Each time BenJarvus Green-Ellis lines up behind Tom Brady in Sunday’s Super Bowl, the Patriots running back will fasten a special chin strap to his helmet, featuring an impact indicator designed to help detect the probability of concussions. During a commercial break, television viewers will be shown a promotional message from the NFL touting the advances the league has made in player safety.

Without question, the NFL has made health issues a higher priority in recent years. Commissioner Roger Goodell has earned genuine respect for what he has done to protect players in both the short and long term. Equipment is better. Rules are stricter — and they’re more stringently enforced.

But what can’t be changed summarily by league office fiat is culture. And in football, a sport in which Ronnie Lott once removed part of his pinkie to stay on the field and Jay Cutler was eviscerated as being soft because he wouldn’t return to the field after being injured in the NFC championship game, attitude shift is more difficult to achieve than rule changes.

Remember Week 14? When Steelers linebacker James Harrison delivered a crumpling, helmet-to-helmet blow to Browns quarterback Colt McCoy during a Thursday night game? Anyone who watched the replay winced. Harrison was given a roughing-the-passer penalty (and later suspended and fined).

But McCoy was never given a concussion test on the sideline and, in fact, returned to the field after missing two plays.

In the aftermath, Harrison asked the most pertinent, sobering question regarding the NFL’s proactive concern for players suffering head trauma.

“If he was hurt so bad, I don’t know why they let him back in . . . two plays later,” Harrison said. “Something should be done to them, I would think. I don’t know. I got a game, what should they get?”

What they did get was nothing. Instead, as a direct result of the Browns’ failing to test McCoy for a concussion on the sideline, the NFL told its 32 teams that an independently certified athletics trainer will be assigned to monitor all suspected concussion-related injuries from the press box.

That was another positive step, but it treated the symptom more than the disease. On paper, the league’s directive is clear: Team doctors have final say in a player’s ability to take the field after being tested on the sideline. But the idea that a team-employed trainer’s voice would supersede a head coach’s immediate game needs is still difficult for most players to genuinely grasp.

“Is it realistic for someone to do that? Yes,” Redskins linebacker Lorenzo Alexander said. “But will it happen when you’re trying to win a game you need to win? I don’t know if that will happen. Especially when it’s one of your top two guys.”

Alexander knows of which he speaks. When he returned to the sideline woozy after making a hit during the Redskins’ game against Arizona in the second week of the season, he remembered his helmet was taken from him and he was given a concussion test in the locker room at halftime.

“I definitely wasn’t 100 percent when I went back out off the field, but I passed,” he said. “It was important for me to be out there with my team. I was fine, I thought. No headaches, loss of memory. Good to go.”

While the league may not be able to change that kind of culture overnight, it can legislate accountability. It’s already happening in the U.S. military, one of the few places where toughness and “playing hurt” are prized in the same way. Col. Geoffrey Ling of DARPA, the Department of Defense’s research and development office, and also a member of the NFL’s Head, Neck and Spine Committee, sat in an Arlington office last month, doing his best to dovetail the troops’ post-concussion experience with that of NFL players.

“The real difference is, in the military our line commanders are held responsible if they aren’t taken off the line,” Ling said. “It goes right up the chain of command, which basically means that the medic can go and do their job. You can understand the pressures perhaps on the line leaders saying, ‘Oh, man, I might lose a couple of these guys, like the radio operator. I can’t lose him.’ But they realize that him impaired probably puts your unit more at risk then him flat-out not being there. The point is that now we’ve taken the onus off the individual patient to say, ‘I am sick.’ ”

In the meantime, don’t give up on changing the culture. Richard Ellenbogen, who chairs the department of neurosurgery at the University of Washington School of Medicine and is another member of the league’s Head, Neck and Spine Committee, remembers giving a presentation to the NFL competition committee a year ago when he was interrupted.

“Hey, Doc, great idea — you need to standardize things,” said John Madden, the former coach and popular broadcaster. “But you haven’t gone far enough. You need to put players in a quiet room. There’s too much screaming on the field. And if a guy doesn’t pass, I want his helmet taken away.”

Three months after they spoke at the combine, Madden was on a conference call with Ellenbogen regarding the league’s concussion policy and its culture change, expressing regret for generations of coaches and players.

“But that was the kind of thinking: don’t hurt your ankle, don’t hurt your knee where you can’t run, or don’t hurt your shoulder where you can’t tackle, but your head? Heck, that’ll clear up in a couple minutes and you’ll be okay,” Madden said. “But we were all that way. When I went into broadcasting, I still had that. . . . I probably said a lot of dumb things as a broadcaster. And if I were to do either one of them over again, I wouldn’t do it again.”

Perhaps in the ultimate nod toward the issue, players in the Madden ’12 video game sometimes suffer concussions. Unlike McCoy on that night in Pittsburgh, concussed players in the video game are unable to return to the field.

For Mike Wise’s previous columns, go to washingtonpost.com/wise.