NFL settlements raise new questions on head trauma and Parkinson’s and ALS

alslat-254x300The National Football League, which long has resisted the growing reality that game-related head blows can cause major harms to its players, may be providing yet new and unintended warnings about the sustained damages of concussions.

The Los Angeles Times reported that pro football’s pay-outs, as part of its billion-dollar head-injuries settlement with NFL players and their union, have been surprisingly high in cases where retirees have claimed damages due to Parkinson’s and ALS.

Parkinson’s, the newspaper noted, is a “progressive movement disorder that produces tremors, impaired movement, and slurred speech.” It is “marked by the buildup of proteins called Lewy bodies in brain cells.” ALS, also known as amyotrophic lateral sclerosis or Lou Gehrig’s disease, is a condition affecting “nerve cells in the brain and spinal cord and ultimately results in a fatal inability to initiate and control muscle movement.”

When negotiating with players and their extensive claims of head-trauma related damages due to their NFL play, the league, its experts, and those for the players had expected some Parkinson’s and ALS claims. The parties, however, anticipated there would be far more cases of CTE, or chronic traumatic encephalopathy. It’s a “progressive degenerative disease of the brain found in people with a history of repetitive brain trauma (often athletes), including symptomatic concussions as well as asymptomatic subconcussive hits to the head that do not cause symptoms,” experts say.

But the Los Angeles Times reported:

In the 18 months since the settlement went into effect, 113 Parkinson’s and 42 ALS claims were filed by former players or their representatives. Of those, 81 Parkinson’s and 30 ALS claims worth a combined $146.5 million either have been paid or approved. Those figures dwarf projections made in a report commissioned by the players’ lawyers, which estimated that 14 Parkinson’s and 18 ALS claims worth a combined $52.6 million would be paid over the 65-year duration of the settlement. A report commissioned by the NFL predicted 31 paid ALS claims over the settlement’s lifespan; it did not provide specific numbers for Parkinson’s.

The settlements — which occurred quickly, partly because Parkinson’s and ALS can be more readily diagnosed than, say, CTE, which now can be found decisively only in post-mortem exams — underscore that medical researchers may need to look even more at head trauma’s role in yet more serious, chronic, and debilitating conditions.

The Los Angeles Times reported that investigators have known that brain injury may increase Parkinson’s risk, and studies have hinted that NFL play may heighten players’ challenges with ALS.

But Charles Bernick, a doctor, associate director of the Cleveland Clinic’s Lou Ruvo Center for Brain Health in Las Vegas, and the lead researcher of an ongoing, long-term study of the brains of professional boxers and mixed martial arts fighters, told the newspaper of data surfacing from the NFL settlements:

“Those are startling numbers. We really don’t know how much of an increased risk there is for those diseases among retired football players, or in combat sports like boxing. But if repetitive head trauma is a risk factor [in Parkinson’s and ALS], we need to understand that. It has major public health implications.”

In my practice, I see not only the harms that patients suffer while seeking medical care but also the damage that can be inflicted on them by brain and spinal cord injuries, notably those related to head trauma, including in sports. Research has pointed to how repetitive head blows occur and can be damaging in a range of sports and recreational activities — not just in football but also in soccer, lacrosse, hockey, wrestling, softball and baseball, diving, and even synchronized swimming and equestrian competition.

Grownups have begun to help young athletes grow more aware and to weigh long-term, sustained risks of their favorite recreations and sports. Youngsters benefit from these greatly, improving their health and social skills. But as the August heat and humidity roars, tens of thousands of youths are sweating through their conditioning for new seasons of competitive activities, especially teen, prep, and collegiate football.

How much is this year’s glory under the Saturday night lights worth to young athletes? Is it worth later debilitation — not just with CTE but potentially Parkinson’s or ALS? This is a tough conversation for which we all need much research and information, pronto, so we can protect the young.

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