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Keep Em Safe Or Let Em Play: Brain Injury in Sports

In recent years the big sports in the US have taken steps to curb head injuries sustained by their players. Some examples are the NFL making helmet to helmet contact a penalty, or the NHL mandating that a player who has a potential head injury must undergo an evaluation from the team doctor before returning to the game. The question remains, are these measures enough to bypass potential irreversible brain damage to players that will affect them later on in life? Or perhaps even sooner than they realize.

Today the NYT published a story about hockey player Derek Boogaard, who died from drug and alcohol overdose at the age of 28. This wonderfully written piece details how the family agreed to let researchers examine their son's brain post-mortem. What researchers found was frightening, a level of chronic traumatic encephalopathy (CTE) that had never been seen in someone so young. CTE is a progressive degenerative disease that is similar in symptom presentation and tissue loss to dementia. So, in this case imagine the brain of an 85 year old with Alzheimer's dementia in the the body of a 28 year old. Higher rates of CTE are seen among athletes in contact sports, more so in those who have a history of fighting or concussions.

That being said, what should sports leagues do about this potential threat? Does hockey try and curb fighting? Does the NFL do more to keep athletes with concussions out of action until they have fully recovered? Or, do we say that it's all part of the game, and who are we to mess with tradition?

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  1. Bettman weighs in with his "people, people, there's not enough evidence to link fighting and CTE":

    The truth might be even more frightening for him (as you suggest): At its current level of physicality, lax restrictions on dangerous hits, and low level of protection for players, HOCKEY causes CTE.

  2. Out of curiosity, what is the connection between concussions and CTE? Is there a benchmark where X number of moderate concussions would likely result in CTE?

  3. Right now the link between CTE and concussions/repeated blows to the head is still being understood. We KNOW there is a connection, but are still teasing out the details. This isn't something that someone who has only had a history of several concussions spread out over their life should be worried about. This is something that happens over the course of a career, decades. Although, in Boogaard's case, it may occur in shorter time than was originally thought, but then again, this was someone who had sustained multiple concussions and been in literally hundreds of fights throughout his career.

  4. Any thoughts on whether changes should be made? If athletes know the risks, do we go on as always? I mean, we've known the risk in the boxing area for years, and as far as I know, rules haven't changed dramatically to address this specific issue. So, should thing slike fighting in hockey be curbed by the league?

  5. Yeah, it's like there's a different status for head injuries if the sport is explicitly focused on causing them (boxing, MMA) vs. if it happens as a product of the style of gameplay (football, hockey).

    I'm very split on this. On the one hand, the athletes are payed very well (unlike in the past), and I am sure that almost every player would tell you that the risks are worth it.

    On the other hand the argument can be made that many players can't adequately gauge the long-term side-effects (i.e., that it could mean they are severely impaired for most of their natural lives) and in some cases (e.g., Rodney Harrison) I think players show a real lack of understanding for what a concussion really is/does to a person.

    But let's face it, a large part of why people watch contact sports is for THE CONTACT. Anyone that tells you otherwise is lying or being self-delusional -- it's like racing fans who swear they get nothing out of the crashes.

    This is the great lie that even players tell themselves. I think a lot of defensive players in football and hockey go at other players with the intention of hurting them. They have to say in press conferences that that is not their intent, but it is.

    In football, violence is a large part of the gameplay. That's why I always laugh when people get bent out of shape about scuffles after the whistle. Wait, you mean to tell me that in a game where 360lb behemoth man-children hurdle their bodies at each other at breakneck speeds some players can't keep their tempers in check? That's CRAZY!

    I'll say it. Without the violence in the sport it would be less interesting, more so for football than hockey IMO. At least for a while. I think after a (possibly) long adjustment period fans would come to accept it and given the research, I think something needs to change. Not sure what though, that would be up to the leagues to decide.

  6. I get the argument that "players are paid well and if they are told about the risks, it's their choice." But I guess my thought experiment argument to that is in the same vein, why not legalize bloodsport, and gladiator style fights to the death? They know they can die, their choice. I know that's an extreme example, but it's a slippery slope. How much risk are we prepared to allow?

  7. I agree Jordan, at what point do we as a society say enough is enough. I often pose the question to friends with kids, would or will you let your kid play football? Usually the sports geeks say yes, but I don't know if I would. Of course I don't really have an attachment to any contact heavy sports. Also any kid of mine will be too busy being small and nerdy to attain skill enough to make the cut anyway.