Head games still persist in sports

During a week in which NASCAR icon Dale Earnhardt Jr. said he had driven in at least five races with a concussion and NFL super-rookie Robert Griffin III was downplaying his concussion despite suffering memory loss after being knocked from a game with a vicious hit to the head, sports fans were again wondering if their favorite athletes — not to mention their sons and daughters — were so intent on being "tough guys" that they were risking brain damage.

NFL Commissioner Roger Goodell took an opportunity Wednesday to take the issue directly to where many believe it is needed most: kids.

After watching a group of youth football players in northern Virginia go through safe tackling drills, Goodell preached the message that good health takes precedence over being a tough guy.

"You'll really have fun playing this game if you do it safely," Goodell said at Centreville High School, surrounded by pee-wee players from the Southwestern Youth Association Wildcats. "You've got to make sure that if you're injured and don't feel right, if something hurts, your head or your ankle or anything else, you've got to make sure you tell your coaches and your parents. Make sure they understand what happened to you. It's not about football. There's nothing wrong with raising your hand and saying, 'I don't feel good.'"

Bravo, says former UCLA linebacker Patrick Larimore, who was the Bruins' leading tackler last season but retired in fall camp of what would have been his senior year because of multiple concussions.

"You've got to get this message to kids," Larimore tells USA TODAY Sports. "They need to know when they enter the sport how serious head injuries are. They need to know about Junior Seau, guys who are killing themselves."

Larimore, disagreeing with some trainers and researchers who say athletes are becoming more candid about their injuries, says the culture in high-stakes college football hasn't changed that much.

"At the end of the day, you're just trying to get to the next level, man," he says. "This is a business. A job. You're trying to get hired, man. Trying to make a team any way you can. You're not going to tell anybody about it."

Changing tough guys

You soldier on. You shake it off. You just had your bell rung, and you get back in there.

That's the mentality that doctors, trainers and even coaches have been trying in recent years to change, given the studies and evidence showing the link between multiple concussions and severe brain damage — and, of course, the pile of lawsuits by former NFL players accusing the league of negligently withholding medical information about brain injuries.

But the tough guys are wont to keep trying to be tough guys.

That's essentially why Earnhardt, NASCAR's most popular driver, was still racing last weekend despite suffering from headaches after a crash during an Aug. 29 tire test in Kansas. Earnhardt was involved in the wild multi-car pileup Sunday at Talladega. He was diagnosed with a concussion Wednesday and is being held out of the next two races.

"The wreck at Kansas was really severe and it surprised me how tough it was to get past that," Earnhardt said Thursday . "I remember everything about that accident and everything after that accident, but you know your body and how your mind works, and I knew something was just not quite right. I decided to just try to push through and work through it."

Another NASCAR veteran driver, Jeff Burton, sees Earnhardt's situation as a shift in tough-guy driving mentality. "Ten years ago, we ain't having this conversation," he tells USA TODAY Sports, "because you just went on. It's easy to say you'll do the right thing. It's another thing to actually do it. When you've worked your whole life to be in this position, to give your seat up is very, very difficult, especially when you can hide it."

Jeff Gordon, one of NASCAR's greatest champions, leaves little doubt he would ignore cautions regarding a head injury if something big were at stake.

"If I have a shot at the championship and there's two races to go and my head is hurting and I just came through a wreck and I'm feeling signs of it but I'm still leading the points or I'm second in the points, I'm not going to say anything," Gordon says. " That's the competitor in me and probably many other guys and that's to a fault. That's not the way it should be. It is something that most of us, I think, would do. ."

That has to be troubling to NASCAR officials, given the danger that a driver competing while suffering concussion symptoms presents to the rest of the field.

"We are hyper-vigilant, and NASCAR is hyper-vigilant about diagnosis, education, prevention, treatment from A to Z in terms of this problem," says NASCAR neurological consultant Vinay Deschmuk. To get back on the track, Earnhardt will need to be cleared by a NASCAR-approved neurosurgeon.

Denial, in the past, was a constant companion to those in high-risk sports. Just rub some dirt on it, athletes were told, or told themselves. Is that what Griffin, the Washington Redskins quarterback, was doing when he shrugged off his concussion this week, suggesting it wasn't that serious an injury?

"I still refuse to say I had a concussion. I had temporary memory loss," Griffin said Wednesday.

Griffin wanted to return to Sunday's game against the Atlanta Falcons but was prevented from doing so by NFL rules that do not allow a player who has left a game with a concussion to return.

"I had great balance," said Griffin, who practiced Thursday but has not been cleared to play Sunday. "I could remember everything. I pretty much put myself through that concussion test and I knew that I was OK."

Of course, league officials do not permit players to give themselves concussion tests, and even Griffin's case can be seen as progress.

"Believe me, just three years ago I bet RGIII is right back in that game," says former safety John Lynch, who was a TV analyst for the Falcons-Redskins game. "It's embedded in our culture people. People respect it when guys do play through things. That's why it's a big, big dilemna."

Not to mention the confusion that can arise over who is or is not concussed.

Detroit Lions receiver Calvin Johnson admitted Thursday that he suffered a concussion — yet returned to the game — when he took a helmet-to-helmet hit from Minnesota linebacker Chad Greenway on Sept. 30.

" He knocked me good," Johnson said. "You could tell. It was obvious."

Johnson went through a series of tests on the sideline and returned. Lions coach Jim Schwartz said Thursday there was nothing wrong with the concussion test that allowed Johnson to re-enter the game.

"Our evaluation was that he was not concussed," Schwartz said. "He was thoroughly checked. We're very strong in our evaluation."

Johnson hinted in a radio interview earlier Thursday at his desire to keep playing through a concussion when he said: "It's a part of football. You get concussed, you've got to keep on playing."

NFL Players Association medical director Thom Mayer is keeping an eye on all this and talks about a potential culture change in the NFL as "a moving target. I think it's changing, and I think it continues to evolve."

He says his role is to "watch the watchers" — that is, the trainers and medical staff who treat players.

He says this is the feedback he gets from players: "You've got to protect us from ourselves."

Monitoring kids

Stefan Duma, department head of biomedical engineering at Virginia Tech, found in a study last fall that some of the hits absorbed by youth football players equate to those seen in major college football.

Duma, who has been using a sensor system placed in the helmets of Virginia Tech football players for the past decade, used the same system on 7- and 8-year-old tackle football players in Virginia. The sensors record G-force — the gravitational force associated with the acceleration of an object relative to a free-fall.

According to Duma, the typical hit for Virginia Tech players is about 20 Gs, and any hit above 98 Gs is cause to check the player for a concussion. Among the youth players he monitored last fall, the strongest hit was measured at 100 Gs, with six measuring 80 Gs or higher.

A month after Duma's study results were made public, Pop Warner football instituted national changes in its practice guidelines, decreasing contact drills.

At all levels, however, athletes continue to be willing to sacrifice their own wellbeing.

"Athletes will not report stuff, because they don't want to be taken out," says Jim Thornton, president of the National Athletic Trainers Association. "Unfortunately, sometimes the best thing for them is that they be taken out. If not, permanent and serious damage can be done to the brain, and we've seen that in some pro athletes that have tried to hide it so they can continue to make their paycheck."

Or, in Larimore's case, keep their starting job, and keep alive a dream of playing in the NFL.

"At that level, all you think about is how I can get better today at football," he says. "You don't think about, 'Oh, I had a concussion.' There's just not enough time. You're not concerned. You're going to do whatever it takes to play."

Larimore was eventually convinced by his parents and UCLA coaches, including former NFL linebacker Jeff Ulbrich, to think about his long-term future , and he left the game behind. He's not holding his breath waiting for those in his position to follow his path.

Contributing: Nate Ryan and Dustin Long in Concord, N.C.; Gary Mihoces in Clifton, Va.; Robert Klemko in Ashburn, Va.; Mike Garafolo in Santa Clara, Calif.; Jarrett Bell, Jim Corbett