Junior Seau and CTE

Junior Seau made the most Pro Bowls (12) of any linebacker in history. He was first-team all-pro six times. Seau was a starter on the 1990s All-Decade Team, but was so skilled and kept himself in such good condition that he played for another full decade afterwards, retiring after the 2009 season as the oldest LB in NFL history. He will be a first-ballot Hall of Famer.

But Seau himself won't be present at his induction into Canton, because he died last week of a gunshot wound to the chest, apparently self-inflicted. Many athletes struggle with the transition away from playing — Seau had been a football player basically all his life, and it was surely a central part of his self-identity — but I don't have anything to add to the speculation concerning a 43-year-old's possible motivations for ending his own life.

Many fans have been struck, however, by Seau's shooting himself in the chest rather than the head. Former Chicago Bear Dave Duerson did the same thing last year, asking that his brain be used for research into chronic traumatic encephalopathy (CTE) caused by his football career. Seau's family has decided to donate his brain for similar research, and frankly it would be shocking at this point if there are no indications of CTE.

CTE is associated with symptoms like depression and early-onset dementia, as well as neurological problems like memory loss or confusion, and more fundamental personality changes like irritability and aggression. Seau was a respected locker room leader, and a community icon who won the Walter Payton Man of the Year Award for his charitable work. He never had any legal troubles, or even any controversies. But in October 2010, less than a year after his retirement, Seau was arrested on domestic violence charges. When he was released, he drove his SUV off a 100-foot cliff, surviving with minor injuries. No one knows for sure, but he didn't seem like the same man who led the Chargers to Super Bowl XXIX or created the Junior Seau Foundation.

I wrote an article last year about Hines Ward and his cavalier attitude toward head trauma in the NFL. Unfortunately, I also wrote about Ward's recent drunk driving citation, which led some readers to feel that I was attacking Ward personally rather than just criticizing his position on an important issue. I thought it was relevant, because someone who regards drunk driving as an acceptable risk probably is not a good judge of whether playing with concussions is an acceptable risk. Obviously I didn't make that clear at the time.

CTE has become an epidemic in contact sports. It's most prominent in football, but this also applies to ice hockey, boxing, mixed martial arts, and other contact sports. Muhammad Ali's condition is famous worldwide. The NHL has dealt with high-profile cases like Bob Probert and Derek Boogaard. This March, Ben Fowlkes wrote for both MMA Fighting and Sports Illustrated about the struggles of Gary Goodridge, a kickboxer and mixed martial artist whose short-term memory effectively is gone and whose personality simply isn't the same as it was when he'd taken fewer hits to the head.

The NFL has taken steps to reduce the impact of conditions like CTE on its players. Moving kickoffs back to the 35-yard line. Extra protection for quarterbacks. The new "defenseless receiver" rules. Fines for the really big hits. New guidelines for players who suffer head injuries. It's not enough. Chris Henry played for the Bengals from 2005 until his death in 2009. This isn't someone like Lou Creekmur or Duerson, or even Seau, who played before we knew how devastating head injuries can be when a player's career is over. Post-mortem analysis of Henry's brain revealed that he had CTE.

The NFL made several big announcements about its new rules for concussions, but those clearly are not being enforced. Last season, in a game against the Jets, the Chargers' Kris Dielman fell down after a block, tried to get up, and fell down again. He stumbled toward the sideline on rubber legs but stayed in the game.

Dielman wasn’t even checked for a concussion until the game was over, and suffered a seizure on the plane ride home. He missed the rest of the season and retired at age 30, a four-time Pro Bowler who couldn't risk further damage to his brain. This is precisely what Commissioner Roger Goodell promised wasn't going to happen any more. Following Dielman's seizure, the league announced that this time, for real, concussions were being monitored. The rest of the world collectively laughed at that idea in Week 14. In front of a national audience on NFL Network's Thursday Night broadcast, the Browns' Colt McCoy took a brutal hit from the Steelers' James Harrison and returned to the field despite an obvious concussion.

Preventing and treating head injuries can't just be a P.R. issue for the NFL, and to be fair, the league has taken some positive steps. Moving kickoffs back to the 35 was a great idea. Limiting contact to the quarterback's head is a good idea, at least in principle — no one likes seeing a 15-yard penalty when a defensive end's little finger grazes the helmet. It would be nice if the league can make a distinction to avoid penalizing harmless, inadvertent contact, or players who deliberately pull up and try to avoid causing damage.

That's the problem with the "defenseless receiver" rules and post-game fines — they're applied too unevenly. Players and fans and even referees don't know what constitutes an illegal hit. The league needs to clarify its policy, stop fining players who accidentally injure opponents, and begin suspending dirty players and head-hunters. I know the players union will fight suspensions, but the league can't give in. Players like Ward, who admitted lying to doctors, need to be protected from themselves.

Junior Seau was never officially reported as suffering a concussion, but his ex-wife told The Associated Press that he simply played through them. That was common until the last couple of years. When I began covering the NFL in 2002, it was almost unheard of for a player to miss a whole game just because of a little brain damage — and that's what a concussion is. The word concussion is interchangeable with the medical term "mild traumatic brain injury". And for years, we've been treating this like it's no big deal. It's in everyone's short-term interest to handle the situation that way. Players want to play, and teams want them out there.

This is not the players' responsibility. Seau played through head injuries. Dielman waved off the training staff to stay in the game. Ward lied to doctors so he could stay on the field. Guys like Ali and Goodridge and Chuck Liddell took multiple fights when it was clear they were already affected by the results of too many hits to the head.

Football and hockey players want to help the team. They feel a responsibility to their teammates, coaches, and fans. Fighters want to entertain, and they need to earn a living. Some of these guys have other ways of doing that, and some of them have made enough money they don't need any more. But then you have guys like Goodridge who have to keep fighting if they want to provide for their families, or Seau, who couldn't step away from the game he loved.

Who can blame them for that? The NFL knows it has a problem, and it has taken some small steps in the right direction. More needs to be done. You can't expect a coach or a team doctor to diagnose concussions and hold the players out. It would be nice if things worked out that way, but in many cases it is not realistic. Teams have a selfish interest in getting the most out of players as soon as possible. The league needs an air-tight, non-negotiable program for independent concussion-monitoring, both in-game and during the week.

There should be a private doctor, qualified to diagnose concussions, on the field for every game, independent of any team. With full access to players and to available replay footage, the doctor should examine any player who appears to suffer a head injury and make a medical decision about whether that player can safely return to action, or whether further testing is required first. We can't have the teams making these decisions, and there needs to be accountability. The NFL must outline a clear procedure and make clear who is in charge and who is responsible if any mistakes occur.

There will be more Mike Websters and Dave Duersons and Junior Seaus. That's probably inevitable. But we can't accept CTE as a necessary by-product of tackle football. Junior Seau was great. In every sense. He was an incredible athlete, a standout basketball player, a champion shot putter, and one of the greatest football players in the history of the sport. He was a good man who started a charitable foundation before it was common for players to do that. He won respect around the NFL as a player and as a person.

He's gone, now. Junior Seau was 43. We don't know yet whether CTE played a role in Seau's apparent personality shifts and depression. But we know we've lost a fine man too soon, and we know CTE is a problem that isn't going away. Athletes are bigger and faster than ever, and modern playing surfaces accommodate greater speeds and stronger impact in collisions.

The NFL is the most popular sports league in the United States, and among the most visible worldwide. Seau's death generated headlines abroad. Goodell and union head DeMaurice Smith have a unique opportunity to take a leadership role in defining how sports respond to CTE and protect their participants. We've made some positive changes, but not nearly enough.

R.I.P. Junior Seau, 1969-2012.