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4th January 2010

‘Ticking timebomb’ in US colleges as American football head injuries linked to dementia

As NFL bows to pressure and changes its rules, a Congressional hearing has opened into fears of long-term brain damage

In a sport that prides itself on its toughness and commitment under physical duress, Mike Webster was about as tough and committed as they come. “Iron Mike” was the anchor of the Pittsburgh Steelers, a gritty job in one of the grittiest teams in American football.

He played for the Steelers from 1974 to 1989, winning the Super Bowl – the annual championship of the National Football League (NFL) — four times, three as captain. He was inducted into the pro football hall of fame, and came to be seen as an icon of the sport.

All of which makes his demise all the more poignant. Even before he retired in 1990, he began to suffer mental problems. He displayed symptoms of dementia, memory loss and depression. As his behaviour grew more erratic, he found it hard to hold down a job and by his death in 2002 aged 50, he was reported to be sleeping homeless in railway stations or in the back of his pickup truck.

Such an ignominious an end for so huge a personality marked a low point of American football. At the time of Webster’s death, the condition from which he was suffering — repetitive brain injury, later dubbed chronic traumatic encephalopathy, or CTE — was not even recognised, let alone understood.

But over the past eight years, partly as a result of Webster’s death, pressure has mounted on the NFL, the professional sport’s governing body, to confront what has been described as a ticking time-bomb that could be facing hundreds of thousands of players.

Concern about the dangers of a sport in which players routinely suffer blows to the head has reached Washington.

The judiciary committee of the House of Representatives today opened a special hearing in Detroit, calling on top sport officials and experts in neurosurgery to help it assess the threat of brain injuries to players, particularly at school and college levels. “Clearly, we have reached a tipping point in our understanding of the causes and treatment of brain injuries in football,” said John Conyers, chairman of the committee.

The committee heard from Kyle Turley, a now disabled former player with the St Louis Rams. He told the panel that he suffered “terrifying symptoms” as a result of many concussions, adding that “my faculties continue to degenerate and my life continues to change”.

Turley spoke angrily about the “arrogance of NFL owners as they neglect the health of those whose careers and talents they should protect”. I see myself, my friends and the heroes of my youth dismissed and thrown away as if all the hard work and dedication they put into building the NFL into the huge financial success it is today meant absolutely nothing.

The hearing was held the day after another incident in the final game of the season, when a quarterback for the Miami Dolphins was admitted to hospital after a head-to-head collision with a defender for Webster’s old team, the Steelers.

The judiciary committee is hoping it can build on the momentum for reform that began with Webster, who was the first American football player to be diagnosed with CTE, a degenerative illness caused by repetitive trauma to the head. The diagnosis was made by Bennet Omalu, the forensic pathologist who carried out the autopsy.

Omalu suspected Webster’s erratic behaviour was linked to his sport and decided to investigate. Webster’s brain appeared normal, but when Omalu sliced it into 250 slides and subjected it to tissue analysis he was astonished to find an abnormal protein called tau at levels usually seen in dementia sufferers in their 80s or 90s.

Further research has steadily deepened understanding of the crisis. A survey of 1,000 retired professional players by the University of Michigan found 19 times more Alzheimer’s disease or dementia than normal for men aged 30 to 49. An earlier study by the University of North Carolina had also found higher levels of dementia among retired players who had suffered concussions.

After years of pressure from brain injury researchers, the NFL has finally accepted the need to tighten its rules. Guidelines introduced last month require any player who shows signs of concussion to remain off the field until the following day.

The guidelines have been greeted as a huge step forward for the NFL. Shortly before the restrictions were announced, Ira Casson and David Viano, who co-chaired the NFL’s committee on brain injuries, both resigned, having come under mounting criticism.

Casson, who was asked to address today’s hearing, had consistently tried to discredit research linking football to dementia and dismissed calls for rule changes.

On the scientific front, understanding of CTE has grown through the work of the Brain Injury Research Institute, co-founded by Omalu. The institute has carried out tissue analysis on up to 11 dead NFL players. In all cases, they found abnormal levels of the brain proteins that cause CTE.

One was a college player aged 18, which suggests that hundreds of school football players who are concussed every year could be at risk. More than a million young people play football at school, and may be storing up long-term mental problems.

“People are starting to wake up to the fact that this is a public health threat,” said Omalu.

Researchers say the NFL guidelines do not go far enough. CTE is most likely to be induced by hundreds of small traumas that can have a cumulative effect in sporting careers spanning many years, rather than a couple of dramatic knocks, they say. Over a 20-year career in football, a player might experience 18,000 jarring blows, a study found.

That poses the sport with a much greater challenge — how to prevent head traumas happening in the first place.

“The NFL and players are finally sitting up and listening,” said Julian Bailes, a former team physician for the Steelers who works with Omalu at the institute. “But now we have to get the head out of the game.”

Bailes wants to see the rules tightened to eradicate all head contact. Paradoxically, he said, football helmets have only made matters worse, encouraging players to use their heads as weapons.

Such a cavalier approach to an organ as sensitive as the brain under the current rules of the game can lend players short-term competitive advantage.

But for those like “Iron Mike” Webster, the payback comes years later in a slow, excruciating fall into despair. © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds

Read the full story at The Guardian

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