Since today is Super Bowl Sunday, and I cringe every time I watch football, it seems appropriate to discuss some of the long-term ramifications of chronic head trauma.
Though many people know what a concussion is, many don't think of it as a head injury, per se. Certainly, it's easy to dismiss a lone concussion. When I was 16, I was mountain biking with my brother and a friend. After having some fun coursing over a fun hill that naturally gave us air time, we were about to call it a night when, on our last run, I watched my friend soar through the air before flipping over and landing helmet-first on the ground.
At first relieved that he got up and started talking, it was fast apparent that he was not okay. He started repeating himself. Even his laugh was repetitive. We insisted on walking the rest of the way home, and by the time he had been to the emergency room, he was diagnosed with a concussion and sent home. Before long, he seemed to be back to normal.
In my friend's case, he was lucky; his concussion was a one-time thing, and he had little difficulty recovering.
Imagine, then, that this happened to him multiple times every year. Imagine that my friend was right back out on the trails, biking away, and flipping his bike over again just like before. Every time he'd hit his head, it would take a little bit longer to recover. But over time, he might think "I've done this so much, I can shake it off."
Now replace my friend with a football player. The reality was that my friend was wise enough to be more careful about things. A football player, by contrast, is considerably less likely to do so. Whether it's hope for getting into college, hoping to go pro, or winning a Super Bowl, the football player will stay the course, repeatedly subjecting himself to more trauma. Helmet or no, the brain is still fragile. Damage it enough times, and there's bound to be less and less resiliency.
Boston University's Center for the Study of Traumatic Encephalopathy describes a condition called Chronic Traumatic Encephalopathy (CTE):
CTE is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head.
This trauma triggers progressive degeneration of the brain tissue, including the build-up of an abnormal protein called tau. These changes in the brain can begin months, years, or even decades after the last brain trauma or end of active athletic involvement. The brain degeneration is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and, eventually, progressive dementia.
So where does this leave us? Though I am no fan of football, the game won't stop being played. My hope is that, with education and outreach, more people learn about the very real consequences of head injuries. While we may not be able to fully prevent them, people need to know that support is available for them, and that they should seek it. While awareness is growing, it's too often after the fact.
What can you do to increase awareness? Talk about head injuries with your friends and family. Share resources. Get involved.
The Centers for Disease Control has some great information. The Sports Legacy Institute has information about CTE and information on how to get involved. Boston University does as well.
With enough awareness, maybe someday we can even move beyond rehabilitation and work toward prevention. Every little bit helps.