Category Archives: concussions

Gray matter: Is watching a brain-addling sport ethical?

 

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Just who among us needs our heads examined?

Football players? Last week’s revelations of the late Giants star Frank Gifford’s positive test for the degenerative brain disease chronic traumatic encephalopathy, or CTE, came days after St. Louis Rams quarterback Case Keenum, attempting to rise after a tackle, was all rubbery and disoriented, while  little imaginary birds twirled around his helmet.

Football fans? There certainly are some who have begun to wonder about the ethics of supporting a sport faced with increasing evidence of its participants’ cognitive impairment. Gifford was the 88th of 92 deceased former NFL players examined who was found to have had CTE.

Parents of potential football players? At the Boston University center that studies CTE, the percentage of positive tests on former players from all levels is a whopping 90-plus percent, and pre-collegiate players have been sustaining some 90,000 concussions per year. Among the public figures who have said that, if they had sons, they would not allow them to play football, is Football-Fan-In-Chief Barak Obama.

How about anyone who thinks these headache-inducing reports signal the imminent demise of our most popular sport? It has been almost 14 years since the first case of CTE was diagnosed in a deceased football player, yet Harris Polls continue to find football to be the nation’s overwhelmingly favorite spectator sport—37 percent of the population lists the NFL as No. 1 and another 11 percent prefer college football. (Only 16 percent of the citizenry list Major League Baseball as top choice and no other sport breaks into double figures.)

In 2009, in a New Yorker magazine piece, Malcolm Gladwell considered football’s future extinction, and a stream of thoughtful reports since then have considered how the ramifications of head injuries might play out: Liability suits that could subject coaches, team doctors and referees to financial exposure. Parental concerns. Skyrocketing Insurance costs. The drying up of advertising and television commitments. Congressional action.

Last year, a self-described NFL fan wrote to New York Times ethics columnist Chuck Klosterman pondering the morality of supporting a league apparently aware that its sport is detrimental to the health of its participants. Klosterman concluded that, as long as everyone is enlightened about the peril that could visit football players, he “can live with” the public loving something that is dangerous.

Me, too. And, after all, football isn’t boxing or—worse—mixed martial arts, in which the primary purpose is to separate an opponent from his or her senses. But we should persist in furthering our education about the potential hazards, and hope that football authorities do the same. Early-onset dementia among players is real gray matter, something to consider in all its shades and consequences.

A crack neurologist once explained to me the brain’s vulnerabilities, and it goes something like this:

The brain isn’t much more than a blob of Jello, about three pounds net weight, floating in a fluid, held in place by a scaffolding of fibers. It is as well-housed as any other internal human gadget—the skull, after all, doesn’t crack easily. But with a blow to the head, whether encased in a helmet or not, the brain easily can rattle off the inside walls of the skull or, worse, twist violently, causing a tear.

A simple concussion brings temporary alteration of consciousness, often so brief as to go unnoticed, yet short-circuits the part of the brain controlling awareness, alertness and focus of attention. A stronger bop on the head can create a contusion, a bruise caused by the brain ricocheting off the opposite wall of the skull and then back again. Even more damage results if the torque force wrenches the Jello mass.

Later this month, the movie Concussion will be released, and director Peter Landesman has said the film can’t help being “a shot between the eyes of the NFL,” because it portrays how forensic neuropathologist Bennet Omalu (played by Will Smith) had to battle NFL efforts to suppress his research on players’ brain damage.

Omalu was the man who, in a 2002 autopsy of former Pittsburgh Steelers lineman Mike Webster, first recognized CTE in a football player. Each of the first nine deceased NFL players’ brains Omalu examined, in fact, had CTE, and he told me during a telephone interview in 2010 that the root cause was not “just concussions. It’s repeated blows to the head. Helmets do not prevent concussions or [undiagnosed] sub-concussions, because they don’t stop the brain from bumping around in the skull.

“We have to take the head out of the game.”

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And good luck with that. Though the NFL and other football authorities belatedly are implementing rules and protocols to limit head trauma, there is this Gordian knot: With both Frank Gifford’s conspicuous 1960 concussion, suffered on what often has been described as a “brutal, blindside” tackle by Philadelphia’s Chuck Bednarik, and Case Keenum’s recent injury, the damage in fact was not a result of an opponent’s contact with the head.

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The Gifford injury, which precipitated his one-year sabbatical from football, was sustained when the back of Gifford’s head struck the ground as he went down. He had attempted to sidestep the charging Bednarick and the two essentially were facing each other at the instant of the tackle. On impact, Bednarick caught the off-balance Gifford with an arm and shoulder across Gifford’s chest, rocking Gifford backward.

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Keenum was tackled waist-high but, like Gifford 55 years earlier, bounced his noggin off the turf as he fell backward. Jello surprise. So how to safeguard against that?

I don’t have a son. So that’s settled. And I will continue to be a football spectator. But I will make sure to check out Concussion as well.

 

 

Football and underinflated heads

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In the run-up to the Super Bowl, amid too much attention to shrunken footballs, let us consider deflated heads. This week’s report of another deceased player found to have suffered from head-trauma disease related to the sport, and a medical study revealing increased risk of memory problems for kids who play tackle football prior to age 12, are what ought to scare the stuffing out of the NFL.

This is the kind of real news—as opposed to the vacuous Super Bowl media angst over players who won’t answer questions, Tom Brady’s sniffles and the chain-of-custody for game balls—that speaks to the future health of a $10-billion-a-year business. That so many former players, and potentially so many children entering the sport, will be losing their marbles prematurely would appear to dull the Big Game’s usual fireworks-and-marching-bands atmosphere.

And it could gradually siphon off future talent and fans, which is why the NFL, as reported by the New York Times, has been taking evasive action by backing nationwide Mom Clinics, meant to convince parents about the safety of having their tykes—as young as 5 years old—cracking heads in youth leagues.

It has become fairly standard for the NFL, and many of its players, to reference increased study of concussions and improved protocol in treating head injuries as their assurance against having a screw loose in later life. True enough that we all have learned plenty about the dangers over the years.

Long ago and far away, during my high school days on the football team in Hobbs, N.M., we dismissed “getting our bell rung” as an insignificant test of toughness. My friend Ronnie Foster, in fact, perfected a ball-carrying style in which he would lower his head to meet a would-be tackler, spinning away from the helmet-to-helmet blow to keep on going. I tried this in practice, with some success, but was fortunate to spend most of my time on the bench, so that I never got enough game-time action to render myself any goofier than I am.

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That was 1964. In 2002, Dr. Bennet Omalu, a forensic neuropathlogist, diagnosed so-called “punch-drunk” syndrome—specifically, CTE, or chronic traumatic encephalopathy—during his autopsy of former Pittsburgh Steelers lineman Mike Webster. But it wasn’t until 2010 that the NFL announced it was hanging posters in all of its teams’ lockerrooms to warn players about the long-term dangers of head trauma.

“Why this took so long, I don’t know,” Omalu told me in a telephone conversation at the time. “I’m no genius; this is something I read about in medical school more than 20 years ago.” Since Omalu’s discovery about Webster, CTE repeatedly has been found in deceased old players. Former New England Patriots running back Mosi Tatupu, who died at 54 in 2010, was the latest cited in a Wednesday Boston Globe article.

Of course, there have been rule changes to prevent “targeting the head area,” restrictions on contact in practice and scientific work on finding the perfect helmet. But Omalu has argued that brain damage results not just from specifically diagnosed concussions but also from repeated blows to the head, and that helmets “do not prevent concussions or sub-concussions, because they don’t stop the brain from bumping around in the skull.”

“We have to take the head out of the game,” he said.

As a cerebral exercise, discovering a way to do that—and still have football as we know it—is a far bigger challenge than keeping all the pigskins inflated properly. Especially when fellows such as Jim Tressel, when he coached at Ohio State last decade, instituted the “Jack Tatum Hit of the Week Award,” glamorizing the viciously aggressive defensive play of a man known as the “Assassin,” and whose savage 1978 hit on New England’s Darryl Stingley left Stingley paralyzed the last 29 years of his life.

Maybe not everyone in football has a screw loose, though. A year ago, the school board in Marshall, Tex.—which fields a perennial state gridiron powerhouse and where Hall of Fame quarterback Y.A. Tittle played high school ball—approved plans to replace the district’s entry-level, tackle-football teams for seventh graders with a flag-football program. At least until they are a little older, those Marshall kids won’t have deflated heads.