As a linebacker tackles New York Giants running back Cam Skattebo on a routine play, Skattebo’s head slams to the ground.
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For millions of people who play the Madden NFL video game franchise, Skattebo will get up and continue the drive unhindered. Concussions do not exist alongside the game’s dislocated shoulders, broken ribs and ankle sprains.
But those players who have installed a free modification of the game will have a distorted experience. They may encounter blurred vision, light sensitivity, nausea, increased heart rate, headaches, shortness of breath, dizziness or tinnitus, the screen shaking as they hear a ringing sound.
The reach of the modification, or mod, that depicts common symptoms of concussions may be small, but its message is clear.
The successful Madden franchise — its newest game, Madden NFL 27, was released Aug. 13 — is extremely faithful in its representation of the National Football League. It incorporates new short-yardage plays, detailed player tattoos and signature throwing styles. For many years, the distinctive tagline for its developer, EA Sports, was “If it’s in the game, it’s in the game.”
So where are the concussions?
A spokesperson for EA Sports declined to comment.
Realism up to a point
Chris Borland, a linebacker who left the NFL after his rookie season because of concerns over the long-term effects of brain injuries, applauded the mod’s effort to raise awareness. But he emphasized that there was a big difference between seeing a visual representation of a brain injury while sitting on your couch and actually experiencing one.
“It’s really realism up to a point,” he said of the mod. “Is there going to be a feature in the game where you can go home and have difficulty with your wife because you’re irritable from your concussion?”
The mod is available to download only for the computer version of Madden 26, last year’s game. It was a collaboration by Klick Health, a healthcare marketing agency, and the Derek Sheely Foundation, a concussion awareness nonprofit, which cite the coach and television analyst John Madden as inspiration.
When concussions were emphasized in Madden 12, which was released in 2011, the game’s producer called it a “teaching tool.” Athletes who sustained concussions were sidelined, and the announcers talked openly about the head injuries. John Madden, who had a major hand in the development of the franchise, told The New York Times that year that “concussions are such a big thing, it has to be a big thing in the video game.”
“Concussions are really serious,” he added. “If we show players playing through them, then kids won’t understand.”
Many athletes who appeared on the covers of previous Madden games — including quarterbacks Michael Vick and Lamar Jackson — have been knocked out with concussions in real games. In versions of Madden from the 1990s, an ambulance whisked injured players away. Well into the 2010s, players who writhed in pain while holding their heads would undergo what appeared to be a concussion test.
But it was around that time that the NFL came under fire.
Hall of Fame linebacker Junior Seau died by suicide and was found to have chronic traumatic encephalopathy, the degenerative brain disease known as CTE. The NFL settled a lawsuit brought by thousands of former players and their families who accused the league of hiding the dangers of brain injuries; the league has since paid more than $1.5 billion in claims. A feature film starring Will Smith, “Concussion,” chronicled the discovery of CTE in pro football players.
Eliminated from the game
By the end of the decade, concussions had disappeared from Madden.
Ben Utecht, a tight end who retired from the NFL in 2010 because of his concerns about the long-term effects of concussions, said the league never wanted to bring attention to head injuries “because obviously you want to inspire parents and kids to continue playing the game.”
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“But,” he added, when it comes to the Madden video game, “you shouldn’t just remove one injury if you’re going to include the rest.”
Other injuries still occur, with gamers forced to decide whether to keep a player with an ankle bruise on the field and risk a more severe injury or to sub him out. They can also decide to turn injuries off altogether.
Members of the NFL’s licensing department review Madden games each year to ensure “quality control,” and they can make suggestions to Electronic Arts. That has involved discussions about the inclusion of concussion evaluations, according to a former league executive who recalled discussions about the feature. Because there are only a few potential concussions per game, the league wanted the head injury to be incorporated realistically, the former executive recalled.
Another person with direct knowledge of the negotiations recalled discussions about what would cause a concussion in a game, because, in real life, two players might absorb similar hits to the head, but only one might get a concussion.
The NFL declined to comment.
Last season, there were 168 reported concussions in the NFL, an increase from 129 a year earlier that the league attributed to rule changes encouraging more kick returns. The league’s concussion protocol requires a blue tent on the sideline where players must undergo testing if they exhibit signs of a possible concussion.
The Derek Sheely Foundation
Kristen Thomson Sheely, the executive director of the Derek Sheely Foundation, said she knew how popular Madden was because her son Derek played it. He died at the age of 22 after sustaining a brain injury during a college football practice in 2011.
“This could reach so many people,” she said of the mod, “a whole different audience of people who would never order a concussion kit.”
Derek Sheely was a fullback at Frostburg State University in Maryland when he complained of a headache during practice after having apparently already sustained a head injury, according to court papers. A coach berated him for complaining, the documents say, and he was sent back in for a 7-on-7 drill.
Sheely was then involved in a collision with a defensive back. He walked back to the sideline, but within a few minutes “collapsed and never regained consciousness,” a legal complaint said.
Eventually, the family reached a $1.2 million settlement with the NCAA and other defendants including Frostburg State, which was required to retire the fullback’s number and display it on campus.
Those playing with the Madden concussion mod are also given a moment to remember Derek Sheely. When their games end, a banner unfurls. It is his jersey, No. 40.
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