A concussion, from the Latin word concussio, is a frequent injury among football players. Concussions occur when the head is subject to a large impact force, resulting in a minor brain injury. There has been a growing concern about concussion since the early 1900s. In 1906, a Harvard student athlete died from a head injury and the team doctors released a report titled “The Physical Aspect of American Football” in the Boston Medical and Surgical Journal describing the type, severity and number of injuries the team sustained in the 1905 season.
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The NFL first began to review the subject formally in 1994, then NFL Commissioner Paul Tagliabue approved the creation of the Mild Traumatic Brain Injury (MTBI) Committee with the stated goal of studying the effects of concussions and sub-concussive injury in NFL players. Tagliabue appointed rheumatologist Elliot Pellman to chair the committee. Pellman's appointment was met with harsh criticism, because he is not a neurologist or neuropsychologist and often admitted ignorance about head injuries. The concussion data collected by the league from 1996 to 2001 has been shown to understate the actual number of diagnosed concussions by ten percent. The league legal representation has been shown to have had ties to the tobacco industry legal defense. [importance?]
The same year, the National Institute for Occupational Safety and Health (NIOSH) reported a statistically significant increase in the risk of neurological disorders such as amyotrophic lateral sclerosis (ALS) in retired football players, which furthered public knowledge about the risk of long-term neurocognitive disease related to repeated head impacts. Despite the NIOSH study, Pellman and the MTBI Committee drew their own conclusions that continued to contradict these findings and those of other organizations. Biomechanical engineers and neurosurgeons informed the Committee that the helmet safety standard at that time was insufficient to minimize the risk of concussions.
The MTBI Committee began studying the nature of tackle plays resulting in concussive impacts and developing its own biomechanical analysis of the effect of these forces on the brain.It started publishing study results in 2003 that stated there were no long-term negative health consequences associated with concussions sustained by NFL players. A six-year study by the Committee concluded that, "Players who are concussed and return to the same game have fewer initial signs and symptoms than those removed from play. Return to play does not involve a significant risk of a second injury either in the same game or during the season."