NFL CONTINUES TO EMPHASIZE PLAYER HEALTH AND SAFETY - Ingles

As part of its continued focus on player health and safety, the NFL this offseason adjusted key rules, introduced new sideline
measures and continued research dedicated to improving helmet design.

During the NFL Scouting Combine in February, the NFL Head, Neck and Spine Committee presented its new sideline concussion
protocol, which is aimed at assisting teams in diagnosing players with suspected head injuries during games. The protocol was
presented by DR. MARGOT PUTUKIAN, chair of the Head, Neck and Spine Committee’s Return-to-Play Subcommittee.

Developed in response to a team medical staff survey conducted last season, the new protocol combines a symptom checklist, a
limited neurologic examination including a cognitive evaluation, and a balance assessment. It was developed by the NFL Head,
Neck and Spine Committee, with input from the NFL Players Association and its medical advisors, NFL team physicians, athletic
trainers and their professional societies, and other medical experts.

“This tool provides a standardized format for evaluating head injury that medical staffs can use on the sideline,” says Dr. Putukian, who is also the head team physician for Princeton University, a past president of the American Medical Society for Sports Medicine and the physician representative of NCAA and the American College of Sports Medicine. “It incorporates the most important aspects of a focused exam, so that injury is identified, and athletes with concussion and more serious head and spine injury can be removed from play.”

As part of the sideline protocol, players will be asked to complete tests like the following:

• They will be told three numbers, such as 4-9-3, and asked to repeat them in reverse order.
• They will be asked to stand with feet together, eyes closed, hands on hips and hold that position for 20 seconds.
• They will be told a list of words (such as elbow, apple, carpet, saddle and bubble) and asked to repeat them back in any
order.
• They will be asked basic things like, “Who did we play last game?” and “What quarter is it?”

The focus on player safety continued with rules changes proposed by the NFL Competition Committee and ratified by the 32 NFL teams this offseason. In March, teams approved a rule change whereby the restraining line for the kicking team was moved from the 30 to the 35-yard line.

In addition, all kicking team players other than the kicker must be lined up no more than five yards behind their restraining line,
eliminating the 15-20 yard running “head start” that had become customary for many players.

In May, teams also approved a new rule that will fine teams if their players are repeatedly disciplined by the league for improper
hits. The rule will go into effect next season and is designed to ensure coaches educate their players in proper technique to avoid hits to the head and neck.

NFL Senior Vice President for Labor Policy ADOLPHO BIRCH described potential fines as “significant but reasonable.”
Competition Committee Chair and Atlanta Falcons President RICH MC KAY views these rule changes as evidence of evolving
mindsets on head injuries.

“I’ve seen a cultural shift, all for the better,” says McKay. “I think the old mentality of, ‘I’m tougher than that. I just got dinged, I can keep going,’ I think we’re starting to move past that.”

To ensure that youth athletes are protected from head injury and treated appropriately when they are suspected of injury, NFL
representatives, including former players, have advocated for passage of the Lystedt Law. The law is named for Zackery Lystedt
who, in 2006, suffered a brain injury following his return to a middle school football game after sustaining a concussion. Zackery, his family and a broad range of medical, business and community partners lobbied the Washington state legislature for a law to protect young athletes in all sports from returning to play too soon after head injuries.

The Lystedt Law contains three essential elements:

• Athletes, parents and coaches must be educated about the dangers of concussions each year.
• If a young athlete is suspected of having a concussion, he/she must be removed from a game or practice and be
prohibited from returning to play. When in doubt, sit them out.
• A licensed health care professional must deem the young athlete fit to return to play in the subsequent days or weeks.

As of July, 26 states (plus the city of Chicago) have adopted youth concussion laws. Four of these states have passed legislation
and are awaiting respective governor’s signatures.

“If I could tell youth athletes one thing, it would be to take care of your health,” says Zackery, who recently graduated from high
school and walked across the stage to receive his diploma. “It makes me feel proud when I hear about Lystedt Laws being passed in other states. Sharing my story is important. I don’t want anyone else to live through what I’ve had to live through every day.”

In June, the NCAA announced that it too is supporting the NFL in its advocacy efforts.

“We are working alongside NFL Commissioner ROGER GOODELL and the NFL to help protect young athletes at all levels of
competition,” says NCAA President MARK EMMERT.

Commissioner Goodell praised the NCAA’s participation.

“We are pleased that the NCAA will support our campaign and add visibility to this issue not only with football but also with the
other 22 NCAA sports for the benefit of young athletes and their families,” says Goodell. “We have learned that while concussions certainly are a challenge in football that it is equally important that young athletes in many other sports be educated on this subject as well.”

The focus on health and safety has spread beyond the playing field and into the virtual world, as video game developers are
implementing new safety measures into gameplay. In April, EA Sports announced that in upcoming versions of their popular
Madden NFL 12 game, virtual players will be shown receiving concussions. When a player is concussed, he will be sidelined for
the remainder of the game. In-game announcers will also refer to the importance of treating head injuries.

“If they can’t play, they have to go through the same protocols (as the league), just to promote awareness,” says JOHN MADDEN,
who also serves as Co-Chair of the NFL Player Safety Panel. “It starts with young kids – they start in video games. I think the
osmosis is if you get a concussion, that’s a serious thing and you shouldn’t play.”

The health and safety of youth athletes is a priority for the NFL. Working with the Centers for Disease Control and Prevention
(CDC) and USA Football, the sport’s governing body on youth and amateur levels, NFL teams help youth and high school
coaches learn the signs of head injury and understand the best methods of treatment and prevention. Coaches are also educated on the subject during the NFL-USA Football Youth Football Summit, which takes place in Canton, Ohio each year.

The CDC’s Heads Up: Concussion in Youth Sports initiative offers information about concussions to coaches, parents, and
athletes involved in youth sports. It provides tailored information on preventing, recognizing, and responding to a concussion for coaches, parents and youth athletes.

USA Football also works with the CDC, and leads another concussion-awareness campaign called Put Pride Aside for Player
Safety. Through public service announcements and instructional videos, the initiative emphasizes the seriousness of head injuries and how damaging it can be to allow pride or bravado to guide decisions on when to remove a player suspected of injury from a game.

While medical professionals agree that helmets cannot fully protect against concussions, NFL researchers are among those
exploring ways to use helmets as a means to provide important data on player health. DR. KEVIN GUSKIEWICZ, Director of
Sports-Related Brain Injury Research at the University of North Carolina and a member of the NFL Head, Neck and Spine
Committee, is testing helmet sensors – called accelerometers – to monitor the impact of hits to the head during games.

“The purpose is to find out in real time out on the field, as opposed to in a laboratory like we’re doing here, what types of impacts players take,” says Guskiewicz.

Guskiewicz, who heads up the NFL Head, Neck and Spine Committee’s subcommittee on safety equipment, is also testing
mouthguards with sensors for the same purposes.

The data provided by these sensors may one day help medical professionals understand why athletes respond differently to head impact.

“I don't think there’s anything that will ever eliminate concussions,” says DR. RICHARD ELLENBOGEN, Chairman of the
Department of Neurological Surgery at the University of Washington School of Medicine Department and Co-Chair of the NFL
Head, Neck and Spine Committee. “But I’d like to see them go as low to zero as we possibly can.”

For more information, visit http://nflhealthandsafety.com.