Head Injuries From Contact Sports a Major Risk

Last week featured the biggest American sporting event of the year, the National Football League’s Super Bowl. For anyone who had been following the news coming to light the weeks leading up to the big game, an uncharacteristic black cloud seemed to hang over the occasion.

Preparing for the biggest game of his career, Ray Lewis, a star player for Baltimore, found himself suddenly in the midst of a doping scandal. On the other side, a San Francisco player made explicitly homophobic comments that received widespread media coverage and backlash. And if this wasn’t enough, the NFL found itself facing the strongest evidence yet that contact sports like football lead to long-term neurological damage due to a poorly understood condition called chronic traumatic encephalopathy, or CTE.

No one is sure exactly how old you must be to start showing signs of CTE, or how much head trauma an athlete needs to show symptoms. Many retired football players have reported symptoms such as dementia, headaches, disorientation, confusion, and vertigo. The final stages of CTE closely resemble Parkinson’s disease accompanied by overt dementia.

Researchers have struggled to identify CTE and its symptoms because there has not been a way to detect signs of CTE in living athletes until just this January. CTE is defined by a number of brain abnormalities, such as the atrophy of the frontal cortex — which controls attention, short-term memory tasks, and motivation — and the temporal lobe — which is responsible for long-term memory. Shrinkage in these areas of the brain is hard to detect because there is no known technology to track specific molecules or phenomena in the brain associated with CTE.

While most CTE research is quite recent, it actually has a long history associated with contact sport. People have known CTE occurs in boxers and prizefighters since the early 20th century, when it was known as “punch drunk syndrome.” Doctors assumed that only boxers could get punch drunk, and didn’t associate it with injuries sustained in other contact sports.

However, the pioneering work done at Boston University School of Medicine since 2008 has forever changed the way we think of contact sports. By performing autopsies in on the brains of deceased NFL players, the lab was able to determine that 33 of the 34 brains they sampled showed damage due to CTE. The lab has also diagnosed CTE post-mortem in the brains of hockey players, soccer players, and wrestlers.

There have also been claims of correlation between player suicides and CTE. Three retired NFL players who have committed suicides in the past six years have all been diagnosed with CTE. There is also speculation that the suicides of three National Hockey League players last year will eventually be linked to CTE. All three athletes played the role of “enforcer” for their team — a position whose main responsibility is to get into fist fights with members of the other team, and often comes along with a number of blows to the head.

Even a college linebacker from the University of Pennsylvania, who took his own life in April 2010, was afterwards diagnosed with CTE by the BU lab. The young man, Owen Thomas, had never been diagnosed with a concussion and never showed any symptoms or behaviors indicative of neurological damage. Researchers suspected that there was a strong possibility his behavior may have been altered by CTE.

As stated above, there has recently been a breakthrough in CTE research. Just last month, researchers at UCLA used new imaging techniques to locate damaged proteins related to CTE. This method allowed them to detect signs of CTE in living subjects. They specifically looked at images of five retired NFL players, all of whom screened positive for CTE. If these techniques prove accurate in further studies, they will bring us a step closer to identifying CTE in living athletes.

Critics of professional football and other contact sports have called for drastic changes in how the games are played. In hockey, new strict enforcement prohibiting blows to the head is in the process of creating change in the way the sport is played. The NFL has similarly engaged in new efforts to protect players in “defenseless” positions and to discourage hitting others in the head or neck areas. However, in the NFL especially, the focus in recent years has been for players to be bigger, run faster, and hit each other harder. Unsurprisingly, this has been a recipe for more head trauma among professional football players in modern football.

What does information like this mean to modern sports? Some are saying that the NFL should read the writing on the wall. They are already facing lawsuits from a collection of retired players suffering from mental health problems as well as concerns from current players about the toll their careers are taking on their bodies. Because there is no known amount of head trauma that leads to CTE, it is hard for the NFL to impose appropriate safety regulations. Current football helmets were designed to withstand strong blows and protect the player from injuries such as skull fractures, but do nothing to protect players from the repeated head trauma that leads to CTE and contributes to concussions. Helmets may even lead to a higher incidents of CTE because players can use helmets to hit their opponents even harder than would have been possible with the old leather football helmets.

Regardless of the risks, the NFL and other professional sports must embrace and respond to the best information we have about the dangers of CTE. The danger is real, not only to professional athletes, but to collegiate athletes and high school athletes. Because so little is known about CTE, we have little to no information about how much head trauma is too much, and how long you must play a contact sport before you sustain long term damage. Until diagnostic tools for CTE are developed and implemented, it’s essential that our professional sport leagues act responsibly and educate professional athletes and student athletes alike about the long-term risks they face. Many have said that the NFL has reached a turning point in its history, but the question remains whether it will embrace the future, or act in ignorance and continue to endanger the next generation of young athletes who will bear the consequences of their inaction for a lifetime.

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