NFL+--+Concussions+Big+Deal+In+Football

Steve Young took the first hit on his chest, just under his chin and at the top of his red No. 8. Then, in whiplash action, the back of his helmet caromed off a teammate's knee and the grass surface of Sun Devil Stadium in Tempe, Ariz. Just like that, the intense quarterback for the San Francisco 49ers was revisiting no-man's land Sept. 27. Out like a light for several long seconds, Young's past and future conspired to paint one frightening picture of a proud athlete on the edge. When consciousness returned, Young found himself back in the center of a controversy over how to deal with an injury that endangers wide receivers and defensive backs as well as quarterbacks. His fourth concussion in three years focused attention on how sports leagues handle concussions and whether athletes should have the final say in deciding when - or if - they can resume playing. For those seeking signs of progress in the NFL, there is this. In 1997, when Young was kneed in the head in the first quarter at Tampa Bay and suffered his third concussion in 10 months, he was allowed to re-enter the game in the fourth quarter. Two weeks ago, when he was knocked out of a game against the Arizona Cardinals on a clean but fierce hit by Aeneas Williams, he was not permitted to return. Although he tried. "He asked me (to go back in)," 49ers Coach Steve Mariucci said the next day. "I simply said, `Steve, you're not going in.' He says, `I can play.' The doctor was there and I said, `Doc, what do you think?' He said, `Hold him out.' "I told Steve to stay out. He's a lawyer, he's going to debate, he's going to negotiate, he's going to try and convince you that his point of view sounds good." In the rush to return to action, oft-concussed quarterbacks like Young and Troy Aikman of the Dallas Cowboys are caught in the middle of a riddle. Do you play on or do you play it safe? And who ultimately makes the decision about when and whether an athlete can return to the field for practice or a game when he has had a head injury? In Young's case, as with most players, it is a combination of opinions. "I think the doctor has the predominant say because they have the most experience and as much diagnostics as possible," said Young, who didn't play last week against the Tennessee Titans and probably won't today at St. Louis. "And I have a lot of say, too. If I'm honest with myself with what happened and what has happened (in the past), then clearly you talk to your family, your girlfriend, and all of the people that are really important to you." It is equally clear that evolving research needs to arrive at an agreed-upon protocol which makes it more difficult for the star player or the obsessive coach to second guess or overrule a medical decision. Scientific research has established that once a player has a concussion, he is more at risk in the next game, week and season. That makes an impartial decision more vital. One of the problems with the system now is that the injured player does have a voice. And denial does play a role. "Certainly, athletes in general - especially elite athletes - have a much stronger sense of invincibility than the rest of us," said Dr. Andrew Tucker, a team physician with the Ravens and director of primary care sports medicine at University Sports Medicine at Kernan. "Whether it be a head injury or a muscular-skeletal injury, their acceptance of that comes a little slower. You're talking about an injury that does not affect your judgement. Concussions have driven any number of players from the game, among them quarterbacks Roger Staubach and Stan Humphries and wide receivers Al Toon and Don Beebe. In a book written by Ronnie Lott, the former 49er safety estimated he had no less than 12 concussions in his career - and lied about his recovery to get back on the field. Aikman suffered the seventh concussion of his career in a 1997 game against the Philadelphia Eagles, and played the following week against the 49ers. Humphries was forced to retire from the San Diego Chargers after the 1997 season, when he endured three concussions in two months, and two in successive weeks. The one that ended his career came after a hit under his chin by Cincinnati's Reinard Wilson. "It was one of the worst," said Humphries, who estimated he had between 10 and 12. "I lost a little feeling in my right leg for an hour or two. It was real scary. That was the last time I was on the field." The list of concussion patients this season already includes some prominent names: Miami Dolphins linebacker Zach Thomas suffered one in a preseason scrimmage Aug. 1, and when he tried to come back a few days later, saw flashes of light when he made contact. He sat out two weeks of training camp but missed only one preseason game. Forty-Niner running back Lawrence Phillips had a "mild" concussion in Week 1 returning a kickoff, but missed no time. In Week 2, Green Bay Packers tight end Mark Chmura was hit in the back of the head by Detroit linebacker Chris Claiborne when he was on the ground, and came away with a concussion and a stinger, or numbness in his limbs. Chmura won't play again this season - or perhaps ever again - because of a disc injury. In Week 3, Jacksonville wide receiver Reggie Barlow, Carolina center Frank Garcia, Buffalo quarterback Rob Johnson and Young all had concussions. The league is concerned about the trend. In 1997 - the season Aikman, Young and Humphries all were hurt - the NFL poured $1.1 million into university medical research grants to study the components and long-term effects of mild traumatic brain injuries. The study is not yet complete. In December 1997, a group 21 representatives of medical societies whose members treat athletes and major national professional and collegiate sports leagues - including Dr. Elliot Pellman, team physician for the New York Jets - met to formulate guidelines on concussions. The recommendations were published in the current issue of the American Journal of Sports Medicine. In the Sept. 8 issue of the Journal of the American Medical Association, research was published that sheds light on how concussion affects the brain. One member of the team that prepared the report offered an explanation of why violent collisions have become such a troubling part of professional football. "That's why concussions are becoming less of a problem," Collins said. "Mass isn't important when you've got more and more 300-pound linemen who can run a lot faster than they have in the past."