As I argued in an earlier article, the use of advanced imaging technologies that can detect Chronic Traumatic Encephalopathy (CTE), should be part of an NFL protocol for monitoring changes in players' brains over time.
With the announcement that Junior Seau's family has decided to donate part of his brain to NIH for research purposes, it's time to revisit the issue of the neurological consequences of playing professional football.
The NFL is clearly in trouble. There has never been a professional sports league that has had to deal with an issue of this scope and magnitude. This goes to the very core of the game itself -- how it's played and the consequences the game has on the long-term mental health of its players.
Football's attractiveness -- the very essence of why people watch -- is its controlled violence. Watching huge players collide at full speed and hearing the resulting "THWACK" creates an adrenaline rush unlike that of any other sport. As talented as these athletes are, nobody would tune in if they were in shorts playing flag football.
The game has gotten to the point where even Kurt Warner, a Super Bowl MVP, questioned whether he would want his sons to play football. His concerns about mental health safety caused quite an uproar. Merrill Hoge, former player and ESPN analyst, responded to Warner's comments with misplaced anger, "... Head trauma is not the issue here -- it's how head trauma is treated. The game is safer than it has ever been because we're being proactive with head trauma. That is the biggest issue." In Hoge's eyes, Warner had violated the 11th commandment: thou shall never diss the church of the NFL.
Perhaps beneath Hoge's anger is some underlying, bone chilling fear. Contrary to his statement, the game is more dangerous than it has ever been because of both the size and speed of the players. The issue is head trauma, its cumulative effects and how, at a certain point in time, nothing can be done to reverse or slow the process of CTE.
It's not just the NFL players that need to be concerned as evidenced by research occurring at the Pop Warner level. Sensors were placed in the helmets of seven youth football players ages six through eight and impact measurements were taken during practice. Five percent of the time the impact reached the level of what is experienced in a car accident! Based on these findings, a large follow-up research venture and a similar "impact" project at the collegiate level are now underway.
The sensor-based research at the lower levels of football begs the question of why the NFL is not participating in these studies? The answer is they are -- sort of. They have talked about impact studies and, presumably, are in the process of putting together a pilot study. It's been two years now since this idea was proposed and, to date, nothing has happened.
While the NFL will eventually do their impact study, the one area that it has yet to address at all is the cumulative effect of playing the game. This is why it's necessary to turn elsewhere for guidance that can help the league make decisions as to how to proceed.
Thankfully, Dr. Charles Bernick, a neurologist at the Cleveland Clinic Lou Ruvo Center for Brain Health has reported the initial results of a landmark study of fighters involving 35 boxers and 43 mixed martial artists. Using MRI technology, cognitive testing and records from fights, research was conducted to further understand the relationship between blows to the head and CTE.
According to Bernick, the brain may be able to absorb a certain amount of trauma before you start seeing changes. In other words, once you surpass the limited threshold of tolerance, things begin moving precipitously downhill. Not surprisingly, the relationship between the number of fights and lower brain volume appears as early as six years into a fighter's career.
Fortunately, he believes a window exists for damage to be identified and (perhaps) treated, because the mental health issues we associate with CTE (memory problems, rage, personality changes and depression) didn't surface until the 12-year mark, on average. Simply put, there may be ways to short-circuit the disease process.
In the immediate aftermath of Junior Seau's suicide, Sports Illustrated devoted quite a bit of space to this story, including the Editor's Letter written by Terry McDonell, the magazine's Hall of Fame editor. At the end of his column, McDonell wrote the following, "it is no longer enough to wait for players to die to look at their brains. New technologies, including advanced MRI techniques, can be used to study the damage in real time."
To state the obvious, the game of football will never be safe. The league can continue to tweak rules to decrease full speed collisions and fine/suspend players for unnecessary headshots. But that's pretty much it. Any other changes would castrate the game.
It is time that the NFL initiate protocols that follow players during their careers by monitoring the subtle abnormalities that might occur in their brain functioning. We now know sophisticated imaging technologies are available which can detect these changes.
It is incumbent upon the NFL to do whatever it can to protect the mental health of its players even if the players themselves -- due to worries about diminished playing time and smaller contracts -- don't want to undergo these scans. Never underestimate the combination of ego and money getting in the way of good judgment.
With one bold move the NFL can protect the players from themselves while, simultaneously, protecting the league from the players. The athletes benefit by having state-of-the-art medical monitoring, and the league benefits by improving its image and limiting future liability.
If the NFL is not already experiencing a sense of urgency, it ought to. This story is not going away any time soon, and the longer it takes to make additional changes, the more irresponsible it looks.
As Yogi Berra once said, "it gets late early out there."
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