Head Injury, Brain Damage, and Contact Sports

Is Brain Damage an Inevitable Result of Playing Football?

This headline from August 7 edition of LiveScience asks the question as the result of a recent report that 110 of 111 brains studied from professional football players showed brain injury typical of that seen with repeated concussions.  The interests wanting to deny this finding are wide and diverse.  Owners don’t want to hear it, and fans want to watch the game.

There are questions about how early the damage begins.  Is it as early as Pop Warner?  Is it a hazard for high school or NCAA football?  The impression is that the injury is seen as a result of the “big hit”.  If you have watched any football you know that hit.  It comes as players are blind-sided in a tackle, when a pass receiver gets hit from two different directions as he comes to the ground with the ball.  Fans love it.  It appears to be deadly.

This news, to quote a Kentucky congresswoman concerning another matter is “as welcome as a breeze off an out-house.”  The question is can it be avoided and how?

Everyone wants to keep the “big hit” but cushion the player.  Maybe that isn’t possible.  I wonder whether less cushioning is the answer.

I first began downhill skiing in my late 30s.  As I was growing up the big fear in skiing was the boot top fracture.  Ski boots are like short leg casts.  They are designed so that your knee is always flexed slightly and your ankle is protected.  By the time I came along the breakaway binding had been invented.  As you began to fall the torque from the long ski popped the binding instead of your tibia and fibula.

I remember my first big fall on the “bunny slope”.  The bindings did just what they were intended to do.  Nothing was injured but my pride.  So, I became daring.  (Actually, I’ve always been daring which has made life exhillerating at times and nearly gotten me killed at others.) 

I took the family skiing for the next five years by which time the kids were too busy with other things to want to go, and the expense for a trip had become prohibitive.  During those five years I became a pretty good skier and have some great memories – like riding to the top of the mountain, skiing to the edge and then leaping twenty feet through the air down the slope into 18 inch deep powder, and off down the slope with my older daughter, her friend, and her friend’s dad.

I fell once – it is  hard to keep your tips up in deep powder – and wasn’t hurt at all.  It was like falling into a pillow.

So, how does this relate to football? 

The way it relates is that I almost pulled a “Sonny Bono”.  My daughters wanted to take a shortcut through the woods in un packed show.  They were more agile than I, used shorter skies, and didn’t weigh as much.  I insisted on going first to make sure it was safe, caught my tip going between two trees, which resulted in me straddling the tree, and suffered a concussion.  My goggles and glasses were smashed, and when I came to I was surrounded by my daughters and a few adults.

The lack of danger of a broken leg caused me to do something that resulted in what could have been a much worse injury.

At one time football was played with a leather helmet and no pads.  It was more like Rugby.  Players got roughed up, skinned up, had their teeth knocked out, but the limitations in “armor” kept two 400 pound locomotive from meeting in a head-on collision.  Too, there were few players in the 3-400 pound class.  Players were smaller and collisions less spectacular.

Fans though love the spectacular hits.  They may worry that their players concussion will keep him out of the rest of the game, but don’t usually think about long term effects.  Football players are like gladiators.  Serious injury or death is regarded as the price of fame.

Also, fans treat the game as though it was war; our army against your army.  They are much like – and often are - those who claim to love the military, but then refuse to pay soldiers a decent salary, help them transition to civilian life, or pay for healthcare after their discharge.  Professional athletes get a nice retirement, but their health cannot be restored if they have traumatic brain injury.

Some of you may have watched Australian Rules football.  It is funny to watch as an outsider, mainly due to the actions of the referees.

Note the lack of padding and helmets for the players.

Australian Rules football reports that while almost all of the injuries related to the sport are to the lower leg in the form of sprains, torn ligaments and fractures, brain injury related to repeated concussions is being studied.  Studies at multiple levels of play show that the number and severity of injuries increase as the player moves through various levels of expertise in clubs, with the highest level being among Elite (professional) players.

So what about the question of Rugby vs. Football as far as injuries go?

Rugby Scrum

Ben Heather, a New Zealand journalist, reported:

“About 1,200 people suffer head injuries while playing rugby each year.

About two-thirds of these injuries are either concussion or brain injuries.

The figures do not account for ongoing health problems which cannot be directly linked to rugby injuries.”

The annual cost of care for Rugby related injuries in New Zealand is estimated to be $50 million.

It doesn’t sound like imitating Rugby is the answer.

Few sports are without contact.  Basketball has contact, but that is not the intent of the game.  The same is true of soccer.  In football and rugby it is part and parcel of the game.

I have seen contact in billiards, but it was usually following a lot of drinking and involved the use of a pool cue.  It is not what the game is about.



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Comment by koshersalaami on August 7, 2017 at 12:12pm

Your thoughts on addressing this? 

Comment by alsoknownas on August 7, 2017 at 12:55pm

I played full gear football in high school. Part of that included being on what was called the "Suicide Squad" which was the lineup sent out on kick-offs. We were supposedly the ones who lacked fear, and would gladly die for the team headed towards other  young men at full speed to collide at our greatest force into one another.

A young fellow from the other school, on the team receiving the ball, came hurtling at me with all he had. He planted the top of his helmet into my chest in order to drive me out of the way of tackling the receiver. Instead, he knocked himself out. He was unable to return to the game and was taken away.

I was given a red star to wear on my helmet but I always felt bad about that kid and wondered if he suffered any long term troubles.

Comment by Boanerges on August 7, 2017 at 1:22pm

What Kosh said. 

Only solution I can see is banning football altogether. Problem is, banning football is just not going to happen. Nor will it with hockey, another prime source of CTE.

I've had concussions over the years, although not to the extent that an athlete in contact sports does. They weren't pleasant experiences. And yes, I always wear a helmet on my motorcycle -- always have. Helmets don't necessarily help.

My personal definition of irony:

Comment by Rodney Roe on August 7, 2017 at 6:12pm

I rarely write comments offline and then post because they become so wordy, but I made an exception this time.

At kosh and Boanerges:

In order to make a decision about football, hockey and any other contact sport I think we need a lot more information.  It is the sort of information that the Australian Rules football study is trying to find.  At what age, or weight, or skill level does concussive injury become a real concern?  If it is present from the Pop Warner, or Junior High level then there are several things to consider.

Parents who allow their children to play and expose them to the real risk of brain damage might be charged with parental neglect.  Children could not be considered able to make the decision to play.  This would extend through High School age at which individuals could make their own choice.

As things exist today every college student would be a walk on because there would be no way to know about skill level, and every player would have to learn the game from scratch.  This would change the college sport entirely.

Another issue to examine is whether the choice to play is really that of the individual, or whether it is the right of society to make that choice.  Seatbelt laws and motorcycle helmet laws were not passed to protect the individual; they were passed to protect the state from the cost of supporting paralyzed or severely brain damaged individuals for the rest of their lives.  This point was lost as a number of states succumbed to the argument by motorcycle riding libertarians that their individual rights were being violated.  They had the right to risk their brains for the thrill of riding with the wind blowing through their hair, and bugs lodging in their teeth.  Consequently, driving through South Carolina you will notice that many, maybe most, riders ride without a helmet.

I can’t help but point out that the states that have reversed the helmet laws are those where riders seem to have the least to lose in a head injury.

If it is decided that having large numbers of adults with chronic concussive brain damage is something that a society can’t tolerate then sports that carry that risk should be eliminated.

Likewise, if it is found that children don’t run the risk of concussive injury until they are, say, high school age, then football might be permitted until High School when it would be eliminated as a sport.  Again, that would change everything. 

Some say that they are willing to take the risk because there is nothing in their future in the way of opportunity without sports.  Again, that should be the choice of a society that has to pay for the result in terms of healthcare.

We need a lot more information – which seems to be coming in now – and then a public dialogue.  In our present era when the pendulum has swung far to the side of individual rights as opposed the rights of society, it is unlikely that we will have that dialogue on the basis of rights of the state.  It is much more likely to happen as an emotional response to many former sports heroes developing severe depression resulting in suicide.

Comment by Rodney Roe on August 7, 2017 at 6:23pm

My own experience with sports was limited to intramural sports; I was too short and too light to play either football or basketball.  I loved basketball and played in an over-forty city group until about fifty when i gave it up.  My only real injury came in college in a pick-up game when, coming down from a rebound, I was slammed from the side just as my foot was reaching the floor.  I felt the bone in my ankle hit the floor and tore the lateral ligament in my ankle.  An MRI done after I developed the cancer on that calf remarked that the ligament was missing.  There was no reason for the player to hit me other than intimidation.  He couldn't have been going for the ball.  Still, sprains and strains and even fractures are the injuries seen in basketball.

What do you think should be the response to these studies?

Comment by koshersalaami on August 7, 2017 at 6:51pm

The simplest way to handle this might be to introduce very heavy liability laws, making dangerous contact sports too expensive to continue without figuring how to change the game in favor of less dangerous contact. Major penalties for use of the head or hitting the head. 

I had a concussion when I was ten or so. Ice skating accident: I was skating across a rink and got hit by a skater moving really fast around the rink. As night fell, as this was nearly dusk, I developed tunnel vision, then lost my sight. In the hospital my parents thought I was hysterical as I fought off doctors. In actuality I didn't trust doctors not to give me a shot when I couldn't see it coming, and at that age I was afraid of shots. I could see in the morning. Oddly, I felt a little fraudulent in the hospital the next day being around kids with broken bones because I felt better and it never occurred to me that my sight might not return. I have no idea if it had any lasting effects. I wouldn't know what to look for. 

Comment by Rodney Roe on August 8, 2017 at 1:21am

Most single concussions leave no lasting effects.  Your transient blindness was due to brain swelling.  Occasionally, people have symptoms that last for weeks or months, but most are like you and I; twenty-four hours later we appear to be normal.

I think diagnosing chronic traumatic encephalopathy still requires an autopsy.

Remember 'flag' football?  I remember that the running backs and receivers had a red bandanna hanging out of their hip pockets and getting that counted as a tackle.  I don't remember what things looked like at the line of scrimmage.  I think we could use our hands - maybe even hold opposing players.  Would people pay to go watch non-contact football?

Think of what banning football would do to Universities.  Most seem to exist primarily for sports now, and educating non-athletes is treated like an irritating necessity.

Comment by Rodney Roe on August 8, 2017 at 4:41am

I don't know. I read yesterday that researchers are still looking for some combination of clinical exam, imaging studies and neurological electrical tests to make a Dx of CTE. 

I was lucky with boxing. I had three fights. My third was with a fellow student, Phillip "Flip", who went on to become all southwest golden gloves champion. He beat me bad and hit me with the fastest jab over and over. He was punch drunk by the time we got out of High School. He could take a punch which was a bad thing.

Comment by Steel Breeze on August 8, 2017 at 5:46am

were i able to make a choice at a young age between a lifetime of busting my ass with dozens of injuries.....or a 5 year career making more than the other choice ever would.....yah,i'll take the 5 and damn the consequences...

i've taken far greater risks for far less reward....

Comment by koshersalaami on August 8, 2017 at 7:11am

Maybe you'll post about that. We know very little.


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