YRACUSE, N.Y. — The play that would be A.J. Long’s last at Syracuse University ended with the sophomore crouched on the field, wracked with pain and cradling his throbbing head.
The quarterback had suffered his third concussion during a practice in October, when he collided with a charging defensive lineman who outweighed him by almost 100 pounds. He awoke the next morning in a fog, unable to tolerate even the dimmest light.
Six days later, Long was told by the school doctor that he was off the team because of his history of concussions.
“When you hear those words, and it’s the final verdict, it hurts,” Long said.
“He told me some alarming things. Like by the age of 45 there is an increased risk of dementia.’’
But where Syracuse officials saw grave risk, other colleges saw opportunity. Coaches from a half-dozen other universities began wooing Long.
His case is not unique. College football players with a history of incapacitating concussions are allowed to transfer to colleges that will permit them to play, a STAT investigation has found. This happens even after doctors at one school determine that the risk to a player’s health is so severe that he should be permanently banned from contact sports.
“If [you] want to go somewhere else, you can find someone to clear you for virtually anything,” said Randy Cohen, the head athletic trainer at the University of Arizona. “The risk assessment for each institution is different.”
The National Collegiate Athletic Association sets no limits on the number of permissible concussions. There’s no medical consensus on how many concussions pose an intolerable danger to athletes. And colleges, ever on the lookout for talent that will reap their teams wins and ticket sales, decide on their own when, or if, players should be medically disqualified.
In interviews with doctors and college officials, STAT found cases in which some players were permanently sidelined after three or four concussions, while others with as many as 10 concussions were allowed to still play.
Take the striking case of one of Long’s Syracuse teammates, Luke Arciniega. In 2010, Arciniega was disqualified from the University of Nevada after suffering concussions. After more than a year away from football, he began playing for a junior college in California, then moved on to Syracuse. Arciniega suffered another concussion in October, and Syracuse then barred him from playing there. He is now done with football.
While he has no regrets, Arciniega said in an interview that he worries that his multiple concussions might haunt him later. “Being disqualified two times in my college career, of course I think about it,’’ he said. “I think anyone who plays this sport will have something down the road.’’
There are about 70,000 college football players, and a 2014 report by the NCAA revealed that nearly 1 in 10 players reported suffering multiple concussions during their college career. Multiple concussions make athletes vulnerable to long-term brain damage from the head trauma.
The NCAA’s chief medical officer, Dr. Brian Hainline, said that in his own neurology practice, he has recommended that athletes stop playing, only to have them seek second or third opinions from doctors who disagree. “We are not at a place in society generally, and the NCAA in particular, to state that there is a universal bar that everyone must adhere to regarding ability to play,” he said.
Once college athletes are disqualified, they receive little guidance about what to do. Young men like the 19-year-old Long are left on their own to seek additional tests and evaluations by concussion experts — and to choose whether pursuing their dream of playing college football is worth jeopardizing their health.
“I was very confused,’’ Long said of the conflicting signals from Syracuse and other schools about whether he should play. “It all wasn’t making sense.’’
In interviews over the last two months with Long, his family, his teammates, his doctors, and officials at Syracuse and other colleges, STAT chronicled the twists and dilemmas he confronted. Ultimately, the sophomore would decide that — no matter what they told him at Syracuse — he would not give up football, even after his plan was denounced by his own coach and strangers on social media.
Disqualified players not tracked
The shuffling of players with concussions from one school to another is rarely discussed.
The NCAA, whose football championship game Monday night will draw millions of viewers, has touted its efforts to limit concussions and improve player safety amid mounting public concern. It has banned above-the-shoulder hits on defenseless players, and required schools to follow standard protocols for detecting and treating concussions.
But the NCAA said it doesn’t keep track of medical disqualifications or how many sidelined players have transferred to play football elsewhere. Most of the schools that make up the lucrative, upper echelon of college football refused to release even basic information about disqualifications.
The college football world is dominated by the 65 schools that are members of the Power Five conferences — the Southeastern, Big Ten, Atlantic Coast, Pac-12, and Big 12. STAT asked each of the schools in those conferences for the total number of athletes disqualified in each of the last five years, the sports they played, and the injury involved.
Only nine universities provided any information. Just two schools — Washington State University and the University of Illinois — provided all of the data. Most of the universities said disclosing even aggregate information on medical disqualifications would violate federal laws on student privacy and the release of medical records.
The lack of information makes it difficult to determine how many players have been able to continue their college careers elsewhere after being medically disqualified. But using information from the few schools that disclose disqualifications, STAT identified a half-dozen athletes playing on other football teams or in the process of moving to other schools after being medically sidelined.
One of those is another of Long’s former Syracuse teammates, Kyle Knapp, who was disqualified in 2014 after multiple concussions but will play this year for Western Michigan University. Former University of Arizona linebacker Dakota Conwell, who was banned from play in 2013 after suffering multiple concussions, transferred to West Liberty University in West Virginia, where he has been the starting quarterback the past two seasons.
But an Arizona teammate of Conwell, disqualified at the same time for concussions, decided to end his career. C.J. Dozier said he was tempted by an offer from a University of Oklahoma coach to be evaluated by their doctors, but ultimately concluded that returning to football would pose too great a risk to his long-term health.
“You have to swallow your pride and give in,” he said. “It’s about your future.”
A bond built on football
Soon after he committed to the university in his junior year of high school, A.J. Long had “Syracuse” tattooed across the inside of his right bicep. That way, every time he cocked his arm to throw, people would see his school’s name.
Rated the 15th best player nationally at his position by ESPN, Long rebuffed offers from higher-profile programs, including the University of California, Los Angeles. He was comfortable on the upstate New York campus, having visited several times to see an older cousin who played for the team.
Long said he’s been a “football junkie” since first putting on a uniform as a scrawny 6-year-old in Bethlehem, Pa. When he wasn’t playing, he was watching other games or studying ways to make himself a better player. Football defined him. It provided him a stage to prove he was special. It bonded him with his father.
Ace Long was himself a celebrated high school player in eastern Pennsylvania with dreams of playing college football. But during his senior year of high school, his first wife became pregnant with A.J. and he joined the Marines to provide for his young family. The couple divorced when A.J. was still a young boy.
A.J.’s father managed every aspect of his son’s football development. He coached him, selected personal trainers, and traveled with him to camps across the country so he could face top competition. “That is what our relationship was built on,” said A.J.
At times, his father’s intensity strained the relationship. He could be harshly critical, and A.J. had a hard time letting go of stinging words. Before the start of his junior year of high school, A.J. decided to move to Tennessee to live with his mother. He didn’t consult his father.
Nonetheless, the senior Long rarely missed his son’s games, making the 24-hour round-trip to Lebanon, Tenn., nearly every week during the season. In the end, the move strengthened their bond.
“He was not trying to coach me,” A.J. said. “He was not trying to be anything but my Dad.”
In his freshman year at Syracuse, Long made a splashy debut against Florida State University, then the top-ranked college team in the country. Entering the game to replace the starter, he passed for two touchdowns. His performance was hailed as a sign of hope for a flagging program, and the local newspaper observed in Long a “bravado that makes him magnetic.” The next week, after a victory over Wake Forest University, he was named Atlantic Coast Conference Rookie of the Week.
In the offseason, however, his prospects waned. Long injured his hand, limiting some of his training. A senior quarterback was returning from an injury and was expected to be named the starter again. More importantly, as Long saw it, the coach who recruited him had left Syracuse. As the 2015 season approached, there was talk of Long changing positions or sitting out the year, or transferring.
Not long after, he suffered his third concussion.
Three strikes and you’re out
Long feared he might get bad news when he was summoned to the head trainer’s office on Oct. 13. He had been confined to his apartment for six days with a pounding headache, unable to go to class.
Other players had been dismissed from the team after a third concussion, the result of what athletes understood to be a three-strikes-and-you-are-out policy at Syracuse. But he wasn’t prepared for the finality of the moment.
Long said team physician Dr. James Tucker told him he was disqualifying him and put down in front of him a press release the school would be sending out announcing the end of Long’s career.
“He told me from his professional opinion it would be best if you didn’t play football anymore,” Long said. The doctor said he was concerned that Long’s concussion symptoms had lasted for days and warned him future hits could harm him later in life.
In studies, multiple concussions have been found to be associated with an increased risk of depression and reduced cognitive performance. Most frightening, repeated blows to the head have been linked to chronic traumatic encephalopathy, or CTE, which results in dementia-like symptoms.
The disease has been discovered in the brains of dozens of deceased football players, including Hall of Fame linebacker Junior Seau, who committed suicide in 2012, and former NFL star and broadcaster Frank Gifford. The research is not definitive, however.
The doctor’s comments left Long reeling. Cast off the team, he felt like “the unwanted third child,” he would say later. He walked back to his apartment and climbed into bed, eventually falling asleep. “Part of me wished it was a dream, but the reality was I knew it wouldn’t change,” he said. He figured there was nothing he could do about his situation.
In interviews with local reporters over the next few days, Long didn’t question the decision. He detailed the headaches, the disorientation, and sickness he felt after his concussions. The first happened in high school, when he was kicked in the head during football practice. The second was a freak accident, just before the start of his freshman year, when he fell out of bed and hit his head on a desk. He said he planned to stay at Syracuse and get his degree.
Not scared of another concussion
Long’s parents suspected that the university’s decision wasn’t entirely about their son’s health — and that the coaches no longer wanted him on the team.
They saw news reports that Syracuse offered a scholarship to a transfer player from UCLA two days after Long was disqualified. To his parents, the timing was no accident, though Syracuse said the events were unrelated.
Long’s father and stepmother, Isla, talked to Tucker after he disqualified A.J., and they came away thinking the decision was made with inadequate testing and without consulting concussion experts. Syracuse would not allow Tucker, who is a family medicine doctor, to be interviewed for this story.
Isla Long is an attorney in Philadelphia, and she researched the Syracuse concussion policy. It says that any student-athlete with two documented concussions resulting in missed practice or playing time will receive a letter from the team physician warning that a third concussion “may disqualify” them from contact sports at the school.
Basing disqualifications on the number of concussions “is not the way to approach this injury,” said Michael Collins, the director of the University of Pittsburgh Medical Center Sports Medicine Concussion Program. He said the policy is well-intentioned, but can lead athletes to hide concussions.
DOCUMENTS: Read the concussion-related policies of the 65 schools in the NCAA Power Five football conferences.
Cohen, the Arizona head athletic trainer, said the severity of symptoms and how quickly a player recovered are more important factors than the number of concussions in determining whether it is safe to keep playing. He said he has disqualified a player after a single concussion but allowed another to keep playing after racking up 10.
A Syracuse spokeswoman, Susan Edson, said there was no hard rule on disqualifying athletes after three concussions. Every case is evaluated on an individual basis, she said, adding that the school would not comment on the case of any disqualified athlete, including Long.
Long was the fourth Syracuse football player disqualified after suffering concussions in an 18-month period, and athletes and coaches told STAT the concussion limit is pretty firm. “My understanding is three is the magic number,” said Syracuse women’s ice hockey coach Paul Flanagan. “The reality is schools have to be careful, and God forbid you allow someone to play and something happens.”
Long’s parents wanted someone else to examine A.J., to learn for certain whether his brain was healthy. They arranged for a detailed evaluation at the Jefferson Comprehensive Concussion Center in Philadelphia.
Ace and Isla Long asked their son in late October if he wanted to play football again. Now symptom-free, he said he did, as long as the doctors in Philadelphia said it was safe.
“I am not scared of another concussion,” Long said in November. “I am not scared of being hit in my head again.”
Internet backlash but still a prospect
Long was not prepared for what happened after he posted his intention to play again on Twitter. Just a day later, he found a message on his Facebook page from a coach at Fairmont State University in West Virginia saying Long would be a great fit for the team’s offense. Other schools soon followed with their own pitches, including Monmouth University, Wagner College, and the University of Tennessee-Martin. Long said he’s also talking to coaches at Rutgers, Ohio, and Towson universities about joining their teams.
But the public’s reaction to his announcement was harsh. Syracuse head coach Scott Shafer told reporters the news was “concerning,” while fans were even more unsparing on comment boards and social media: “Best wishes to A.J. and sincere hope that he still has brain cells communicating among themselves when he’s 50,” wrote one commenter. Another raised the prospect of “his suicide in 20 years due to CTE.”
The comments infuriated A.J., but didn’t deter his drive to find a new place to play. In mid-November, Long and his father went for an unofficial visit to Monmouth University in New Jersey. He met with the coaches, who he said were ready to offer him a scholarship as soon as the results of the Philadelphia clinic’s testing were available. Monmouth was now his top choice. It was only 90 minutes from his hometown.
Long ramped up the intensity of his workouts, and most days he would post a video of himself on Instagram lifting weights or throwing passes. After working out, the route back to his apartment took Long past the Syracuse practice fields. He no longer used the equipment at the football facility or ate at the team cafeteria. He was on his own.
One night, he stood on a small incline and silently watched his former teammates prepare for their next game under the lights. He confessed to his dad that the scene upset him. What would he do, he wondered, if the Philadelphia doctors didn’t clear him to play?
“Am I only seen as a football player?” he thought. “Is that all I am good for?”
The results are in
Long couldn’t sleep in the days leading up to his meeting with the concussion specialists who would decide his future. “All I could think about was this visit,” he said.
On the Monday after Thanksgiving, he arrived at the Jefferson concussion center in Philadelphia a few minutes before 9 a.m. Wearing a red hoodie, baseball hat, and sweatpants, he moved slowly. He said he was tired.
But when he emerged from the appointment 90 minutes later, Long was jubilant. He said a neurologist told him he was healthy and able to play football again. He posted the news on Instagram.
“God is Amazing,” he wrote. “Now it’s time to finalize where my new home will be!!!”
The doctor may have found no problems, but the concussion center was not ready to clear Long. He would have to return several more times through December. One day, therapists tried to induce concussion symptoms by putting Long through an intense workout. He went back another day for a special magnetic resonance imaging scan for concussion victims.
Meanwhile, Long packed up his apartment at Syracuse and loaded his belongings into a rental van his father drove up from Pennsylvania.
Two days before Christmas, Long was back at the Jefferson concussion center. He met with Dr. Robert Franks, a concussion specialist who is a team physician with USA Wrestling, to review his test results. Long walked out clutching a note clearing him for “full activity” and “full contact practice.”
The clean bill of health came too late for Monmouth University, however. A coach called him only days before to say the school doctors were unable to clear him to play based on the information they had. T.J. DiMuzio, the Monmouth coach in charge of Long’s recruitment, said the school had been close to offering him a scholarship. “It was a strong consideration for us,” he said.
Long said he was disappointed but is now focused on finding another school. He hopes to hear something in the coming weeks.
“I have had plenty of people come talk to me about it,” he said, “and they are like, ‘Listen, we don’t think it is smart for you to play football anymore.’ At the same time, those people don’t have to live with what I live with.
“They don’t have to watch football on Saturdays knowing that you can do the job of people out there just as well if not better than they are doing it. They don’t have to come and sit in class with old teammates and listen to them talk about the game. You don’t have to walk by practice and have that feeling of [being] left out and aloneness and have this pit in your stomach that you just feel empty,” Long said. “They don’t have to deal with that.”