NFL makes some headway

In response to the troubling cases of ex-NFL players such as Patriots linebacker Ted Johnson and mounting evidence of the long-term deleterious effects of concussions, NFL commissioner Roger Goodell announced yesterday at the league's concussion summit in Chicago that when training camps open up this summer, a "whistle-blower" system will be in place to protect players.

Under the still-to-be-finalized plan, anyone in an organization can report anonymously when team medical personnel are coerced into providing clearance for concussed players to return or when players are pressured to return.

Goodell's announcement provided a timetable for the player protection system, which the commissioner had announced (along with a series of concussion reforms) at the spring meetings last month in Nashville.

"I have said repeatedly and will continue to say that medical decisions must override any competitive decisions," said Goodell. "And if anyone feels they are being forced onto the field when they are not ready to play, we want to know about that and look into it."

The league held a closed-door meeting yesterday at the Westin O'Hare Hotel, where the commissioner, NFL Players Association president Troy Vincent, and medical representatives from each team listened to presentations from experts. The league opened up the floor to medical experts who are not members of the NFL's independent committee on mild traumatic brain injury.

The league had drawn criticism for questioning the validity of a study done by the University of North Carolina's Center for the Study of Retired Athletes that said players who reported sustaining three or more concussions in their careers had a three times greater rate of depression than those who reported suffering no concussions. More than 2,500 ex-NFL players were surveyed.

In a Globe story in February, Johnson said that postconcussion syndrome, which he said was the result of being rushed back from a concussion by Patriots coach Bill Belichick, had left him so severely depressed that at times he was unable to get out of bed.

Former Philadelphia Eagles defensive back Andre Waters committed suicide in November at age 44, and Dr. Bennet Omalu, a neuropathologist from the University of Pittsburgh, said his research revealed that Waters had the brain of an 80-year-old.

Dr. Julian Bailes, a West Virginia University neurosurgeon who founded the Center for the Study of Retired Athletes, worked with Omalu on the cases of Waters and former Pittsburgh Steelers offensive linemen Mike Webster, Terry Long, and Justin Strzelczyk, all of whom died in the last five years. Omalu found evidence of "punch-drunkness" in all of their brains, although that was not the direct cause of death in any of the cases.

Bailes, a former Steelers team doctor, was a presenter at yesterday's conference. He said NFL officials were receptive.

"I think they listened. It was an open process. It was inclusive and I think it was a good meeting," said Bailes.

"Where the rubber meets road is what comes next and how they continue to work on this issue and problem. I think the room was full of dedicated team trainers and doctors who only want the best for their players."

However, at least one concussion expert thinks the conference was missing some teeth. Patriots team dentist Gerald Maher said NFL research showed that 70 percent of concussions are the result of blows to the jaw. But he said not a single jaw expert was invited to the conference.

Maher has been outfitting Patriots players with his mouth guards since the early 1980s and said that 40 current members of the team wear them. Johnson wore one.

"To not have a TMJ [temporomandibular joint] expert on the panel is extremely shortsighted," said Maher. "I don't understand why they don't. It's one of the pieces that we should be looking at. We should be looking at prevention."

Part of the NFL's concussion crackdown, which includes neurological baseline testing for all players, will be to enforce the use of chin straps. Maher said that's more likely to hurt than help, as it locks the jaw in a position where the end of the jawbone can strike the temporal lobe of the brain.

"That's the worst possible physiological position they can put it in," said Maher.

The path to reducing concussions and their effects may be as foggy. But those who had feared an NFL dog-and-pony show seemed assuaged that the league was ready -- and willing -- to listen.

"I had no criticism of what they did, but the proof is in the pudding," Bailes said. "It was a good step."

Material from the Associated Press was used in this report.