Latest Football CTE Study Report: Parents' Thoughts?

Parent Cafe
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The real issue with brain injury and football is the g forces the head takes, the human brain is not anchored, it moves around in the head, and when you are playing football when you get hit, there is massive deceleration, a typical hit is 30-50gs, and some can go as high as 150gs. Better helmets help to a certain extent (the foam getting crushed when you decelerate helps cut down the g forces some), but no helmet can bring a 100g hit down to ‘normal’ range.

Measuring the number of concussions means very little to nothing, because as others rightfully point out, the concussion is a conclusion of a certain number of hits, but players routinely take hard hits that are way, way up there, and don’t get concussions from it, and the point of CTE is that apparently it is caused by the brain repeatedly being banged around, it accumulates, so one bad hit that causes a concussion might cause X amount of damage with that one hit, but you might get that same amount of X damage from let’s say 10 repeated hits that are large but don’t cause a concussion. In a sense the concussion issue is kind of a red herring and might be a dangerous one IMO, because the NFL can say “we have reduced the number of concussions from 150 a season to 50, and players now have to wait until they are recovered to play again”, but that of course doesn’t address the routine, non concussive hits. Popular perception and the NFL now encourages this, is that only concussion level hits cause problems, but the reality is normal physics does, but by focusing on Concussions the NFL can create a smokescreen about how they have fixed the ‘concussion’ problem. Personally I trust the NFL about as much as I trust politicians promises, this is the same NFL that had as head of their so called ‘concussion’ panel a doctor (and I use that term loosely) who was a rheumatologist who got his medical degree from some medical school in Guadalajara and who was telling neurologists and neuropathologists who were experts and had gone to top notch research medical schools they didn’t know what they are talking about.

I agree that the number in this study is meaningless, in the sense that it is a self directed study, ie the people involved likely had symptoms and their family wanted them checked. In a perfect world, the families of former players would agree routinely to any player who has died, or anyone who played football, to be tested for CTE routinely, or even better that anyone who is autopsied be studied for CTE, which could allow comparing, for example, the incidence of CTE in the football playing population with non players, and compare for example people who played in high school, people who played in college and people who played in the pros, and look at the percent with CTE.

Ultimately the real indication will be if they can come up with a test for CTE that can be done while people are alive, a brain scan that doesn’t require getting samples of brain tissue that can only be done after death. This would allow us to see what percent of active players in the NFL have the indications of CTE, retired players, and even do studies of college and high school players.

I think that the focus on changing the rules has helped, for example the jerk coaches who not too long ago were teaching kids to put their helmet down when running or or tackling, a couple of years ago I was watching a pee wee football game and saw kids putting their heads down and tackling and the coaches were applauding the ‘big hit’. Other fundamental changes might be putting weight limits in football, while I have no way of knowing (given how sparse CTE data still is), I suspect that incidences of CTE were lower decades ago, in the late 1960’s defensive linemen and O linemen weighed around 250 pounds or so , and they tended to be slow, today linemen are easily 300 pounds and over, and they are fast as well, basic physics says the amount of force being generated is much greater than back then (these days, 250 pounds is a typical weight of a linebacker).

As someone who has played the game, and also enjoy watching it, I am torn, but I don’t think the answer is to shrug it off or try and ‘prove’ as some posters on here or the many out there say, that since we don’t know how many people have CTE, what percent get it, we should assume it is something that may tragically affect a small number of players and not worry about it until we have more evidence that it is widespread, that is the wrong approach. I personally think we should limit kids before high school to flag football and for example, modify how kids are allowed to block and such, and also modify how high school players and beyond practice and the like. I think it is also appropriate of course to research if we can make the game safer (and not just use concussion numbers), maybe limiting things like the weight of players (personally, from what I have read by people like Damien Woody and others who have retired who were the “big men”, being that big takes a huge toll on their bodies as a whole and may not be so healthy, they don’t get to that size naturally, not saying steroids,but rather they have to do all kinds of crazy weight training and eating to get that big and fast). I think my priority (not that anyone would listen to me) would be in finding a test for living people, and also in how do we treat the victims of this.

And yes, other sports have seen CTE, not surprisingly, Rugby Players have been diagnosed with it post mortem, and I am sure that some players in other sports, or even for example some fighter pilots, race car drivers and the like might have it, but I would bet that because of the nature of football, with how many big hits they absorb all the time, they will have by far the most.

I don’t think the game is going anywhere, it is too big a business, both at the pro level and at the college level. My big fear is the industry and its supporters don’t turn this into another political football and try things like, for example, banning studying college football players or gathering data on CTE (if they can do it when they are alive) on players in their states as a way to try and protect the game, among other things, that will almost guarantee that if the CTE data is really really bad, the game will die, I am hoping with facts that the game can survive and the players know the risks, and also that there is a way to help treat them if it does happen. Unfortunately, I already have heard a lot of fans saying things like “of course football is violent, it is what the sport is, and if someone plays it, well, they take the risks of playing it” which is not only pathetic but also tells just how cold and selfish the person saying it is. As others have pointed out, sports often for some people is a way to a better life, division one football programs have 85 kids on football scholarships and a lot of them will never play ball, may not have decided to, but end up with enough education to do well, and they may be willing to take any risks to have that, but I think it is also our duty to make sure they know the exact risks, we do everything we can to protect them and treat them.

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"
In fact, Michael Morse of the San Francisco Giants received a concussion during an on-field fight a couple months ago against the Washington Nationals. He still hasn’t returned to play and may never play baseball again. So. it’s just not football, although football is the worst offender for obvious reasons."

Again, it isn’t about concussions only, people focus on that because it is an obvious symptom, the thing is you don’t get CTE only if you have had concussions, it is about constantly getting into situations with massive deceleration/hits, what the evidence is showing is that players who haven’t had any concussions at all have CTE, and the fact that linemen have the most tells the story, because among all football players they tend to get hit, hard, on every play, the receiver who takes the spectacular hit at speed is something you say “wow, no wonder they get brain trauma”, but that happens only a few times a game at most, and many plays the receiver doesn’t get touched at all, whereas a left guard or tackle it getting hit, hard, each play that is run.

I suspect that if they could get brain tissue from Pistol Pete Reiser (fielder with the old Brooklyn Dodgers), who was probably the most concussed player in MLB history (back then the walls were not padded in places like Ebbets field, where he played his home games), they wouldn’t see much evidence of CTE (could be wrong), whereas I would be willing to bet that a large percent of those who play the line would show at least some evidence of it, and I suspect with baseball players (leaving out that many of them likely played football in high school) that very few would show signs of it.

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Also, I’d add that catchers in baseball get a lot of brain trauma from foul balls into their masks. Mike Matheny, a former catcher and the current St. Louis Cardinals manager had to retire from playing because of multiple concussions. Also Buster Posey has had a few hits to the head too and he has to be very careful. He avoided that on-field fight a couple months back, probably from not wanting to get hit in the head.

I just think folks tend to focus on football a lot, but ignore other sports in terms of potential CTE issues.

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I steered my kids into tennis. Very little chance of serious injury. It’s non contact sport. You need to find only one other person to play. The equipment doesn’t cost a fortune. And you can play the sport in your senior years. Learn the skills and you have a sport for life.

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All hits to the head (both big/concussive and small/non-concussive) are concerning. Most of the focus and progress so far has been on the big hits, but the research and counter-measures relating to small hits is a much more recent thing. The good news on this may be that if the volume of small hits is proven to be the bigger issue, reducing the volume of small hits is relatively easy to do. Current football methods, for example, have already reduced the amount of hitting in practice WAY below what we would have experienced in HS football 30 years ago.

By their nature, football and boxing stand alone in terms of the volume of big and small head hits experienced by participants.

Next worse (but a long ways back) is probably soccer. There’s a decent amount of big hits (head to head; head to ground, head to post, head to elbow) and also a good amount of small hits (from heading the ball). As with football, lots of soccer leagues have already significantly dialed back the amount of head-to-ball hits that are allowed in practice.

Rugby is probably back in the pack with other sports like hockey and lacrosse. The lack of serious helmets, shoulder pads and blocking in rugby likely makes it much more brain friendly than football. In fact one of the ways football could evolve to be more brain friendly is to dial back the protective gear. You couldn’t hit and be hit at today’s level of force wearing an old fashioned leather helmet as compared to six pounds of hard plastic and padding. Getting rid of (or minimizing) the football facemask would also tone things down a lot.

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@northwesty:
With Rugby, I know that some players have been found to have had CTE, but as far as I know no one has done any intensive study on rugby players. I suspect you are correct, rugby players for one thing tend to be a lot smaller in comparison to football, and the lack of gear (love rugby jerseys and shorts, but not exactly padded lol)., so the hits will be less. It is ironic that the protective gear they have developed for football to try and prevent injuries is a two edged sword, because I agree that it is a lot easier to make a huge hit when you are wearing a well padded, heavy helmet and all kids of protective pads that help with a hit, since the hitter won’t feel it as much as if they did it wearing the equipment. I still think there would be CTE even if they played without protective gear, but it might reduce it somewhat.

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I agree that in a way, better protection makes things worse because there are hits that never would happen without all the protection. Could reduce the protection in an effort to slow the game down somewhat. Though that likely reduces its appeal to many.

There have been parents who refuse to let their kids play football (or other “dangerous” sports/activities) ever since we have had “dangerous” sports/activities. I expect CTE issue will increase the numbers of such parents. Though its less clear to me that the reduced numbers will have dramatic impacts on high school. college and pro football levels. I would expect lower levels would be impacted more/first.

Boxing was at one time huge. But there are a lot of other sport options now. And Boxing/MMA seem to be making gaining in popularity. As someone noted, we humans seem to thirst for violence.

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99.9% of HS football players will not go pro. In so far as most parents are concerned, a far more relevant study would look at players who never played a day after HS graduation.

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My thought was, I’m glad neither of my kids play football. I thought of kids I know now who do play, and worry for them.

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@roethlisburger:
I agree with you, it could be that for example kids who play peewee and high school football don’t have the level of CTE you see down the road, and hopefully someday soon they will invent a test that can be done when the people are living. However, what you are implying is that kids who don’t go beyond high school football are perfectly fine and all the problem is those who play college football and or/ pro football, but we don’t know that, we don’t know how much it takes, we don’t know if even if the kid starts playing in high school that that will prevent CTE…and if we don’t know, it generally is better to lean towards the side of being cautious…and honestly, the NFL should be promoting that, too, not just for example their program to try and get safety information to pee wee and high school football coaches, but also encouraging that kids start with things like flag football and don’t play tackle until high school. Why? Because if they want players down the road, by taking that kind of precaution a lot more parents may let their kids play.

The biggest thing the NFL should do is what I just said, come up with a test that can be run on high school kids playing football, for example, to see what their brains look like, to get the facts, because until you have those there is real fear, and not unwarranted, on the part of parents about the long term consequences of football. From what I have read about the NFL’s program with CTE, they spend a lot more money promoting the sport and putting out advertising about their coaching programs and such for lower level coaches then they do on research, and there has been controversy that they are giving money to researchers who basically are trying to show that CTE is not a concern (kind of like climate science denial with the energy industry), rather than finding the truth…and I can understand why, because a broad based test of living people can’t be explained away as 'directed studies" of people who died and their families donated their brains to the research.

Given the way the NFL has treated CTE, not to mention the NFL players association (I thought it was the ultimate irony that Dave Duerson, who actively refused help to players suffering from brain issues as part of the NFL health program, and denied it was an issue, denigrated the doctor who discovered it, ended up the way he did), as a threat to be buried, rather than find the truth, I suspect the breakthrough won’t come about through them.

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The “brainy” Ravens player who is pursuing a PhD has now retired.

http://www.nydailynews.com/sports/football/ravens-ol-john-urschel-26-abruptly-retires-cte-study-article-1.3361639

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Couple points. First, the NFL is currently sponsoring some research being done by the Cleveland Clinic on high school players by measuring their cognitive function at various points in time over their career, and by monitoring and recording those diagnosed with “concussion like symptoms”. My son’s high school was one of the teams that participated. So some work is being done, although most of this stuff at every level is in its infancy and more certainly needs to be done. Second, in my non medical opinion, the NFL is exactly correct in focusing on educating coaches at the lower levels. Some of the problems we see absolutely are the result of truly terrible coaching on fundamentals and technique. I coached a bit of high school ball before my son got old enough to play, and I can’t count the number of times I heard youth coaches say utterly inane things to kids.

FWIW, I think that kids who play at the youth and high school level are running some risk of log term injury, but I think that has a lot more to do with poor instruction and poorly fitted/unsuitable equipment. I agree with @roethlisburger that the difference in the level of violence in the NFL or even Division 1 is such that work being done on either concussion or CTE at that level is maybe not the most instructive for the risks run by normal high school and lower level players.

One last thing. I hate the move to flag football. We see too many kids who play flag up until junior high school or high school who then come out for “real” football with no idea how to protect themselves. They run upright, they lead with their head on defense because they are used to looking for the flag, etc. What’s worse, they often have an unwarranted comfort level with the game because of their flag experience, so they are not as cautious as a kid who comes out for the first time in ninth grade.

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What are the levels of CTE damage and practical impact/symptoms at each level?

Pro and scholarship athletes can’t really do a cost/benefit analysis until they know exactly how severe the effects are likely to be,

For instance: Are migraines (arbitrary hypothetical symptom) worth a free college education? Are they worth a $20 million career and early retirement? And the fun – is CTE worth all the fun of playing football?

For those not aspiring to D1 college or pro football:

  1. They won't be playing competitive football as long, so they will be involved in fewer collisions, and...
  2. Those hits will almost certainly be less violent than college or pro hits, so...
  3. The overall head damage is very likely going to be less than what a college or pro player is likely to face, so the risk of CTE (and severity of CTE) is probably quite a bit less.

Up through high school i’d say absolutely, go ahead and play.

For college and pros I’d ask the kid to weigh the risks and rewards.

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But the risks are not known at this point. Chances of getting CTE are not known (at any level of play). There may be other factors involved that increase/decrease chances. More data is needed.

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More coaches need to get on board with the no-helmet rugby style tackling. It is better for both teams.

I know the NFL has gear deals but they should all go to VICIS helmets immediately. If one of my kids were playing even rec level, I would have one made for him. The Seahawks used them last year and reviews were very good.

On another topic mentioned, my D’s nationally ranked college rugby team had up to 6 players out at a time for concussions. They play with 15 on the field and it is a game with violent contact, just more controlled because of the ability to pass the ball before being tackled.

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The problem is a helmet can only do so much to ameliorate the physics of an impact. Your brain basically is this spongy tissue that floats inside your head, and when you have deceleration the brain sloshes around and hits the skull as it swishes around, which is what causes CTE. A helmet is designed primary to stop the person from cracking their skull open, but the padding in the helmet, while it can absorb some of the impact (it compresses, slowing the heads motion down a bit), it cannot adjust for the 50-60 g’s we are talking about. Yes, things like not putting your helmet down when tackling or running helps, protecting defenseless receivers, penalizing late hits on QB’s, and so forth helps cut down on CTE likely, but it won’t prevent it, just an ordinary hit a lineman takes on each play seems to add up.

It is why studies are needed to find the answers, but I am not confident it is going to happen, I think the NFL if they had half a brain would be funding serious studies and find a way to detect CTE when someone is alive, that would let us answer questions like is it safe to play football, and when, as a kid, and what is the border between acceptable and not , but the NFL is still in the mode I think of being afraid of the truth, because it might show something they don’t want. Problem is, then they are faced with what you see with vaccinations, people are going to see results like this one, as flawed as they are in the sense they don’t tell a complete story, and act out of fear rather than based on fact, and with all their billions the NFL may lose. In a sense, they could end up in the same position football was in around te turn of the 20th century, when Teddy Roosevelt thought seriously of banning the game, because it was a very violent game (they used to have the ‘flying wedge’ where blockers linked arms to incapacitate the defense on a play, tended to cause pretty bad neck trauma including death and paralysis), football adjusted by banning the flying wedge and also with the forward pass, not so sure they can do that with CTE.

Not disagreeing about bad coaching, there are still idiot coaches out there who yell at players to put their heads down and give it to the other player, and having watched shows like “Friday Night Tykes” some of the coaches teaching young kids football should be banned from the sport, bloody idiots act like they are Nick Saban or something, and have the kids doing all kinds of stupid things.

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interesting coincidence today as I was catching up on this thread. My H received legal notice regarding the NCAA Student-Athlete Concussion Injury Litigation Class Action Lawsuit. The legalese is beyond me, but card was for a proposed settlement and stated
“if you are a Current or Former Student Athlete Who Played An NCAA-Sanctioned Sport at an NCAA School at Any Time through July 15, 2016”

Kind of surprised to receive this as my H played NCAA football… forty years ago (1973-77)!!!

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I think fairness requires mentioning that the VICIS was developed in large part because the NFL put the money up for it. And I think it is a promising helmet, but right now it is really, really new. Some teams in the NCAA used it last year in addition to the Seahawks in the NFL, and we will see how it is received going forward. I also like the work Ridell is doing with the Speedflex (what my kid and most of his teammates wear). Schutt has a newer helmet out too that soem guys in my son’s circle seem to like. Helmets are really personal, and the higher up you go, the more picky guys get. Especially now that players are becoming aware of the dangers of concussions and CTE.

Again, education is a huge factor here. During my era, when inflatable air helmets were a thing, the trainers would pump them up almost to the point of pain so that the helmet didn’t slide down and break your nose after an impact. I am sure that wearing helmets that tight did very little to absorb the impact being transmited to your head, but it was what was thought safest at the time. Eventually, guys started sureptitously taking all the air out of their helmets (because they would hurt when you had a “headache”), and then they would be so loose that helmets would pop off all the time. But they were more comfortable to wear that way. Nobody thought about long term brain damage.

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@gosmom, my daughter received that card too. There is no money for any of the players but there is concussion testing. The lawyers will make the money.

My daughter has missed more practices from strep throat than from concussions (none) or other injuries. She’s never missed a game.

Coaches and parents need to make sure their kids are wearing mouth guards. I see kids spitting them out, chewing on them, twirling them. I’ve seen coaches and parents get pissed at the refs for penalizing the player for not having it in the mouth, between the teeth. Mouth guards are to prevent concussions. The rules require them in many sports (football, hockey, lacrosse) but players don’t think they are necessary.

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@ohiodad51:

The real problem is the lack of facts, and with the NFL and the Players Association, not to mention the big time college football programs, I feel like they have the attitude that if we don’t study the condition, they can do what some posters on here have done, and basically say “well, in the absence of hard data, then there isn’t a problem”.

I played the game so am not exactly anti it per se and am a fan.When people say “well, players choose to play the game and take the risks”, they are leaving out that to accept risk, you have to know what it is. In the military, for example, guys who do ordinance disposal or are in forces like the SEALS know and accept the risks, people who work the crab boats in Alaska know the risks, and are willing to take it. With football, we now know that CTE is a real condition that has affected players, but outside that we know so little. What kind of hits induce CTE? And if everyone playing football has some form of CTE as a conjecture, how much can you take before it affects you? With risk, my take is the players and parents need to know the risks to be able to accept them…and what the NFL and the big time football programs and the NFL PA don’t realize is in the absence of facts, fear takes over, and then you can end up with outright bans, already some schools have dropped football because of the fear of injuries of all kinds, including CTE.

I am not sure a helmet can help all that much, how do you stop the brain from sloshing around with a 50, 60g deceleration? I don’t know of any material that is let’s say even an inch thick (padding in the helmet), could absorb that kind of force and keep the brain from sloshing around like a tennis ball in a jar of water if you run with it and suddenly stop. Some birds can take 100, 150 g’s impact because their brains are designed for it, but can something external stop that kind of sloshing…or would it take in a sense something internal to stop the brain from moving around like that (science fiction, obviously).

Some of it may be limiting playing weights for football, maybe going back to a league without 350 lb linemen and the like would help, too, they do that in pee wee football, maybe limiting weights would do something (the forces generated when a 350 lb person hits you who can run a 4-6 40 is huge,which translates into de-celeration when the person is hit.

Obviously, things like the concussion protocol they now have will help, as will the decrease in full contact practices, better equipment, banning helmet to helmet hits entirely, but we need facts, which we don’t have. Until we have more facts, I don’t think we can assume anything is okay and maybe rethink things like young kids playing tackle until we do know, or maybe finding ways to limit hitting if we do allow it, until we know for sure.

We also need widespread studies when people die where we check for CTE routinely when an autopsy is performed, and then we do an analysis of people and their background, if the person ever played football (and obviously, also looking for other things that could cause head trauma routinely to weed out non football causes), and seeing for example if someone who played high school football (maybe take a kid who sadly dies in high school or when still young) shows signs of it, if studies show not, then we may be able to safely assume the real risk is college and beyond. Even better, finding a test that can be done with the equivalent of an MRI or other scanner so we can do monitored studies of players and see.