Literature Review

In my review of the literature I will first focus on how head injuries are sustained and how they affect football players, the literature also addresses the support needed to sufficiently care for concussed patients and retired players who have long-lasting head injuries. A Concussion is a very common injury, one that players play through, but it is also a very serious injury with potential long term consequences. Many researchers interview NFL players and veterans, collegiate athletes, and parents. Other studies focus on how politics and demographics affect how people view concussions and the safety of football, and the policies, or lack thereof, put in place because of the injuries. Some sources used methods of media/framing analysis and some measured viewership of media outlets. The media’s framing of concussions affects the way viewers feel about the severity of traumatic head injuries. Many of the studies use frame analysis and key word searches to study how journalists downplay the severity of concussions, and push a “tough it out” masculine attitude in their reporting. 

Traumatic Brain Injury 

Not surprisingly, football is a leading cause of concussions and traumatic brain injuries in the sports world, and the sport is under constant scrutiny for the way these injuries are handled. In order to get an inside look at how these injuries are sustained and treated, According to  Joe DeLamielleure in  2014, “As an NFL offensive lineman for 13 years, I suffered a huge number of hits to the head — an estimated 215,000 at least” (DeLamielleure 2014). DeLamielleure goes on to speak about how he felt lucky, that despite the astronomical number of impacts he received, he only lost hearing in one ear, in comparison to the numerous players who have lost their lives to CTE. To examine CTE in the NFL Casson et al (2014) conducted interviews, asking players to estimate the number of concussions the player had and how many years they played professionally, they then conducted MRI’s on these players. The results showed that the players that played only around 5 years and were younger had few signs of brain damage, but the player who was in his 50s and had played 20 years had a lot of neurological damage. It is also important to consider what types of hits are causing these traumatic brain injuries in order to get to the root of the problem. In the article, Bartsch and Adam (2014) discuss how being hit from different sides or the rear during a football career can have differing effects. They studied this by using impact monitoring mouthguards on eighty-three high school and college level football players. They found that being hit in the head from the side and rear end produced abnormal post collision behaviors.

Other researchers studied the impacts of head injuries on college players. Wayment and Huffman (2018) interviewed that most athletes in the study agreed the concussions are a natural part of football, but that there should be safety protocols and support systems in place for when an athlete does sustain a head injury. Similarly, Creating Concussion Management Policy: How School Leaders, Coaches and Parents Can Work Together to Ensure Kids Stay Safer in Sport notes that it is parents and coaches’ duties to ensure that safety protocols are in place and being followed. This article is beneficial because it talks about rules and laws about concussion management and how parents, coaches, and schools react to them, which is another helpful viewpoint to add to my study. It also recommends ways to go about concussion management, showing how much more we have learned about the effects and protocols of traumatic head injuries and how they must be taken seriously. Concussions not only lead to severe brain damage later in life, but also can lead to depression and other mental illnesses (Vos, Bodil C., Karen Nieuwenhuijsen, and Judith K. Sluiter. 2018), so it is essential that people know the truth about head injuries so that they can make informed decisions about their health and others they care for. 

Framing

Injuries are framed in various ways in the news which affects the publics’ responses. Many studies used framing analysis and key word searches to determine how journalists and various media outlets speak about concussions. Concussions are oftentimes talked about in the same conversations as more minor injuries. Some studies examined media coverage of the NFL, on ESPN.com, for exaple to analyze how concussions were brought up and spoken about. One study “used a time frame of 2013 and 2014 to examine ESPN.com articles (N = 446) for prevalent and key themes in articles relating to concussions in the NFL” (Karimipour, Hull 2017). The results showed that concussions were commonly framed as an everyday football injury, often talked about with broken bones and pulled muscles to seemingly distract people from the severity of them. The issue is not with the frequency in which traumatic brain injury is discussed in the media, but there is a major issue with how it is framed. Within this, it’s important to account for different demographics (athlete, non-athlete, gender, age)and how they view the seriousness of concussions. A study used different groups of people to read different articles about concussions, with some saying they are very serious and others writing them off as a minor injury. The study found that the seriousness and severity of the article directly translated to how the people reading them later felt about concussions. This shows a bigger picture too: the way concussions are framed in the media creates the potential for bad consequences towards how concussions are perceived and how seriously they are taken. In order to minimize emotional response to concussions, he NFL’s PR is shown to interact with more social media platforms and therefore more fans than any other major sports league so that people do not associate negative feelings with the NFL when they see concussion and injury media. The NFL also makes sure to frame injuries in ways that won’t ignite as much of an emotional response through different verbiage or announcement measures.  

Some of the issues with media framing revolve around the use of certain verbiage that downplays the severity of injuries. One paper exposes journalists for using terms such as “mild concussion” when a player has in fact sustained a traumatic brain injury (Ahmed, Hall 2017). This is misleading, and despite the journalists not being medical professionals, they do have a lot of reach and influence that can sway people to think of concussions as a typical or non-serious injury. “The broadcast approached the concussions only within the context of the unfolding game, noting the loss of an important player. These presentations treated every concussion on its own terms, never connecting them to the broader concussion issue” (Mirer, Michael, and Mark Mederson 2017). In addition to brushing over concussions during games, the media also sweeps deaths and suicides by CTE under the rug, so that people do not associate the two. 

Aside from the way that news media outlets cover and portray concussions, there are also issues in the way the NFL handles the distribution and classification of materials related to concussions and safety protocols. The article, NFL Sued Over Players’ Brain Injuries: Helmet Company also Named in Suit Alleging Negligence, studies a lawsuit alleging that “the NFL has known of the potential consequences of concussions since the 1920s, but withheld the information from coaches, players, trainers and the public until June 2010” (Zolkos, Rodd 2011).

Much of this downplaying of concussions comes from a background of masculinity and the “tough it out” ideals frequented in the male sports world, and specifically in football.  Football has always been a sport framed around masculinity (Anderson, Kian 2012). Many articles talk about how the media frames people who bounce back from injury, or don’t take proper rest measures as heroes. A media analysis of reporting done on Aaron Rodgers’ post head-collision self-withdrawal, found “that increasing cultural awareness as to the devastating effects of concussions, in the form of chronic traumatic encephalopathy, combined with a softening of American masculinity is beginning to permit some prominent players to distance themselves from the self-sacrifice component of sporting masculinity” (Anderson, Kian 2012). This is supported by retired NFL athletes, like Chris Boland, a player who retired in 2015 citing head injuries. An article on Boland looks into the common themes from several media outlets about the injury and finds key themes such as Health risk and parental choice (Cassilo, David and Jimmy Sanderson). 

Politics, Demographics, and Framing 

When looking into the media portrayal of injuries, it is important to consider how different demographics are exposed to different forms of media and information, and how politics and demographics affect how people view concussions, the safety of football, and the policies, or lack thereof, put in place because of it. Many articles look into the question of how politics, social class, and education affect the sports people enroll their children in, and their views about science, safety, and concussions. One study measured the viewership of two of the most collision based sports, Football and Ice Hockey, and they discuss how prominent figures in the Football world have attempted to suppress the seriousness of concussions to the public, and how different demographics are informed and how they respond (Lindner, Andrew M. and Daniel N. Hawkins 2021). Going further into viewership, a nationally representative survey was conducted to examine the social, political, and demographics and how it correlates to their attention to concussions in sports. Their findings concluded that people who were older, more educated, and left-leaning paid more attention to concussions in sports, in addition to people who regularly watched football (Lindner, Andrew M. and Daniel N. Hawkins 2021).

There is also a lot of discrepancy relating to how different demographics are treated when it comes to sustained head injuries, specifically with Black vs. White athletes. A case study involving a black student and white student having a head on collision at a football game was performed. The white student was taken out of the game for further assessment, while the black student stayed in and was told to shake it off, and ended up with longer lasting season-ending repercussions. The researchers also conducted a cross-sectional analysis of emergency department (ED) visits from the National Electronic Injury Surveillance System for the period 2008 to 2017 and found Black athletes are often misinformed about the implications of concussions, and symptoms more often go untreated in comparison to White athletes (Wagner R, Zach K, Kobayashi Y, Gottschalk). Another article studied college athletes and the invulnerable framing of black athletes (Haslerig, S. J., Vue, R., & Grummert, S. E. 2020). Another element discussed by the articles is disparities between private and public health insurance, which correlates somewhat closely with socioeconomic status. Children and athletes with public insurance policies were often sent back to sports sooner, while those with private health insurance were able to see specialists who advised them in ways more beneficial to their healing process that ultimately led them to a better outcome.