NFL Settles Concussion Suit: Is It a Win For Player Health?

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Professional football receiver making over the shoulder catch over defender crowded stadium in background
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On Thursday, the NFL settled a lawsuit for $765 million with more than 4,500 former players over allegedly hiding known concussion risks .

The money will go toward compensating players for concussion-related medical costs and injury compensation as well as for continued exams for retired players who may have been concussed during their careers. Some of the settlement is also designated for research and education to better understand the condition’s consequences. The suit included former Dallas Cowboys running back Tony Dorsett, Super Bowl-winning quarterback Jim McMahon and the family of Pro Bowl linebacker Junior Seau, who committed suicide last year and showed signs of chronic traumatic encephalopathy (CTE), a type of brain damage associated with concussions.

Now, all retired NFL players, regardless of whether they were involved in the suit, can have their brains evaluated for potential care or treatment. If they pass a threshold of impairment, they will be given a benefit card that can be applied toward additional treatments. Players that develop brain problems such as severe dementia, Alzheimer’s disease or amytrophic lateral scelerosis (ALS) can receive as much as $5 million in compensation, according to players’ attorney Christopher Seeger. He told USA Today that the families of those who showed signs of degenerative brain damage and committed suicide will be eligible for a seven-figure payout. “You don’t have to prove that your neurological problem is related to a concussion. You don’t have to prove in the settlement that you sustained a concussion in the NFL. You just need to be a former retired player and you’re in the program,” Seeger told the paper.

(MORE: The Problem with Football: How to Make It Safer)

The NFL has still not admitted to wrongdoing, or to hiding the dangers of concussions from its players, and says that safety remains a high priority. But football is one of the leading sports for brain injuries — and not just at the professional level. High profile coverage of the dangers of concussions in the NFL have raised awareness and concern about the damage that might be occurring in the amateur ranks as well; high school players suffer 43,000 to 67,000 concussions per year, and the majority do not report having symptoms to avoid being benched.

The settlement may close out the suit that has consumed the league since 2011, but it likely won’t be the last action the NFL will have to take concerning concussions. A wealth of research shows that the repeated blows to the head that are a staple of regular training and play can add up to life-long damage that may contribute to memory loss, depression and more serious degenerative brain diseases. A study commissioned by the league found that ex-NFL players over the age of 50 were five times more likely than the general population to have memory related disease and players between the ages of 30 to 49 were 19 times as likely to become debilitated.

MORE: Concussion and Alzheimer’s Patients Show Similar Brain Changes

Research from places like the Cleveland Clinic and the Boston University Center for the Study of Traumatic Encephalopathy (CSTE) revealed that it may not even take a concussion to launch potentially damaging brain changes. Soccer players who didn’t receive concussions but repeatedly headed the ball also showed similar aberrations.

What concerns brain experts is the fact that protective equipment, like helmets, don’t adequately cocoon the brain from damage. As TIME’s Sean Gregory writes:

The human brain, although encased by a heavy-duty cranium, isn’t designed for football. Helmets do a nice job of protecting the exterior of the head and preventing deadly skull fractures. But concussions occur within the cranium, when the brain bangs against the skull. When helmets clash, the head decelerates instantly, yet the brain can lurch forward, like a driver who jams the brakes on. The bruising and stretching of tissue can result in something as minimal as “seeing stars” and a momentary separation from consciousness.

(MORE: Study Details How Brain Damage From Concussions Progresses)

Much of the latest concussion research focuses on the condition called CTE. Earlier this year, Boston University scientists diagnosed 33 cases of CTE, which can only be identified on autopsy, in 50 deceased ex-NFL players, an indication of how prevalent the damage from concussions really is. That’s why the settlement applies to all 18,000 retired NFL players, and provides them with the opportunity to receive screening for signs of brain damage and funds towards medical care for any related diseases.

While some critics of the league have called for overhauling rules of play to reduce head-banging contact — already, head-on moves that strike above the shoulders are prohibited — it’s not likely that the game will change dramatically to accommodate these requests. Other protective measures that have been suggested by members of the medical and sports industry include mixing up practice regimens to ease up on full-contact hits, or using new helmet technologies that alert everyone on the field when a blow has reached a certain threshold.

In the meantime, medical and sports groups have proposed guidelines for non-professional play that they hope will trickle up to the professional ranks. In March, the International Conference on Concussion in Sport updated its Consensus Statement on Concussion in Sport. The revisions included recommendations that young players not return to the field to play on the same day they experience a potential concussion, an acknowledgment that it may take longer for kids to recuperate from head injuries since their brains are still developing.

The statement also addressed the equipment issue, noting that helmets and mouth guards provide only minimal protection to the brain, but give players a false sense of protection that encourages them to act more aggressively:

An important consideration in the use of protective equipment is the concept of risk compensation. This is where the use of protective equipment results in behavioral  change such as the adoption of more dangerous playing techniques, which can result in a paradoxical increase in injury rates.

(MORE: NFL Players Have A Higher Risk of Death From Brain Disease)

In practical terms, the compensation offered in the suit is unlikely to adequately cover the long-term care needed by the retired players already affected by brain damage from their head injuries. Kevin Turner, a former fullback for the Philadelphia Eagles and New England Patriots has suffered from ALS for the last four years and spends about $8,500 a month on medical care, according to the New York Times.

Even beyond the individual players, there is a broader question, about whether the settlement will change the culture surrounding injuries in pro sports — a culture that encourages sacrificing the body for the sake of the game. It’s too early to say, but having a large number of players and family members come forward to shed light on a life-threatening medical issue, and forcing the league to acknowledge its consequences, may be the first step.