The National Football League is producing a poster that bluntly alerts its players to the long-term effects of concussions, using words like “depression” and “early onset of dementia” that those close to the issue described as both staggering and overdue.

The poster, soon to be hung in locker rooms leaguewide, becomes by far the N.F.L.’s most definitive statement on the cognitive risks of football, which it had discredited for most of the past several years as academic studies and reports of deceased players’ brain damage mounted.

The new document also warns players that repeated concussions “can change your life and your family’s life forever,” a clear nod to retired players’ wives who have spoken out on the issue, occasionally before Congress. A draft of the poster also features photographs of unnamed youngsters in various sports with the reminder, “Other athletes are watching.”

The new poster, which will also become a brochure given to all players, presents a stark change in league approach. It replaces a pamphlet given since 2007 that said, “Current research with professional athletes has not shown that having more than one or two concussions leads to permanent problems if each injury is treated properly,” and also left open the question of “if there are any long-term effects of concussion in N.F.L. athletes.”

The sobering new warning could affect not just the behavior of current N.F.L. players and youth athletes, but also how retired players’ claims of cognitive decline are handled under the disability plan operated jointly by the league and the players union.

“That poster is shocking,” said Domonique Foxworth, a cornerback for the Baltimore Ravens. “It gives people facts before they take risks. But it’s not exactly a new revelation.”

Matt Birk, the Ravens’ center, said: “To put it out there in writing in locker rooms, at least it’s publicly acknowledging that, ‘Hey, this is real.’ There’s risks in everything you do, and this one is real. You can’t sweep it under the rug anymore.”

Greg Aiello, a league spokesman, said in an e-mail message that the poster, spearheaded by the league’s new head, neck and spine medical committee and written in collaboration with the players union and the Centers for Disease Control and Prevention, “is intended to present the most current and objective medical information on concussions and will be distributed to the players and clubs in the near future.” He said Commissioner Roger Goodell provided his full support.

“We took a very firm stance,” said Dr. Thom Mayer, the union’s medical director and a member of the committee who worked on the text. “This is a clear step forward in educating players.”

The poster lists symptoms that players should look out for, including headaches, confusion, memory problems and feeling more emotional, and warns them not to ignore symptoms.

Beyond detailing the symptoms and severity of head injuries, the poster extends the league’s broad redirection in concussion policy since last fall. Then, the league adopted stricter rules regarding when players can return from head injuries, and then only with an independent neurologist’s permission.

Other changes to playing rules, practice procedures and equipment are being considered, with history suggesting that alterations could be adopted at the college and youth levels.

The new language is a glaring departure from words used by the league’s old concussion committee, whose comments and research that played down the evidence of concussion risks eventually led to its chairmen’s resignations. Their successors, who directed the poster project, Dr. H. Hunt Batjer and Dr. Richard Ellenbogen, did not return phone messages Monday.

The league’s reversal is not necessarily complete. On April 30, an outside lawyer for the league, Lawrence L. Lamade, wrote a memo to the lead lawyer for the league’s and union’s joint disability plan, Douglas Ell, discrediting connections between football head trauma and cognitive decline. The letter, obtained by The New York Times, explained, “We can point to the current state of uncertainty in scientific and medical understanding” on the subject to deny players’ claims that their neurological impairments are related to football.

Mr. Lamade did not return a message left Monday at his law firm, Akin Gump Strauss Hauer & Feld in Washington. Mr. Aeillo said the league would comment on the letter at a later time.

Brent Boyd, 53, a Minnesota Vikings lineman in the 1980s, is among scores of players whose symptoms of early-onset dementia have been ruled ineligible for the considerably higher disability payments given to players with on-field injuries. That denial took place soon after the last of three plan-chosen doctors ruled in 2001 that a particular concussion Boyd sustained “could not organically be responsible for all or even a major portion” of his condition.

Denied the higher benefits by the disability board, Mr. Boyd has been fighting to reverse the decision ever since. Two months ago, another of his appeals was denied because, the reply noted, “There are no changed circumstances,” and Mr. Boyd refused to see a fourth doctor.

Mr. Aiello and a union spokesman, George Atallah, declined to discuss any possible effect the new poster might have on disability claims. Most likely, the onus will remain on players to assert that their individual conditions did derive from professional football — similar to how players must handle worker’s compensation claims — although that assertion could gain credence with the league’s imprimatur.

Meanwhile, the most immediate effects of the new poster could be on the mind-set of current and future players. Mr. Birk said that some players would still try to play through head injuries “because the culture is so strong, but it’s a good start.”

Mr. Foxworth said: “Ninety-nine percent of the people who put helmets on don’t get the payback we do, but they’re taking the same risks. It’s probably more valuable to them than it is to a lot of us.”

Chris Nowinski, a co-director of the Sports Legacy Institute and an advocate for youth concussion awareness, said he was relieved to learn about the new language. “The old pamphlet that said ‘no evidence of any long-term effects,’ it slowed down progress — it helped create a latency environment when the evidence showed great urgency for change,” he said. “There’s a greater need for culture change on the lower levels. When coaches and people around the games don’t have all the information, simple documents and simple messages are the most important.”

I first met Nico when I was leading a team at Apple. We immediately hit it off and each time I saw him after that, we just picked up from our last conversation. When the time came for him to choose a university he shared his top two interests. I remember distinctly saying to him, “Youʼre kidding me right? You have to go to New York…” he laughed and in his wisdom simply responded, “Weʼll see. I have a lot of options. I do have family there.” The rest, as itʼs said, is history.

Over the years, I have watched Nico develop his ideas and follow his passion of reaching out to people to make a difference not only in their own lives but in the lives of others as well. His spirit and compassion are of truly monumental proportion and I would absolutely place him in the category of Humanitarian. It is because Nico possess both the needed qualities of the heart and the intellect of the mind that this foundation exists. I am most honored to support him and the work of Next Season.

In the United States, about 30 million children and teens participate in some form of organized sports, and about 3 million injuries occur each year, which cause some loss of time and participation. Almost one-third of all injuries incurred in childhood are sports-related injuries. By far, the most common injuries are sprains and strains.
Obviously, some sports are more dangerous than others. For example, contact sports such as football can be expected to result in a higher number of injuries than a non-contact sport such as swimming. However, all types of sports have a potential for injury, whether from the trauma of contact with other players or from overuse or misuse of a body part.

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Accounts of spinal cord injuries and their treatment date back to ancient times, even though there was little chance of recovery from such a devastating injury. The earliest is found in an Egyptian papyrus roll manuscript written in approximately 1700 B.C. that describes two spinal cord injuries involving fracture or dislocation of the neck vertebrae accompanied by paralysis.* The description of each was "an ailment not to be treated."

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On behalf of Next Season, I would like to personally thank Mr. Alan Schwarz and The New York Times for allowing us to post his recent article featuring Next Season’s own, Dr. David Lechuga. Mr. Schwarz is a celebrated writer and author who has taken a particular interest in brain trauma and its correlation with playing professional football. Next Season is honored to feature the work of Mr. Schwarz and graciously thanks him for his support.

Sincerely,

Nicolai Lechuga
CEO/Founder

David M. Lechuga, Ph.D., Clinical Neuropsychologist
Director, The Neurobehavioral Clinic & Counseling Center
Lake Forest, California

VAN NUYS, Calif. — The five paper-clipped sheets that were slipped into a wire basket at the Van Nuys State Office Building looked no different from the other workers’ compensation claims filed by welders and cashiers. But this packet was different: it will almost certainly become a test case in considering National Football League teams’ liability for the dementia experienced by retired players. The claim was filed by Dr. Eleanor Perfetto on behalf of her husband, Ralph Wenzel, contending that his dementia at 67 is related to his career as an N.F.L. lineman from 1966 to 1973.

California’s workers’ compensation system provides a unique, and relatively unknown, haven for retired professional athletes among the 50 states, allowing hundreds of long-retired veterans each year to file claims for injuries sustained decades before. Players need not have played for California teams or be residents of the state; they had to participate in just one game in the state to be eligible to receive lifetime medical care for their injuries from the teams and their insurance carriers.

About 700 former N.F.L. players are pursuing cases in California, according to state records, with most of them in line to receive routine lump-sum settlements of about $100,000 to $200,000. This virtual assembly line has until now focused on orthopedic injuries, with torn shoulders and ravaged knees obvious casualties of the players’ former workplace.

But Dr. Perfetto’s contention that Mr. Wenzel’s dementia relates to his football employment represents a significant shift, several lawyers involved in the California system said. They estimated the case’s potential value at more than $1 million if it reaches its conclusion, probably in two or three years.

THE WIFE Dr. Eleanor Perfetto helping her husband, the former N.F.L. player Ralph Wenzel, 67, into bed at an assisted-living facility

Given the dozens and perhaps hundreds of players who could file similar claims, experts in the California system said N.F.L. teams and their insurers could be facing liability of $100 million or more. They identified a wide spectrum of possible effects: these costs could merely represent a financial nuisance for a league that recorded $8.5 billion in revenue last year, or, if insurance costs rise drastically because of such claims, the N.F.L. could be forced to alter its rules to reduce head trauma. Officials already are considering decreased contact in practice and forbidding linemen from using the three-point stance.

The more routine orthopedic claims filed by retired players have helped persuade a newly formed version of the Arena Football League to stay out of the state, the league’s commissioner, Jerry Kurz, said. Dr. Perfetto’s lawyer, Ronald G. Feenberg of Los Angeles, likened football head trauma to asbestos exposure: a workplace danger whose effects can take 20 to 40 years to manifest.

“Medical science has recently put those puzzle pieces together — that hitting your head over and over on the football field causes certain conditions,” Mr. Feenberg said. “All of these hits could have injured Ralph Wenzel’s spine. But they didn’t. They injured his brain.”

While at the law firm, Lysette and Nico gained knowledge and experience dealing with athletes and their respective injuries. Moreover, they became students of Partner, Mel Owens, and grew to value his wisdom of sports, athletes, injuries and their unique relationship. By the end of the summer, the idea of forming a non–profit organization that would provide aid to athletes arose. Over the next two years Lysette and Nico fleshed out the idea of founding such an organization and began to look to their contacts for help.

In February of 2009, Nico and Lysette founded Next Season, Inc., a non–profit organization aimed at providing aid to athletes who have suffered injuries while participating in sports. Together, they expanded the Board of Directors to include Nico’s father, Dr. David Lechuga, a neuropsychologist in Southern California, as well as Eric Traut, a family friend of the Lechuga’s and an extremely successful trial lawyer. Soon thereafter, the Board voted to bring in Craig Underwood as Executive Vice President, and most recently, Mike Borokhov and Elliott Spruell joined our team to help out with marketing and media.

Today Next Season’s team is stronger than ever, but the goal remains the same. Next Season is determined to fulfill their mission of providing help to athletes whose lives has been irreversibly harmed due to their participation in sports. Next Season will continue to build relationships, not only with those in need, but also with those who are destined to help. Moreover, Next Season will continue to educate and inform as many people as possible to prevent further injuries. Next Season will advocate for all athletes, their safety, and their quality of life after sports.

In sum, Next Season has come a long way from those days in the file room, but Next Season has a huge job ahead of them, and they are committed to the responsibility that has been bestowed upon them. If you or anyone else would like more information on how to get involved, please contact any member of the Next Season team.

Preston Plevretes, right, who sustained brain damage during a college football game, at the hearing with his father, Ted.

In what could have been a fresh start for the N.F.L.’s committee on head injuries, its two new co-chairmen, making their first official remarks on concussions before a House Judiciary Committee panel on Monday in Manhattan, were heatedly rebuked by lawmakers for sounding “like the same old N.F.L.”

That characterization by Linda T. Sánchez, Democrat of California, was the most pointed comment toward Dr. Richard Ellenbogen and Dr. Hunt Batjer, the two new N.F.L. committee co-chairmen, whose predecessors resigned last fall amid questions of bias and poor science.

Although other witnesses Monday included two retired N.F.L. players, the mother of an injured college player and three other doctors, the gathering became a litmus test for the N.F.L.’s new leaders on the issue of head injuries.

At one point, Anthony D. Weiner, Democrat of New York, asked if anyone on the panel could speak about helmet technology and became visibly irked when no one — particularly Ellenbogen and Batjer — offered a word. Later, after those doctors explained that they might retain approaches and data from their predecessors, Weiner said, “You have years of an infected system here that your job is to some degree to mop up.”

At one juncture, Weiner said, “Your answer doesn’t leave me very comforted.” At another, he chided, “You’re in charge of the brains of these players!”

Batjer, the chairman of neurological surgery at Northwestern Memorial Hospital, said in an interview that the three-hour hearing was reasonable. Ellenbogen, the chief of neurological surgery at Harborview Medical Center in Seattle, said, “I took it to heart.”

Ellenbogen said of Weiner: “I hear him loud and clear, O.K.? I didn’t have any problem with that. I think he’s right on. The bottom line is we’re coming in new and we’ve got a lot to do.”

Since a similarly heated hearing before the House committee last October, the N.F.L. has made several substantive changes to its approach to brain injuries, including the use of independent neurologists for return-to-play decisions and the airing of public-service announcements.

Just last week, Commissioner Roger Goodell wrote to the governors of 44 states without explicit concussion guidelines for youth sports urging them to follow Washington State’s law, which Ellenbogen helped devise.

In March, Batjer and Ellenbogen replaced Dr. Ira Casson and Dr. David Viano on what the N.F.L. renamed its Head, Neck and Spine Committee, further distancing itself from the group’s controversial past.

Batjer opened the hearing by detailing the league’s redirection and its current goal to make all sports, not just football, safer for athletes of all ages.

Ellenbogen discussed the Washington law, a new league injury database and the N.F.L.’s interest in assessing the cognitive decline of retired players. He concluded by saying, “I can assure you that the N.F.L. will be the leader now in this area.”

Sánchez and Weiner, the only two members of the House committee present for most of the hearing, later pressed the doctors for details. When Weiner received no response to his general question about helmets, he said, “If no one here is qualified to talk about it, I guess in the future we could perhaps drill into this.”

The doctors’ responses often cited subcommittees and outside experts — at one point, Weiner interrupted sarcastically to say, “I appreciate this roll call, but do you remember my question?” — rather than the mind-set of Batjer and Ellenbogen themselves.

Weiner said in a subsequent interview that despite their being in the leadership positions only two months, he expected greater proactivity and assertiveness from the N.F.L. doctors.

“I was troubled by the idea that the N.F.L.’s new experts on head trauma would be so unprepared to answer even basic questions about helmets,” he said.

Sánchez focused on retired players, who studies — including one commissioned by the N.F.L. — indicate to be reporting dementia and other cognitive disease at several times the rate of the national population. When Batjer discussed how a fellow committee member could use data collected by Casson that outside experts strongly discredited, she wondered how the group’s new leadership could consider following the path of the old.

Sánchez said in an interview, “I know they’re relatively new, but they’re not young and naïve.”

She added later, “I can only cross my fingers and hope they’ll be a little more responsive to retired players and a little more willing to part with the N.F.L.’s older way of doing things.”

Other witnesses testified about their own areas of expertise.

The retired players Nolan Harrison, 41, and Corey Louchiey, 38, recalled pressure to ignore injuries and their current fears of future cognitive problems.

Charlotte Bingham, the associate vice chancellor of administration at Texas Tech University, detailed a well-publicized incident last year in which Coach Mike Leach responded to the concussion of a player, Adam James, by angrily sending him to a dark shed in which he had to stand for an entire practice. Leach was later fired.

The most personal testimony came from Tammy Plevretes, whose son, Preston, was seriously injured while playing football for La Salle University in 2005. Contending that the university did not follow proper procedures for handling concussions, the family settled a lawsuit against La Salle last fall for $7.5 million.

Preston Plevretes, who watched Monday’s hearing from the audience, sustained permanent neurological injuries and almost five years later can barely speak or walk.

“This is not a broken arm or a broken leg,” Tammy Plevretes said through tears. “This is a broken life.”

Later, while one of the N.F.L. co-chairmen spoke about league policies, Weiner noticed Preston Plevretes’s father, Ted, gingerly hoisting his 24-year-old son out of his seat. Weiner watched as Preston struggled up the stairs and disappeared behind a door, then returned his stare to the doctors.