After first years of denial followed by years of posturing for litigation purposes, a high-ranking NFL official finally admitted the link between former players and chronic traumatic encephalopathy, commonly known as CTE. The NFL's senior vice president for health and safety Jeff Miller acknowledged the link during a U.S. House Committee on Energy and Commerce hearing on Monday. When asked by Representative Jan Schakowsky (D-IL) if there was a link between football-related head trauma and neurodegenerative diseases, Miller replied, “The answer to that question is certainly yes.” While most scientists and commoners alike have already either acknowledged or assumed the link, this is the first public admission of it by a senior NFL official. On Tuesday, the NFL released a statement supporting Miller, writing that "The comments made by Jeff Miller yesterday accurately reflect the view of the NFL."The admission reflects an evolving stance by the league over the past decade regarding concussions, CTE, and the often-violent collisions inherent in the sport. From 2003-2009, the NFL attempted to refute evidence that concussions led to long-term brain injury, forming the now defunct Mild Traumatic Brain Injury committee, and submitting scientific papers claiming that not a single player acquired long-term brain injury as a result of playing in the league. Since CTE can only be identified post-mortem; little scientific data was available to refute those claims during the committee’s early years. Starting in 2005 however, with the work of Dr. Bennet Omalu involving former Pittsburgh Steeler Hall of Famer Mike Webster, whose life spiraled out of control after his retirement until his death at age 50, the medical establishment began fighting back against the NFL’s stance. Omalu’s battle against the league has been well documented, first by the Frontline documentary “League of Denial,” and then in the Will Smith movie, “Concussion.” In addition to Omalu’s research, the 2011 and 2012 suicides of former stars Dave Duerson and Junior Seau respectively, as well as the January 2012 class-action lawsuit, now involving thousands of former NFL players, have brought the issue to the forefront. Also putting the issue back in the spotlight has been the recent diagnoses of recently deceased Hall of Famers Frank Gifford and Ken Stabler, as well as the drug overdose death last year of 27 year-old former player Tyler Sash, who was discovered to have stage 2 CTE in January following a series of postmortem testing.

, which concluded that 90 of 94 (96 percent) of deceased NFL players she examined showed symptoms of CTE. Among the living, these symptoms include frequent headaches, depression, memory-loss, and dementia. The joint study between the university and the Department of Veterans Affairs also discovered that 79 percent of people who played football at any level high school and beyond had physical signs of the disease. These findings have led scientists to conclude that it is the long-term, repeated collisions that do the most damage, as opposed to occasional or infrequent collisions, even if those individual incidents are more violent. Miller acknowledged the Boston study, saying "I think certainly, based on Dr. McKee's research, there's a link, because she's found CTE in a number of retired football players." Miller added however, "I think the broader point is what that necessarily means and where do we go from here with that information."[caption id="attachment_9718" align="alignnone" width="367"] Photo courtesy of Wikimedia Commons[/caption]The massive class-action lawsuit against the NFL that could include up to 20,000 former players, and the legal positioning involved can be affixed some of the blame for the league’s reluctance since 2012. After years of litigation, Eastern Pennsylvania District Court Judge Anita Brody approved a roughly $1 billion settlement between the NFL and the class of former players last April, awarding up to $5 million for players who have retired before July, 2014, to pay for medical expenses involving head trauma. That agreement however, is tied up in federal appeals court in Philadelphia. Some legal analysts believe the change in posture reflects the NFL’s desire to waive its liability from further litigation among current and future players. Admitting the link between football-related head trauma and CTE should eliminate most, if not all future liability. As Omalu explains, "It's like if you smoke now, you can't sue the cigarette industry. It's already established. The same applies to football. Moving forward, you can't sue someone, claiming that someone else is responsible for your injuries."Although some consider the language in the NFL’s concussion settlement to be “bulletproof” the admission could mean that the league is forfeiting leverage in the appealed settlement, and especially for litigation involving over 200 former players who opted-out of the class-action in order to sue individually. Plaintiffs’ attorney Steven Molo wrote a letter to the court on Tuesday, saying given the admission, "the settlement's failure to compensate present and future CTE is inexcusable," Lead attorney Christopher Seeger was more diplomatic in his statement following the admission, saying "We welcome the NFL's acknowledgement of what was alleged in our complaint: that reports have associated football with findings of CTE in deceased former players." NFL attorney Paul Clement does not believe the admission will affect the appeal or the settlement, countering Molo in a letter stating, "The NFL has previously acknowledged studies identifying a potential association between CTE and certain football players, including Dr. McKee's work, to which the NFL has contributed funding.”Since 2010, the NFL has given mixed signals about its acceptance of the link between the head trauma caused by the sport and CTE. Although the league made a $1 million donation to the brain bank that was used by the Boston/VA study, officials have spent years, first denying the link, and then claiming that there was a lack of evidence to support the link. In 2013, the NFL initiated its “concussion protocol,” which now means players are required to receive a doctor’s clearance to return to competitive play after reporting concussion-related symptoms. Diagnosed concussions declined during the first two years of the protocol, but rose to record levels in 2015. Commissioner Roger Goodell explained the evolving stance the week prior during the pre-Super Bowl festivities saying in a February 5th news conference, "We learn more from science," adding, “We learn more by our own experience and we have made great progress. We continue to make rule changes to our game to make the game safer and protect our players from unnecessary injury, from acts that we see can lead to increased probability of an injury." During the same week, however, Goodell compared the risk of kids going out and playing football to that of “sitting on the couch.” The NFL’s official position for years had been that the results are inconclusive and the league was waiting for additional studies to confirm such a link. Additionally, neurosurgeon and the chair of the NFL subcommittee on long-term brain injury Dr. Mitch Berger claimed during Super Bowl week that no direct link between football and CTE had been established.[caption id="attachment_9720" align="alignnone" width="333"]NFL Commissioner Roger Goodell. Photo courtesy of Timothy A. Clary/Getty Images

Another mixed signal that Detroit Lions linebacker DeAndre Levy rightfully addressed last Saturday was why the NFL continues to employ Dr. Elliot Pellman as an adviser. Pellman was the former chair of the league’s concussion research committee, who is largely faulted for concealing the dangers of in-game head trauma. In the mid-2000’s, Pellman repeatedly argued that sustaining a concussion, "does not involve significant risk of a second injury either in the same game or during the season," as well as provide "no evidence of worsening injury or chronic cumulative effects of multiple MTBIs in NFL players.” Levy asked the NFL via Instagram Saturday, writing "@nfl Why is Dr. Elliot Pellman, the rheumatologist who helped concealed and lied about the link between football and CTE, still employed by you guys."My guess is that the NFL and Goodell will soon be “evolving their policies” in a manner that excludes Pellman and Berger from future public contact in an attempt to “protect the shield.” Goodell has been very vocal, controversially so, about his desire to protect the NFL brand. Much like many other issues he has faced in his tumultuous tenure, his administration has looked inconsistent, spotty, reactive, and hypocritical regarding head trauma. Like many cases before involving disputes between Goodell and NFL players, the federal court system may ultimately issue him another stern rebuke of his authority. It would appear that Miller’s statement certainly opens the door for another such episode to occur.Additional Reading:Bleacher Report – Scott Polacek CNN – Jill Martin ESPN – Michael Rothstein TSN –The Canadian Press, Dave Campbell, and Teresa M. Walker Yahoo Sports – Eric Edholm