dfwabel

Football and CTE

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I have friends who are parents and some of them have sons, and they have been steering their sons in the direction of baseball and basketball rather than football. 

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The New York Times comes through with an amazing article.

 

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At Colorado, a Breach in Football’s Wall

 

BOULDER, Colo. — The University of Colorado hired a new football coach in December and, as coaches are wont to do, he talked tough.

 

“Our team, we will be physical,” Coach Mel Tucker said at his introductory news conference. “My dad always told me the name of the game is hit, hit, H-I-T. There is always a place on the field for someone who will hit.”

 

He was preaching that old style pigskin religion. Unfortunately, Tucker, who came from the University of Georgia, runs a football program that has seen at least a half-dozen former players — including several who played in the N.F.L. — kill themselves. Other former players are alive but afflicted by severe post-concussion problems.

 

Two university regents, dissenters from the Church of Hit, Hit and Hit, read Tucker’s remarks and shook their heads. A few days later these heretics voted against his five-year, $14.75 million contract. They could not block the contract, but another cannon had been fired in the football concussion wars.

 

Linda Shoemaker, one of the regents, described her pilgrimage from casual fandom to casting a vote against football.

 

“I really thought at first that we could play football safely with better rules and better equipment; I drank the Kool-Aid,” she told me. “I can’t go there anymore. I don’t believe it can be played safely anymore. I want these young men to leave C.U. with minds that have been strengthened, not damaged.”

 

The N.F.L. long ago settled on a tobacco-industry stance toward the damage done by concussions and sub-concussive hits; its officials have covered up, obfuscated, and only reluctantly conceded liability for the many hundreds of former players left with minds that fade in and out like old television sets. It is a $14 billion industry, and acting in its pecuniary interests is deplorable but perhaps not surprising.

 

The nation’s universities face a more ticklish problem known as morality. These institutions were founded with the purpose of developing and educating young minds. It is difficult to square that mission with the fate of those like running back Rashaan Salaam, who ran so beautifully for the University of Colorado and then as a pro, and like Drew Wahlroos, a fearless, rampaging Colorado linebacker. Both men suffered emotional and cognitive problems that friends and family and even university officials related to thousands of hits taken over the course of their careers. Each killed himself.

 

There are, too, those like Ryan Miller. I wrote about him yesterday, an intelligent and introspective giant of a young man and a former stalwart offensive lineman for the University of Colorado who at age 29 suffers migraines and the shakes and once in a while gets into his car and has to think many minutes before recalling where he intended to go.

 

I came to Boulder because of these outspoken regents and because of Bob Carmichael, a long-ago player at Colorado, who has taken upon himself the role of moral goad and pushed others to speak out. “I try to tell players that risking your future when you are in your early 20s is a stupid concept that many players, myself included, regret,” Carmichael said.

 

Thanks to these three, the University of Colorado has come closer than most institutions to wrestling with an urgent question: Is running a college football program unconscionable?

 

“We should move in the direction of offering lifelong insurance and medical care for football players who become badly damaged,” said John Kroll, the other regent to vote against the coach’s contract. “But to do that is an implicit acknowledgment this game is incredibly dangerous to play.”

 

I spoke with the chancellor, the athletic director, two doctors and the chief trainer, who talked a lot about safety and sounded earnest. They have built a beautiful sports medicine center into the side of their football stadium, a placement that occupies a land between admirable and sadly metaphoric. Their staff teaches nutrition and healthy habits, and they have spotters in the stands who look to see if a coach has missed a player grown too wobbly on the field. Their football team, like many others, has limited the practices in which players are made to tackle and hit.

 

They have embraced the current college vogue for studies of the effects of rattling hits on brain health. The N.C.A.A. and the Defense Department are working on a study, as is the Big Ten-Ivy League Traumatic Brain Injury Research Collaboration. Now the University of Colorado, as part of the Pac-12 Conference, has a Student-Athlete Health and Well-Being Concussion Coordinating Unit.

 

This is grand. Yet I wondered if they could save themselves time and money and read the work of the Boston University C.T.E. center, which found evidence of degenerative brain disease in 99 percent of brains obtained from deceased N.F.L. players and 91 percent of college football players and 21 percent of those who played high school football.

 

It’s perhaps worth noting that college football players who experience head trauma are not eligible for workers’ compensation or disability benefits. They are not, after all, employees.

 

Universities, Colorado included, have scientists and doctors beavering away at efforts to create safer helmets. I asked Miller, the former offensive lineman, about this, and he said that better helmets mostly make players feel like cruise missiles.

 

Dr. Sherrie Ballantine works at the sports medicine center, and she is certainly not a football abolitionist, but she too sounded dubious of an armament fix.

 

“The more you pad a player, the more aggressive and stupid they play,” she said. “We’re better off padding the goal posts.”

 

Miguel Rueda, the associate athletic director for health and performance, noted that the staff trains freshman football players to speak up if injured. “We go over the risk of injury because there is a tie to mental health from any injury,” Rueda said. “They are encouraged to understand their part in the injury process.”

 

Have you ever, I asked, suggested that incoming freshmen read synopses of the Boston University reports before they signed their health waivers and embarked on a football career?

 

Rueda saw no reason for that.

 

“There is no proven direct link between concussion and C.T.E.,” he said. “There are a number of people who are out there actively pursuing the investigative process.”

 

That answer sidesteps the key point. There is much unknown about brain trauma and C.T.E., including the role of individual body chemistry and the precise nature of the most dangerous hits. Those brains studied, by definition, came from men who worried about brain degeneration. Still it appears irrefutable that a link exists, and that nutrition and better ways of tackling and blocking will most likely not change that.

 

No freshman player, Rueda said, ever declined to sign a health waiver.

 

I sought the counsel of Brian Cabral on the question of better training. He was a magnificent linebacker at the University of Colorado and played nine years in the N.F.L., earning a Super Bowl ring with the Chicago Bears. Then he returned to Colorado and became a linebacker coach.

 

He recruited the running back Salaam and coached the linebacker Wahlroos, both of whom are dead. He also coached Ted Johnson, a brilliant linebacker who has spoken with aching honesty of his struggles with depression and memory loss after more concussions than he can count.

 

Cabral loves the band of brothers aspect of football, and yet he cannot dodge the shadows. He knows too much, and several times during our conversation he paused, choked up.

 

“I hate to say this, but I taught players what I was taught,” he said.

 

And what was that technique?

 

“Put your helmet right in the guy’s jaw and drive up through his throat to his head,” he said. “I regret it, I really do.”

 

I noted that officials said better technique might offer a sort of salvation. He nodded yes, and then quickly shook his head. “They try to take the head out of tackling, but come on,” he said. “We bang heads and guys get concussions.”

 

In a few weeks spring football practices would begin; in late April the team will play a televised game, kicked off by a “Healthy Kids” session for middle schoolers.

 

Shoemaker is a former journalist and now a grandmother, and several times she has walked down to the football field and just listened. “It’s frightening to hear the hits,” she said. “We have physicians there, but they all work for the university and they are very much in favor of football.

 

“Hard hits lead to head trauma, and that makes lives more brutal. I can’t do this anymore. I don’t think the game can be played safely.”

 

If I cast my dice, I’d roll in the direction of Shoemaker’s bottom line.

 

Powerful, powerful stuff.  Spends too much time on concussions and not enough on the sub-concussive hits that happen on every single play, but better than most writing on the subject.  And, of course, the work from those two Colorado regents is inspiring.

 

I'm glad that some people in positions of responsibility at colleges are starting to see the light. 

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Really highlights the nature of the argument.  On one side we have:

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“I really thought at first that we could play football safely with better rules and better equipment; I drank the Kool-Aid,” she told me. “I can’t go there anymore. I don’t believe it can be played safely anymore. I want these young men to leave C.U. with minds that have been strengthened, not damaged.”

 

and this:

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Dr. Sherrie Ballantine works at the sports medicine center, and she is certainly not a football abolitionist, but she too sounded dubious of an armament fix.

 

“The more you pad a player, the more aggressive and stupid they play,” she said. “We’re better off padding the goal posts.”

 

And on the other you have the NFL and athletic programs channeling their inner Nathan Thurm.

 

 

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“We go over the risk ofinjury because there is a tie to mental health from any injury,” Rueda said. “They are encouraged to understand their part in the injury process.”

 

Have you ever, I asked, suggested that incoming freshmen read synopses of the Boston University reports before they signed their health waivers and embarked on a football career?

 

Rueda saw no reason for that.

 

“There is no proven direct link between concussion and C.T.E.,” he said. “There are a number of people who are out there actively pursuing the investigative process.”

 

Pretty stark contrast.

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Ugh,  I need a shower after that last tweet.  Disgusting.

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An Ohio dad suing football-helmet maker Riddell over his son’s death from apparent football-related brain injuries has been given the green light to proceed to trial.

 

On Tuesday, an Ohio judge ruled that Riddell will have to face off against Darren Hamblin’s claims that the company’s helmets are responsible for his son’s untimely death after a decade of playing tackle football, starting at the age of 8.

 

Hamblin’s son, Cody Hamblin, died in 2016 — five years after his high school football career ended — from a seizure while fishing with his grandfather, which caused him to fall off the boat and drown.

 

An autopsy later revealed that the former Miamisburg High School football star suffered from chronic traumatic encephalopathy, or CTE, a neurological injury associated with football that can only be detected after death, court papers show.

 

https://nypost.com/2019/05/15/man-wins-right-to-sue-riddell-football-helmet-company-over-sons-wrongful-death/

 

 

 

And

 

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And in soccer-related news...

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This week the British Journal of Sports Medicine (BJSM) published the results of a randomized trial of headgear to reduce concussions in soccer players.

 

Before I jump in to my criticisms, I do want to commend the authors for running a randomized trial on an important question. Preventing concussions is a matter of physics. It’s all about dissipating collision forces so less of it transmits to your skull and shakes your brain inside of it. Helmets in sports like football were designed for a totally different engineering task: preventing skull fractures, which they’re great at. And as big of a concern as concussions have become, we only know of one surefire way to prevent them: stop collisions that shake people’s heads. All that is to say rigorous studies on new technologies that claim to protect the brains of sports participants from concussions are extremely important.

 

Well, it’s dumb luck that I looked at this study more closely even though it confirmed what I expected to see. Someone tweeted out the main results table from the study and something didn’t look right – in fact, something was mathematically impossible (SEE Irregularity #2 below). That led me to read the whole paper, and there are some substantial irregularities in the analysis I want to call everyone’s attention to.

 

 

 

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Yes, soccer will have to change its rules too. In twenty years, the head will be as off-limits as the hands, an automatic penalty. 

 

The difference is that, in our country at least, the organizing body for soccer has already taken very real, very concrete steps to take heads out of the youth game. While at the same time, football is doubling down on their ability to sacrifice the lives of children on the altar of their own fragile egos.

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3 hours ago, Gothamite said:

Yes, soccer will have to change its rules too. In twenty years, the head will be as off-limits as the hands, an automatic penalty. 

 

The difference is that, in our country at least, the organizing body for soccer has already taken very real, very concrete steps to take heads out of the youth game. While at the same time, football is doubling down on their ability to sacrifice the lives of children on the altar of their own fragile egos.

True...but I think it's in part because it's impossible to even mitigate in football (barring playing flag football, which is a growing thing for elementary/middle school ages).  

 

When you think of the sports that are most likely to lead to CTE, football's probably the only one you can't significantly reduce the risk for without essentially ending the game as we know it...except boxing and MMA, which I don't think kids participate in.  Maybe some of the hockey folk will disagree with me, but I think you can play hockey with virtually no checking for kids.  No heading in youth soccer?  So?  Kids are still getting everything out of it they otherwise would (exercise, teamwork, making friends, winning and losing, etc.).  

 

Soccer taking heading out is kinda low-hanging fruit and I hope it doesn't contribute to what I think is a false notion that direct contact to the head is the only contributor to the problem.  I still think it's the impacts that sort of snap your head around, even if you don't hit the ground and nothing directly hits your head...the dialog is still stuck at "blow to the head."

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That’s true.   But blows to the head, while not the only problem, do seem to be the major problem.

 

If football can’t evolve, then it doesn’t deserve to exist. 

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12 minutes ago, OnWis97 said:

...it's impossible to even mitigate in football (barring playing flag football, which is a growing thing for elementary/middle school ages).  

 

When you think of the sports that are most likely to lead to CTE, football's probably the only one you can't significantly reduce the risk for without essentially ending the game as we know it...

 

I would disagree with this.  Perhaps you have not heard of the American 7s Football League.  The A7FL plays tackle football with no helmets or pads. These players, like rugby players, tackle while protecting their heads.

 

 

This particular league features players on a broad spectrum, from very athletic to a bit comical; the level of play is not much higher than in a pickup game.  But it nevertheless makes the point that you can perfectly well play real tackle football without dressing the players in armour and encouraging them to use their heads as weapons.

 

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To

36 minutes ago, OnWis97 said:

True...but I think it's in part because it's impossible to even mitigate in football (barring playing flag football, which is a growing thing for elementary/middle school ages).  

 

When you think of the sports that are most likely to lead to CTE, football's probably the only one you can't significantly reduce the risk for without essentially ending the game as we know it...except boxing and MMA, which I don't think kids participate in.  Maybe some of the hockey folk will disagree with me, but I think you can play hockey with virtually no checking for kids.  No heading in youth soccer?  So?  Kids are still getting everything out of it they otherwise would (exercise, teamwork, making friends, winning and losing, etc.).  

 

Soccer taking heading out is kinda low-hanging fruit and I hope it doesn't contribute to what I think is a false notion that direct contact to the head is the only contributor to the problem.  I still think it's the impacts that sort of snap your head around, even if you don't hit the ground and nothing directly hits your head...the dialog is still stuck at "blow to the head."

Out this month.

https://www.ncbi.nlm.nih.gov/pubmed/30890373

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Abstract
BACKGROUND:

Studies cite the incidence of pediatric blunt cerebrovascular injuries (BCVI) ranges from 0.03% to 1.3%. While motor vehicle incidents are a known high-risk mechanism, we are the first to report on football injuries resulting in BCVI.

 

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2 hours ago, Ferdinand Cesarano said:

 

I would disagree with this.  Perhaps you have not heard of the American 7s Football League.  The A7FL plays tackle football with no helmets or pads. These players, like rugby players, tackle while protecting their heads.

 

 

This particular league features players on a broad spectrum, from very athletic to a bit comical; the level of play is not much higher than in a pickup game.  But it nevertheless makes the point that you can perfectly well play real tackle football without dressing the players in armour and encouraging them to use their heads as weapons.

 

It would be very interesting to see how a lifetime of playing this would compare with a lifetime of playing padded football.  I've wondered about football vs. rugby and Aussie rules on this thread. I tend to think the problem would be closer to "mitigated" than "solved" but we are probably a long way of really having good evidence to show the difference.

 

I've actually wondered lots of things:

  • Football vs un-padded full-contact sports like rugby
  • Football vs. MMA and boxing
    • I wonder whether the problem in football is practice...that's a lot more hitting.  Depends on how impactful those kinds of impacts are.
  • QBs vs. other positions
    • Because QBs don't take hits in practice

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24 minutes ago, OnWis97 said:

 

  • QBs vs. other positions
    • Because QBs don't take hits in practice

 

Well, it’s not like QBs have been immune to CTR in the past.  Even young ones. 

 

https://www.seattletimes.com/sports/wsu-cougar-football/wsu-quarterback-tyler-hilinski-had-signs-of-cte-at-suicide-family-says/

 

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The results indicated that (21 year old Washington State quarterback) Tyler Hilinski had the brain of a 65-year-old, with signs of extensive brain damage known as chronic traumatic encephalopathy, or CTE, which has been found in hundreds of former NFL players.

 

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As long as tackling is part of the sport of football I wouldn't go so far to completely eliminate pads entirely. You'll always need protection from knees and shoulders and elbows from hitting heads and faces. You need something protective, but not so protective that it makes the wearer feel invulnerable enough to use the equipment as a weapon the way they use today's hard plastic helmets and shoulder pads. 

 

The problem as I understand it is the repeatedly bonking heads in hard shell helmets. The helmet doesn't absorb the blow so much as stops it creating a whiplash effect inside the skull. The skull stays in the same place, but forces the brain to slosh around in your brain goop and it bumps into the sides of your noggin, which is where that dangerous CTE damage occurs. I'm no physicist, but I think the solution then would be some kind of thick foam helmet, with facial protection (like a boxing helmet) and thick foam shoulder pads, that absorb blows and don't deliver as much force by the tackler wearing it. I could be way off here, of course. 

 

The other thing you can do is eliminate the lineman crushing heads on every single play and make hand contact the only legal form of blocking. Maybe go to CFL rules and make the defense line up a yard off the ball so both lines have more time to get their heads up. 

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On 5/15/2019 at 10:19 AM, dfwabel said:
 

 

 

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2 hours ago, McCarthy said:

The other thing you can do is eliminate the lineman crushing heads on every single play and make hand contact the only legal form of blocking. Maybe go to CFL rules and make the defense line up a yard off the ball so both lines have more time to get their heads up. 

 

That would be a good step.

 

Then again, so would eliminating the 3-point stance.  Which could be done tomorrow, if the NFL was actually interested in addressing the problem. 

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On 5/22/2019 at 12:26 PM, McCarthy said:

The problem as I understand it is the repeatedly bonking heads in hard shell helmets. The helmet doesn't absorb the blow so much as stops it creating a whiplash effect inside the skull. The skull stays in the same place, but forces the brain to slosh around in your brain goop and it bumps into the sides of your noggin, which is where that dangerous CTE damage occurs. I'm no physicist, but I think the solution then would be some kind of thick foam helmet, with facial protection (like a boxing helmet) and thick foam shoulder pads, that absorb blows and don't deliver as much force by the tackler wearing it. I could be way off here, of course. 

 

What you said here got me to go back to the SI archive. Previously, I read a three-part series about Brutality in Football from 1978 (believe it or not). On the page I am reading, here is this quote:

 

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Dr. Donald Cooper (who was the Oklahoma St. team physician back then): The modern, hard-shell football helmet is the damndest, meanest tool on the face of the earth.

 

Here is a link to that issue: https://www.si.com/vault/issue/70793/75

 

Another thing that was talked about in that three-part series (spanning three issues. I don't know if it's in this one or not) is the shoulder pads. Back then, someone wrote that the coaches maybe don't like pads with extra padding because they like to hear the pads pop.

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The New York Times reminds us that football is not alone in trying to pretend that this isn’t a problem:

 

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With the Stanley Cup finals underway, Joanne Boogaard and a growing group of former players worry that people have moved on to a stage of acceptance — that the N.H.L. has emerged from its concussion crisis by steadfastly denying that hockey has any responsibility for the brain damage quietly tormenting players and their families.

 

Other factors contribute to the lower sense of urgency around head injuries in the sport compared to the N.F.L., including hockey’s lower profile in the sports landscape, and fewer deaths making headlines.

 

But hockey’s strategy of willful denial stands out.

 

The NFL isn’t the only immoral, indefensible league headed for a serious reckoning. 

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