A survey shows more players would rather conceal a potential concussion during a game than report it.
Head injury mind over matter for a majority of NFL players
Ask Maurice Jones-Drew, the Jacksonville Jaguars running back, whether he would try to play through a concussion or take himself out of a game, and he provides a straightforward answer.
"Hide it," the NFL's rushing leader said. "The bottom line is, you have to be able to put food on the table. No one's going to sign or want a guy who can't stay healthy.
"I know there will be a day when I'm going to have trouble walking. I realise that. But this is what I signed up for. Injuries are part of the game. If you don't want to get hit, then you shouldn't be playing."
Other players say they would do the same.
In a series of interviews about head injuries, 23 of 44 NFL players told the Associated Press they would try to conceal a possible concussion rather than pull themselves out of a game. Some acknowledged they already have.
Players also said they should be better protected from their own instincts: More than two-thirds of the players interviewed said they would like to see independent neurologists on sidelines during games.
The interviews were with a cross-section of players - at least one from each of the 32 NFL teams - to gauge whether concussion safety and attitudes about head injuries have changed in the past two years. The group included 33 starters and 11 reserves; 25 players on offence and 19 on defence; all have played at least three seasons in the NFL.
The players tended to indicate they are more aware of the possible long-term effects of jarring hits to their heads than they once were. In a sign of the sort of progress the league wants, five players said that while they would have tried to conceal a concussion during a game in 2009, now they would seek help.
"You look at some of the cases where you see some of the retired players and the issues that they're having now, even with some of the guys who've passed and had their brains examined - you see what their brains look like now," said London Fletcher, the Washington Redskins linebacker, the NFL's leading tackler. "That does play a part in how I think now about it."
But his teammate, back-up fullback Mike Sellers, said he has hidden concussions in the past and would "highly doubt" that any player would willingly take himself out of a game.
"You want to continue to play. You're a competitor. You're not going to tell on yourself. There have been times I've been dinged, and they've taken my helmet from me, and I'd snatch my helmet back and get back on the field," Sellers said.
"A lot of guys wouldn't say anything because a lot of guys wouldn't think anything during the game, until afterward, when they have a headache or they can't remember certain things."
Justin Smith, the San Francisco 49ers defensive lineman, captured a popular sentiment: Players know of the potential problems, yet would risk further damage.
"It doesn't take a rocket scientist to figure out if [you have] a concussion, you're probably damaging your brain a little bit. Just like if you sprain your wrist a bunch, you're going to have some wrist problems down the road.
"Yeah, I'd still play through it. It's part of the game. I think if you're noticeably messed up, yeah, they'll take you out. But if you've just got some blurry vision, I'd say that's the player's call. And most guys - 99 per cent of guys in the NFL - are going to play through it."
Smith said he sustained one concussion in high school ("You don't know who you are," is how he described it) and another in college ("Walking around the whole time, but I don't remember anything until six hours later").
The NFL likes to say that views about concussions have shifted from simply accepting they are part of the sport to doing what is possible to lessen impacts. Commissioner Roger Goodell talks about "changing the culture", so players do not try to "walk it off" after taking hits to the head.
Yet the Associated Press interview with players showed there is room for more adjustments, which did not surprise Dr Richard Ellenbogen, the co-chairman of the NFL's head, neck and spine committee.
"The culture change takes awhile," Ellenbogen said. "Why would these guys want to go out? They love playing the game. They don't want to leave their team. They want to win.
"I understand all that. And that's why we have to be on our toes with coming up with exams that are hard to beat, so to speak."
Zach Strief, the New Orleans Saints offensive lineman, put it this way: "We all grew up with, 'Hey, get back in there. You [only] got your bell rung'. And while it's changing now, I think it's going to take time for the mindset to change."
A few players said they would be particularly inclined to hide a concussion if it happened in a play-off game or the Super Bowl. Some said their decision would depend on the severity of a head injury - but they would hide it if they could.
Clearly, there is a stigma associated with leaving the field, no matter the reason. One player who said he would exit a game if he thought he might have a concussion did not want to be quoted on the subject.
Other findings from the survey:
Ÿ Asked whether the NFL should have independent neurologists at games to examine players and determine if they should be held out because of concussions, 31 players said "yes", and 10 said "no". Three did not answer.
"They've got guys looking at your uniform to make sure you're wearing the right kind of socks," said Quintin Mikell, the St Louis Rams safety. "Why not have somebody there to protect your head? I think we definitely should have that."
He said he has tried to clear his head and stay on the field "many times".
"I'll probably pay for it later in my life," Mikell said, "but at the same time, I'll probably pay for the alcohol that I drank or driving fast cars. It's one of those things that it just comes with the territory."
Ÿ Regarding concussions, 28 of the 44 players think playing in the NFL is safer now than in 2009, while 13 think it is the same and two think it is more dangerous.
One was not sure.
Those who think safety has improved gave credit to the rise in awareness; more fines for illegal hits; this season's changes to kick-off rules that have cut down on the number of returns; and the new labour contract's reduction in the amount of contact allowed in practice.
"When I first came into the league, it was like, 'Whatever goes'. It was more of that old-school, just 'beat-him-up' football. Not wanting to hurt anybody, but show how tough you were.
"Back in the day, it was like if you come out [of a game] with [a] slight concussion, then you weren't giving it all for your team," said Andra Davis, the Buffalo Bills linebacker. "But now, they're taking that option away from you."
Davis, a 10th-year veteran, said he has had a couple of concussions. He is one of those whose view on seeking help for such injuries has changed.
"The younger me would definitely hide it," Davis said.
"But the older me now - with wife and kids and looking more at life after football - I would say something about it."
Ÿ Asked whether more can be done to protect players from head injuries, 18 players said "yes" and 24 said "no". Two did not respond.
Players on opposite sides of the ball generally drifted toward opposing views: Those on offence seemed more likely than those on defence to say more can - and should - be done to improve safety.
Linemen, meanwhile, often complained that there is no way to improve their plight, with the helmet-to-helmet banging that takes place at the snap on play after play.
One player described those collisions as "micro-episodes that build up over time".
Nearly three-quarters of the players who said they think safety can improve - 13 of 18 - suggested equipment can be improved, too. Helmet technology, mouth guards and chin straps all were mentioned.
Two players suggested more education about concussions is needed.
Little-discussed until reporting by The New York Times led to an October 2009 congressional hearing on concussions in the NFL, head injuries are now part of the daily conversation about professional football. Last Saturday alone, two starting quarterbacks, Cleveland's Colt McCoy and Arizona's Kevin Kolb, sat out because of head injuries, while a third, Minnesota's Christian Ponder, left his team's game with what his coach called "concussion-like symptoms".
At least eight lawsuits have been filed against the NFL in recent months - including three within the last week - by dozens of former players who say they have medical problems related to brain injuries from their time in professional football. The NFL's stance, in part, is that players knew there were risks of injury, and there was no misconduct or liability on the league's part.
"It's a physical sport. Guys are going to get hit in the head," Brent Celek, the Philadelphia Eagles tight end, said.
"It's not like, 'Oh, I'm going to play this because my head's going to be fine when I'm done playing'. It's a risk you take playing this game, but I think the league is doing everything in their power to make it as safe as possible."
And while the players tend to feel better about the way concussions are handled now than in 2009, they will not deny that dangers lurk.
"You're never going to be totally safe from concussions in this game," said Stanford Routt, the Oakland Raiders cornerback. "This is the only place where you can actually legally assault people."