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Comment by soneca | Hacker News Reader

I find it interesting that at the end he doesn't blame american football in itself for the negative long term effects in his health as I thought he was heading to. He ends up (spoilers alert) coaching football.

I myself do not have a strong opinion on the matter of the ethics of creating a billionaire business around a game that is so dangerous to everyone that plays it seriously, from high school to pros. I am instinctively against, but as long as the issues are clear, transparent and everyone involved have all access to information needed to do their own informed choices, it seems correct.

That said, a very brave and insightful tale on how these personal struggles are. Very well written too. And glad to know that there are effective treatments out there that can help this kind of health problems.

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>He ends up (spoilers alert) coaching football.

That is actually really sad.

Motor sport used to be very deadly half a century ago, and it took hard work from drivers to change that. Drivers that were often ridiculed for talking about the need for safety. Now professional motor sport is surprisingly safe, just take Scott Dixons crash at Indy 500 yesterday from which he escaped unscathed.

Football players have to demand their safety is taken seriously before any positive change is going to happen to the sport.

I think it's going to take more than just the players demanding their safety, mainly because as this article notes, it's not going to happen on it's own.

Why not align the incentives? Fans of the game should be putting pressure on the coaches about ensuring that their favorite players aren't injured, coaches should be pressuring the association to force better safety systems so their players don't get removed from the game, the contracts with players should value their long-term abilities more than their short-term wins, the association can start including more and more safety requirements and rules to make sure that the fans keep watching for their favorite stars.

This kind of thing needs to be attacked at all angles, make everyone involved WANT better safety by making it make beneficial to everyone involved.

There is only so much safety when you're talking about 300 pounds meeting 250 pounds. The problem with football is physics.

Then change the rules of the game.

Racing did it, they regulated the max amount of fuel, they reduced the top speeds, they added safety barriers, etc...

Do it with football. Change their gear, change the allowed "hits", remove their cleats, etc... I don't actually watch football so I'm not sure what would help or wouldn't, but don't act like this is just impossible to resolve.

Yeah, people would probably hate these kinds of solutions right now, but if you get the public opinion on your side, and you start moving in that direction people will change, they will realize being able to watch a safer form of football with their favorite players in it beats being able to watch "current football" but with all their favorite players horribly injured with their lives ruined.

This is happening, although not as much as it could and probably should be. One example is moving kickoffs to a higher yard line so that the chance of a touchback (no return) is greater. Since kickoff returns are some of the more dangerous plays, it lessens the times returns actually happen. Helmet to helmet collision rules are another example. So is the rule for the horse collar tackle. Things are changing, but perhaps not enough or fast enough. Further, as a huge fan, these rules are minor changes and do not at all detract from the game, IMO.

They should just play flag football and skip that tackling stuff.

I really don't know anything about American football, but in Rugby a lot of work has gone into this kind of thing. You can't tackle a player who has jumped to catch the ball until his feet touch the ground. If you pick a player up, you are responsible for putting them down. High tackles (around the neck) or not attempting to wrap your arms around a player when (so you 'clothes-line them) you tackle is much heavily penalized. All of these will result in 10 minutes in the sin-bin at least, maybe bans after the game. All head injuries result in the player being sent for 'assessment' by a doctor during the game, and a concussion protocol which enforces long breaks from the game. With regards to American football I have two questions

1) Is the impact to the brain higher because of the protective equipment? Would people tackle as ferociously without it? You are allowed very little of that gear in Rugby. Head clashes in particular are rare in Rugby, without the helmet you put your head to the side of someone when you tackle!

2) American football players seem to carry a lot of body mass for fast people. Is it possible that their advanced sports science is a bit too pharmaceutical in nature? I wouldn't want to suggest anything, but is there a chance steroid use is widespread? If this is the case then clamping down here would presumably lessen the hits?

It's likely that a bit of the size /bulking up is steroid based, but a lot more is just based on the relative size of the population pool and the kinds of exercise and diet regimens used with a focus on size and burst speed. Where some sports will stop at a certain level then focus on stamina and maintenance, US football may keep pushing for more bulk.

How much time would the average player actually spend on the pitch in American Football? It seems a lot of sprints and changes. Rugby players play for 80 minutes with one half-time break. I'm guessing that produces a more compromised physique.

I've definitely heard arguments along the lines of your (1) before. I personally think it's a promising route, but it would definitely need to be a slow one. Right now, if you just took everyone's gear away, the players would probably end up killing each other. Not purposefully; just out of rote training and muscle memory. It would be good to introduce the behavioral bans first, then eventually remove the gear.

Out of curiosity, how severe is the average injury in Rugby?

My general impression from playing a bit of Rugby and watching a fair but, with no statistical analysis at all..

I would say the most common injuries by far are related to muscle strains, tendons and ligaments etc like you could see in any sport. Cuts to the head are fairly common, as are the fabulous 'cauliflower ears' caused from bleeding inside your ear. But this is from being squashed and abraded, not hit. I haven't watched too much American football, but it seems a lot more stop-start, with considerably more changing of players. In Rugby you are running around for 80 minutes, so more athletic injuries rather than collision related. Perhaps having to pace yourself also lessens the hits? Spinal injuries seem very rare, and are much more likely due to some kind of contortion rather than impact.

Concussion does happen, but normally seems to be an accidental clash of heads or falling on a knee, perhaps. When it happened to me it was a result of me running to join a ruck (think lots of people pushing each other over a ball on the the floor after a player has been tackled), which kind of split in half and someones head slipped through to catch me in the face. In the top level, if the referee sees you suffer a head injury or get knocked out you are sent off to see the doctor for 10 minutes. If he suspects concussion you wont play again for two weeks. A Welsh international (George North, Wales is Rugby mad btw) got a concussion on his return from a concussion break and this resulted in him spending the best part of a year out of the game!

I don't think head on head hits are common at all. When you tackle in Rugby you have to attempt to wrap your arms around the player, and tackles are much more 'tacklers shoulder to midriff or legs'. I think being winded or hurting your stomach muscles is most likely. you certainly cannot tackle above shoulder high. Re: protective equipment, I wore non at all. Gum shields are common, as is electrical tape around your ears and some petroleum jelly on your eye-brows! Now a number of players where a 'scrum-cap' which is a close fitting lightly padded cloth device to help stop cuts and abrasion to your head. Professional players often wear a kind of shoulder pad designed to protect your collar bone, but it barely makes a dent in your shirt it is so small!

> 1) Is the impact to the brain higher because of the protective equipment?

Yes.

> Would people tackle as ferociously without it?

No.

Back in the day, some ~100 years ago, American football wore leather "helmets", which weren't hard helmets as we think of them today.

From time to time, a player would die from a skull fracture after a rough tackle. Then they implemented hard helmets to prevent people from dying.

The unintended consequences of that was it allowed for rougher tackles and repetitive, regular brain trauma.

Same thing happened with boxing. Back in bare-knuckle days, human fists couldn't last too long against the skull. After they introduced gloves to protect hands and have the fights last longer, the weakest link became the brain.

> "...is there a chance steroid use is widespread?"

Considering the level of competition in American football I would be surprised to find a significant number of players not taking steroids.

What kind of competition is that? Drug vs Drug? It is a bit like Robot-wars! Best technology wins. A decent drug testing regime could make a huge difference to the impact then...I thought anabolic steroids were completely trivial to test for.

On the "drug vs drug" question, are you implying that the competition is reduced to who takes the best or most drugs? I would have to disagree. These are professional; highly-trained athletes who work long and hard to be the best at what they do. Taking drugs makes them better, but they don't work any less hard. Drugs just raise the standards a little more.

As a general rule, the more elite your level of something, the lesser the difference in ability between you and your peers. Also, at the elite levels you get diminishing returns on your "investment" of more training.

Thus, at the level of, say, the NFL, can you really imagine an athlete turning down a drug that will boost his performance by, say, 5%, when he is training 100 hours per week to improve by 1%?

Also, athletes who do not take steroids are probably weeded out at the high school and college levels, so by the time you make it to the NFL you probably have few, if any, "natural" players.

W.r.t. steroid testing, I could be wrong but last time I read on the subject the tests used were easily circumvented.

My understanding for point #1 above is that the tackles are extremely violent and therefore the need for heavy helmets, not the other way around. The things you describe in the first paragraph as being illegal in rugby are all legal in American football (with the exception of grabbing the neck/head itself or a helmet to helmet collision; those are illegal though they still happen). There are frequent collisions with players who are not moving, players in the air, and players moving in opposite directions. There are also frequent gang tackles. Legs go one way, upper body another, and head another. Also, players are frequently running at top speed / acceleration when they make / get tackled. Not really sure how that compares to rugby. It's a sport I'd love to get into but I don't fully understand. As for #2, I wouldn't be surprised if there is widespread steroid use, but I don't know for sure.

Interestingly most of the things I described as illegal, became illegal in the last 20 years. Tackling at top speed, in groups, etc is all fair game in Rugby, and frequent. But since you are not wearing a helmet, you put your head to the side of a player when you tackle! As for getting into Rugby, there are a lot of subtle rules around contact which can make it seem quite complicated and inaccessible.

In the UK Rugby fills an interesting social space. In southern England Rugby Union is a game played by posh schools (and indeed named after one), and remained amateur(ish) until 1995, in Wales it was a working class game and a way-of-life. In northern England they play a completely different game called 'Rugby League' which was always professional, further north in Scotland they play rugby Union again. In Ireland again it is associated with posh schools and English occupation! Occasionally (as is the case this summer) all of the nations team up as the 'British and Irish Lions' to go and take on the mighty All-Blacks of New Zealand, or in other years Australia and South Africa. It does strike me that with several US sports you seem deprived of the drama of regular international competition...

One idea I've heard would be to increase the number of games in a season (without significantly increasing the calendar length).

More games means coaches have to optimize for not injuring players.

More games = more potential for injury. People need time to rest and recover after those games, Monday & Thursday night games are already extremely demanding on their bodies.

Sports that play more games do naturally cycle through rosters of players to let some rest, and prevent injury to optimize for healthy players. Look at basketball. It's not uncommon to see star players not play for a few games in a row. With so many games played, a few games isn't statistically as much as a single football game in the normal season. At 16 games for a normal season, a single football game makes a huge difference, and it can be hard to sit out an overworked player when that may make the difference between a win and a loss.

Comparing injury rates between sports without acknowledging the fundamental differences in the games and how physical they are is an incorrect way to view the problem.

Attempting to force teams to bench their best players for injury prevention / adding games to the schedule that will be played by the bench players will also lower the quality of pro games, and turn off even more fans to the NFL - which is already not doing great.

I wasn't comparing injury rates, I was comparing the willingness of a coach to sit out a player, and attributing some level of influence on that decision based on how many games are in a season (and thus how important every individual game is).

Additionally, nobody was talking about forcing coaches to bench players, we're talking about setting up the system such that coaches feel it's in the best interest of the team to occasionally bench (rest) players. Also, you don't send an entire team of lower quality players out at once, you cycle them through such that you're still always playing at a high level, just maybe not the peak possible (which you often aren't because of injuries anyway). There may be additional benefit to running more games when it comes to fan viewing and involvement, I'm not sure, but there's probably good data on it for many other sports.

The history of the rules of football is a constant struggle between making the game less deadly while preserving the inherent bloodlust in it. Fans and players want the game to be violent. People were clamouring for safer rules from the very beginning in the history of the game. Concessions have been made, little by little. It's a huge struggle and debate each time.

https://en.wikipedia.org/wiki/History_of_American_football#V...

To a certain extent sure, but there's a full spectrum. Football does have safer rules than it did a couple decades ago, so obviously there is and has been room for change. Rugby has similar sized guys (not quite as big, but big) and don't even wear protective gear (not that rugby players are immune to concussions). There's a big spectrum of rules in similar games, and football is still pretty far on the dangerous end of that spectrum.

One of the issues with football is that because they're wearing helmets they think that contact on the head is safe. It's incredibly not.

Rugby Union does a lot to regulate how contact happens. Rugby League (actually a different sport) has a combination of the lack of protection of Union and the outright violence of American Football. I don't follow League enough to know whether the lack of protection tends to lessen injuries. I understand it to be a game with a short shelf life for top players.

Grand Prix racing involves a 1500 pound car hitting a wall at +200 mph, with fuel. Death used to be guaranteed during the course of a season, but now any serious injury is rare.

Dismissing safety as impossible "because physics" is just silly. Technical solutions are the easy part. It's the culture change that is difficult.

You might be surprised, while mandating full exoskeletons is off the table there is quite a bit more we could do,

You can for example mandate braces which would prevent most joint injury. The added weight while minor slightly reduces performance so it can't catch on at an individual or team level.

There seems to be a fair amount of body armour (helmets, padding etc) involved already. I'd imagine there was a lot of resistance when that was introduced, but it's normal now.

I'm totally on board with you. But I think unfortunately that it has to start with the athletes, as they have most skin in the game.

In the documentary The Killer Years about the safety of old grand prix racing there is a clip with a fan. She is asked who her favourite driver is, and her answer is that he is dead. But she was still at a race supporting the sport as it was.

Fans might dislike loosing their favourite players. But for fans it is ultimately entertainment. So if your favourite player is injured/dies you feel sad, pick a new favourite and move on. You don't start investing your life in sport politics. It is compounded by safety measures often, at the face of it, makes things less extreme in a sport. And fans love the extreme and extraordinary.

For coaches and contracts, profit motives works against any bettering from their side. Why use money on safety, when you have a long line of young players ready to step up and carry on.

Anyone see the movie Concussion with Will Smith? It's all about this.

Boxers still coach boxing though. This is just a smaller version of the mentality of people watching gladiators.

Justin Wilson wasn't as lucky a couple of years ago. He was a great guy and had two young kids. Tragic.

> Football players have to demand their safety is taken seriously before any positive change is going to happen to the sport.

Keep in mind that there are many viewers who are not really interested in the sport itself but explosions, injuries and other accidents. For them, the lack of safety is a "feature." You can easily check the view counts of videos for "big football hits" or "nascar crashes" on youtube to see that it's not a small audience.

There's also the fact that having additional protection makes people feel more confident and take more risks than they normally would. With all the additional padding, there are a lot fewer minor injuries but more of the serious (and less frequent) injuries.

> Football players have to demand their safety is taken seriously before any positive change is going to happen to the sport.

In the NFL, the players don't have much authority past their players union, and it's been documented that most of the players who hold power are the NFL stars, who's comp structures don't incentivize participation in CBA's.

Pro Football players live on average more than the average american male.

https://blogs.cdc.gov/niosh-science-blog/2012/01/30/nfl/

Here's some more articles about football health effects:

– "Football, dogfighting and brain damage"[1] by Malcolm Gladwell.

– "Football continues to dominate high school sports despite concussion risk"[2]

– "What Happened Within This Player’s Skull"[3], which examines acceleration/etc from each hit

[1]:http://www.newyorker.com/magazine/2009/10/19/offensive-play

[2]:http://www.foxnews.com/sports/2012/09/08/football-continues-...

[3]:https://www.nytimes.com/interactive/2017/01/09/sports/footba...

"League of Denial: The NFL's Concussion Crisis" covered this well... http://www.pbs.org/wgbh/frontline/film/league-of-denial/

Here are some interesting perspectives from NFL players on that thought:

http://bleacherreport.com/articles/2705935-joe-thomas-says-h...

https://www.washingtonpost.com/news/sports/wp/2016/06/07/chr...

Arian Foster was on the Joe Rogan podcast a while back, they were talking a lot about head trauma, how it affects people and how they're dealing with it in NFL. Very interesting to watch/listen to.

https://www.youtube.com/watch?v=neVsniQdOnM

Thanks! Impressed how smart and well articulated these players are. Impressive interview from this Chris Borland.

I am used to follow soccer. Soccer players in Brazil don't usually finish school properly and come from very poor background where education is awful even if you finish school. It is a sad state of basic understanding of the world and autonomous thinking.

In the NFL they've all gone to college, and the game selects for mental ability quite strongly. They'll tell you the locker room is not unlike any other professional workplace (except perhaps more fun and with more unity), and while I've never been there, I believe it.

> He ends up (spoilers alert) coaching football.

Jesus. It's like one of those generational cycle of abuse stories.

Eh, we don't know that. Maybe he goes back, trains players better to avoid injuries, and prioritizes their safety.

> ...as long as the issues are clear, transparent and everyone involved have all access to information needed to do their own informed choices, it seems correct.

That's a tall order though. I don't think all those conditions are necessarily being met!

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