NFL, Army Partner to Combat TBI

WEST POINT, N.Y.  -- The Army and National Football League are working together to improve awareness of traumatic brain injury and further research into its causes, prevention and treatment.

The top leaders of both organizations -- Army Chief of Staff Gen. Ray Odierno and NFL Commissioner Roger Goodell -- met at the U.S. Military Academy August 30 to discuss the issue and sign a letter of agreement to continue working together to combat TBI.

They were joined by a panel of Soldiers and retired NFL players who have had concussions while serving on the battlefield and the playing field. Also, about 200 cadets attended, as well as representatives from Army medicine.

Odierno explained how some of the best traits in Soldiers can sometimes hinder many from seeking help following concussions: "Mental and physical toughness, discipline, team over self and stressing the importance of resilience are fundamental to the cultures of both the NFL and the Army. We have the Warrior Ethos, reinforced by the Soldier's Creed," said Odierno.

"While commendable and essential to what we do, these traits make it particularly difficult for individuals to come forward and identify physical and mental issues, especially mental," he continued. "We are seeking to educate both players and Soldiers about TBI, to empower them to seek treatment both on the battlefield and playing field."

The Army and NFL are continuing the dialogue and sharing of research on TBI, said Odierno, citing examples of joint efforts at monitoring TBI, including placing special sensors in the helmets of both Soldiers and NFL players, which can detect a possible concussion following trauma to the head.

Both NFL players and Soldiers are now coordinating strategies and using special types of tests to determine if a concussion has occurred, added Dr. Richard Ellenbogen, chair, Department of Neurological Surgery, University of Washington. He expects research to continue to reduce TBI.

The NFL commissioner then addressed the cadets. "You are the future leaders of Army," he told them. "Together, we can make a big difference, sharing medical research, and helping players and fighters and bringing a greater awareness to society as well. I believe we can change our cultures, with athletes and Soldiers sharing their experiences."

The cultural shift to which Goodell was referring is the reluctance of many football players and Soldiers to ask for help after receiving concussions.

"A frank conversation needs to take place at the lowest levels with the people most powerful in Soldiers' lives -- not me, but their platoon sergeants and first sergeants," said Odierno, referring to the change he said has to take place. "Soldiers must be made to realize that there will not be retribution of any kind for asking for help."

"Sometimes the NCOs must make the decision for the Soldiers and not penalize them," said Staff Sgt. Shawn Hibbard, addressing the reluctance of many Soldiers to seek help on their own. "When I got blown up I felt like, 'hey, I'm mentally still in the fight.' That NCO must check those injured and remove them from the fight so they can get better." Hibbard suffered concussions during recent combat operations, but was reluctant to seek help.

Maj. Christopher Molino, who also suffered a concussion during recent combat operations, agreed that small unit leaders must step in and take charge. "Removing yourself is counterintuitive to Soldiers' instincts. That's why good leadership is important."

Troy Vincent had a concussion on the field so severe, he said he was unconscious and didn't recall the event. No one got him to seek help, he explained. "They protected me with some play calls and didn't expose my weakness at the time," he said.

"The coach told me that 70 percent of you is better than 100 percent of the second string (players)," meaning that despite losing 30 percent of his ability to play due to concussion, he was still better than many of the other players without injury. Vincent was a cornerback for the Miami Dolphins, Philadelphia Eagles, Buffalo Bills and Washington Redskins.

Bart Oates, who also suffered a concussion on the playing field, agreed that the mindset is hard to change. He played center for the New York Giants and San Francisco 49ers.

Goodell said that old school mentality of not asking for help will no longer be tolerated. He stressed the importance of accountability. "Myself, the coaches and other members of this organization have a responsibility to make the lives of players better, both on and off the field," he said, adding that he hopes those in other sports -- especially young athletes -- get the message and provide proper leadership and supervision.

"We need to learn to rely on the players to do the right thing; to raise their hand if they need help or ask others to seek assistance," he said. "Someone needs to say 'hey, you're not feeling too well,' and allow medical personnel to make the call whether to stay in the game. The coaches or players should not make that call. You can play smart as well as tough. Seeking help is playing smart."

The commissioner said he's not satisfied that enough progress has been made. "We're not going to stop; we're going to continue, we're going to make a difference."

Odierno concurred that more has to be done, despite recent policies and directives designed to protect the health of Soldiers.

Directive-Type Memorandum 09-033, for instance, stipulates that Soldiers have a minimum of 24 hours of downtime and get a medical clearance before returning to duty following a blast or vehicle incident.

Maj. Sarah Goldman, program director of Army Traumatic Brain Injury at the Office of the Surgeon General, Rehabilitation and Reintegration Division, emphasized that seeking help more often than not does not take a Soldier "out of the fight." She said more than 13,000 service members sustained some form of concussion since 2010 and 95 percent were returned to duty.

The general, who played high school football, admitted that he likely would not have sought medical attention for a concussion. "I wouldn't have taken myself out. Someone else would have had to." He added that kind of thinking is wrong.

"I worry about our leaders more than anyone else. They're the ones who feel the burden of leadership and responsibility. They're the ones who won't take themselves out of the fight. I'm asking that leaders look after leaders," he implored. "First sergeants looking after NCOs, sergeants major looking after commanders, senior commanders looking out for junior commanders. We've got to have a bond to take care of each other."

The Army and the NFL have had a close working relationship over the last few years. "It was my honor to visit Soldiers in Iraq and Afghanistan," said Goodell. "Our cultures are similar in so many ways. We owe it to our players and Soldiers (to remove the stigma of seeking help)."

"Having played football and been the senior commander in Iraq for almost five years, I've personally seen the impact of traumatic brain injury," said Odierno. "Roger and I got together on several occasions. He's passionate about taking care of his players. Our organizations make a really good match. I'm excited. I hope this partnership helps both Soldiers and players."