It's been a week, but the excitement of Super Bowl Sunday is still in the air, especially in New York. And somewhat overshadowed by that epic Giants win was the appearance of ex-Saints player, Steve Gleason. You see, Steve Gleason is not just an NFL veteran. At the age of 34, he is also living with a debilitating disease, amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's Disease. And he's not alone. A recent story in Scientific American profiles Kevin Turner, called "the collision expert," who played for the Patriots and the Eagles. In 1995, Kevin was the NFL's second-highest paid fullback. Today, he cannot button his shirt.
Nobody really knows what causes ALS, and there is no cure. Scientists have tried and continuously failed to find conclusive evidence linking ALS to concussive injuries sustained during contact sports like football. And now, controversial new research coming out of Boston University suggests that these players may not have ALS after all, but another motor neuron disorder with similar symptoms and a similarly bleak prognosis. Except this one has a clear cause: repeated blows to the head.
Many researchers aren't convinced, but one thing they agree on is that the types of head injuries sustained during football games can cause depression, changes in mood and behavior, memory loss, and even early dementia. They call this syndrome chronic traumatic encephalopathy (CTE). It's characterized at autopsy by the buildup of two proteins, tau and TDP-43, which leak out when brain cells are injured and can buildup where they aren't supposed to be.
I know I keep throwing around the word concussion, which to most of us is a pretty vague term describing some type of bruise or injury to the brain. Well, that's almost correct. In medical parlance, a concussion is a traumatic brain injury that causes transient alterations in the function of the brain. It can be mild or severe, and it can cause bleeding or swelling. Symptoms usually go away within weeks following a concussion, with proper care. For those who stay in the game after a concussion, they are at a high risk for second-impact syndrome, which can result in lasting brain damage or death.
When it comes down to it, it's the damage to individual brain cells, called neurons, that cause the real problem. When a brain cell is injured, its membrane (the sack surrounding it) can be breached, causing all sorts of complications. And that's not all—these head-in-motion injuries can also cause a phenomenon called diffuse axonal injury, or axon shearing. See, the soma (or cell body) is connected to a long fibrous part of the cell, called an axon, which acts as a neuronal "wire," delivering information from one part of the brain to another. Axons follow along defined tracts and make up the white matter of the brain, which sits beneath the cortical grey matter. Well, when your head is moving, especially at an angle, and it is suddenly impacted, those axons can stretch and break, causing diffuse injury to the very areas of the brain necessary for communicating with one another. And even if the injury doesn't breach the cell membrane and cause nectrotic damage, apoptosis (so-called cell suicide) may still occur, if the cell deems the injury too severe to warrant repair.
When the cell bodies rupture, their contents can leak out, creating a toxic environment for neighboring cells. This can occur during a specific type of injury that's common in sports and automobile accidents, known as a coup contrecoup injury. We don't think about it, but the brain isn't really tacked down to anything inside the skull. It's simple physics really. An object in motion tends to stay in motion unless it is acted upon by an external force. Imagine that your helmeted head is traveling toward the helmeted head of another player. Boom. They collide. Although your skull may stop traveling through space, your brain will lag behind. Think of an egg yolk inside its shell. First your brain will smash up against the front of your skull. And next, if it's traveling fast enough, the abrupt collision will cause it to bounce backward, colliding against the back of the skull as well. Now instead of one severe injury from a single impact, there are two.
But is it really just concussions that we should be worried about? Any only with football players? Since the 1920s, boxers have described getting "punch drunk" in the ring: feeling unsteady, slow, and mentally dazed. And hockey players, rugby players, pretty much any players of contact sports can recount similar experiences. We now know that these are signs of a concussion, but not everyone experiences that dazed and confused feeling And many young athletes who do push through and play on anyway, hoping that it will prove to their coaches and teammates that they're strong, tenacious, and wont let the rest of the guys down.
How will the science behind sports injuries change the way we play the game? What do you think? You can reach out to me on Twitter, Facebook, or leave your comments right here on The Huffington Post. Come on, talk nerdy to me!
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