Brain Damage. Really?

Wednesday, February 23, 2011
I've been hearing lately on NPR how medical professionals are now realizing that playing football can cause repeated Traumatic Brain Injuries (TBI). These injuries are often followed by permanent brain damage. The NFL Players Union is trying hard to work with the owners to determine the best possible way to manage this risk on an moving forward basis, because it seems obvious at this point that those who choose to play football for a living are taking a huge risk with their long-term health and well-being in order to do so.

Now, I don't really care about football, or even necessarily about football players, except in the generic sense that I care about any human being who suffers a life-changing disability. I've always thought football really was a barbaric sport, with no redeeming social value except for what's derived from working on any team. My kids never expressed much interest in it, even as spectators, and my son never wanted to play.

So basically, I have no dog in this fight.

Given that, I don't understand - knowing what we know now about the long term risks associated with this activity, why is this sport still so popular? It causes BRAIN DAMAGE. IRREVERSIBLE BRAIN DAMAGE.

Now I realize that some of the activities I participated in when I was a teen weren't exactly risk free. Accidents happen, even when reasonable precautions are taken, and I'm sure my Hot Mom had more than a few white knuckle moments with me. My point here is that football has been shown to cause BRAIN DAMAGE even with reasonable precautions and protective gear.

I don't get it. At all.

8 comments:

neurondoc said...

I have a Great Dane (or even a St. Bernard) in this fight -- from the health care perspective, not a personal one.

Medical professionals have known for years that getting repeatedly smacked in the head causes traumatic brain injury. You don't need to be a rocket scientist or a brain surgeon to figure that out. TBI in football players was a topic of discussion in the neurological world when I was in residency (15 years and counting). A quick PubMed search of the term "traumatic brain injury AND football" finds articles back to 1957. So regardless, of what the newspeople say, it's not a new concept to us.

One of the big barriers to general acceptance of sport-related TBI is the accepted behavior of players, trainers, coaches, and team administrators.

Players don't want to let down their teammates, appear weak, or be seen not willing to "play through the pain". These are not uncommon attitudes in professional and amateur athletes (adults and children), and they interfere with the diagnosis and treatment of TBI (especially mild TBI). If the athlete does not admit to symptoms and/or is not diagnosed with TBI, then he (or she) is likely to be sent back into the game, placing him at risk for a second injury, which is likely to cause much worse symptoms ("Second Impact Syndrome").

In professional sports, if players are not playing, then they're not earning their keep, and the team is less likely to win. So coaches and trainers and team owners have a financial stake in NOT keeping players out of the game or off the field. It's a business decision, not a medical decision.

What seems to be changing is the willingness to admit to the injury, by both players and the teams they play for. Regardless, playing a sport that has been shown, even with padding, helmets and facemasks, to cause irreversible injury to the brain is just so completely stupid. (In the spirit of transparency, I don't watch the Superbowl, even for the commercials...)

And I must add that the correlation between brain injuries received "for fun" on the football field and TBI sustained by soldiers on the battlefield is pretty damn obvious.

Some recommended articles (medical journals and mainstream media):

Traumatic Brain Injury — Football, Warfare, and Long-Term Effects

A Late Hit for Pro Football Players

The Center for the Study of Traumatic Encephalopathy

Football's Brain Injury Lessons Head To Battlefield

Janiece, must you keep poking my hot buttons? :-)

Janiece said...

The fabulous NeuronDoc weighed in with a fabulous comment, and it appears that Blogger ATE IT.

Which irks me, because I was hoping that she would weigh in, being my reader with the most expertise in this matter.

Luckily, I captured it in e:Mail, and will repost here in its entirety:

I have a Great Dane (or even a St. Bernard) in this fight -- from the health care perspective, not a personal one.

Medical professionals have known for years that getting repeatedly smacked in the head causes traumatic brain injury. You don't need to be a rocket scientist or a brain surgeon to figure that out. TBI in football players was a topic of discussion in the neurological world when I was in residency (15 years and counting). A quick PubMed search of the term "traumatic brain injury AND football" finds articles back to 1957. So regardless, of what the newspeople say, it's not a new concept to us.

One of the big barriers to general acceptance of sport-related TBI is the accepted behavior of players, trainers, coaches, and team administrators.

Players don't want to let down their teammates, appear weak, or be seen not willing to "play through the pain". These are not uncommon attitudes in professional and amateur athletes (adults and children), and they interfere with the diagnosis and treatment of TBI (especially mild TBI). If the athlete does not admit to symptoms and/or is not diagnosed with TBI, then he (or she) is likely to be sent back into the game, placing him at risk for a second injury, which is likely to cause much worse symptoms ("Second Impact Syndrome").

In professional sports, if players are not playing, then they're not earning their keep, and the team is less likely to win. So coaches and trainers and team owners have a financial stake in NOT keeping players out of the game or off the field. It's a business decision, not a medical decision.

What seems to be changing is the willingness to admit to the injury, by both players and the teams they play for. Regardless, playing a sport that has been shown, even with padding, helmets and facemasks, to cause irreversible injury to the brain is just so completely stupid. (In the spirit of transparency, I don't watch the Superbowl, even for the commercials...)

And I must add that the correlation between brain injuries received "for fun" on the football field and TBI sustained by soldiers on the battlefield is pretty damn obvious.

Some recommended articles (medical journals and mainstream media):

Traumatic Brain Injury — Football, Warfare, and Long-Term Effects

A Late Hit for Pro Football Players

The Center for the Study of Traumatic Encephalopathy

Football's Brain Injury Lessons Head To Battlefield

Janiece, must you keep poking my hot buttons? :-)

Janiece said...

NeuronDoc, thanks for your thoughts. I figured those "in the know" were actually, you know, in the know long before this made it into the MSM.

neurondoc said...

I'm glad you were able to resurrect it. I actually emailed myself a copy of the comment yesterday before I tried to post it, having some presentiment that Blogger was being evil.

Darren said...

While I'm not really a football fan, I can speak to the more general idea of choosing to do something with very high risk, even though you have no hope of mitigating that risk.

There are two reasons for such behavior. First, the danger itself can be exhilarating. Second, the enjoyment of the activity can outweigh the risk.

For example, I know full well that smoking tobacco is terribly hazardous for one's health. Yet, each month I attend a club wherein I consume several cigars and at least one pipe. Why? Because the pleasure of that activity outweighs the risk.

For another example, more in line with my first given reason, I enjoy downhill skiing -- VERY fast downhill skiing. I don't wear a helmet when doing so. Why? Because the thrill of applying physical skill to avoid danger on a moment-to-moment basis is worth the risk to my health.

I don't know why, but it seems (in our culture at least) to be largely gender-associated. I know very few women who understand why anyone would deliberately take high risk for only the reward of "fun", but nearly every man I know does.

I guess it's just one more way in which our culture establishes gender roles.

Janiece said...

Darren, but would you allow your child to participate in smoking cigars or super-fast downhill skiing without a helmet?

Adults can make their own self-destructive decisions with no quarrel from me. I don't get it, but it's not really up to me, and I'm fine with it.

But kids are a different matter.

Anne C. said...

I'm not a football fan myself, but I have some very good friends who are and could dig up some treatises on the excitement and beauty of the athleticism and strategy. (I think it mostly boils down to Natalie's analogy to battle.)

But I really have no answer when it comes to putting children at risk. All sorts of things cause irreparable damage - smoking and drinking are some of the most common - and we restrict it to consenting adults.

As a person who takes calculated risks myself, I would NEVER permit a child I loved to take the risks I do until they're old enough and mature enough to participate in the selection of those risks.

Steve Buchheit said...

Bread and circuses. Someone's got to man the circus.

Also, tradition. The "I did it as a kid" and the "We're so proud of our team. Next year will be the best ever" excuses.

Most of the players are very young. It'll never happen to them. Or so they think.