Alexi Casilla And The Prevalence Of Concussions In Baseball And Other Sports That Aren’t Football


Alexi Casilla after suffering a possible concussion Monday.

Alexi Casilla after suffering a possible concussion Monday.


Two weeks ago, as the National Football League was still in the wake of reaching a settlement with 4,500 former players over how it handled concussions, an interesting headline showed up on the league’s web site. “Concussion issue continues to grow in Major League Baseball,” the headline popped. It was an obvious attempt to deflect attention on concussions and brain injuries toward someone — anyone — else, and it drew inevitable, immediate, and deserved criticism. If any league has room to lecture others on concussion problems, it certainly isn’t Roger Goodell’s.

Football has been on the receiving end of the brunt of the concussion concerns, and rightly so: while hockey and soccer have highly-publicized concussion problems too, no sport faces the fundamental — and perhaps existential — threats concussions and brain injuries pose to football. The truth is, though, the source of the headline obscured an important story: concussion are posing problems for baseball, and it isn’t alone. Sports with far less expected contact than football, from basketball to stock car racing, are dealing with similar issues.

Monday night, Oakland Raiders quarterback Terrelle Pryor left the field in the fourth quarter after suffering a concussion against the Denver Broncos. But just hours earlier, Baltimore Orioles second baseman Alexi Casilla left his game, a crucial tilt against the Tampa Bay Rays, after crashing into the leg of right fielder Nick Markakis:

After laying on the turf for a few minutes, an obviously-dazed Casilla stayed in the game through the end of the inning before he got dizzy in the dugout. He stayed in Tampa overnight with concussion symptoms, raising questions that apply to football each weekend: why was Casilla still in the game, even briefly, after banging his head so violently?

Around the same time, the Minnesota Twins announced that Joe Mauer wouldn’t play again this season after more than a month of recurring concussion symptoms. Catchers like Mauer are “suffering concussions at an alarming rate” in 2013, and in the 30 days preceding Mauer’s injury on August 20, seven other catchers — Alex Avila, John Jaso, Carlos Corporan, Yorvit Torrealba, David Ross, Ryan Doumit, and Salvador Perez — suffered concussions and ended up on baseball’s seven-day concussion disabled list. Across the sport, concussions are up: according to USA Today, 18 players had landed on the disabled list for concussions as of September 13, up from 13 in 2012 and 11 in 2011, when the concussion DL was first established. 10 of them were catchers, and some of them had injuries far more routine than Casilla’s collision. Mauer’s concussion resulted not from a bone-crushing play at the plate but from taking too many foul tips off his mask, and that was the case for nine of the 10 concussions suffered by catchers this year, according to USA Today. If that’s the case, concussions for catchers may be just as inherent — if far less common — to that position as concussions are to football players, a result of playing the game that can’t be removed no matter how hard baseball tries.

And while the plights of former football players are well-documented, baseball has its troubles there, too: last December, 36-year-old retired outfielder Ryan Freel was found dead in his home from a self-inflicted gunshot wound. Freel missed 30 games in 2007 after suffering a concussion; he estimated once that he sustained at least 10 concussions in his eight-year Major League career.

Baseball has taken steps to reduce the instance of concussions. In addition to the seven-day concussion disabled list, it also established mandatory protocols for assessing players suspected of suffering concussions in 2011. Those protocols require mandatory baseline testing and an evaluation from a team-designated specialist. Before the player can take the field again, the team must submit a “Return to Play” form for Major League Baseball’s evaluation and approval.

Those policies are similar to those the NBA instituted in 2011, and concussion awareness has grown in sports like stock car racing and gymnastics too. To baseball’s credit, its policies haven’t faced as much open criticism as rule changes and concussion protocols in football. But that’s not necessarily true in other sports, even if the criticism isn’t as prevalent. New Orleans Hornets coach Monty Williams last year blasted the NBA’s concussion policy for “treat[ing] everybody like they have white gloves and pink drawers” on. “It’s a man’s game,” Williams said. “They’re treating these guys like they’re 5 years old.” Williams was fined and later apologized. The NBA’s concussion policy made headlines again during the playoffs when it forced Indiana Pacers guard George Hill and Golden State Warriors forward Harrison Barnes to the sidelines.

In all leagues, there is another consistent challenge: players don’t want to leave games. That’s certainly the case in football, and it’s true elsewhere too. “I guarantee you there are some guys playing with concussions now because they feel like it’s not serious and they can just keep playing,” Chicago Cubs catcher Dioner Navarro said earlier this year. LeBron James has proclaimed that he is “too tough” to suffer concussions. “Honestly, I hate to say this, but I wouldn’t (admit it),” NASCAR Sprint Cup driver Jeff Gordon said after Dale Earnhardt Jr. missed two races due to concussions in 2012. No matter the league, players still aren’t convinced that their long-term health should take precedent over playing and winning in that moment.

None of this should deflect attention away from the NFL, the NCAA, or football at any level. It is still the most dangerous of the sports when it comes to concussions — according to court documents in a lawsuit from former NCAA athletes, college athletes suffered more than 29,000 concussions between 2004 and 2009, with football accounting for more than half (roughly 16,000) — and it is still the sport that faces the biggest threat to its future if it doesn’t improve its methods of protecting the futures of its players. But concussions aren’t just a football problem, and if it’s important for the NFL and NCAA to take the lead in improving recognition, assessment, and treatment of concussed players to set an example for lower levels, it’s imperative that other leagues do that too. Even if athletes at all levels aren’t facing as high a risk in baseball and basketball as they are in football, they deserve quality treatment and evaluation when concussions do occur. The good news is that it seems like leagues like the NBA and MLB are taking the problems seriously. But as concussions remain an inherent part of all our sports, those leagues need to be committed to awareness at all levels — and to constant evolution in how they face the problems concussions present.