03.05.14

Sounding the Alarm: CTE Risks Evident in Many Sports

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soccerIn the days leading up to Super Bowl XLVIII, I wrote about chronic traumatic encephalopathy (CTE) in football and the role that law and policy may play in reducing concussions and protecting the health of athletes. Last week, concussions were back in the news as a groundbreaking study revealed that athletes in other sports – including those that are traditionally perceived as “safe,” such as soccer and baseball – are not immune to the danger of concussion-related degenerative brain diseases.Until recently, CTE was most commonly observed in football players, hockey players, and boxers. But the new study showed that Patrick Grange, a former Major League Soccer player, died at age 29 from a degenerative motor-neuron disease likely related to his amyotrophic lateral sclerosis (commonly known as Lou Gehrig’s disease). He was said to have been especially proud of his ability to “head” the ball which resulted in repeated blows to the head. Following the results of his autopsy, Grange was identified as the first soccer player to have died from CTE.

But Grange was not alone. The same researchers concluded that Australian rugby union player Barry “Tizza” Taylor died in 2013 of dementia at age 77 as a result of complications of severe CTE. Ryan Freel, a former Major League Baseball player who committed suicide last year, also suffered from CTE.  Freel retired in 2010 after reportedly sustaining at least nine concussions during his career.

Physical activity – such as participation in athletics – is particularly important for young people, especially given current childhood obesity rates in the United States. While such activity should be encouraged, the emerging evidence linking brain trauma to sport suggests that young players and their parents need to fully understand the risks of playing, and we must give sufficient weight to our current sports culture in addressing this risk.

In nearly every type of locker room at every level of sport, athletes are praised for persevering through pain and sacrificing their own wellbeing for the success of the team. Indeed, athletes often report that their most profoundly satisfying experiences revolve around playing as a part of a team and striving to push one’s physical limits in pursuit of athletic achievement. Combatting such a culture in responding to the concussion crisis could be critical to protecting athletes’ health.

In addition to cultural shifts, states have been active in addressing youth concussions.  State laws already recognize that concussions can result from participation in any type of sport and thus apply broadly to youth athletes.  On January 30, 2014, Mississippi became the last state to enact a youth sports concussion law. As mentioned in a previous post, most of these laws require concussion education and that athletes who are believed to have a concussion be removed from play immediately and prohibited from returning to play or practice before at least 24 hours and only with permission from a health care professional.

 Unfortunately, such laws, while critical, may not go far enough to resolve this critical public health issue and suggest that additional study is needed. The laws for example, do not include penalties for failure to comply with the new regulations and provide few protections to ensure that mandated brain trauma training for coaches and trainers is actually effective at reducing youth concussions. In most states, trainers and coaches are simply required to view an online video without an evaluation to assess whether they have mastered the material or learning objectives. 

With the new knowledge that athletes in many different types of sports are vulnerable to CTE, federal and state policymakers should be spurred to action to ensure that all athletes – no matter their sport or age – are protected from the dangers of concussions. 

 

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