The National Football League held its annual hall of fame induction ceremony Saturday night, in Canton, Ohio. Eight players were given football's highest honor, including a posthumous induction for Junior Seau, the former linebacker for the San Diego Chargers who killed himself in 2012.

After his death, Seau's brain showed signs of chronic damage — the same kind of damage that has been found in dozens of other former NFL players.

Scientific studies have shown that the kind of repeated hits NFL players take is linked to chronic traumatic encephalopathy, or CTE, a degenerative brain disease. CTE is associated with memory loss, impulse control problems, depression and eventually dementia.

Some players are rethinking their careers — like up-and-coming linebacker Chris Borland, who quit after his first season with the 49ers a few months ago — for fear of head injuries.

Parents are weighing the risks as well. So when someone like Chicago Bears coach Mike Ditka talks, they listen. When host Bryant Gumbel asked Ditka on HBO's Real Sports earlier this year whether, if he had an 8-year-old now, he would want him to play football.

"No," he answered. "That's sad. I wouldn't, and my whole life was football. I think the risk is worse than the reward."

This week on For the Record: Football's reckoning. Click the audio link on this page to listen to the full interviews.

Tregg Duerson

Tregg Duerson's father, Dave Duerson, a defensive back who played most of his pro football career with the Chicago Bears, killed himself in 2011 in his Miami home. Duerson was part of the legendary '85 team that won the Superbowl, and five years later helped the New York Giants win their own championship.

He retired from the NFL after the 1993 season and started working in business. He had some successes, some failures, but nothing that his family thought would drive him to kill himself.

In the suicide note, Tregg Duerson says, his father detailed a devastating decline.

"He described having trouble with spelling, blurred vision, short-term memory problems, issues with putting full concepts and sentences together," Duerson says.

"He said at one point that he is thinking about other NFL players that have similar issues," he says.

Duerson shot himself in the chest and requested in the letter that his family donate his brain to science to help others understand the connection between concussions and traumatic brain injuries.

Tregg Duerson sued the NFL in 2012, alleging that the league's handling of Duerson's on-field concussions led to his brain damage and ultimate suicide.

Chris Nowinski, co-director of the Boston University research group that studied Duerson's brain

Chris Nowinski was a defensive tackle for Harvard University and later spent time as a professional wrestler. He was forced to retire after suffering a serious concussion in 2003.

Nowinski is now head of the Sports Legacy Institute, an advocacy group focused on what they call the concussion crisis. Duerson's brain showed advanced CTE, Nowinski says. He was in the third of four stages, the fourth being the most severe and almost always associated with dementia.

"Dave had damage on his frontal lobe, throughout his medial temporal lobe, which controls things like memory and emotional control," Nowinski says.

The BU team has studied 79 brains of former football players, and found 76 showed signs of CTE. They still don't know the precise cause.

"We're still kind of guessing," Nowinski says. "We don't know what is actually triggering the beginning of it. Is it one hard hit? Is it one hard hit followed by a bunch of small hits? Is it two concussions close together? Because not everybody gets this."

But he is sure about the connection between the number of hits a player takes over a career and the incidence of CTE. The longer someone plays football, he says, the higher the chances of getting multiple concussions that could lead to CTE.

He believes kids should not be allowed to play football until high school.

"To think that we would hit kids in the head a few hundred times each fall, under some concept that we're teaching them lessons, through this sport, that are better than any other way we could teach them, is insane to me," he says.

Jon Butler, executive director of Pop Warner Little Scholars

Pop Warner runs football programs around the country for children as young 5.

"Relative to other youth sports, we are remarkably safe," Butler says.

The Pop Warner leadership is keenly aware that concussions are a real risk, but Butler insists that the risk is no higher in football than any other typical childhood mishap.

"If you take a typically active boy or girl, 8, 10, 12 years old, and they want to play football, and you say, 'You can't play football,' it's not like they're going to sit on a couch wrapped up in bubble wrap," he says. "They're going to be active. They're going to go out and fall off a roof or bicycle into a concrete bridge abutment by accident or something. So, yes, concussions have certainly always been around, always been part of not only football, but all kids activities and all sports."

The league has changed its policies to try to reduce the risk of concussions in its young players. In 2012, Pop Warner introduced rules limiting the kind of contact allowed in practice. They prohibit full-speed, head-on tackling and blocking and intentional head-to-head contact.

The rules also limited the amount of contact during practice to one-third of practice time.

Nowinski says those changes are an improvement, but that the culture of the game has to change in order to diagnose concussions when they happen.

"We're not teaching kids or encouraging them to report when they do get symptoms," he says. "We have this kind of culture of silence around the injuries, so coaches really need to be specific with their players that they want them to report."

Dave Duerson's son Tregg understands why that's hard. He himself played college football for Notre Dame.

"You want to be in the game with your friends," he says. "You don't want to let them down. You don't want to leave over a concussion. Taking yourself out of the game is something that's just not in most people's DNA."

It's an instinct he shared with his father, along with a love of the game. Duerson has a job in finance, a also works for a mental health advocacy group. But his father's suicide has left a big void in his life.

"I still love the game," he says. "I think it's just people going in with complete eyes open, that there is risk out here and that no matter what we do, the risk is still going to be there. So for me, I still like the game but would I want my child to play in the future? No."

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

RACHEL MARTIN, HOST:

The National Football League held its annual Hall of Fame induction ceremony last night in Canton, Ohio. Eight players were given football's highest honor, including a posthumous induction for Junior Seau. The former linebacker for the San Diego Chargers killed himself in 2012. His daughter, Sidney Seau, spoke at last night's ceremony.

(SOUNDBITE OF SPEECH)

JUNIOR SEAU: I want nothing more than to see you come on stage, give the speech you were meant to give, give me a hug and tell me you love me one last time, but that isn't a reality.

MARTIN: After his death, Seau's brain showed signs of chronic damage, the same kind of damage that's been found in dozens of other former NFL players. Scientific studies have shown that the kind of repeated hits NFL players take are linked to a degenerative brain disease. Some players are rethinking their careers, like up-and-coming linebacker Chris Borland who quit after his first season a few months ago for fear of head injuries. Parents are weighing the risks as well, so when someone like Chicago Bears coach Mike Ditka talks, they listen. Here's Ditka in an exchange with Bryant Gumbel on HBO's "Real Sports," earlier this year.

(SOUNDBITE OF TV SHOW, "REAL SPORTS")

BRYANT GUMBEL: Is this going to wind up being the cross on which football is nailed?

MIKE DITKA: Let me ask you a question better than that. If you had an 8-year-old kid now, would you tell him you want him to play football?

GUMBEL: I wouldn't, would you?

DITKA: Nope. That's sad. I wouldn't. My whole life was football. I think the risk is worse than the reward, I really do.

MARTIN: For the Record, today, football's reckoning. We begin with Tregg Duerson.

TREGG DUERSON: My father took his own life in 2011 in his Miami home.

MARTIN: Tregg's dad was Dave Duerson. He was a defensive back who played most of his professional football career with the Chicago Bears. He was part of the legendary '85 team that won the Super Bowl, and five years later, he helped the New York Giants win their own championship. Duerson retired from the NFL after the 1993 season and started working in the business world. He had some successes and some failures, but nothing his family thought would drive him to kill himself. Tregg remembers that day four years ago.

DUERSON: And when we went to the scene of the event, we were given a suicide note that was handwritten for the most part.

MARTIN: In that note, Tregg says his dad detailed a devastating decline.

DUERSON: He described having trouble with spelling, blurred vision, short-term memory problems, issues with putting full concepts and sentences together.

MARTIN: Was he suggesting in his note that the cognitive problems he was going through had something to do with football?

DUERSON: Directly. There's direct sentences in there that are talking about the hits that he took during the game. He said at one point that he is thinking about other NFL players that have similar issues.

MARTIN: Duerson shot himself in the chest, and in his suicide note, he made a request to his family. He asked that they donate his brain to science in hopes that it could help others understand the connection between concussions and traumatic brain injuries. That's where Chris Nowinski comes in. He's co-director of the Boston University research group that studied Duerson's brain. and now he's the head of the Sports Legacy Institute, an advocacy group focused on what they call the concussion crisis. The conclusion they found when they looked at Duerson's brain...

CHRIS NOWINSKI: He did have advanced CTE. So Dave had damage on his frontal lobe, throughout his medial temporal lobe, which controls things like memory and emotional control.

MARTIN: CTE stands for chronic traumatic encephalopathy. It used to be called punch drunk, which is a pretty upbeat name for a degenerative brain disease that's associated with memory loss, impulse control problems, depression and eventually dementia. Chris Nowinski started his work back in 2006.

NOWINSKI: At the beginning, I was literally reading obituaries. And so I'd have to track down a phone number, and, in most cases, just cold call the house.

MARTIN: The Boston University team has studied 79 brains of former football players, and out of those, 76 of them have shown signs of CTE. But Chris Nowinski says there are still a lot of questions about what causes this.

NOWINSKI: We're still kind of guessing. We don't know what is actually triggering the beginning of it. Is it a - one hard hit? Is it one hard hit that you - followed by a bunch of small hits? Is it two concussions close together? Like, you know, because not everybody gets this.

MARTIN: But what he is sure about is the connection between the number of hits a player takes over a career and the incidence of CTE. Nowinski says the longer someone plays football, the higher the chances of getting multiple concussions that could lead to CTE, and for him, that means keeping kids out of tackle football until high school.

NOWINSKI: And to think that we would hit kids in the head a few hundred times each fall under some concept that we're teaching them lessons through this sport that are better than any other way we can teach them is insane to me.

JON BUTLER: Relative to other youth sports, we are remarkably safe.

MARTIN: This is Jon Butler, and he's the executive director of the Pop Warner Little Scholars program. If you've ever seen really little kids playing football in shoulder pads and helmets, the whole deal, that's Pop Warner. They have programs all over the country for kids as young as 5 years old.

BUTLER: I think team sports in particular teach so much in terms of socialization skills and, even more so, when it comes to contact sports because truly, they're - football, lacrosse, rugby, some other sports - you're forming even closer psychological bonds.

MARTIN: In addition to the life skills and social bonding that football creates, Jon Butler says you might as well let kids play tackle football because that's what they want to do.

BUTLER: What we hear all the time is kids who play flag football, they'll say, gee, I really had fun. I did that for a year or two. When do I get the pads and the helmet?

MARTIN: Butler says there is a keen awareness in Pop Warner that concussions are a real danger, but he insists that the risk is no more than any other typical childhood mishap.

BUTLER: If you take a typically active boy or girl, 8, 10, 12 years old, and you - they want to play football. And you say, you can't play football, it's not like they're going to sit on the couch, wrapped in bubble wrap. They're going to be active. They're going to go out and fall off a roof or bicycle into a concrete bridge abutment by accident or something. So yes, I mean, concussions certainly have always been around, always been part of not only football but all kids' activities and all sports.

MARTIN: Even so, the Pop Warner League has changed its policies to try to reduce the risk of concussions in its young players. In 2012, the league rules limiting the kind of contact allowed in practice. They don't allow full-speed, head-on tackling and blocking, no straight-ahead hits and no intentional head-to-head contact. They've also limited the amount of contact in practices. It can't be more than a third of practice time. Jon Butler insists that teaching players how to block and tackle correctly can help prevent dangerous hits. Chris Nowinski says changes like that are good, but the whole culture of the game has to change, he says, in order to diagnose concussions when they happen.

NOWINSKI: We're not teaching kids or encouraging them to report when they do get symptoms. And so the kids are staying quiet, and the coaches are coaching the game and don't really have - they can't see inside a kid's head. And so we have this kind of culture of silence around the injuries. So coaches really need to be specific with their players that they want them to report.

MARTIN: Dave Duerson's son, Tregg, understands why that's hard. He himself played college football for Notre Dame.

DUERSON: You want to be in the game. You want to be in the game with your friends. You don't want to let them down. You don't want to leave over a concussion. Taking yourself out of the game is something that's just not in most people's DNA.

MARTIN: It's an instinct he shared with his dad, along with a love of the game.

DUERSON: We'd go in the backyard. We'd run sprints. We'd work on technique. We'd go through different formations on a notebook because football's a very structured game. And if you can understand the formations, you can really start understanding the bigger picture.

MARTIN: Tregg Duerson still lives in Chicago. He's got a job in finance, and he works for a mental health advocacy group now, too. But his dad's suicide has left a big void.

DUERSON: Whenever I see a cap with 22, I think of my father. Or whenever I see a player on a field with - wearing 22, I always think of my father.

MARTIN: I asked Tregg if he still has the same love for football that he did growing up.

DUERSON: I'm very conflicted to be honest. I probably speak for a lot of people when I say that I still know the game very well. I still love the game. I think it's just people going in with complete eyes open that there is risk out here and that, you know, no matter what we do, the risk is still going to be there. So for me, I still like the game, but would I want my child to play it in the future? No.

MARTIN: Tregg Duerson talking about his father, the former NFL defensive back Dave Duerson who killed himself in 2011. We also heard from Jon Butler, the executive director of the Pop Warner Little Scholars program and Chris Nowinski of the Sports Legacy Institute. Transcript provided by NPR, Copyright NPR.

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