In the last three decades of the 20th century, the organizational field around concussion in sports continued to grow. Several high-profile concussion injury events in professional sports called more attention to the seriousness of SRC. In response to this increasing interest, some SGBs founded concussion committees and began to support concussion research. Some professional SGBs enacted stricter regulations around vicious plays that could cause
concussions. In the research sector, more scientists became involved in research on SRC and started to investigate the long-term effects of concussions. Early concussion activists also joined the field to advocate for change in SGBs. Despite the seemingly considerable attention to SRC, players still tended to take concussions lightly.
Key events
Severe concussion incidents in professional sports garnered increasing attention during this stage. Professional football continued to be played violently. Quarterbacks, running backs, and wide receivers often became targets of attack, and players in these positions frequently sustained one or multiple concussions. For instance, after the first quarter of a game between the
Jets and the Steelers in 1989, several players were taken out with concussions: the Jets’ receiver Al Toon and quarterback Pat Ryan and the Steelers’ quarterback Bubby Brister (Wallace, 1989). Serious concussions also occurred in professional ice hockey and baseball; in a baseball game in 1987, Ray Knight of the Baltimore Orioles was struck in the head during a collision and suffered a severe concussion (“Knight Has Concussion,” 1987).
The 1990s also saw several high-profile concussion injuries in the NFL. Four prominent players chose to retire after suffering multiple concussions throughout their professional careers, including the Kansas City Chiefs’ center Mike Webster (1991), New York Jets’ star receiver Al Toon (1992), Chicago Bears’ running back Merril Hoge (1994), and San Francisco 49ers’ quarterback Steve Young (1999). These prominent concussion injuries and subsequent exits called further attention to the issue of concussion in sports (Heinze & Lu, 2017). As noted by Dr. Jeffrey Barth, a neuropsychologist at the University of Virginia, “Concussions are a hot topic because of these high-profile cases[.] … if Aikman had a knee injury before the Super Bowl, we'd be talking knees like crazy” (Farber, 1994, p. 39).
Organizational responses
During this stage, some SGBs, such as the NFL, National Hockey League (NHL), and NCAA, began to fund research on SRC. In 1994, the NFL founded the Mild Traumatic Brain Injury (MTBI) Committee to investigate the impacts of concussions in NFL players. In 1997, the NFL and NHL Players Association established the NFL-NHL Players Association Concussion Program to manage concussions using a scientific approach. In 1999, the NCAA funded a long- term concussion study with Dr. Kevin Guskiewicz of the University of North Carolina (UNC), director of UNC’s Sport-Related Traumatic Brain Injury Research Center, and Dr. Michael McCrea, director of brain injury research at the Medical College of Wisconsin.
Further, some professional SGBs became stricter on plays that could result in
concussions. For instance, in a game between the Seattle Seahawk and the Denver Broncos, the Seahawk receiver Steve Largent was knocked out of the game with a concussion; his opponent Mike Harden was fined $5,000 for “unnecessary viciousness” (“Bronco Is Fined,” 1988). The National Basketball Association (NBA) also strengthened rules around violent plays. For instance, Rick Mahorn from the Pistons was fined $5,000 for elbowing Mark Price of the Cavaliers, who sustained a concussion (“NBA Fines Mahorn,”1989).
New knowledge
In the research sector, SRC received greater attention from sports medicine scientists and neurologists, whose findings elicited new knowledge around SRC. Some researchers questioned the effectiveness of helmets in preventing concussions. Dr. Frederick Mueller, a sports injury expert from UNC, and Richard Schindler, assistant director of the National Federation of State High School Associations (NFHS), argued that helmets may not help reduce the number of concussion injuries because “Helmets may give rise to a sentiment that the head was so well protected that it was invulnerable, which in turn encouraged hit’em in the numbers” (Rogers, 1986, p.A00026).
Scientists also began to consider the potential long-term effects of SRC and the
seriousness of SIS. Dr. Donald Bennett, a neurologist at the University of Nebraska contended that years of concussions may have serious consequences on the brain (Bennett, Fuenning, Sullivan, & Weber, 1980). In the early 1980s, the death of professional boxer Willie Classen led Dr. Bennet Derby of New York University to host seminars on neurological assessment of
concussions inside a boxing ring. According to Dr. Derby, “When a fighter receives a concussion and the opponent continues to beat on him, the opponent could damage the fighter” (Neumann,
1989, p.87). Dr. Derby pointed out that a secondary hit to the head in a short period of time may result in more serious and longer-lasting consequences. He recommended that once a fighter sustained a concussion, the boxer should not be allowed to continue to play.
Advocacy
Some early concussion activists joined in the field during this stage, advocating for change in SGBs. A leading activist was Leigh Steinberg, an agent for numerous NFL players, many of whom had suffered multiple concussions. Beginning in 1994, Steinberg publicly
criticized the way the NFL managed SRC. As Steinberg noted, “It is a horrendous thought, but it might take someone to die on the field before the league takes this issue seriously” (Freeman, 1997, p.10). In 1995, Steinberg organized a concussion seminar and invited medical experts from around the country. With these experts’ support, Steinberg argued the NFL should adopt more stringent rules to outlaw helmet-to-helmet tackling and develop new concussion practices, such as mandatory medical counseling, a better concussion grading system, and sideline concussion evaluation by healthcare professionals (Heinze & Lu, 2017; Smith, 1995).
Athletes’ responses
Despite growing attention to SRC, key stakeholders and active players continued to underestimate the seriousness of concussions. Several professional football players recalled having played in the 1980s and 1990s, a period when players were rarely concerned with concussions. Upon sustaining a concussion, athletes explained, “You got your bell rung. And unless you liked being called frilly names, you got back on the field as soon as you could locate it” (Cook, 2012, p.A31). For some players, even after suffering concussions, they chose to return to the game in which they had been hurt. New York Giants’ quarterback Dave Brown, “I would
have gone back in the next play. I would have known what the risk was, but it wouldn't have mattered. I wanted to go back in” (Freeman, 1994, p.B00029).