Repeated, lesser head hits, and not just concussions, linked to brain harms

As the science keeps getting deeper, the news keeps getting worse about the harms that can be inflicted by repeated blows to the head in sports — and in life.

The path-breaking medical scientists at Boston University and elsewhere, who have helped to establish how concussions, notably in football, may lead to the onset of the neurodegenerative disease chronic traumatic encephalopathy or CTE, have told the Washington Post that their latest study may show that, “It’s really the hit that counts.”

Although earlier studies suggested that concussions, a more severe form of head trauma, led to CTE, lesser and repeated cranial blows also may result in major harms, the researchers suggested, based on their seven-year, complex work (see the video above for more details).

They established this with engineering know-how, especially with heavy-duty computer modeling, combined with mouse studies, and post-mortem work on a small but key number of youths to see how head trauma is tied “to the origins of CTE and its relationship to traumatic brain injuries, concussions and sub-concussive head injuries,” The Washington Post reported.

The skeptics at, a watchdog site on media coverage of health and medical matters, have doubts about the news reports on this study. They note that researchers offered a hypothesis and not conclusive evidence, especially because they’re so reliant on data from such a few number of teen-agers, examined after death — four of them. They derive much of their findings from mouse experiments and computer models, both of which the site points out, offer information that’s far from conclusive in humans.

But the Boston experts had suspected that trauma did not need to reach the severity of concussions to spark CTE, and they said their study — published in the neurology journal Brain — may now support this, helping to explain why 20 percent of known cases of the brain disease had no record or report of concussion.

The new findings, however, raise new and extended concerns for athletes and others. Although football, for example, has tried to put in new protective measures, such as the NFL’s “concussion protocol” which pulls athletes out of play for closer examination if they appear to have suffered a significant head hit, these steps may not deal with significant harms that result from lesser, repetitive brain injury incurred as a routine part of the game. Linemen regularly slap each other in the head as a tactic. Defensive players get cracked on the head often while making tackles. Quarterbacks and receivers get their heads banged against the ground a lot in games. Football players, some of whom start in the game in elementary school, may suffer years of smaller but damaging head blows.

Grown-ups may need to look hard at frequent, lower-level head hits not just in football but also in boxing, soccer, hockey, lacrosse, wrestling, martial arts — just name the game, with so many having routine smacks to athletes’ noggins.

Blows to the head also occur with tragic frequency for abused youngsters and women and men with abusive domestic partners. The homeless and those in jails and prisons may suffer frequent head strikes, as may abused mental patients and the sick and handicapped who are in bad care.

In my practice, I see not only the major harms that patients suffer while seeking medical services but also the terrible damage that can be inflicted on those with brain and spinal cord injuries. As adults and young athletes get increasing information about the risks and damages caused by head hits, how will they respond? Will they think it sufficient to improve protective gear and adapt safer game practices, including, say, starting contact sports at later ages to try to minimize harms? It may be tougher and tougher for professional football to retain its claim as a most popular U.S. viewing and playing pastime, and bruising pro wrestling and martial arts to keep rising in public interest.

Maybe, though, it could be a good thing if not only the high-paid brutality on playing fields were diminished, and so, too, was the cruel and already unacceptable slapping around of abused kids, domestic partners, and other vulnerable people

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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