When Football Goes to Your Head

It’s no secret that, except in parts of the country where there is little else to occupy your time, American-style tackle football losing popularity among X and Y generations. Maybe they just have too many other distractions in this over-connected contemporary world, or maybe there is something inherently unattractive about the sport itself. Perhaps something that earlier generations simply did not know about or did not care. That college and professional players have, over the years, gotten larger and heavier has not helped.

It’s hardly news that serious brain disorders have surfaced among ex-NFL players, leading to early deaths, suicides, pounding headaches for years, blurred vision, balance issues and erratic behavior. There have been lawsuits, settlements, negotiations with the Players’ Union, and massive news stories for several years now. But instead of allaying our fears from brain damage from harsh slamming to the head, inherent in the sport itself, instead of being grateful for the introduction if on-field diagnoses under new concussion protocols, we are discovering that the litany of very serious medical issues related to such hard contact to the head is growing.

For football players, boxers and a host of other sports that may not reach the level of those athletic activities in terms of brain risk, the news is not good. “Discussions over the long-term health risks of playing football have primarily focused on CTE. Eighteen months into the NFL’s concussion settlement, claims worth more than $140 million have been paid out or approved for two diseases some players say were never highlighted — Parkinson’s and ALS.

“Before Chris Borland decided to walk away from the NFL in 2015, he spent a season learning about the long-term risks of the sport, reading books and talking to neuroscientists… Nobody mentioned Parkinson’s disease. A single article, he said, referred to amyotrophic lateral sclerosis, or ALS… ‘It was mostly about CTE [chronic traumatic encephalopathy],’ said Borland, who retired at age 24 after a standout rookie season as a linebacker with the San Francisco 49ers.

“Three years later, the number of players with a Parkinson’s or ALS diagnosis who have applied for and received payments under the NFL’s concussion settlement is significantly larger than projected, raising the possibility that professional football players may be at greater risk of developing the neurodegenerative diseases than previously believed.

“In the 18 months since the settlement went into effect, 113 Parkinson’s and 42 ALS claims were filed by former players or their representatives. Of those, 81 Parkinson’s and 30 ALS claims worth a combined $146.5 million either have been paid or approved.

“Those figures dwarf projections made in a report commissioned by the players’ lawyers, which estimated that 14 Parkinson’s and 18 ALS claims worth a combined $52.6 million would be paid over the 65-year duration of the settlement. A report commissioned by the NFL predicted 31 paid ALS claims over the settlement’s lifespan; it did not provide specific numbers for Parkinson’s.

“Though research has established a link between brain injury and increased Parkinson’s risk — as well as a possible link between playing in the NFL and increased ALS risk — there is no consensus within the scientific community about how repetitive head trauma contributes to movement disorders. As such, scientists are uncertain why the rates of both diseases among retirees enrolled in the settlement are higher than projected.

“‘Those are startling numbers,’ said Dr. Charles Bernick, associate director of the Cleveland Clinic’s Lou Ruvo Center for Brain Health in Las Vegas and the lead researcher of an ongoing, long-term study of the brains of professional boxers and mixed martial arts fighters.

“‘We really don’t know how much of an increased risk there is for those diseases among retired football players, or in combat sports like boxing. But if repetitive head trauma is a risk factor, we need to understand that. It has major public health implications.’” Patrick Hruby writing for the August 9^th Los Angeles Times. CTE is bad enough without these additional brain disease risks.

“Symptoms of CTE, which occur in four stages, generally appear 8 to 10 years after an athlete experiences repetitive mild traumatic brain injury… First-stage symptoms include attention deficit hyperactivity disorder as well as confusion, disorientation, dizziness, and headaches. Second-stage symptoms include memory loss, social instability, impulsive behavior, and poor judgment. Third and fourth stages include progressive dementia, movement disorders, hypomimia, speech impediments, sensory processing disorder, tremors, vertigo, deafness, depression and suicidality.

“Additional symptoms include dysarthria, dysphagia, cognitive disorder such as amnesia, and ocular abnormalities, such as ptosis… The condition manifests as dementia, or declining mental ability, problems with memory, dizzy spells or lack of balance to the point of not being able to walk under one's own power for a short time and/or Parkinsonism, or tremors and lack of coordination. It can also cause speech problems and an unsteady gait. Patients with CTE may be prone to inappropriate or explosive behavior and may display pathological jealousy or paranoia.” Wikipedia. Not only is there no real treatment for CTE, it is so far nearly impossible to diagnose until there is an autopsy.

Now we also have to consider Parkinson’s: “Early in the disease, the most obvious are shaking, rigidity, slowness of movement, and difficulty with walking. Thinking and behavioral problems may also occur. Dementia becomes common in the advanced stages of the disease. Depression and anxiety are also common, occurring in more than a third of people with PD. Other symptoms include sensory, sleep, and emotional problems.” Wikipedia. And ALS or “Lou Gehrig's disease, [which] is a specific disease [that] causes the death of neurons controlling voluntary muscles. Some also use the term motor neuron disease for a group of conditions of which ALS is the most common. ALS is characterized by stiff muscles, muscle twitching, and gradually worsening weakness due to muscles decreasing in size. This results in difficulty speaking, swallowing, and eventually breathing. Wikipedia. In short, with ALS, your organs and muscles simply atrophy until you die, a really ugly way to go.

As parents and potential audiences for a great game in a contact sport, clearly we need to start asking the right questions and taking appropriate action. At what point does a contact sport become so risky that continuing to support that activity can be justified at any level? And while hard sports often represent a rare form of contemporary upward mobility out of poverty, does there come a point in time where we need to limit or ban those contests? After all, children start playing these sports, becoming addicted and competitive, usually at an age where they cannot appreciate the risks that only become apparent years later (and are really too young to consent)… and are increasingly impacting children starting in their high school years where their body mass grows to powerful and dangerous levels.

I’m Peter Dekom, and we need to step up and take responsibility for dangerous behavior once we know the facts behind that danger.