As NFL talks up lesser head harms, study shows repeated slams injure brains

footballrochester-300x200Although commentators and pro football itself have argued that rule changes by the National Football League have notably reduced possible head harms, new evidence from college athletes shows that even knocks that aren’t severe enough to be deemed concussions may injure young brains.

Those findings come from a University of Rochester study based on brain scans and helmet data from members of the school’s Division III football team (shown above), the New York Times reported.

Researchers scanned the athletes’ mid-brain area twice, once before the season kicked off and at its end. They did so because that region would most likely show the effects of impacts, including those that might be tougher to gauge in other areas of the brain. They also compiled data from special equipment on players’ helmets, registering the number and intensity of every impact — not just from player collisions but also when athletes hit the ground.

The researchers were startled to find that the 38 players and their helmets recorded 19,128 hits, many minor but some powerful. They compared their information, including matching it against players who were diagnosed as suffering from concussion.

A kind of ‘fraying’ of brain tissue

They found significant individual variation as to visible effects of players getting their heads hit, as the New York Times reported, quoting Dr. Bradford Mahon, an associate professor at Carnegie Mellon University and the scientific director of the Program for Translational Brain Mapping at the University of Rochester, and  Adnan Hirad, a colleague and co-researcher who is completing an M.D./Ph.D.:

“When the researchers … compared the scans and the helmet data, they saw a disconcerting pattern. Most of the players’ mid-brains were subtly different. The area’s white matter, which is the tissue that connects neurons, was slightly less healthy now, the scans showed. ‘There was a kind of fraying’ of the tissue, Dr. Hirad says. And the players whose heads had absorbed the most hits, especially if those hits involved slightly off-center impacts and head rotations, showed the greatest disruption inside their mid-brain’s white matter. For all of them, Dr. Mahon says, these brain injuries ‘were clinically silent,’ causing no symptoms.”

As reporter Gretchen Reynolds summarized the implications of this research:

“The study, which concentrated on changes to white matter in players’ brains, amplifies growing concerns about the effects of repeated, sub-concussive hits to the head and whether we are doing enough to protect athletes from knocks that once might have seemed minor … many sports-related hits to the head do not cause concussions, a condition that, by definition, is a cluster of symptoms. Someone with a concussion might lose consciousness, have a headache, feel dizzy or disoriented, be unable to follow a moving finger with his or her eyes, and hear ringing in the ears after a resounding hit to the head. Someone else might absorb a similar hit, however, without displaying those symptoms and would not, then, be said to have suffered a concussion.”

Concussions, of course, have been linked — from football and other contact sports, including soccer, lacrosse and hockey — to “later cognitive problems, including, at the extreme, chronic traumatic encephalopathy, a form of degenerative dementia,” Reynolds wrote.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them by injuries to the spinal cord and the brain, especially due to collisions (including those involving motor vehicles) and concussions (notably those in sports).

Football, after much resistance, has reluctantly started at many levels of the game to deal with the long-term nightmare that head injuries create. The NFL reached a settlement of a civil lawsuit with thousands of its players, an accord that may cost the league $1 billion. The processes for players to recover damages and receive medical help has been fraught with back-and-forth claims and arguments, including persistent and for the league painful reports from former athletes and their families about unfair treatment.

And though the pro league — especially through the PR machine it has at its disposal with televised games, notably a long and dull preseason — may claim that relatively simple moves like rule changes can ease concussion harms, its kerfuffles with its own active players suggests otherwise.

Helmet costs: an issue in game safety

Antonio Brown, a Pittsburgh star who since has moved to Oakland, has been the subject of much fan and sports page attention and ridicule, holding out from the preseason in a tiff with his team and the league purportedly over his helmet. The NFL has told 32 players, including Brown, that they cannot keep wearing head gear that the league says is too old and may not provide state-of-the-art protection. The league insists that all players, including the likes of soon-to-be Hall of Famer quarterback Tom Brady, pick approved helmet models, that they not change them out game by game, and that they be subjected to inspection by safety experts.

Players have whined about this gear, arguing about whether the attached masks give them the sight lines they need, or if familiar and lucky items really need to head for the trash heap. Maybe it’s part of the star-driven game. But this popular pastime also has young fans who idolize and emulate its players and practices.

So, here’s the part that many of the jocks and sports pages aren’t chattering about in the helmet controversy: the protective gear’s cost. Do the online searches for models under discussion and they run anywhere from a few hundred to a grand or more. When players pull down tens of millions of dollars and franchises are worth billions of dollars, maybe outfitting a couple dozen burly guys with extensive protection that runs a couple grand each is a peanuts, a mere cost of business. Is it the same for peewee wannabes, or high schoolers — many of whom may compete in districts where kids are going hungry, much less worrying about their brains’ future and if a $1,000 helmet is even in the realm of the possible?

Parents, young players, coaches, and athletic administrators — and yes, we fans — have a lot of thinking and work to do to keep what are supposed to be games and sports both fun and safe. With the summer dwindling and fall sports revving up into high gear, here’s hoping that those in positions of responsibility take steps to ensure athletes don’t harm themselves practicing in the heat, that their coaches and trainers are laser-focused on their charges’ well-being, and that all the injury prevention appropriate is in full force, especially to protect players noggins. Head’s up and stay healthy and well, please!

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