Since the tragic and untimely death of Junior Seau the concussion issue has begun to fester like a three-day old pimple on a 13 year-old’s greasy face. It is ready to pop and keeping up with all of the pertinent articles and “specials” has been very trying. In this post I will attempt to link up and highlight as many as I can (surely I will miss many, however Concerned Mom in the comment section will have more).
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Lets begin with ESPN and the Outside the Lines week-long look at concussions. I have found this to be must see, my DVR is a testament to this; using previous stories and bringing in commentators on the subject have provided information and even fireworks. Yesterday Merril Hoge and Matt Chaney did just that – provide information and create fireworks. You can find the podcast here (panelists begin about 7:30 mark).
Hoge drew my ire earlier this week with his admonishing of Kurt Warner’s statement of being a father, however yesterday he did have a very valid point about the management of concussions. I have said is ad nausea here: the elephant in the room is the management of concussions, however Hoge sounded a bit “underconcerned” about the actual injury. Which is where Chaney had very valid points about the exposure of concussions to the youth. They are both right in my estimation; the management is the larger issue but we are seeing too many too young people being effected by concussions. There needs to be work in both areas and remember this is not just a football issue.
We have the duty to protect our kids and if that means flag football for 5-13 year-olds then I am cool with that. If we find after making such a drastic change that has not been enough then we can take it further if needed. I feel that a change like this will allow a few things: 1) more time to let the brain develop and thus allowing research to catch up to what we know. 2) employ more medical providers in a position to find, assess and manage concussions (see athletic trainers). And 3) begin a culture shift about the seriousness of concussions, after all this is a brain injury.
As Chaney later told me;
“no one, including you or Hoge, can do shit with these grand ideas until we get the damn game down into manageable size… again, ATCs must face this fact and act, especially, or this whole fucking show will disappear, and relatively soon”
“I’m still open for tackle football ages 14-17; I’m just saying mounting experts and literature and assumption of risk law don’t bode well for even adolescent participation much longer”
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There was a debate on ending college football with many dubious and well written experts. It was designed to originally talk about the corruption of college sports but it did bleed into head trauma. You can see the full debate here courtesy of FORA.tv. Listen to Malcolm Gladwell, Buzz Bissenger, Tim Green and Jason Whitlock debate. It was brought to us by intelligencesquaredus.org, thank you.
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An abrupt retirement from a lesser known makes us all think for one second;
“One of my biggest concerns when it comes to the game in general is my personal health. One thing that’s obviously on the minds of a lot of people lately is brain research and all the stuff that’s going on with that. One of the big things that I thought about when I was considering this is how much do I love the game? How much can they pay me to take away my health and my future and being able to be with my family and just have a healthy lifestyle?”
So after eight seasons — the last four of which came with the Rams — encompassing 109 regular-season games and 100 starts, Bell is calling it a career. He said he has contemplated retiring for the last year or so. But the recent death of linebacking great Junior Seau was the “cherry on top.” In other words, it may have pushed him over the top in terms of deciding to retire.
Would Bell, who signed a one-year free-agent deal with Cincinnati less than five weeks ago, still be playing if Seau hadn’t taken his own life?
“That’s a good question,” he said. “I’ve been thinking about some different things, thinking about health, thinking about the future of my family having to deal with some kind of crazy disease that nobody even knows about, where people want their brains studied after they’re dead. Donating their brains to research.
“It’s just crazy to see how someone like Junior Seau took his own life over — God knows what he was really struggling and dealing with. But you have to believe it came from the game of football. I want to get out before the game makes me get out, where I can get out on my own terms, and I can limit the amount of stress and negative impact that the game would leave on me.”
I can’t help to think there are many more players going though the same thought process.
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Here is an article that I just don’t know what to make of it from USAToday;
Do football players die younger?
A records-based study of retired players conducted by the National Institute for Occupational Safety and Health (NIOSH) concludes that they have a much lower death rate than men in the general population, contrasting the notion that football players don’t live as long.
The findings, emailed Tuesday to about 3,200 former players who retired before 1993, came less than a week after former linebacker Junior Seau’s suicide death at 43, and renewed concerns for the long-term health of players.
“That’s surprising to me because of the blows we took when we played,” said former Oakland Raiders defensive back George Atkinson, 65. “You’d think football players didn’t live as long as the average person.”
Hall of Fame guard Joe DeLamielleure, 61, said he’s not convinced. “I think it’s bogus. Just think of the guys who have died before they got into their 60s or 70s. Don’t tell me we live longer. I don’t believe it.”
Of the 3,439 former players in the study, 334 were deceased. Based on estimates from the general population, NIOSH anticipated 625 deaths. The results, completed this year, came from further research after a study requested by the NFL Players Association (NFLPA) was completed in 1994.
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From the Today Show, girls and concussions in the sport of soccer; you can find the video here. Again it highlights that football is not the only place for concussion and boys are not the only ones affected.
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How about a point of view from Marc Bulger, from ESPN.com;
That’s why Bulger finds it so hard to believe that the former NFL players who recently filed the federal lawsuit against the NFL were unaware of the dangers. He doesn’t doubt many former NFL players struggle with severe effects of concussions, such as dementia and chronic traumatic encephalopathy (CTE), but their struggles aren’t the NFL’s fault.
“I may have it,” Bulger said of CTE. “I’ve had 10 to 15 concussions. I played in the NFL 11 years. There were six or seven years where I was the most sacked quarterback for that span. So, this could affect me.
“I’m just saying there’s a slippery slope. If we go that route, is it the college coaches as well? Do we blame the high school coaches? I think it is going to have a negative impact on the sport. ”
Bulger believes the NFL will not survive if decisions are made to soften the physical aspects of the game.
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The Concussion Blog 
In regards to USA article you had listed and you didn’t know what to think of it…what I didn’t see was the breakdown of positions and death rates. The results could be misleading when all football players are lumped within the results. Now if the results broke down by position with O line and D line separate, there you might find that death rates are potentially higher and not just due to issues from concussions and all the hits but also due to their girth and the impact their girth has on heart and joints. What would have been interesting is those that died prematurely from natural causes and been able to look at their brains. Had they not have died at a young age from heart disease, would the effects of football on their brain been their demise?
But I digress. The main reason I don’t take much stock in the USA article that football players live longer, is I did a research paper on Football players and obesity rates by position.
It looks like Chaney was out numbered. In the interest of fairness, I propose the following panel to ESPN OTL:
Dr. Omalu, Dr. McKee, Dr. Brady, Dustin Fink, Irv Muchnick, Matt Chaney
versus
Merril Hoge and USA Football spokesperson (sure any of them would be interchangable and equipped with the same talking points … wonder if they’ve run them by focus groups …. in fairness I will say they’re proposing some good ideas, I just don’t think it’s feasible to believe they’ll be widely implemented in a timely fashion, the average child probably doesn’t even have access to adequate concussion health care, nevermind academic accommodations or return to play protocols)
Now, as far as the moderator, I would suggest Joe Bloggs if he was willing to blow his cover (he cuts through bull like no one else) or Dr. Benford.
The spin is crazy.
Let’s look at facts instead of Hoge’s blather. Chaney was the low man on the totem pole.
Facts:
Omalu says no collision play until one is at the age of majority.
McKee, Cantu – no collision sports until 14 years old.
Allesi – no collision sports until 10 years old ?
I would hope we could get an opinion from Dr. Flaura Winston at Chop. Very bright researcher.
The brain does not complete maturation until we are in are early 20s.
Nonetheless, Chaney was shouted down by Hoge when he offered hard facts from competent clinicians and researchers. All Hoge and USA football could point to are people who have a dog in the fight and are anything but disinterested.
I hope everyone noted that Osi Umenyiora did not play junior level football. He joins Jason Pierre Paul and Tom Brady in going pro without the dubious privilege of playing for poorly coached and poorly medically managed programs. Perhaps these players will have better lives and longer careers simply because they started later in life. I wonder how many other professional football players started at high school.
Hoge should show the attrition rate of players from pee-wee forward? How many players are nothing more than tackling dummies? Does playing pop warner have anything association with college scholarships or going pro? Do pros would played early have shorter careers?
As far as treatment being the solution, for young children one should avoid the problem, for teenagers carefully executed care is necessary but seldom available and for adults they should no what they are in for.
Life is about trade-offs and obesity and diabetes are national health problems so sport and exercise need promotion. On the other hand, bad coaching, sorry equipment and poor medical care leaves players in a lurch.
Time to get real.
I just finished watching the debate about ending college football, and although it may be time for change, I can’t say that I’m motivated to ban any particular college sport (the main focus of educational institutions needs to be education though). The CTE findings should be viewed as a red flag, and full contact practices and hitting should be limited. Actually, based on the negative outcomes associated with multiple concussions, head impacts in all sports should be reduced as much as possible.
A year ago, I wasn’t paying attention to football and was not in any way motivated to speak out against youth football. Unfortunately, my son had a negative experience and in less than two months of playing, sustained a concussion which is still limiting his participation in organized sports over eight months later. Not being able to sign up for spring soccer was painful for both of us.
I have friends who played football and they claim to have experienced many benefits by participating in the sport. We know of other families in our community who have had multiple generations participate at the pee wee, middle school, high school and college level. High School football is viewed as a vital component of our community, and the near death experience of a player a couple of years ago is viewed as a “freak accident,” which is unlikely to occur again due to ImPACT testing.
Now, if people really want to see football continue, they may want to do something about the poorly run programs that are out there. I know I’m speaking out to prevent other families from experiencing a similar situation or worse.
You see, not only did my son sustain a concussion at age eight, but he learned that life is unfair and that he can’t trust adults to look out for him. He learned that he wasn’t important enough for practice to be stopped so his injury could be evaluated. Since school personnel weren’t educated about concussions, he also learned that sometimes you can get accused of lying even when you’re not (staff didn’t understand why the use of math software during afternoon computer lab was causing headaches, and assumed he must be lying about his symptoms to get out of difficult tasks).
I learned that school systems aren’t always looking out for the welfare and safety of students (hey, if they can offload liability through a facilities rental agreement, unsafe programs aren’t their problem). I also learned that a parent who advocates for their child by asking for accommodations can be viewed as a problem. I guess another lesson I learned is that many people find it very difficult to accept new information, and that it’s going to be very difficult to make some youth programs safer.
Dustin, in a recent video you posted, Cantu refers to the condyle Tmj area as a potential theory that may cause concussion. A mouth guard mandate in the NFL is needed, most experts agree regardless of its effectiveness on concussion, simply reducing facial/teeth injury is reason enough. Evaluating all athletes for Temporal mandibular joint dysfunction is one thing that is already available to concerned parents.
Next up … bubble wrap??? pillows??? Seriously, can you imagine trying to bring all this padding down to the lower levels, most kids end up wearing pants and pads that don’t really fit them as it is.
http://www.cbssports.com/nfl/story/19005294/ten-ways-to-fix-the-nfls-growing-concussion-crisis
“We set out to write 10 things the NFL can do to save itself from a concussed, brain-damaged future. One of those things might happen soon, and it could change the look and pace of the sport.
On the agenda for the upcoming meeting of the NFL’s competition committee is a proposal to make the wearing of hip pads, thigh pads and knee pads mandatory beginning in the 2013 season.
Commissioner Roger Goodell has been quietly pushing this for several years. The idea is that the extra padding would do two things, both related to helping prevent concussions. First, by wearing knee pads, if a player’s knee makes incidental contact (or purposeful contact) with the head of a player, a padded knee would offer more protection for the head than an unpadded one. Second, the wearing of the equipment would slow down the game which in turn might lessen the harshness of the collisions.”
How many hits to the head can a young athlete take … ? (I think that was actually the opening line to the video!)
http://www.13wham.com/news/local/story/concussion-injuries-and-brains-studied/UZS5eoqdiUCDTNav2P7GBw.cspx
“”A lot of people are still not aware of what a concussion is or feels like. Sometimes, athletes assume they are supposed to have a headache when they get hit in the head, but that’s not normal,” said Mark Mirabelli, MD and member of the University of Rochester’s Concussion Center.”
“The U of R is in the midst of a head trauma study pertaining to football.”
Good video by Dr. Bazarian of U of R (it’s from 3/11/2011):
http://www.publicbroadcasting.net/wxxi/.jukebox?action=viewMedia&mediaId=957765
http://www.urmc.rochester.edu/news/story/index.cfm?id=1036
“Unfortunately, the widespread use of the CT scan as the primary tool for diagnosing head injuries has biased the way we think about concussions,” Bazarian said. “For many people, a more significant axonal injury has occurred, and this underlies the problems they have with motor skills and memory, and may also be a risk factor for later development of Alzheimer’s and Parkinson’s diseases.””
“From the Today Show, girls and concussions in the sport of soccer; you can find the video here. Again it highlights that football is not the only place for concussion and boys are not the only ones affected.”
I couldn’t get the linked video to play for me, but was able to find it along with some additional Brian Williams NBC Nightly News coverage at Hulu.
http://rockcenter.msnbc.msn.com/_news/2012/05/09/11604307-concussion-crisis-growing-in-girls-soccer?lite
“Her parents said that they knew about the danger of concussions in sports like football, but it wasn’t until Allison had her first serious head injury that they realized what a big problem concussions can be in soccer.
“I think that we were blind to what was going on around us because, yes, it was about the team. It was about the winning. It was about all the, it was almost like a routine of, like I said, an awful lot of practices and you just went through it and really your lives rolled by with soccer being the most important thing,” said Lex Kasacavage, Allison’s father.
Sports psychologist Richard Ginsburg says that enthusiasm for the game and the kids by parents and coaches, while well-meaning, might be making the concussion crisis worse.
“We get wrapped up,” said Ginsburg, the author of ‘Whose Game is it Anyway?’ “We want success for them and so sometimes we get, we lose perspective. It doesn’t make us terrible people. It just makes us human. “ “
It seems like goalies are in paricular danger of sustaining concussions based on what I’ve read elsewhere.
http://well.blogs.nytimes.com/2012/05/10/concussions-may-be-more-severe-in-girls-and-young-athletes/?smid=tw-nytimeshealth&seid=auto
” … Megan Wirtz, a goalie for her high school team, was bending down to pick up a ball when an opposing player mistakenly kicked her in the face.
Her face swollen and bleeding, Megan was taken to an emergency room and stitched up. No one realized she had suffered a severe concussion until three weeks later, when a player ran into her during another game and she fell to the ground, suffering a seizure on the field.”
““In retrospect, we hadn’t thought as much about her brain as we clearly should have,” said her mother, Barbara Wirtz, a nurse in East Lansing, Mich.”
http://fifthdown.blogs.nytimes.com/2012/05/06/youth-football-the-debate-and-the-dangers/
“Extra point It’s hard to find fault with Warner’s concerns as a parent. Some sports involve less head contact than others. And the impact of repeated collisions on young brains needs more study. Flag football is always an option for children. At what age do you think it’s appropriate to start playing tackle football?”
My coaches wouldnt have stopped me from hitting. THINK of all the lives ruined by this epidemic whodid make to even college or the pros.
I think ultimately the first line will be drawn for football that hitting won’t be allowed until 12 years old.
The risks at a younger age do not warrant the possible benefits of playing “real football”. The disproportionate head size in younger players compounded by the lack of muscle strength and control means that most collisions are more likely to have head contact, and more uncontrollable contact as well. This leads to a larger amount of collisions with head contact that at any other level. While the maximum impact forces might not be the same as the adult level, the fact that the lower level impacts happen with much more frequency is a huge concern.
No matter how great the post injury care gets, the disproportionate rate head injuries occur in football will have to lead to changes. I actually think that it will probably be the insurance companies that do it. If the liability insurance rates for youth football don’t skyrocket then it will be the first insurance company who charges higher premiums for children who play football (maybe even ice hockey or soccer). Those resulting costs will be the things that bring about change. Age restrictions on hitting (like the ones USA Hockey already has) might come about first, but they will be the result of being pro-active to avoid those resulting insurance costs.
I don’t think the sport (or any sport) needs to be done away with for adults. It’s just the days of looking at youth sports athletes (18 and under) as miniature adults will soon be gone for good.
Excellent comment, Bryan ATC.