such as veterans who are most likely ready to volunteer for such initiatives. The other major implementation that the NFL can use in preventing concussions is actively engaging scientific knowledge in research. The involvement can take different approaches. First and foremost, an intensive study into the scientific process of concussion should be launched. According to Ossola (2017), the NFL allegedly suppressed the research into Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE concussions for fear of the limiting of the league’s abilities. However, if the league was to engage an expert panel of researchers and provide the funding necessary for research, substantial findings may emerge and aloe the league to get a breakthrough of how to prevent the occurrence of the concussions. Also, financing a dedicated panel of scientists would produce quick answers which would probably take longer outside the scope of the league. The recovery process from concussions is critical as it is a key determinant of the mental health of the player. Observing the key symptoms and dedicating treatment towards the players can allow the NFL to limit the cases of mental instability seen among several players who end up committing hideous crimes or being depressed. The NFL is very competitive; perhaps the most competitive professional sports league in the U.S. Due to the pressure to perform and get back in the game, players may not see the need to take enough rest for stabilization before going back to the game. The coaches alike, may not be considerate enough hence allowing their ‘star’ players to resume a little bit early (McGuine, 2014). The NFL should ensure it follows closely on the rest period allocated to players who incur a concussion to ensure that the recovery is complete. The rest period that adds up to the recovery of the player involves both physical and cognitive rest. In the NFL, management has always focused on the physical rest whereby the player can be prohibited from engaging in any physical activity that could break a sweat. However, the NFL could go a step further in monitoring the social lives of players who incur concussions. They could do that by providing guidelines to clubs which then delegate care takers to supervise the players during the recovery period. The supervisors who would be referred to as more of health experts should ensure the players do not engage in activities Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE straining their cognitive abilities such as reading, watching too much TV or listening to loud music. The recovery process is also an emotional one since most players are overcome with anxiety. As discussed earlier, the players feel pressured to get back on the field and perform. The anxiety could lead to stress and depression (Ossola, 2017). This destabilization of the mental health could be detrimental to the player. Therefore, NFL can provide mental health care for players undergoing recovery from concussions. Psychoanalysis therapy and counseling could be made available for the players to remain mentally stable and recover successfully. Stress also prevents the cognitive rest and tackling the mental health would allow the player to rest well and also limit the probability of reoccurrence of a concussion. NFL needs to put in place new initiatives that will prevent, diagnose and treat head traumas because its current commitments to reduce concussions have been on the spotlight as former players have been diagnosed with chronic traumatic encephalopathy, a progressive and deteriorating brain condition set off by recurring head injuries. Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE References Abreu, A. (2016, February 12). Tag Archives: concussion prevention technology. The Sport Journal, 19. http://thesportjournal.org/article/tag/concussion-prevention-technology/ Atkins, N. (2017, February 10). Here are the steps of the NFL's concussion protocol. Retrieved from http://www.mlive.com/lions/index.ssf/2017/02/here_is_the_nfls_concussion_pr.html Bien, L. (2017, April 18). NFL concussion protocol cannot save football. Retrieved from https://www.sbnation.com/2017/4/18/15213420/nfl-concussion-protocol-cheating-test Carroll, W. (2017, April 12). Why the NFL's Concussion Policy Is Failing. Retrieved August 03, 2017, from http://bleacherreport.com/articles/1800166-why-the-nfls-concussionpolicy-just-isnt-working Collins, M. W., Lovell, M. R., & Mckeag, D. B. (1999). Current issues in managing sports-related concussion. Jama, 282(24), 2283-2285. Didehbani, N., Munro Cullum, C., Mansinghani, S., Conover, H., & Hart, J. (2013). Depressive symptoms and concussions in aging retired NFL players. Archives of clinical neuropsychology, 28(5), 418-424. DiSalvo, D. (2015, November 16). Is The NFL Doing Enough To Prevent Brain Trauma? '60 Minutes' Probes For Answers. Retrieved August 03, 2017, from https://www.forbes.com/sites/daviddisalvo/2015/11/16/60-minutes-probes-what-thenfl-is-doing-to-decrease-brain-trauma-from-head-injuries/#22cfde9a5b13 Knoblauch, A. (2017, January 26). NFL sees decrease in concussions from 2015 season to 2016. Retrieved August 03, 2017, from http://www.nfl.com/news/story/0ap3000000779315/article/nfl-sees-decrease-inconcussions-from-2015-season-to-2016 McCrory, P., Johnston, K., Meeuwisse, W., Aubry, M., Cantu, R., Dvorak, J., ... & Schamasch, P. (2005). Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004. British journal of sports medicine, 39(suppl 1), i78-i86. McGuine, T. (2014). Protective Equipment and Player Characteristics Associated With the Incidence of Sport-Related Concussion in High School Football Players: A Multifactorial Prospective Study. The American Journal of Sports Medicine, 42(10), 2470-2478. Doi:10.1177/0363546514541926 Running Head: CUNCUSSIONS IN THE NATIONAL FOOTBALL LEAGUE NFL. (2017, January 1). NFL Head, Neck and Spine Committee's Protocols Regarding Diagnosis and Management of Concussions. Retrieved from https://images.nflplayers.com/mediaResources/lyris/pdfs/NFL_Diagnosis_Mgmt_Concu ssion.pdf Ossola, A. (2017, February 3). NFL game changer: Scientists tackle concussions head-on. CNBC Modern Medicine. Retrieved from http://www.cnbc.com/2017/02/03/nfl-gamechanger-scientists-tackle-concussions-head-on.html Pellman, E. J. (2003). Background On The National Football League’s Research on Concussion in Professional Football. Neurosurgery, 53(4), 797-798. oi:10.1093/neurosurgery/53.3.797 Person, J. (2015, September 14). How does the NFL's concussion protocol work? Retrieved from http://www.charlotteobserver.com/sports/nfl/carolina-panthers/article35258697.html Putukian, M. (2011). The acute symptoms of sport-related concussion: diagnosis and on-field management. Clinics in sports medicine, 30(1), 49-61 Raguse, L. (2017, March 23). Mouth guard to detect concussion hits. KARE.com. Retrieved fromhttp://www.kare11.com/sports/nfl/superbowl/mouth-guard-to-detect-concussionhits/425145992 Red, C. (2016, December 12). Supreme Court ruling paves way for ex-NFLers to receive benefits. Retrieved August 03, 2017, from http://www.nydailynews.com/sports/football/nfl-1billion-concussion-settlement-approved-supreme-court-article-1.2908003 Step 1: Get to Know Your Team As described in the scenario, you will be working with a small team to produce your deliverables. Your instructor has assigned you to a team of up to five; take some time to review your teammates' LinkedIn profiles and bios to understand the experience and skills within your group. Because it is important that the team's projects represents the work of all members of the group while still maintaining one cohesive voice, it may be helpful to read this guidance on group work. Be sure you reviewed the rubric under Assignments in Course Home that will be used to assess your paper and the contribution of members. There will be a discussion area allocated for each team. You are welcome to use outside collaborative tools (e.g., Google Docs). Your team will use this area to establish ground rules for communication, adding ideas and information. The group will then complete and sign the team communications plan. After the plan is completed, elect one person to attach or link the final document to the team folder.This step should be completed early in week 8. Now that you know how you will communicate with your team, take some time in the next step to read some of the theories about teams and leadership. Step 2: Learn About Organizational Behavior In the previous step, your team got to know each other and agreed on a communications plan. In this step, take some time to read about teamwork and leadership. Think about the challenges members must overcome to work together effectively, and how they can do this to achieve a positive outcome for the organization. Bad experiences have their own lessons for individuals and groups. In your own group, you will experience some practical challenges of schedules, resistance to group work, and perhaps failure of some members to contribute fully. Consider this an incubator of sorts, in which you may encounter experiences similar to the case you are studying. As you grapple with logistic, technical, and other team issues, you are experiencing normal team challenges. So, relax a bit and consider this a useful journey! In the next step, you will choose your case. Step 3: Choose a Case to Analyze Now that you have a better understanding of various aspects of organizational behavior from the reading in the previous step, take a look at these case studies. Your team can choose one of these cases or look for other options. In response to the case study, your team will write an instructive white paper (1,400-1,600 words) that analyzes a company's management and leadership environment in a particularly challenging period. Your paper should: • review the issues of the case study as background for the events relating to the role of the leadership and teams • • analyze the leadership practices of the organization in the case study, and define the practices that leaders used to create collaborative and successful teams, or failed to effect successful working relations resulting in negative conditions propose remedial principles and practices that the organization might adopt to enable a better outcome After the paper is written, you will create a one-page executive summary of the paper and an asynchronous presentation of 12 slides, excluding the references slide and cover slide. You will have three weeks to complete the following: • • • create a team project plan by the end of week 8 conduct research, develop an analysis of the issues of the case, determine your argument, provide supporting facts, and identify recommendations with an explanation of your rationale draft and finalize your paper and executive summary, and create a narrated presentation In the next step, you will come up with a project plan. Step 4: Create Your Project Plan In the previous step, your team chose a case study. In this step, you will work with your team to establish how you will apportion the work and create a single document with participation by all. Be sure you are using team spaces to exchange ideas and drafts. If you use any outside collaborative tools, keep your instructor apprised and provide access to review, as necessary. Finish this step by creating and submitting the final version of the team's project plan to your team space. This step should be submitted by the end of Week 8. Step 5: Conduct Research In previous steps, you studied organizational behavior, and then the team chose a case and agreed to a project plan. Now it is time to do a closer read of the chosen case and do any additional research. Revisit guidelines on conducting research, if needed. Then look at Table 1, which provides some topics for your search strategies. In your search, you should consult scholarly resources as well as online resources, newspapers, and business blogs and sites for similar contemporary cases. Table 1 Topics to Consider as They Apply to Your Team's Case 1. Principles of teamwork within an organization: What were the practices of this organization, and how did these practices influence the issue and challenges the project team and leader confronted? 2. Best practices for leaders: What practices did the team (or leadership) employ that influenced the outcome, leading to resolution of the crisis, or further exacerbating the situation? Table 1 Topics to Consider as They Apply to Your Team's Case 3. How the composition of leadership influences outcomes: Were there unique characteristics of the project team and leaders? 4. Judging the success of project teams, immediate and longer term: Are there any unique issues, challenges, or practices relevant to the leaders, industry, or company? This step might be completed well before your paper is finished, or you may continue to do research as the paper is developed. Ideally, much of this step should be complete by the end of Week 9 to ensure time for writing. Move on to the next step when you feel you are ready to begin whatever writing component the team’s project plan has allocated to you. Step 6: Writing the Paper Using the research from the previous step, you and your teammates will write the white paper and executive summary as determined in the project plan. Your team paper and contribution to the team project will be graded using the team project rubric, so be sure the team reviews that document. The white paper and executive summary must be completed by the end of Week 10. After your paper and summary are been completed, the team should move on to the next step, in which your team will create the narrated presentation. This next step must also be completed by the end of Week 10. Step 7: Narrated Presentation In the previous step, your team completed the white paper and executive summary. Your team must now create the asynchronous presentation that captures the primary argument and supporting facts of your paper. The presentation should be engaging and should convey: • • • • a synopsis of the issues of the case your team's analysis of the connection between leadership and outcomes any unexpected discoveries in this case proposals to mitigate challenges and your team's rationale for such recommendations In the final step, the team will submit the paper, summary, and presentation to the correct locations.
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