By Scott Malone
NEW YORK (Reuters) - Fans watching Sunday's Super Bowl can count on seeing long passes, big tackles and dramatic running plays. They should not see a player lying prone on the field after the sickening crack of a helmet-to-helmet hit, thanks to an NFL effort to reduce player concussions.
With a growing body of research showing that hits to the head over years on the football field can lead to early dementia, violent behavior and other mental problems later in life, league officials, former players and medical experts have been working to reduce the number of concussions on the field.
Medical officials with the National Football League said changes including banning helmet-to-helmet hits and more aggressively monitoring players' condition on the sidelines have paid off: the number of concussions suffered by players dropped 13 percent in the 2013 season from 2012. The figures, compiled by the league, could not be independently verified.
The latest data was encouraging to Shawn Wooden, 40, a retired defensive back who spent most of his career with the Miami Dolphins and is one of 4,500 former players suing the NFL, saying the league knowing downplayed the risk of concussions to player health.
"Thirteen percent, that's a step forward for the safety of the game," Wooden said during an interview in New York. "That's what everybody wants, making sure that player safety is the main objective. ... Making sure that we are taking care of guys who are suffering from some of the injuries, some of the head trauma."
A growing body of medical research shows the repeated hits to the head suffered by football players, hockey players, boxers and other athletes can lead to a debilitating brain condition called chronic traumatic encephalopathy, or CTE.
The condition, which can currently be confirmed only after death, has been found in some players who died in recent years, including former San Diego Chargers star Junior Seau, who shot himself in the chest in 2012.
One of the biggest rule changes the league made this season aimed at reducing concussions is stopping players from spearing each other with the crowns of their helmets.
"There were actually very few of those violations called by the officials, so I think there is an awareness that this is something that has to be taken out of the game," said John York, a doctor and co-chairman of the San Francisco 49ers.
Some 228 concussions were recorded during the 2013 pre-season and regular season, including practices, down from 261 in 2012, according to figures the league released this week.
The league has financial incentives to work on minimizing concussions. A federal judge in Philadelphia this month rejected the NFL's $760 million settlement offer in the lawsuit by former players, saying more may be needed to cover future needs of those who were injured.
The NFL has taken a more active approach to evaluating players for possible concussions during games, keeping a doctor on the sidelines who is paid by the league, not the teams.
"There are uniform protocols on the sidelines for diagnosing these and that's part of the change," said Jeff Miller, NFL senior vice president of health and safety.
Players who have suffered hits that could lead to concussion are put through a set of standardized tests that evaluate their memory and balance, which doctors and trainers use to decide whether to pull the player from the game.
Medical staff have become quicker to pull athletes out of a game if they may have suffered a concussion. The concern is that someone who has suffered even a mild concussion may be at risk for a more serious one. That requires a firm approach when dealing with professional athletes, who try to hide signs of concussion to return to play, doctors and players said.
"As a team physician, I've told players, listen I'm trying to do this for your benefit, please be honest with me," said Matthew Matava, an orthopedic surgeon and doctor for the St. Louis Rams. "As I'm doing that I'm also taking his helmet so he can't run back on the field."
Stefan Duma, a professor of biomedical engineering at Virginia Tech in Blacksburg, Virginia, who studies concussions in football, called the decline "pretty significant."
He noted that improvements in helmets have likely helped reduce concussions but said the most important factor was changes to the rules limiting head-to-head hits.
"Not getting hit in the head is the best thing," Duma said.
One of the biggest factors in reducing concussions in football is cultural, both changing play so that athletes don't lead with their heads and convincing players to take the risk of concussion seriously, experts said.
Denver Broncos wide receiver Wes Welker, who suffered two concussions this year, told reporters he is glad to see the league trying to limit them.
But when asked if he would let a concussion keep him out of Sunday's championship matchup against the Seattle Seahawks, he replied, "What do you think?
"I mean, you want to be out there. The Super Bowl, this is what you dream about," Welker said. "You're going to be there, I don't care what it takes."
Even Duma said he understood the sentiment. More important, he said, is avoiding concussions at lower-level play.
"If you're in the penultimate game of your career ... the majority of people would do whatever they can to stay in that game," Duma said. "That's very different form pee-wee football, high school football, 99 percent of the games we play."
(Reporting by Scott Malone; Editing by David Gregorio)