Healthscopenews

Keeping it real and using science to explain

“Mammas Don’t Let Your Babies Grow Up to Be Football Players?”

Football picture resized

Let ‘em be cowboys and such. “… pick guitars and drive them old trucks.”

If you’ve been keeping up with the NFL over the last couple of years, then the odds are you’ve heard something about the risks of concussion and the impact of football on players’ brains.

And in case you missed it, Hall-of-Famers and current NFL players have made headlines recently with remarks regarding the alarming dangers of football.

NFL Hall-of-Famer Harry Carson, a former New York Giants linebacker who suffers from post-concussion syndrome, went all- in when he announced that he doesn’t want his grandkids playing tackle football.

“Not at any age, not in any program.”

It’s a spiraling issue. And with parents deeming the sport too risky, it begs the question, “Is it ‘game over’ for tackle football”?

 

NFL legends pitch to parents

A couple of days before the Super Bowl, the founders of the Concussion Legacy Foundation (CLF), Chris Nowinski, Ph.D., and Robert Cantu, M.D., held a press conference to tackle the controversy of Post-Concussion Syndrome.

They were joined by Hall of Famers, Nick Buoniconti, Harry Carson, and the Oakland Raiders’ legendary linebacker, Phil Villapiano. The athletes showed their support for the CLF and raising concussion awareness. They developed a key program, with the key message:

“Flag Football Under 14”

According to Dr. Cantu, decades of research on Chronic Traumatic Encephalopathy (CTE) have demonstrated the importance of delaying the enrollment of children in tackle football until the age of 14. He says this is the best way to prevent brain trauma in young football players.

Nick Buoniconti, middle linebacker for the legendary 17-0 1972 Miami Dolphins, is now a dementia sufferer and has been diagnosed with probable CTE. He publicly acknowledged his regrets for starting tackle football so young.

“I made the mistake starting tackle football at 9 years old. Now CTE has taken my life away. Youth tackle football is all risk with no reward.”

Buoniconti, now confined to a wheelchair,  told reporters this January that he has trouble speaking, is more forgetful, and struggles to complete basic tasks. Looking back, he estimates that he took over 500,000 hits to the head over his career.

“Unfortunately, I am a victim of 15 years in the NFL, four years of college and high school and sandlot football. I used to be eloquent as a speaker,” said Buoniconti. “I can’t even tell you how I feel now. It is so bad, it’s not funny.”

 

What is CTE?

The ‘punch-drunk’ professional boxers of the early 20th century were the first athletes to be identified with this brain condition, later dubbed ‘dementia pugilistica’.

As with Alzheimer’s Disease, the condition was found in more and more cases as research findings accumulated. Now known as Chronic Traumatic Encephalopathy, it is a degenerative brain disease caused by repeated trauma to the head, as occurs in contact or ‘impact’ sports.

The blows cause abnormal deposits of a protein variant called p-tau inside the brain. As with Alzheimer’s, the condition causes tangles and plaques to slowly spread throughout the brain, ultimately resulting in cell death and alterations to brain function.

Symptoms typically slowly progress. With time the after effects can result in memory loss, difficulty controlling impulsive or erratic behavior, difficulty with balance, and a gradual onset of dementia.

 

How do people get CTE?

We associate concussive head injuries with symptoms such as blurred vision, slurred speech, nausea, and vomiting. Sometimes we think of just a bad headache. However, data suggests that CTE damage can occur from less severe, repeated hits over a period of time.

In a 2013 study from the Oxford scientific journal, Brain, researchers analyzed the postmortem brains of teenage athletes who sustained closed-impact head injuries. They found brain pathology even in the absence of concussions.

“The concussion is really irrelevant for triggering CTE,” said Dr. Lee Goldstein, one author of the study and an associate professor at Boston University School of Medicine, in a Washington Post interview. His point is that it’s really the cumulative total of the hits that counts.

Goldstein sheds light on three different categories of head injuries: concussion, traumatic brain injury (TBI), and CTE.

Concussion is defined by what happens after you get hit in the head. “It’s nothing more than a syndrome.”

A TBI is different. “It’s not a syndrome. It’s an event and it involves damage to tissue. If you don’t have a concussion, you can absolutely have brain injury and the converse is true.”

CTE is “a bona fide neurodegenerative disease. It will progress independently of whether you have future hits. There is an injury and then it goes on to spread in the brain.”

 

Concussions, helmets and the NFL

Concussions don’t tell us anything about TBI’s or preventing  CTE. The wheels have already come off the bus it seems, in terms of the narrative.

According to Goldstein, “It’s the injury on top of the injury on top of the injury. In football, it happens in minutes; tens of minutes or over a day or week.”

He describes this as the ‘bobblehead effect‘. “The cumulative effect, when the brain is not fully healed, particularly in younger people, is really, really damaging,” Goldstein said, “And that’s the problem. You won’t see it by focusing on concussion.”

Responding to growing medical and public concern, and to the 2015 movie Concussion starring Will Smith, the National Football League is in action. They want to tackle both concussion specifically and players’ long-term brain health in general. They are doing this in several ways:

  1. The Head Health Challenge

The NFL are hosting the Head Health Challenge (up to Round Three last year), highlighting R & D initiatives on new protective technologies. People from sport, industry and academia compete for prizes and seed funding from sponsors such as General Electric and Under Armour Inc. (2015 winners ranged from padded football field underlay mats to dynamic head-immobilising straps that kick in, like a car’s airbags, only when the impact is severe.)

2. Tracking concussions

They are keeping count of concussions in games across the NFL each season, and sponsoring, with the NFL Players Association, helmet testing in independent labs.

(As an aside, not many people are aware that players pick their own helmets, but they do. Currently, there is no requirement on one type or model. Helmets simply come in standard sizes, extra large, large, medium, and small – rather than being specifically tailored to individual heads, like in other sports.)

3. The King-Devick Test (K-D Test)

Working with the Canadian Football League to trial new sideline testing and live game monitoring, including the K-D Test. The King-Devick Test (K-D Test) is an objective remove-from-play sideline concussion screening test, based on eye-movement. The X2 app, a step-by-step checklist of protocols for assessing players suspected of head injury, is already an established component of NFL in-game care.

4. Trialing and co-promoting innovative helmet technology

One such, the Vicis ZERO1, has four different protective layers, including a custom-fittable form liner, each playing a different part in mitigating impacts. Here’s a catch, though: the ZERO1 costs anything from $950 to $1,500, even though prices may fall as technologies and competition develop. And is that available in child sizes?

 

Football, CTE and our kids

The time is coming for parents to register their children for summer activities, including football programs. There are now non-head impact alternatives to traditional football to consider.

One such is flag (or ‘flag and touch’) football. NFL Flag, the largest flag football program in the nation, offers a fun non-contact football experience for boys and girls ages 5-17.

Additionally, the Concussion Legacy Foundation has launched the Flag Football Under 14 program. This advocates flag football – or something else – for kids under 14. It suggests that kids wait to try tackle football until reaching high school. Learn more at FlagFootballu14.org or nflflag.com.

 

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Some people advocate a ban on football for any youth under 12 because of CTE. But everyone who loves the sport, I think would agree that the goal is not to end football, or cheer for our favorite teams any less. We want our kids to stay healthy, and playing organized sports is a great way to do that.

Instead, there is definitely a new awareness we need, and new things that we could try to help tackle CTE (which we didn’t think of when Carson, as Giants captain, helped defeat the Denver Broncos in Super Bowl XXI, 1987.)

So, in words from the song by Ed and Patsy Bruce, also sung by Willie Nelson and Waylon Jennings, whether you

“… let your babies grow up to be cowboys

or

Don’t let ’em pick guitars and drive them old trucks. Make ’em be doctors and lawyers and such”…

Just be sure you tell ’em… “keep your head (safe)”!

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