Brain & Abdominal Injury in Sports

  • Three high school students died from football-related deaths during September 2015; and 16 died from 2013 - 2015.  With emphasis on concussions, players are now taught to prevent helmet-to-helmet hits by tackling lower, between the shoulders and knees - but that opens up a new potential fatal worry.  Now injuries are to the liver, kidneys and spleen, an area of the body that has no protection at all.  The lower abdomen, ribs and chest are now targets of hard hits, which is good for the head and concussions, but the risk of internal injuries there can also be fatal. 

    A protective shirt is available which football players can wear.  The shirt, made by EvoShield, molds a polymer padding around a player's midsection and retails between $50 - $90. 

    Be advised
    - that no one is tracking how often these injuries occur in the U.S.  Parents must be their child's advocate.  You cannot depend on the school administration, coaches, athletic trainer, or anyone else to protect your child as well as, or more than, you.  ("Tackling Safety.  Parents shift focus to football abdominal injuries," Dr. David Marshall, sports medicine specialist at the Children's Healthcare of Atlanta, CBS This Morning, October 2, 2015) 

  • Roughly half of the estimated 1.1 million high school players got hurt last year, and a quarter of those injuries were concussions, according to the National High School Sports-Related Injury Surveillance Study.  That's upwards of 100,000 developing brains exposed to trauma.  There were 5 direct football deaths at the high school level last year, according to the National Survey on Catastrophic Football Injuries compiled annually at the University of North Carolina at Chapel  Hill.  Every single one was from a head injury.  Source:  "We're seeing the dark side of high school football," by Brian Lewis, New York Post, October 1, 2015. 

    The death number rose to four when another football player, a high school senior age 17, was injured October 2, and died on October 5, 2015.  "Kenney Bui, Evergreen High School Football Player, Dies from Game Injury," by Cassandra Vinograd, NBC News, October 5, 2015)   

  • Young athletes should not just try to shake off a head injury.   
Athletes feel pressured not to disclose potential concussions; however, in 2009, 250,000 athletes ages 19 and under were treated for concussion. 

The highest rates of concussions for men are 1) football, 2) ice hockey, 3) Lacrosse, 4) wrestling, and 5) soccer.   Among the highest rates for women are soccer and college ice hockey.  

There is no evidence that soccer headgear reduces the risk of concussion.  The same is true in football.  Helmet manufacturers already post warnings like, "Contact in football may result in concussion/brain injury which no helmet can prevent."  

"Helmets were originally created to reduce the number of skull fractures and intracranial bleeding and oral and eye injuries; however, they do not necessarily reduce the forces that lead to concussion injuries,"  according to Dr. Neha Raukar, MD of Brown University School of Medicine. 

Athletes with a concussion are at risk for a more severe one the next time around.  10-20% of patients have symptoms lasting more than 2 weeks   Returning to play before full recovery increases the risk of more severe brain injury.

"Every person recovers at a different rate
, so the approach to a patient with a concussion has to be individualized," said Dr. Raukar.     (Sports-Related Concussions in Youth, CBS News, October 30, 2013)

  • “Concussions are a serious concern for soccer players.  About 10 million women play soccer in the U.S., compared to our 2 million football players. You have about five times as many people playing with this one sport that we don't know a lot about.

    Dr. James Noble is a concussion specialist who says that women suffer from concussions at a higher rate than men.

    World Cup athletes are testing a new impact concussion-fighting headband,
    which helps to understand how head injuries happen. The headband helps players keep track of how hits are impacting their brains before concussions take them out of the game completely.   The Triax impact headband is designed to measure how often and how hard a player gets hit. It will not diagnose a concussion; but instead, it downloads hit statistics in real time to a computer or mobile app. It measures things like force and rotation which is analyzed by users, doctors and researchers. The idea is, how many small hits are too many? In the future we may have a limit for how many hits a person is allowed to take in a week or a month or a season. Other new technologies being used are able to track and protect players wearing protective headbands during games.  Some players are now wearing protective caps, or a headband that is stronger than steel.   (“Head in the Game," reporter Jericka Duncan, CBS this morning, June 12, 2015)

  • “Most people don’t want to admit that our most beloved, popular sport can (cause players to) end up with brain damage.  It’s a hard…but true message.”  (Dr. Julian Bailes, M.D., Team Neurosurgeon, Steelers, 1988-97)
“I intuitively knew the damage was occurring every week, and that this was not just a football issue.  If it was happening to football players in the pro’s, it was happening in college, it was happening in high school, it was happening to every player in every collision sport.  It was a huge societal issue.”  (Leigh Steinberg, Sports agent)

“If 10% of the mothers in this country would begin to perceive football as a dangerous sport, that is the end of football.”  (stated by an NFL doctor in a private meeting with Dr. Bennett Omalu, M.D., M.P.H.)

Children can develop brain injuries as a result of playing football.  No one under 14 should play tackle football, because the damage to children is even greater.”  (Dr. Robert Cantu, M.D., Neurosurgeon, BU CTE Center)  The NFL now promotes a youth football safety initiative, a Heads Up program. 

The thing parents want their kids to do is to succeed in life and be all they can be, and brain concussions will prevent that.  Ann reported that 45 of 46 brains of former NFL players had CTE.    (Dr. Ann McKee, M.D.) 

Physical injuries come with the territory, as well as injuries that cannot be seen.  Some doctors, including a NFL doctor, have concluded that football head injuries can cause dementia or permanent disabling injury to the brain. 

“Repetitive brain trauma starts a cascade of events in the brain…and starts destroying the integrity of the brain cells, in what is called CTE (Chronic Traumatic Encephalopathy).  This impacts the way the brain is working, erupting in issues around memory, agitation and anger.” (Dr. Bennett Omalu, M.D., M.P.H., published in the Neurosurgery journal) 

“In football, one has to expect that in almost every play of every game of every practice they are going to be hitting their heads against each other.  That is the nature of the game.  Those things seem to happen around 1,000 - 1,500 times a year.  Each time that happens it is around 20g or more - that is the equivalent of driving a car at 35 mph into a brick wall 1,000 - 1,500 times per year.”  (Robert Stern, Ph.D., Neuropsychologist, Boston University)

The NFL markets violence.  Their film reduction celebrates the violence and the spectacle.  In pro-football games, the biggest cheers are for the touchdown; but the second biggest cheers are for a nasty hit. 

“The actual logo of Monday night football shows 2 helmets hitting together.”  In the darker side of football “I watched athletes play with collapsed lungs, fight with doctors to get into the game, deceive coaches when they were injured…the issue is so critical.”  (Leigh Steinberg, Sports agent_

Dr. Omalu knew that playing football could cause permanent brain damage, but his work was attacked by the NFL league officials.  The NFL long denied the dangerous and lasting consequences of concussions, contrary to science and medicine; and saying that players could play immediately after receiving a concussion, putting money ahead of players.   The NFL can earn almost $8 billion in one year.  (Superbowl 43).  Money has come before safety. 

The NFL League finally admitted after years of controversy that “Football can cause brain disease.”  Repetitive trauma to the head in football can cause a permanent disabling injury to the brain.(2000)  The NFL’s retirement board has linked playing with football and dementia. 

In September 2006, NFL Commissioner Roger Goodell took over.  In 2007, the NFL doctors and the Commissioner listened to outside scientists, but excluded Dr. Omalu and his research on CTE.  Dr. Julian Bailes delivered Dr. Omalu’s research and findings, and once again the NFL rejected his findings.  Although a growing body of science suggested there was a link between football and brain disease among the players, the NFL continued to deny the dangers of playing football. 

In 2008, Dr. Ann McKee, M.D., Neuropathologist and a leading Alzheimer’s researcher, looked at the brains of former NFL players and declared brain injury a crisis.  Six of six former NFL players’ brains had CTE.  (Dr. Ann McKee, BU CTE Center)

Brain trauma can lead to restlessness, irritability, discontent, drug addiction, depression, violence, suicide, and severe disabilities.  Chris Nowinski reported that he had violent nightmares and headaches for years after brain trauma from football and professional wrestling.  (Chris Nowinski, author, book/film Head Games)

An internal NFL research document was leaked to a reporter.  The report was titled “National Football League Player Care Foundation - Study of Retired NFL Players.”  This scientific study of former players was commissioned by the NFL itself.  On page 32, they had asked players if they had been diagnosed by a physician as having Alzheimer’s, Dementia, or any other memory-related diseases.  Former NFL players seemed to have memory-related disorders at a much higher rate than people in the regular community.  It showed that the prevalence of brain disorders was far higher among football players than the NFL anticipated; however, the NFL denied their own study results.  (“Dementia Risk Seen in Players in N.F.L. Study,” by Alan Schwarz)

Eventually, women who were the wives, widows, sisters, mothers and daughters of NFL players, along with Dr. McKee, forced this issue into American consciousness.  In 2009, Congress called Commissioner Goodell to answer why the NFL has failed to act on scientific research for over 10 years, by denying the results.  As a result, the NFL issued a series of new policies designed to protect players from concussions.  An NFL spokesman also admitted that it is clear that there are long-term consequences to concussions in NFL players.  (“N.F.L. Acknowledges Long-Term Concussion Effects,” The New York Times, 2009)

In 2010, “…an advanced case of CTE was found in the brain of a 21-year old football player who had never had a diagnosed concussion; however, he might have gotten CTE from the everyday sub-concussive hits that do not have symptoms of a concussion - meaning, that just playing the game can be dangerous.”  Dr. Ann McKee, M.D.

“The little mini-concussions are just as dangerous as the big hits," said Harry Carson.  You may sustain a dozen mini-hits during the course of a game.”

Steve Young of the San Francisco 49ers, said that these nefarious mini-brain injuries are ones you never feel until it is too late.  That is the thing that is most alarming to me.”  An 18-year old high school senior who played multiple sports, also had CTE.

On February 3, 2013, after nearly two decades of research since 1994, NFL Commissioner Goodell still refused to admit there is a link between football head injuries and brain damage called CTE.  (CBS News)

The NFL League was finally sued by 4,500 retired players, claiming the NFL had fraudulently concealed the danger to their brains.  The players were requesting around $2 billion.  The NFL knew the little secret, that there was a very severe hazard present in professional football, and withheld it from the players.  The NFL settled out of court to prevent testimonies of doctors, trainers, neuropsychologists, owners and ex-commissioners who would have to testify under oath as to what they knew and when.  Those testimonies that would have incriminated the League and exposed their guilt; therefore, in August 2013 the NFL agreed to pay $765 million to resolve the law suit.     (“League of Denial:  The NFL’s Concussion Crisis,” Frontline, PBS, KSPS TV, http://www.pbs.org/frontline, October 8, 2013)
  • A TBI (traumatic brain injury) can happen to anyone at anytime, causing long-term disability or even death.  TBI's occur from falls, auto accidents, recreational vehicles, and sports. Just in sports alone, concussions are occurring at a very, very high rate.  As a result, some States are instituting a new rule requiring that a child who has been injured and has had a concussion must then be treated in a certain manner before the child is cleared to play again.

    Most of the mild brain injuries or concussions are relatively benign, and have good recovery and good restoration of function. There are other situations when the brain can swell very quickly, and a concussion can have very adverse and serious complications.

    When someone takes a blow to the human brain, the soft tissue in the whole brain moves and is damaged, leaving some of the tissue no longer functioning normally. A part of the brain can shrivel in appearance as the brain cells die and the brain atrophies and shrinks.  TBI's are sometimes referred to as a silent injury, because unless you have damage to the motor centers of the brain, you have no outward manifestation that you have a brain injury.  You can look absolutely normal to others, so it is quite silent and ignored. The length of a coma is a very important determiner of the injury and the level of deficit that the patient may have after a trauma to the head.

    Dr. Erin Bigler, an expert on the human brain, says that the brain is like warm butter.  It is very soft, very pliable, and for the most part once the cells are damaged, and the pathways disconnect, they do not regenerate or reconnect; therefore, the damage is permanent. The brain does have some capability to adapt, but the actual damage itself is often permanent.

    TBI's can also change a person’s personality.  The right side of the brain is more nonverbal, visual and spatial, being able to spatially judge distances, put blocks together to follow designs, and do art and graphic work.  The left side of the brain deals more with language, and being able to speak or write.  One of the most common problems in patients with traumatic brain injury is a problem with short-term memory.

    When people do not have medical insurance, there are no real services for rehabilitation and care. This kind of care is not funded by insurance. This is one reason why all States should have helmet laws. People also need to learn more about head injuries, so that they understand the risks in skiing, football, mountain biking and climbing, and other forms of recreation.     (Brain Injuries and Healing, Dr. Erin Bigler, PhD, professor of Neuroscience and Psychology at BYU, Interviewed by Jon Du Pre, Insight, September 4, 2011)

Statistics
  • In spite of the rule changes to reduce the risk of concussions, the NFL reported a 58% incraese in concussions from 115 during the 2014 season to 182 during the 2015 season.  Dr. Robert Cantu, M.D., Neurosurgeon, said that, "90 to 100% of the professional players on the field on Super Bowl Sunday will suffer from CTE.  By the time you reach the professional level, the players have received hundreds or even thousands of blows to their heads."   (NFL Concussions, CBS Evening News, February 2, 2016)

  • A new study finds that concussions can cause academic problems for students, especially in high school.   Researchers followed students who had suffered a concussion, and found that 88% of them complained of headaches, fatigue, and an inability to concentrate. More than 75% reported having to spend more time on homework.   The problems appeared to get worse in high school.   (KREM 2 TV, May 11, 2015)

  • 96% of former NFL players tested positive for degenerative brain disease, according to new research, which is in line with previous research.  Eighty-seven out of 91 players suffered from chronic traumatic encephalopathy (CTE).  The more recent figures show 79% of football players overall suffered from CTE, when including people who had played high school, college and semi-professional football.  Researchers believe the disease is caused by repeated hits to the head, and it has been found to lead to memory loss and dementia.  Forty percent of the players who were found to have the disease were offensive or defensive linemen.   (Source:  "New Data Shows 96% of NFL Players Test Positive for Brain Disease," by Victor Luckerson, Time Magazine, September 18, 2015, Dept. of Veteran Affairs, Boston University, Frontline Reports)
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  • Many high schools are dropping their football programs.  The number of high school football players in the U.S. has declined by 25,000 over the past 5 years.  In 2014, five high school players died playing football, which is more deaths than in college, semi-pro or professional levels.  (reporter Don Dahler, CBS Evening News, September 30, 2015) 

  • "Concussion," by Jeanne Marie Laskas.  Concussion is the riveting, unlikely story of Dr. Bennet Omalu, the pathologist who made one of the most significant medical discoveries of the twenty-first century, a discovery that challenges the existence of America’s favorite sport and puts Omalu in the crosshairs of football’s most powerful corporation: the NFL.