Chris Henry had CTE: Time to Re-investigate the safety of football?

The Game Room
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gonzomax’s thread from two years ago touched on the topic of whether “football was too dangerous to be allowed”, due to increased knowledge of the drastically raised incidence of chronic traumatic brain injury. From footballoutsiders, comes a story that deceased Cincinnati Bengals wide receiver Chris Henry had Chronic Traumatic Encephalopathy. The story cites a blog and Pittsburgh Post-Gazette article where his (CTE) (wiki goes to dementia pugilistica, which I don’t think is the same, but there you are.), and how he potentially acquired it, are discussed. Naturally, you’ve all heard of the Gladwell “New Yorker” article where he compared pro football players to fighting dogs.

I have to say, these findings for Mr. Henry give me pause. Traditionally, CTE was thought to be implicated for football positions with more potential head impacts E.g. Linebacker, O and D-Linemen, Running Backs, and Special Teams. Mr. Henry was a wideout. Other than kicker/punter, or QB, you’d think the incidence of head impact for wideouts would be the lowest. Moreover, he’d only been playing the game at a college or pro level for several years, 7 and a half, I think, once you parse out his suspensions, not the multiple years for other famous CTE sufferers such as Mike Webster or Andre Waters. Finally, Henry never missed playing time from suffering a concussion during either his college or pro career.

Given all that, my question to you all is, what further should be done, if anything at all? Unfortunately, currently CTE cannot definitively be diagnosed until after death. Ban kickoffs and punts? Give everyone “Gazoo” helmets? Mandate use of force monitoring helmets?

I like sports—obviously, since I post here, play soccer, fantasy football, etc…—and I don’t support preemptively banning activities that consenting adults choose to engage in. I like watching NFL football. Still, the idea that playing football at Pop Warner level or high school may give susceptible individuals chronic, irreversible mental deficits, is really troubling to me. 26 year olds in a lower impact position, shouldn’t be suffering these kinds of brain trauma, and yet, judging by Mr. Henry’s brain sections, it’s possible that they are.

Anyway, I just wanted to post this article, and see if anyone’s opinions have altered since gonzomax’s post two years ago. FWIW, I don’t think football should be banned or restricted, but these types of findings make me a lot less steadfast in that belief than I was, say 10 years ago.

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There have been cases of CTE in football players as young as 18 years of age as well as a former college football player who never played in the NFL.

Insert “mild brain injury” in the place of “concussion” and you can see why the cumulative effects of multiple concussion and multiple sub-concussive blows are very real.

I happen to be a concussion researcher… I don’t let my kids play football, ice hockey, or lacrosse.

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There’s been a series on brain injury in football players running in the Chicago Sun-Times recently; here’s the first article. It’s written by a former college football player for Northwestern University, talking about his own experiences and those of his teammates. That first article mentions CTE.

The second article discusses former teammate/former NFL player and now Chicago sports broadcaster Mike Adamle, who suffers epilepsy due to brain lesions caused by the physical damage that football inflicted on him. The seizures didn’t appear until years later.

The third article is on a groundbreaking study of the forces on the head and brain during football games, conducted on those Northwestern players and too far ahead of its time to be recognized for what it indicated about how dangerous it is. The older doctor who conducted the research also played football; it’s possible that his Alzheimer’s diagnosis might have actually been CTE.

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While wideouts suffer fewer collisions as an absolute number (and this figure is not as low for slot receivers, like Henry) the ones they do suffer are at much higher speeds; instead of being hit by a lineman who isn’t at full speed, they’re being hit by safeties running twice as fast.

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The Telander series is mentioned in the comments of the Iowa blog I cited. Just forgot to add it to an already link-heavy post. Excellent series and thanks Ferret Herder for linking to all of them.

What’s really needed is an in vivo test for tau protein and other indicia of CTE. To be fair, I have no idea what the incidence of tau protein is in individuals that did not play contact sports. A commenter in the footballoutsiders article mentions potential confirmation bias in the sampling: the staining for tau protein is definitely not a typical part of an autopsy—autopsies aren’t typical, for that matter—and so the only people who get stained for it are deceased Alzheimer’s victims and, now, contact sports athletes. Ordinary people aren’t tested for it so we don’t have good control data for what the incidence should be. Also, not to pick on American football or combative sports, but soccer players may also have elevated incidences of tau protein, due to heading the ball.

I’ve met many former NFL players in my old jobs. I’ve seen the canes and crutches. It’s sad, but I see it as really “Achilles’s choice.” My primary concern is for college players and younger. (Irony, as I’m definitely not a “But won’t someone think of the children?!” type)

Moreover, I hope that the respective organizations (NFL, NCAA, high school sports leagues) get in the forefront with increasing player safety, because they probably do not want to leave it to state and federal legislatures to regulate it instead.

For RNOTB’s observation, that Henry’s injuries may be due to the much greater speeds in a WR/DB hit, in the follow-up to the Iowa blog post, a commenter mentions altering the field composition, to make it softer, and indirectly, slower. Besides slowing down the athletes and lowering impact forces that way, the softer field helps with decreasing peak forces when the player hits the ground. However the costs of heavily modifying the field (or cynically, just keeping up with the recommended maintenance) is not something likely to go over well with a high school or college athletic department.

I agree with the point that the speed probably has a lot to do with the severity; however, the damage suffered by O and D-Linemen is thought to occur from the frequency of their collisions, not necessarily high speeds. Personally, as much as I like to see Devin Hester and (hopefully) Trindon Holliday ply their trade, I’d like to get rid of kickoff and punt returns entirely and omit an entire area filled with very high speed, high impacts.

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Although the NFL’s mTBI Committee was widely discredited, some of the biomechanical research they produced was top-notch. One article outlined the physics of a select sample of open-field hits (two cameras were required that had the same view of the same on-field markers), and identified blows in which a concussion was sustained averaged 98 g and 16 mph of translational force.

To simulate, strap on a helmet, go to the nearest “school zone” with a 15 mph speed limit, and place your head in traffic at “bumper height”…

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From what I understand, all CTE cases are compared to controls, and researchers studying CTE have ample control samples from athletes and non-athletes… the incidence of tau proteins in a non-contact athlete or normal control is basically nil. I will try to hunt down some data on this…

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I see what you’re saying, but isn’t boxing the obvious place to start? After all, what other sport do you score points for rendering your opponent unconscious?

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Mixed martial arts?

Strictly speaking, rendering your opponent unconscious doesn’t score points in boxing; it gets you an automatic win (either by knockout or TKO).

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I think it is safe to say that boxers are aware of the danger and likelihood of brain trauma…

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I think I read somewhere that the advent of the modern helmet, ironically enough, has led to more of these types of injuries. The theory is that unlike no helmets or the old leather helmets, these newer helmets give players a sense of invulnerability and are essentially weaponized.

It also went on to say that back when players wore the soft leather helmets there was more focus on tackling fundamentals (wrapping up the legs, etc) rather than trying to “blow someone up”.

I dunno.

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How do head injuries in football compare with rugby? Both are pretty much full contact sports, and while the flow of the game is different (football is more stop/start action, rugby is more fluid), which could lead to a discrepancy in the type of contact, I would imagine rugby could make a good case study.

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There’s been some discussion in recent years that MMA is theoretically less violent WRT brain injuries than boxing for the simple reason that MMA fights that result in knockouts happen faster than boxing, in large part because boxers wear gloves that protect their hands from blows but NOT their opponent’s heads from the same.

MMA fighters can get knocked out with one swift kick to the head, while boxers tend to pummel away for dozens of punches to the head. Getting knocked out isn’t ideal, of course, but getting hit a couple of times is preferable to getting hit dozens of times (and countless more times during sparring).

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I’d agree - for all the “bloodsport” claims, MMA is almost certainly safer than boxing, and possibly safer than football. Boxing matches are much longer than MMA fights and have many, many more blows to the head. If a MMA fighter suffers a “flash knockout,” the other fighter is on top of him in a second and the ref ends it, but a boxer who gets a flash knockout has a ten count to rise (or a standing eight count from the ref, depending on the rules) and fights for as much as nine more rounds, taking many more blows to his already injured head in the process.

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Contact with the head during tackling is a heavily penalisable offense in rugby, and basic rugby tackling technique is for the tackling player to put his head away not towards the player he is tackling. Head injuries do occur but there is far fewer blows to the head.

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Another Telander article, for those interested. It centers around George Keporos, who tried out for the Bears after his years at Northwestern, then went into the family business of car sales. No years of NFL play, and yet he’s suffering from brain injury as well.