Congress needs to recognize the seriousness of football-related brain injuries

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It’s just a ding, the coach would tell the parents. He will be okay. He needs to be a man and get tougher. Everything is fine.  This is what I heard growing up in a place where football was valued more religion. In fact, it was our religion. Unfortunately, we now know that a ding is not just a ding. It’s a potential tragedy.

Some members of Congress recognize the seriousness of the problem but, to date, there has not been any legislation proposed that would mandate minimum standards or guidelines to reduce sports-related brain injury. That’s something for which physicians, community leaders, and other members of the public should ask their representatives.

{mosads} Last year, a friend’s son was dazed from a hit to his head while he was playing in his eighth grade football game. The boy was a straight-A student, but following his injury, he struggled to earn passing grades. He gradually recovered, but it took nearly 6 months for him to fully heal.

Repeated concussions from athletics can produce a traumatic brain injury (TBI) similar to what our soldiers experience with explosive devices such as an Improvised Explosive Device (IED).

It is hard to know how many hits to the head are necessary to cause irreversible damage. The New York Times reports that Kevin Turner, who played eight seasons of professional football, “suffered for six long years with a brain disease that research has linked to head trauma in football.” He died in March of this year at age 46.

Turner’s situation isn’t unique. The Journal of the American Medical Association ((JAMA) recently published an updated study that found 99 percent of deceased National Football League (NFL) players whose brains had been donated to science suffered from chronic traumatic encephalopathy (CTE).

Among deceased players across all levels of American football (including high school, college, and professional) whose brains were studied, 87 percent were diagnosed with CTE. This is a neurodegenerative brain disease caused by repeated head trauma, including concussions.

Dr. Ann McKee, the study’s senior author, warns against accepting the results at face value. By her own admission, the study was biased, because all the brains were donated. According to NPR, Dr. McKee cautions, ” ‘Families don’t donate brains of their loved ones unless they’re concerned about the person. So all the players in this study, on some level, were symptomatic. That leaves you with a very skewed population.’ “

That said, the National Football League (NFL) formally acknowledged a correlation between football and CTE in 2016. Jeff Miller, the NFL’s senior vice president of health and safety policy, said there is “certainly” a link between football and degenerative brain disorders such as CTE.

Despite awareness of the disease, some players are willing to accept the consequences. For example, New York Jets player, Jamal Adams, told his fans “he would be fine with dying on the football field.” Others who are less cavalier may still succumb to pressure from their coaches and managers to get back in the game since “everything is fine.” 

But, often, everything is not fine. We now know the effects of brain trauma are cumulative, and the onset of symptoms can be delayed by years.

With all of the risks associated with football, some people have debated the merits of banning it at the high school level. I’m not sure whether that’s necessary or even desirable. Team sports help young people grow physically and socially, and the payoffs of learning about winning and losing can be invaluable.

However, we should not allow the brain trauma and destruction to continue without making efforts to prevent it from occurring. The NFL, National Collegiate Athletic Association, and the National Federation of State High School Associations could help prevent harm if they were to come up with new rules regarding how to monitor the health of players and maintain their safety while they play the games.

Brain imaging with CT scans are not useful in diagnosing injury from concussions, because the trauma produces microcellular injuries not seen on scans.  

But there is a promising alternative. The University of Pittsburgh Medical Center-Center for Sports Medicine has developed an on-line computer-based neurocognitive test to assess the real-time effects of brain trauma. It is intended to be used at baseline before a player begins a season. In the event of concussion, the player can be tested at the time of the injury and then periodically until the test results return to baseline. There should be medical guidelines that, based on tests results, recommend the timing of future play.  

Players at all levels (and, if appropriate, their parents or guardians) should receive pre-season information about potential harm. This could be similar to an informed consent document that is used in the medical field before surgery/procedures.

Let the games be played, but let’s ensure that brains are protected and that the safety of the individual is always the top priority. We have to care more about football players than we do about the game.

Lynn R. Webster, M.D. is Vice President Scientific Affairs for PRA Health Sciences. He the former president of the American Academy of Pain Medicine. In addition, he is a co-producer of the public television, “The Painful Truth.” You can find him on Twitter: @LynnRWebsterMD.

The views expressed by contributors are their own and not the views of The Hill.

Tags Brain injury Chronic traumatic encephalopathy Clinical medicine Concussion Emergency medicine Head injury Major trauma Medicine Neurotrauma Sports injury Trauma Traumatic brain injury
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