Wednesday, January 28, 2009

Concussions in football players

This might be the most important football-related news in many years. Followed this link off the Football Outsiders web site, so compliments to them on disseminating this. From CNN:

Dead athletes' brains show damage from concussions

using tissue from retired NFL athletes culled posthumously, the Center for the Study of Traumatic Encephalopathy (CSTE), at the Boston University School of Medicine, is shedding light on what concussions look like in the brain. The findings are stunning. Far from innocuous, invisible injuries, concussions confer tremendous brain damage. That damage has a name: chronic traumatic encephalopathy (CTE).
On Tuesday afternoon, researchers at the CSTE released a study about the sixth documented case of CTE in former NFL player Tom McHale, who died in 2008 at the age of 45, and the youngest case to date, an 18-year-old multi-sport athlete who suffered multiple concussions. While CTE in an ex-NFL player's brain may have been expected, the beginnings of brain damage in an 18-year-old brain was a "shocking" finding, according to Dr. Ann McKee, a neuropathologist at the Veterans Administration Hospital in Bedford, Massachusetts, and co-director of the CSTE.
CTE has thus far been found in the brains of six out of six former NFL players. "What's been surprising is that it's so extensive," said McKee. "It's throughout the brain, not just on the superficial aspects of the brain, but it's deep inside." ... McKee, who also studies Alzheimer's disease, says the tangles closely resemble what might be found in the brain of an 80-year-old with dementia.
"I knew what traumatic brain disease looked like in the very end stages, in the most severe cases," said McKee. "To see the kind of changes we're seeing in 45-year-olds is basically unheard of."
The Center for the Study of Traumatic Encephalopathy, along with other research institutions, has now identified traumatic encephalopathy in the brains of late NFL football players John Grimsley, Mike Webster, Andre Waters, Justin Strzelczyk and Terry Long, in addition to McHale. ... "Guys were dying," said Nowinski. "The fact of the matter was guys were dying because they played sports 10 or 20 years before."

The article said the NFL released a statement: "Hundreds of thousands of people have played football and other sports without experiencing any problem of this type and there continues to be considerable debate within the medical community..."

That seems disingenuous. Hundreds of thousands of people have played football without being diagnosed with problems of this type; but the data emerging from the study suggests that these problems may have gone undiagnosed and unreported, for decades. And I don't think there's any debate within the medical community about whether concussions are bad for you. The question has always been, how bad? This study suggests the answer is: potentially devastating.

Football is, of course, a massive business. The NFL itself is a huge enterprise, a multi-billion dollar monster. And the NFL is in some ways just the tip of the iceberg. The NCAA is also a pretty big operation: think of all the big money boosters at places like Georgia and Auburn and Michigan and Notre Dame and USC etc etc. Where I'm going with that is, there will be colossal resistance to the notion that football should be regulated or policed. Think of the political hue and cry over Monday Night Football being broadcast on basic cable (ESPN) rather than over public airwaves. Yet these data suggest that football cries out for, I dunno, OSHA intervention or something.

We as fans have always known that NFL football was "dangerous". Darryl Stingley was rendered quadriplegic by Jack Tatum on the field in 1978; Joe Theisman was maimed by LT on Monday Night Football in 1985; Korey Stringer died of heat stroke during training camp in 2001; Kevin Everett was paralyzed during a kickoff return in week 1 of the 2007 season (although he walked again some months later). Sure, it can be dangerous, sometimes. But I think we've always rationalized it a little, pushed it to the back of our minds. It only happens sometimes. Sure, there are occasional broken legs and torn ACLs and turf toes and ruptured biceps and hammy pulls: but most guys are fine. Stingley called his injury a freak accident.

But in recent years we've started to hear disturbing stories about ex-NFL players. The former linebacker who suffers from depression and Alzheimer's and has attempted suicide. How Joe Montana, in his 50s, can barely walk and can't lift up his grandkids. I wonder how soon we are going to be forced to conclude that football is a sport that feeds on the destruction of human beings. Not like horse-racing, where there's an occasional casualty: more like Michael Vick's much-criticized dog fighting rings, where the destruction of the participants is a certainty.


  1. "'Hundreds of thousands of people have played football and other sports without experiencing any problem of this type and there continues to be considerable debate within the medical community...'"

    Plenty of people ride in cars without getting into accidents; let's suspend all traffic laws and rip out all the seat-belts, as there's clearly not a problem.

    It's all about assuaging guilt-- go ahead and watch football! MOST of the people playing for your enjoyment probably won't end up with catastrophic brain injuries.

  2. I don't really know that's actually true. That's not what this research is indicating. It's saying in fact that the vast majority of players WILL end up with catastrophic brain injuries.

    The thing is, how much should we really be bothered by it for players today? This should be a situation considered much like smoking. No one knew about this before. Now we do. There should be warnings, but largely these guys know what they're getting themselves into. They're being paid millions of dollars to sacrifice their bodies and make names for themselves. Even the low men on the totem pole make more than 5x the average salary in the US.

    Great article, Jim.

  3. How much of the increase in injuries is brought on by public demand for bigger and bigger guys, making harder and harder hits?

    It *is* an arms race-- teams have to recruit bigger "freak of nature" players to compete with who the other teams have. When you have two 330 pound athletes who are also built for tremendous speed crashing into each other, how surprising is it that bad stuff happens?

    I think of the position of the players as more akin to people joining the armed forces-- they sign on to an incredibly physically risky profession, as adults, for reasons of their own. Their ownership of this decision, though, doesn't release those who are in positions of authority from the requirement to acknowledge and ameliorate the risks these guys take.

  4. >>>>How much of the increase in injuries is brought on by public demand for bigger and bigger guys, making harder and harder hits?<<<<

    None. None of the guys mentioned in the article were playing from this era. None of the six played in the last 10 years, and only one was over 300 pounds, at 305. We aren't talking about six 350 pound guys here. We're talking about guys that mostly were playing around 250, one as low as 200ish.

    These guys played back when William "The Fridge" Perry was considered a mamouth at 325. These guys getting bigger and hitting harder now just emphasizes the issue.

    Also, remember that hitting was different back then. Deacon Jones had his famous "head slap." How many concussions do you think that guy caused?


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