NCAA Medical Chief on Concussions: ‘There’s a Sense of Urgency’

“I’m speaking to you with a fire in my eyes.” I thought of those words this weekend, as I was reporting on the latest movement in a federal concussion lawsuit against the NCAA.

The words, which came from an interview I had this month with Brian Hainline, the NCAA’s new chief medical officer, illustrate the seriousness with which the association says it takes health and safety issues, including concussions.

The NCAA was founded to help protect the safety and welfare of students, and says it has been at the forefront of safety issues throughout its existence. On Friday it announced a $399,999 grant to study the long-term effect of head injuries. It has rejected claims in the lawsuit, which seeks class-action status.

Since starting at the NCAA, in January, Dr. Hainline, a neurologist and the former top medical officer of the United States Tennis Association, has been traveling the country to spread the word about three of the biggest challenges he sees: concussion, which he calls the “elephant at the table”; student-athlete mental health; and the delivery of health care in a “patient-centered” model.

If you read some of the e-mails filed on Friday in the U.S. District Court for the Northern District of Illinois, where the case is being heard, you might think NCAA colleges have a long way to go on that last challenge.

According to a 2010 NCAA survey on concussions, nearly half of the responding institutions said they had allowed players back into a game on the same day of a concussion diagnosis. One assistant trainer said he had personally seen a football player knocked unconscious and then returned in the same quarter of a contest.

Dr. Hainline would not comment on the NCAA’s concussion litigation, saying that it raised complex questions that could take hours to explain (he and David Klossner, the NCAA’s director of health and safety, spoke to me for more than 30 minutes).

But Dr. Hainline said that, until the end of 2012, there was not a widely accepted consensus among medical experts about the need to keep players out of action on the same day of a concussion. Before that, one closely watched set of guidelines suggested that players should not be returned on the same day—but left open a window for adult or elite athletes under special circumstances.

Dr. Hainline argued that the decision to return is complicated by the players themselves, who often report that they are ready to go even when they shouldn’t. He pointed to a forthcoming study showing that 50 percent of players in one Division I conference were underreporting injuries, including concussion.

“Players have a sense of invincibility,” he told The Chronicle. And he said parents were sometimes just as culpable as athletes and coaches in wanting to get players back quickly. “This is a real societal problem.”

In that environment, some of the NCAA’s guidelines have become increasingly strict in recent years.

Its guidance on concussions now states: “Under no circumstances should a student-athlete diagnosed with a concussion return to a sports activity the same day.”

Many of those guidelines are hard to enforce, the NCAA has acknowledged. But Dr. Hainline brushed off any notion that the NCAA was not taking the issue of player safety seriously.

“There’s a sense of urgency,” he said. “But to do my job well I have to have a sense of urgency and patience.”

That’s in part because the NCAA cannot mandate change.

“We can say, ‘This is how we believe medical care should be delivered,’” Dr. Hainline said. “That said, the NCAA is not the NFL. We can’t just shift and say, ‘Now everyone’s going to do this.’”

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