A large study on brain damage caused by American Football revealed the brain disease CTE in 99 of the deceased players examined.
American Football
American Football is awesome. As a child, I already had a preference for American sports and played baseball and basketball. However, American Football was not played in my city. If it were, it could have only provided a part of the experience I was seeking.
American Football is much more than a sport. It is an essential part of American culture, partly due to the way the American school system is structured and sports play a significant role in the school experience. Every boy naturally wants to be the quarterback as a realization of the American hero and leader. Even if it’s just to uphold tradition and go to the school dance with the captain of the cheerleading squad.
American Football is pure masculinity embodied in a sport and baptized in testosterone. Perhaps due to the great similarities with warfare and the ancient instincts of the warrior it invokes. Fighting with the sole purpose of advancing on the battlefield. Struggling for a few yards gained to reach the next trench.
Glorious…
Unfortunately, the comparison with warfare extends beyond symbolism. Research among veterans has recently shown a link between suffering a concussion and an increased risk of Alzheimer’s [1].
Concussions have become a painful point of attention for the NFL (National Football League) in recent years, thanks to Will Smith. Or rather, thanks to Nigerian physician Bennet Omalu, whom he portrayed in the movie “Concussion”. Omalu performed an autopsy on a well-known American Football player in 2002 who had exhibited strange behavior before his death (from a heart attack at the age of fifty). Omalu discovered a type of protein (‘tau’) in the brain similar to that found in deceased boxers. He named the condition of progressive brain damage “Chronic Traumatic Encephalopathy” (CTE).
He published his findings in 2005 [2].
This case highlights potential long-term neurodegenerative outcomes in retired professional National Football League players subjected to repeated mild traumatic brain injury.
Dr. Bennet Omalu, University of Pittsburgh
He might as well have started talking about Black Pete. Or suggest that Max and his F1 colleagues should drive with a Halo from now on.
Omalu was rather ignorant when it came to the role American Football played in American culture. He overlooked the enormous financial consequences his findings could have and the personal implications. In the most masculine sport, ‘safety’ is the little brother of ‘wimp’.
“How dare this outsider, who understands nothing of our culture, claim that our national sport is harmful? SIRE is trying to make it clear that boys should just be able to play.”
What would it mean legally if the NFL had done too little over the years to protect players? Or worse; if the danger was deliberately concealed?
Omalu and the co-authors of the publication were thus dragged through the mud. Subsequent research, however, confirmed their findings, and by now, more than 20,000 former players have filed a joint lawsuit against the NFL. A previous settlement amount of 765 million was rejected by a federal judge, and an ultimate settlement is expected to cost the NFL a tidy billion [3].
99% of deceased NFL players had CTE
Yesterday, it was once again evident that former players and their families have suffered damage after the publication of the largest study on CTE to date [4].
Boston University conducted this research to examine the relationship between playing American Football and the likelihood of developing CTE. They examined the brains of 202 deceased players who had played at various levels, from high school to the NFL. The average age of death was 66.
Across the entire group, signs of CTE were found in 87 percent. In the case of the pro NFL players, this was over 99 percent. The researchers found signs of CTE in 110 out of 111 NFL-level players and in 48 out of 53 college-level players. They also examined the brains of players from the Canadian league. Seven out of eight Canadian pro players showed signs of CTE, 9 out of 14 semi-pros, and 3 out of 14 high school players.
The three high school students showed signs of ‘mild CTE’.
In addition to examining the brains, the researchers also asked the families of the deceased players to answer questions about the players’ mental state prior to their death.
In cases of ‘mild CTE’ (regarding the brain damage found), 96 percent of the players had behavioral and mood problems. 85 percent had cognitive symptoms, and 33 percent showed signs of dementia. In cases where severe signs of CTE were found, the behavioral problems and cognitive complaints were similar. Signs of dementia were much more common, occurring in 85 percent of cases.
More than 1,800 former athletes and veterans have now pledged to donate their brains to the Concussion Legacy Foundation for CTE research. Players who say they would not have played football if they were aware of the risks of CTE. But also, family members of players who have committed suicide and therefore would like research into a possible cause.
The stakes are high, as evidenced by the billion-dollar lawsuit. This also makes objective research difficult. Family members who provided information about the mental state of deceased players have a personal interest in emphasizing the severity of the problem. The researchers from Boston therefore warn that these percentages should not be interpreted as absolute truth.
For the NFL, it’s a tough task. How do you make a sport like American Football safe? The NFL has pledged $100 million for CTE research. But then how do you deal with such outcomes?
Soccer and Brain Damage
You might breathe a sigh of relief because in the Netherlands, we actually use our feet for soccer. Unfortunately, soccer players also have an increased risk of brain damage. A study published in February this year found that players who head the ball frequently (more than 125 times in two weeks) are three times more likely to suffer a concussion [5].
This has already led to discussions in America about banning heading until a certain age. This will not entirely prevent concussions. In a 2015 American study, 69% of concussions in male soccer players were caused by unintended contact with an opponent or teammate. In girls, it was 51 percent of cases [6].
“Those who are about to die salute you”
Some knowledge is rather painful. However, such studies are important to at least be aware of certain risks. The gladiators in the Roman Empire also knew that they might not leave the arena under their own power.
I don’t know if in the future we’ll see American Football players with personal mini airbags that deploy with every physical contact. Or if we’ll see soccer players playing with a beach ball and F1 being driven in electric cars made of marshmallows.
It’s an inevitable aspect of the development of a sport that safety may come at the expense of spectacle.
Like the thicker boxing gloves in boxing and the fact that helmets are worn in American Football. Just as we now long for soccer without dives.
There will come a time when we nostalgically look back on the days when the number of concussions caused was a nice statistic in a player’s records.
References
- Jasmeet P. Hayes, Mark W. Logue, Naomi Sadeh, Jeffrey M. Spielberg, Mieke Verfaellie, Scott M. Hayes, Andrew Reagan, David H. Salat, Erika J. Wolf, Regina E. McGlinchey, William P. Milberg, Annjanette Stone, Steven A. Schichman, Mark W. Miller. Mild traumatic brain injury is associated with reduced cortical thickness in those at risk for Alzheimer’s disease. Brain, 2017; aww344
- https://academic.oup.com/brain/article/140/3/813/2888535
- Chronic traumatic encephalopathy in a National Football League player. Omalu BI, DeKosky ST, Minster RL, Kamboh MI, Hamilton RL, Wecht CH.Neurosurgery. 2005 Jul;57(1):128-34; discussion 128-34.
- deadspin.com/the-billion-dollar-nfl-concussion-settlement-is-a-new-k-1793787616
- Mez J, Daneshvar DH, Kiernan PT, Abdolmohammadi B, Alvarez VE, Huber BR, Alosco ML, Solomon TM, Nowinski CJ, McHale L, Cormier KA, Kubilus CA, Martin BM, Murphy L, Baugh CM, Montenigro PH, Chaisson CE, Tripodis Y, Kowall NW, Weuve J, McClean MD, Cantu RC, Goldstein LE, Katz DI, Stern RA, Stein TD, McKee AC. Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football. JAMA. 2017;318(4):360-370. doi:10.1001/jama.2017.8334
- Symptoms from repeated intentional and unintentional head impact in soccer players. Walter F. Stewart, Namhee Kim, Chloe S. Ifrah, Richard B. Lipton, Tamar A. Bachrach, Molly E. Zimmerman, Mimi Kim, and Michael L. Lipton10.1212/WNL.0000000000003657; published ahead of print February 1, 2017, doi:10.1212/WNL.0000000000003657: 1526-632X
- JAMA Pediatr. 2015;169(9):830-837. doi:10.1001/jamapediatrics.2015.1062
