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A New Era of Football?

Emphasis on preventing long-term brain injury has league executives changing policies.
February 5, 2010

On Sunday the National Football League holds its championship game, Super Bowl XLIV. It will be the first Super Bowl since the league acknowledged the link between mild head trauma–often caused by the game’s rough style of play–and long-term brain damage, and overhauled its policies toward concussions. As many football fans may have noticed, players this season were more likely to remain on the bench than return to the field after a blow to the head, thanks to new rules forbidding them from playing after showing significant signs of concussion.

That change has been a long time coming, writes Deborah Blum in an Op-Ed today in The New York Times. While brain injury in football players has seen a growing emphasis in recent years–both in the media and in Congress–strong evidence for the link has been around for more than 80 years. In the piece, Blum describes a paper published in The Journal of the American Medical Association on October 13, 1928. “This raises the question–at least for me–as to why we are announcing the athlete concussion-dementia link as a new, and still somewhat debatable, issue some 80 years later,” she writes.

In that study, performed by Dr. Harrison Martland, chief medical examiner in Essex, NJ,

Martland did autopsies on more than 300 people who had died of head injuries, looking for patterns of brain damage. For his study of boxers, he talked a fight promoter into giving him a list of 23 former fighters he thought could be labeled as definitely punch drunk. Martland was able to track down only 10 of the former athletes, but in those cases, he found the promoter’s diagnosis was on target. Four were in asylums, suffering from dementia. Two had difficulty forming sentences or responding to questions. One was almost blind, two had trouble walking and one had developed symptoms similar to those of Parkinson’s disease.

More recently,

Surveys done in the last few years have found that N.F.L. players are at higher risk of dementias and other mental disorders than the general population. Autopsies of athletes – notably the brains of former N.F.L. players who suffered from profound dementias – consistently found dark clusters of nerve cell proteins, formations more common to elderly Alzheimer’s patients. Similar patterns of damage were recently reported in wrestlers and soccer players. Most of these athletes were dead by age 50.”

…At a Congressional hearing on football brain injuries, held in Houston on Monday, legislators accused college athletic officials of ignoring risks and failing to adopt polices that sufficiently protected young players. “It’s money, money, money,” said Representative Steve Cohen, a Tennessee Democrat, “and health care ought to be considered.”

Researchers are working hard to develop better ways to study the problem, including helmets designed to detect concussions, which would alert players or coaches when they need to be benched, or even prevent them. And new ways to study mild traumatic brain injury, which doesn’t show up in traditional brain scans.

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