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Discussion in 'Neurology' started by facetguy, Dec 13, 2012.
From PBS Frontline and ESPN:
I'm not really sure what the motive of your post is, but I'll bite.
The NFL wants there to be a concussion issue, rather than a CTE issue, because they can address concussions with rules and support iterative advancements in equipment design. It makes them look like they're proactive and can solve the problem (not that they're doing all that good a job of it, but still).
But CTE can occur with or without a classic history of multiple concussions, and that issue is much more insidious and almost impossible to address in a traumatic sport like football. The CTE is what leads to depression, PTSD, dementia, etc. We see it in vets with concussive blast injuries, and we've now seen it in the brains of dead veterans and football players.
Look, doing something is better than nothing, and I'm glad concussions are being sought out rather than covered up. But I think there is definite potential for a false sense of security, which the NFL is all too happy to play into. This is to say nothing of the lower levels of the sport, where substantial undiagnosed injuries are occurring in developing brains. Who's to say whether the concussions suffered during NFL play even matter that much, after the damage done in high school and college ball? Awareness of the issue will trickle down, but there aren't neurologists and impartial watchdog personnel roaming the sidelines of every high school football game, and in many cases there are serious incentives for kids to play hurt.
If people want to go in with both eyes open and accept the inherent risk of the sport, that's fine with me (although I question whether such informed consent is even possible). But saying we're going to take care of this "concussion issue" and then everything will be fine is patently untrue.
I love football. I played safety in high school. I watch it religiously every weekend. But it keeps getting harder and harder to ignore that while many of these athletes will go on to live happy and healthy lives after their NFL careers are over, some of them really, really won't.
No motive. Simply saw the web page, thought those reading a neuro forum might be interested, and linked.
Interesting. I was a defensive end. Maybe that explains my poor memory and pugnacious attidude.
Does anyone have opinions or comments about the relatively new "Sports Neurology" fellowships? I'm curious which places and names are leading the way in this area?
There is an individual that I have heard of proposing no contact football until the age of 18 years?
If you are interested in Sports Neurology, contact Frank Conidi in Florida. He is approachable and is a big man in Sports Neurology, conferences, education, etc. If you want to know ANYTHING about education, possible fellowships, etc. He IS the man to ask. He gave a lecture at a headache conference that I attended two years ago and it was worthwhile!!
Anyways, as Dr. Conidi advocates, proper hitting and take down techniques should be taught and advocated early in football. Additionally, he makes an interesting point that LESS padding, yes, you heard me right, LESS padding should be advocated. The argument is, you are less likely to run down another player and hit them like a freight train if you are going to get hurt too.
As a side note, I used to be a big wrestling fan and I remember watching Chris Benoit perform flying head butts. Typically, whenever a wrestler does this, they put their forearms over their forehead at the very last second for protection. Not Benoit!! He would simply put his arms to his side and drop like a torpedo. I used to say, "wow, he has to be hurting himself for real!". Sure enough, he ends up in a double murder suicide and brain autopsy consistent with dementia pugilistica?
Hell, look a Muhammed Ali!! This was the biggest trash talker of all time now parkinsonian?
Sports is a big industry, a MONEY making industry, we won't see it die so I am with Dr. Conidi, better education, better techniques, safer play.
Awesome, thank you!
Typhoon is exactly correct. Great topic btw.
I'd go further than this and recommend no football to anyone. All we know about repetitive head blows is that some seem to tolerate them better than others, but we don't know who or how much. There is probably no safe dose of head blows on a prospective basis.
Football should be banned and in a rational world it would be. Such as the world is, we can still try our best to prevent injury for course entertainment. No-one should stand silent while children put themselves at risk of an incurable but preventable disease, CTE.
I fear that "sports neurology" and "concussion clinics" only serve to give credibility to those who would deny and coverup the facts of the matter. In part you can see that happening now. By focusing on concussions only, we're not focused on the forces drving CTE.
Doctors have been co-opted in the manner before by tobacco, and the parallels between smoking circa 1950 and now are striking, offering their support or at least their assent towards allowing smoking. That's one reason to be a zealot and to draw red lines. A neurologist at the sidelines offers exactly ZERO protection against CTE, only (perhaps) moderate to severe concussions. But he offers credibility to the sport and to the interest$ that keep football going.
I fear that sympathetic doctors will have an opinion that differs from mine adn states that some head blows are permissible (and that's fine, rationale people can disagree), but they will be incentivized towards being entirely cavalier.
I've almost posted in response to this thread a couple times, but have always decided not to. Didn't want to make anyone feel like I was plugging anything since a lot of you might already know about it.
However, there is a lot of research going into concussions/TBE/etc at the collegiate, high school, and even elementary school levels. Virginia Tech/VCOM along with several other colleges (like Wake Forest, but can't think of the others off the top of my head) are using helmets to track actual G-forces for each hit obtained during games, practices, scrimmages, etc. They are hoping to really add to the understanding for what the brain goes through during football.
Here's a link to the VT Football Helmet Ratings (STAR): http://www.sbes.vt.edu/nid.php
Here's a citation for one of the papers published:
Frequency and Location of Head Impact Exposures in Individual Collegiate Football Players
J Athl Train. 2010 Nov-Dec; 45(6): 549–559.
I am no athlete, nor will I pretend to be, but lets not be hasty here. I suppose I would ask, why pick on football? How about the NHL? Apparently, being a MLB umpire is a dangerous job? Boxing? Professional Wrestling? UFC? Come to think of it, I think I have seen a few good knocks to the head from womens' vollyball (they can be damn brutal!)
Again, I am not an athlete, but in my childhood/adolescent days, a pick up game of tackle football or baseball was not unusual. Nobody sustained a concussion and guess what, we did not use helmets!! Well, there again, I go with the Dr. Conidi theory that you are less likely to hurt somebody if it means hurting yourself just as badly.
Anyways, back on topic. The problem with banning professional sports, and I hate to present it this way, would be the financial aspects of it all. I am sure that right now, there is some high school student that can make a solid argument that their only hope of a college education is a sports scholarship.
Sports are a past time and a big part of our culture in the US, good luck banning them!
Does anybody remember the Saints last year having a "hit" bounty out on star members of other teams? If a player is already tackled, then why do 20 other guys need to pile up on top afterwards? Teach these players how to tackle, be mindful of injuries/concussions, and enforce this! That is the key. Hefty fines for inappropriate hits on the field will likely calm down a few aggressive behaviors.
How about proper screening? I am sorry, but I think we all know that somewhere, a team physician is likely inappropriately clearing a player due to public or internal pressures. Would you want to be known as the doctor would that is blamed for the team missing playoffs because you would not clear the star QB for play? The public and "armchair QBs" are brutal on the players enough.
The culture of professional sports must change as a whole. We must place emphasis on the safety and health of our players instead of making it to the playoffs, or gaining financial endorsements. Coaches and executives need to respect this.
The forces and accelerations in football are like nothing else. And considering they occur on every down on every game and every practice, the frequency is like nothing else, except perhaps a hockey enforcer. Yes, boxing is barbaric, but given the matches in which combat occurs to concussion occur rarely, it is a pale gray next to football. (It just so happens that I have an ex-boxer with a non-progressive cognitive/parkinsonian and delusional disorder (phantom border) that I now think of as questionable CTE).
A few "good knocks to the head" probably aren't that great for someone. But football is more than that. Knocks to the head 6 days a week, age 14, for months at a time.
I agree with previous posters that helmets have gotten out of hand, and allowed the game to be played at much higher speeds. The trade off is no skull fractures (which would nearly be certain every game) and fewer concussions for this chronic head blow situation giving rise to the tauopathy.
I've seen them. Sad. This is part of the reason I don't want to get involved in concussion clinics. I try to tell them what I really think and then follow the guidelines, which I think of as about 2 decades behind the science. Perhaps a 16 year old can make an informed choice under the best circumstances, but a 16 year old who sees himself as part of a team, who sees that the only way for him to get success, girlfriend, friends, status is via football is a hard sell and willing to take a risk.
I'm not into watching sports. But off the top of my head: soccer, basketball, baseball, biking are very safe. Even hockey and MMA are pretty safe. Football is the problem. And things could tip. I think in a generation or two football will be like NASCAR: viewed by a few and generally thought of as a stupid thing by everyone else. Football might become a white red-neck and black inner city thing exclusively. People who's parents don't care or don't know about brains.
Yep. And what I think is that football is just so corrupt and evil that it's like a malignant tumor. It's all bad, but in ways you can't imagine, with mets everywhere. Also Penn State.
I fear this as well. How'd you like to be the doctor who allows a kid to enter the arena and die of second impact syndrome? Or have one of your kids go nuts and have tangles?
It's going to take a lot to reduce football's influence, especially at the NFL level. Look at these annual revenues. Note the projected doubling between now and 2016:
Exactly. With that kind of money floating around, kids and their parents can keep making "balanced, informed decisions" about the long term risks of football, and the NFL can keep up the smokescreen that this is a concussion issue that can be addressed just by throwing more money at it.
My kid won't be playing, as much as it hurts me to say it. I know too much.
Look at these Nielsen ratings. NFL dominates. That's no consolation for those with brain trauma, but it's going to be awhile before football loses it's luster.
Thought this would be relevant:
Very sad. Again, the NFL takes these cases over the huge denominator and then says that football is safer than the drive to the game. That's true if you're measuring death. But it is false if you're measuring 30 year cognitive data. Football is just an unsafe activity and these deaths are the tip of a very large iceberg.
Yes, this concussion watch thing is a wag-the-dog type of move to keep an institution afloat for both financial and cultural reasons. I never got into football b/c I thought it was incredibly boring. I personally wouldn't have a problem if it were never played again but I realize (as a resident of a city with a crazy allegiance to the local NFL team) that football is a juggernaut of a cultural institution. The problem is that CTE is so separated from the actual injury that it's a tough sell to the general public that all of football-dom needs to be uprooted and tossed out.
That is where I think any sort of true change has to come from- the consumers of football, because if there were no $$ in it no one would care if it stayed or went. This isn't the only example of the NFL putting their players through the proverbial meat grinder for profit. Check out the lawsuit over toradol use.
Maybe we should at least tax football to pay for the nursing care all these guys at highschool and college levels are going to need in the future? The whole thing is sad to me and makes football a bloodsport in my opinion. I don't think you need to have actual blood on the ground to be causing people significant problems in the future.
Junior Seau had CTE:
Hopefully the doc's will be afforded the ability to assess players without pressure to clear them to play, but I doubt it