By Ken Reed

On Christmas Day, thousands of theaters across America will begin playing the new Will Smith movie, Concussion. The film is based on the story of American immigrant, Dr. Bennet Omalu. Omalu made the first discovery of CTE, a chronic brain condition caused by repetitive blows to the brain. It’s also the story of Omalu’s quest to make the truth about concussions, football and CTE known. That effort led to Omalu’s David vs, Goliath confrontation with the mighty National Football League.

I’m hopeful the movie increases the national conversation about the safety of football and other sports, including girls soccer, the youth and high school sport with the most concussions after football.

As we approach the release of Concussion, I thought I’d provide a quick synopsis of some of the research and analysis findings related to football-and-soccer-related brain trauma:

Football

According to the Brain Injury Research Institute, in any given season, 20 percent of high school football players sustain brain injuries.

Over 40.5 percent of high school athletes who have suffered concussions return to action prematurely, which can lead to death from Second Impact Syndrome (SIS), a condition in which the brain swells, shutting down the brain stem and resulting in respiratory failure.

It’s just not concussions we’re concerned about today. Purdue researchers recently compared changes in the brains of high school football players who had suffered concussions with the brains of players who were concussion-free and found brain tissue damage in both. That’s scary stuff. That means brain injuries are occurring without players, coaches or parents being aware of it.

Repetitive subconcussive hits to the head can cause as much damage as concussion-causing hits.

A growing focus in the brain trauma field is chronic traumatic encephalopathy (CTE), a brain degeneration disease. It has many symptoms similar to Alzheimer’s and other neurological diseases, however it isn’t the result of some endogenous disease but due to brain injury –being hit too many times in the head.

Now consider that the average high school football lineman receives 1,000 – 1,500 shots to the head during a single football season, based on estimates by Boston University researchers.

Moreover, the effects of football-induced brain trauma often get worse over time. Consider that the number of former NFL players between the ages 30 and 49 that have received a diagnosis of “dementia, Alzheimer’s disease, or other memory-related disease” are 19 times the national average for that age group. In particular, NFL players suffer from Alzheimer’s at a 37 per cent higher rate than average. Moreover, players who have suffered multiple concussions are three times more likely to suffer depression.

There aren’t enough safety measures we can implement to overcome the fact that the brain isn’t built to withstand the repetitive brain trauma inherent in a game built around violent collisions.

Helmets are of little or no help. They’re great at preventing skull fractures and lacerations but terrible at preventing brain damage. The reason is that the brain is like Jell-O bouncing up against the walls of the skull. It’s a whiplash effect that leads to concussions. That’s why players can receive concussions without even being hit in the head. A blow to the chest can send the brain splashing against the skull with as much force as a head-to-head shot.

Soccer

Girls’ soccer is second only to football in terms of the number of concussions in youth and high school sports.

Most soccer concussions are the result of collisions between players, or falls in which a player’s head strikes the ground.

However, we’ve learned it’s not just concussions that soccer players, parents, and coaches need to worry about. It’s the repetitive sub-concussive hits the brain absorbs during games and practices as a result of heading, the act of redirecting soccer balls with one’s head, which of course houses one’s brain.

Soccer balls can reach speeds of up to 50mph prior to heading.

Habitually heading soccer balls may have similar effects on the brain as the repetitive sub-concussive hits that offensive and defensive linemen receive banging heads along the line of scrimmage in football.

“Long-term (brain) damage may have less to do with the number of diagnosed concussions and perhaps more to do with the number of sub-concussive impacts to the head,” according to Kevin Guskiewicz, a brain researcher at the University of North Carolina.

A study published in the Journal of the American Medical Association by Harvard researchers compared the brains of soccer players to those of swimmers. They found negative changes in the white matter of soccer players’ brains that weren’t there in the brains of swimmers.

Another study, this one conducted at Humboldt State University in California, revealed that soccer players who headed the ball the most during a game did worse on cognitive tests after the game than their peers who hadn’t headed a ball. Moreover, the players that did the most heading also suffered more often from headaches and episodes of dizziness compared to players that headed the ball less often.

Moreover, a recent study in the journal Brain found that it’s total head trauma – concussions and sub-concussive hits – that is cause for concern. This is noteworthy because most sub-concussive hits don’t result in any immediate symptoms for athletes. The damage appears to be cumulative.

“Heading a soccer ball is not an impact of magnitude that will lacerate nerve fibers in the brain,” according to Dr. Michael Lipton, lead author of a study that showed that regularly heading a soccer ball can lead to brain injury. “But repetitive heading may set off a cascade of responses that can lead to degeneration of brain cells.”

Dr. Robert Cantu, a neurosurgeon and co-director of the Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University Medical Center, believes heading should simply be eliminated from youth soccer under the age of 14, and then closely monitored and limited thereafter. (Note: In November, the United States Soccer Federation implemented a policy that sets strict limits on youth players heading the ball. The new guidelines will prohibit players age 10 and under from heading the ball and will reduce headers in practice for those from age 11 to 13.)

But it’s not just young people, or girls, that should be concerned about soccer’s safety. A study of retired professional male Scandinavian soccer players showed memory deficits among the former pro players.

Ken Reed, Sports Policy Director, League of Fans

 

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