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Hoge helping players at all levels get ahead of curve on head injuries

WASHINGTON, D.C. - Few people are more aware of the signs of concussions than Merril Hoge, so when the former NFL running back saw one of the youngsters he coaches in youth football suffering from the symptoms, he immediately pulled him off the field.

Hoge made sure the player, just 13, was being cared for, assuming that everyone on the sideline understood there was no chance of him playing football again on that day, or perhaps for quite some time. He told his assistants to watch the child for signs of nausea and headaches. Five minutes later, one of his assistant coaches was tugging at Hoge's arm, telling him the young man was feeling fine and ready to return, urging Hoge to put him back in the game.

Hoge, who suffered numerous concussions during his 8-year NFL career and eventually retired in 1994 after suffering two in close succession, was on the one hand stunned -- this particular assistant coach was the older brother of the player who had been concussed -- yet not altogether surprised given his years of experience in youth football.

"I understand the magnitude of what's going on (in regard to concussions)," Hoge said, "but here it was his own brother and he was willing to put him back out there. That may be an extreme example, but it's an indication of the kind of ignorance about concussions that is still out there. He had no clue. This is what we're dealing with."

Hoge was speaking outside a massive ballroom at the Renaissance Hotel in downtown Washington Wednesday morning, during a break in an all-day symposium to further research and discourse about brain trauma in football. Hoge, a cancer survivor and a member of the NFL's Head, Neck and Spine Committee, was among those giving a presentation. Johns Hopkins Medicine was conducting the event, at the behest of the league, with more than 300 doctors and experts in attendance, including 49ers owner John York (a doctor), and many military representatives, who are gathering more information on ways to limit head injuries for those who serve our country.

Hoge has become quite educated on brain injuries, but concedes that much of the medical lingo being bantered about is beyond his reach (or that of pretty much anyone; "Chronic Traumatic Encephalopathy: A Distinct Pathologic Entity Associated with Repeated Brain Injuries," was the title of one presentation, for instance). But he easily intermingled with the surgeons and team physicians during the break from the meetings, and was there to lend his real-world experience, tell his story and try to help the cause.

Most importantly, Hoge continues to forge ahead with USA Football to inform players at all levels about the severity of these injuries and to work to attain a singular voice on this topic that can be easily digested by novices -- a voice free of any divisiveness between the NFL, NFLPA or any other interested party.

"To me the most important thing that can come from events like this is to continue to develop one voice and one message," Hoge said. "We're really working to change a mindset, and it's not going to happen overnight. It's an arduous process."

Hoge likens the movement to make advancements in concussion awareness across all sports to the generational differences with wearing seatbelts. Many of us can remember, as children, seeing adults routinely drive without them, until laws were strengthened and, over a decade or so, norms changed to the point where strapping on a seatbelt is second nature to most drivers now.

Hoge's work at the grassroots level involves promoting proper running, tackling and drill techniques, and informing parents and coaches of the signs and symptoms to look for in concussion victims. At the NFL level, it involves working within his committee to find the best practices and equipment possible for players, while realizing the intense physical demands of the game will always require a certain risk.

"Equipment alone will not eliminate concussions," he said.

Hoge is still flabbergasted at times by emails he receives, detailing that some family practitioners have mistreated concussions, telling parents that their child couldn't be suffering from a concussion since they never lost consciousness. "You don't have to be unconscious to have a concussion," Hoge said.

He still recalls his first concussion, playing for the Steelers against Kansas city in a Monday night game. "I've never been in an earthquake," he says, "but that's the only thing I relate it to." It's a confused, awkward, scary feeling he hopes others won't have to experience.

With that in mind, Hoge isn't interested in getting involved in any "mudslinging" over the past, and what were clearly dark ages in terms of concussion treatment and care during his playing days. And he's enthused about the direction the league is headed in, particularly the commitment exhibited by Commissioner Roger Goodell. When first approached about joining the committee, Hoge was a little skeptical, but was quickly won over.

"(Goodell) didn't just give me lip service," Hoge said. "He was an advocate. He wants to understand more and do more."

Goodell addressed the doctors assembled here Wednesday before the symposium began, outlining several priorities, including: "Make sure medical decisions always override competitive considerations. No compromises." Goodell also stressed the need to "be open and transparent."

"We have to understand what we don't know, and work together," he told the symposium. "Transparency is critical."

Goodell also spoke of being able to help usher in critical changes over the coming years that will have a positive impact not only in football, but in the progress of concussion advancements worldwide.

"We'll look back at this moment in time and how many strides we're making to keep this game safer and more appealing to all who play it at every level," Hoge said.

Rams at least have a shot

Give the Rams some credit. They might not end up retaining safety O.J. Atogwe long-term, but they were shrewd and calculated in their approach to his unique free-agent status, and just might be rewarded for it.

Coming off a year in which he was a franchise player, the Rams faced the prospect of paying him $7 million for one season on a high restricted free-agent tender. The option of "renting" him again at that price, on a team coming off a one-win season, was clearly not preferable to them. Ultimately, they were unable to agree to an extension before June 1, so he now is allowed to test the waters in free agency.

But make no mistake, the Rams have benefitted by going through this process now, rather than back in March when free agency began in earnest. In the past few months we have seen many teams essentially spend their budgets already, and many teams have already addressed their safety needs in free agency or in the draft.

That alone has eliminated several prime competitors for Atogwe's services. Well played. Furthermore, the Rams are aware that many teams are hesitant to spend big on the safety position in general. They figured ultimately the market for Atogwe, even if unrestricted, might not be that great. They also knew that a lot of teams signing free agents from other clubs have had it backfire over the years, which might also make others wary.

In the end, free-spending Miami might end up providing the only real competition. The Rams have done well to maintain a strong relationship with the player throughout the negotiating process. They realized the unique hand they were dealt in this uncapped season and, if in the end someone still offers a deal they did not believe the market would bear, then so be it.

But it just might be their offers were the best all along, and still will be. I would not be surprised if that's the case. Give executives Billy Devaney and Kevin Demoff credit for their strategy and acumen navigating the process.

Unrest brewing in Indy?

Friday is going to be a very interesting day in Indianapolis. Both Robert Mathis and Reggie Wayne are candidates to skip the mandatory minicamp. Neither absence would surprise me at this point.

It's hardly a cause for massive concern in either regard, but it just might play in the back of Bill Polian's mind as he prepares once again to make Peyton Manning a historically rich football player. Finding a way to keep enough cash (and future cap space) on hand to satisfy other players on the roster will be a challenge.

Wayne and Mathis each have two years left on their deals, with the bulk of the money in their contracts already paid out. Regardless of any June statements that might be made about skipping a mandatory weekend of work, I can't imagine them not being there for training camp. Make no mistake, though: Those being told to bide their time behind Manning will be watching closely as he inevitably becomes the game's highest-paid player ever.

Extra points

Peria Jerry had essentially a lost season as a rookie first-round pick for the Falcons. And the young defensive lineman has been pretty limited through the spring as well, but the club expects him to be fully healthy for training camp … Similarly, Antwan Odom, who was leading the league in sacks before his season was ended in mid-October, is slated to be full go for training camp for the Bengals … Any soccer fans out there -- you know, the other football -- who are interested in my take on the U.S. National Team heading into the World Cup, check out by buddy Trevor's blog ( Getting pretty pumped for the start of the World Cup in a week.

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