Like a lot of guys who grew up in the United States, I played football for a good portion of my youth. To be specific, I played American football; no disrespect to soccer intended! Every year from 6th grade until I graduated high school, I spent August through October trying to protect our quarterback or clearing room for our running backs as an offensive lineman. I wasn’t particularly good, but I was big enough that I wasn’t a liability either, so I was lucky enough to get plenty of playing time.

Football was a lot of fun, but I remember that it hurt a lot, too. Over the years that I played, I broke every finger and every toe, sprained both ankles, jammed my neck, amassed an archipelago of bruises, and suffered a couple of concussions. That may sound like a lot of damage, but anyone who has played for at least as long as I did knows exactly what I’m talking about – injuries are just a part of football, by the very nature of the game. Practice and training can help reduce the risk of injuries, but it simply isn’t possible to totally eliminate all the hazards inherent in a high-impact contact sport. Playing football entails some risks.

If you follow football in the news at all, then you’re probably aware of the discussion about the long-term damage playing football can possibly cause, especially the effects of repeated head trauma (like concussions) on cognitive function. Over time, the effects of concussions and other non-penetrating head injuries can add up, and lead to the development of a condition known as Chronic Traumatic Encephalopathy (CTE), a neurological disorder with symptoms that look a lot like Alzheimer’s Disease (which really scares me!). Patients start to show impairments with their memories and judgments, as well as changes in personality and mood, all of which get progressively worse over time, before the disease eventually kills you. Worse yet, there is no accurate way to detect CTE in living people – a proper diagnosis requires an autopsy – and there are no reliably effective treatments available.

CTE is a devastating disorder, which is one of the big reasons that the largest employer of professional football players in the world (the NFL) and the scientific research community are dedicating a lot of resources to investigating the disorder. In 2008, the Center for CTE was founded at Boston University, which was the first research center dedicated to the study of CTE. The NFL donated $1 million to the Center in 2010, and dozens of NFL players have agreed to donate their brains to the center for research. Another big reason the NFL cares about CTE research is that thousands of former players are suing the league, claiming that they are suffering from cognitive declines directly resulting from their professional playing days.

There has already been some positive turnaround from research into CTE. Scientists may have developed a way to diagnose the condition in living people using a technique known as positron emission tomography (PET), where a chemical dye is used to mark specific proteins in the brain. However, these findings are very preliminary, and only involve a few former NFL players. There are far more unresolved issues remaining.   Some scientists are not convinced that CTE is caused directly by concussions, whereas other scientists argue that hits to the head that aren’t strong enough to cause a concussion can still do enough damage to lead to CTE. Clearly, much work remains.

To touch on one final issue, this whole discussion of CTE and head injuries in general in football players has led many parents to wonder whether children should be allowed to play football. This is a very valid concern – if blows to the head might cause long-term problems in otherwise healthy adults, then it is perfectly plausible that similar injuries can have a negative impact on still-developing kids. Indeed, a recent attempt was made to limit contact in football practices in Illinois (the bill didn’t pass, but its existence illustrates the importance of this issue). I don’t think that I’ve suffered any long-term consequences from the concussions I experienced playing football in high school, but everybody is different. When it comes time to decide whether my own kids should be allowed to play, I really hope we have more conclusive evidence on the consequences of head injuries. I really loved playing the game, but with my own kids, I’m not sure that the benefits of playing will outweigh the risks.

I went to a very cool event last night here at Northwestern, sponsored by a number of groups including the Medical Humanties and Bioethics program. They brought New York Times editor Jason Stallman to speak about series of articles the NYT published (written by Alan Schwarz) about football players and the long-term effects of concussions they sustained while playing.

In addition to Jason, the program also featured commentaries by physicians who work directly with players both on collegiate and professional teams, and a group discussion with many participants who are also neurosurgeons/neurologists.

The end result was a fascinating conversation that made me think a lot about being an NFL fan. I know that concussions have been front and center lately, both with the congressional hearing and high-profile players like Ben Roethlisberger and Kurt Warner missing games (to the chagrin of some of their teammates) after suffering concussions.

What I didn’t know was just how many former players are suffering from the after-effects of brain injury, such as depression, dementia, and even suicide. In fact, a recent study commissioned by the NFL and conducted by the University of Michigan’s Institute for Social Research found that, in men ages 30-49, Alzheimer’s Disease and other memory-related problems have been diagnosed in 19 times more NFL players than members of the general population. The study isn’t perfect (it was not peer-reviewed and it was conducted over the phone- more on that here) but other, independent studies suggest similar links.

Thankfully, while denying the connection in the past, the NFL has finally stepped up and instated a new policy that prohibits players who suffer concussions from returning to the field during the same game. However, this is just one, very small step toward fixing a big problem. (Read more…)