The first concussion crisis: head injury and evidence in early American football

Am J Public Health. 2014 May;104(5):822-33. doi: 10.2105/AJPH.2013.301840. Epub 2014 Mar 13.


In the early 21st century, sports concussion has become a prominent public health problem, popularly labeled "The Concussion Crisis." Football-related concussion contributes much of the epidemiological burden and inspires much of the public awareness. Though often cast as a recent phenomenon, the crisis in fact began more than a century ago, as concussions were identified among footballers in the game's first decades. This early concussion crisis subsided-allowing the problem to proliferate-because work was done by football's supporters to reshape public acceptance of risk. They appealed to an American culture that permitted violence, shifted attention to reforms addressing more visible injuries, and legitimized football within morally reputable institutions. Meanwhile, changing demands on the medical profession made practitioners reluctant to take a definitive stance. Drawing on scientific journals, public newspapers, and personal letters of players and coaches, this history of the early crisis raises critical questions about solutions being negotiated at present.

Publication types

  • Historical Article

MeSH terms

  • Brain Concussion / etiology
  • Brain Concussion / history
  • Craniocerebral Trauma / etiology
  • Craniocerebral Trauma / history*
  • Craniocerebral Trauma / physiopathology
  • Football / history*
  • Football / injuries
  • Head Protective Devices / standards
  • Head Protective Devices / statistics & numerical data
  • History, 19th Century
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Risk Factors