The NFL Concussion Saga, Who Needs To Tell The Truth?

In 2002, Dr. Bennet Omalu discovered an anomaly in the brain of Mike Webster, a career NFL player who died when he was 50 as a result of a heart attack. Webster was known to have cognitive impairments, mood disorders, and had multiple recorded suicide attempts. Omalu had never watched football, but he noticed that Webster’s brain contained many toxic proteins, a condition formerly seen in boxers. In 2005, Omalu named the disease he discovered, “Chronic traumatic encephalopathy” in his 2005 case study “Chronic Traumatic Encephalopathy in a National Football League Player.”

What is Chronic Traumatic Encephalopathy (CTE)? Dr. Sanjay Gupta, an American neurosurgeon and CNN Chief Medical Correspondent, explains symptoms and possible causes of CTE.

Patients with CTE are reported to suffer “memory loss, confusion, impaired judgement, progressive dementia, and suicidal problems.” Due to the progressiveness of CTE, there is currently no way to use MRI or other brain imaging technologies to diagnose people with CTE; the only method is an autopsy analysis of the brain.

Between Mike Webster’s death in 2000 and November 2016, 90 out of 94 former NFL players who had autopsies after their death were diagnosed post-mortem with CTE. Despite this overwhelming evidence of a disease, NFL officials did not admit until March 2016 in a press conference that there is a link between CTE and concussions in NFL players.

To explain the origin of CTE and symptoms of this disease further, I created an audio slideshow that shows the symptoms, history, and current CTE research being performed.

New research shows that the effects of CTE are wider than originally thought, occurring in many former high school football players, as well as individuals involved in contact sports. In an interview, Dr. Walter Koroshetz, the director of the National Institute for Neurological Disorders and Stroke, stated that,

“At least at this early stage, it seems to be much more common than anybody imagined. That’s kind of what we’ve been afraid of for a while, and now we have data that it is more widespread. … I think we have a significant problem that’s getting bigger as we see how this pathology is more common.”

In 2010, Debra Pyka’s 25 year old son, Joseph, committed suicide; he played youth football from ages 11 to 14, and Debra sued Pop Warner Football stating that Joseph suffered from CTE. Pop Warner settled the suit in March 2016 for $2 million dollars. In the past 5 years, youth football has suffered nearly a 33% decline in participants (from 3 million in 2010 to 2.169 million in 2015). High school football has also suffered a moderate decline of participants over the last decade.

What has the NFL done wrong in handling the concussion crisis?

In 2016, PBS Frontline’s Concussion Series, a series of videos highlighting the NFL’s concussion crisis, reported about NFL doctors hiding evidence from the public on their knowledge of the link between CTE and concussions.

After 18,000 former players received $765 million in a 2013 lawsuit over concussion-related brain injuries, the NFL has seldom-reported on new CTE-related research. Frontline’s two hour video sought to research, “What did the NFL know, and when did it know it?” Mike Florio, a sports reporter for NBC, summarized PBS’s video by writing,

“The point here is that the NFL doesn’t want the insurance companies to gain access to evidence that may show the NFL knew enough about concussions to show that the league knew or should have known that players were being adversely impacted by them. The effort to shield such evidence from view strongly implies that such evidence exists.”

This was not the first instance of the NFL hiding information relating to concussions. PBS’s Frontline Series created a timeline of the history of NFL concussion awareness. From the creation of the Mild Traumatic Brain Injury committee in 1994 to present day, there have been many instances where the NFL tried to shut down questions relating to concussions. The NFL’s current commissioner, Roger Goodell, must #tellthetruth and release all scientific documents relating to concussions and CTE. The NFL must stop continuing to settle with past NFL players and take a proactive approach and end CTE before it begins in youths.

After Omalu released his research in 2005, Dr Elliot Pellman, a rheumatologist who had no experience with neurology, dismissed the research. In an attempt to dismiss Omalu’s research, Pellman wrote, “Omalu’s description of chronic traumatic encephalopathy is completely wrong. The diagnosis of a chronic condition requires a medical history indicating a long-standing nature of the illness … Such a history is completely lacking in Omalu’s report.”

However, the dismissal of Dr. Omalu’s research was unfounded and ultimately CTE was recognized as a serious disease. Dr. Omalu was recently awarded the American Medical Association’s Distinguished Service Award in November 2016 for his research relating to CTE.

What steps are the NFL taking to limit concussions?

In 2013, the NFL announced new concussion protocol for NFL teams; the protocol includes staffing independent neurologists, 29 medical officials, and enforcing a concussion test to any player who shows symptoms of a concussion.

Despite the NFL’s new concussion protocol, players such as Case Keenum of the St. Louis Rams stayed in a game after suffering a concussion.

The NFL’s new penalties over head-to-head contact were also questioned this year after Cam Newton of the Carolina Panthers suffered multiple hits to the head and did not draw a single penalty. In an interview following a postgame loss to the Denver Broncos, Newton admitted that he, “struggled to remember what happened after the game.”

Sub-Concussive Hits and CTE

Concussions are not the only cause of CTE. According to a USA Today report of a study performed by the Cleveland Clinic on college football players, 40 out of 67 players exhibited, “elevated levels of an antibody linked to brain damage.” Not a single player in the study suffered a concussion. According to the report, the players had elevated levels of the serum S100B, which disrupts blood to the brain; this serum was shown in the autopsies of NFL players who had CTE.

CTE has been shown to occur in college football as well as high school football. The earliest recorded diagnosis of CTE was in an unidentified 18 year old multi-sport athlete. Owen Thomas, a 21 year old football player for the University of Pennsylvania, committed suicide after suffering a, “sudden and uncharacteristic emotional collapse.” His autopsy confirmed that his brain showed signs of CTE. During Thomas’ football career, he was never diagnosed with a concussion. Dr. Perl, an experienced neuropathologist, spoke on Thomas’ death by saying, “It’s not unreasonable that aspects of his behavior were related to the underlying brain disease that was detected.This is a call for a broader range of research into this problem that extends beyond the heavy duty N.F.L. level of athletics.”

How Can The NFL Be Proactive During The Concussion Crisis?

First, the NFL should continue to fund research and develop technology to determine whether athletes have suffered a concussion during a game. Recent studies have shown that technology can show whether athletes suffered a concussion after suffering hard contact to the brain. Instead of placing more medical personnel on the field, funding new concussion technology will ensure athlete safety. In addition, the research had shown that new artificial turf used in NFL stadiums has caused over 15% of concussions during the last few NFL seasons from head contact to the turf. Softer turf as well as more helmet technology must be created by the NFL to increase player safety.

Next, the NFL must work with the NCAA and Pop Warner football leagues to determine the impact of sub-concussive hits on CTE. The average football player suffers between 1,000 and 1,500 sub-concussive hits per football season; the NFL must be the leader in new research and create new technology that limits the impact of sub-concussive hits on all football players. The NFL must work with Boston University and UCLA’s medical schools (the two leading research institutions in CTE field) to fund their research into diagnosing CTE antemortem.

Lastly, the NFL must stop hiding evidence relating to brain injuries. The NFL continues to settle concussion cases with former players and continues to hide CTE-related information from them; this must stop. Roger Goodell insisted for 5 years that “there was no admission that CTE was caused by football”. After top NFL officials admitted in March that there was a link between football and CTE, the Dallas Cowboy’s owner Jerry Jones said in a statement that, “it’s absurd to link CTE and playing football. There’s no data in any way that creates a knowledge.”

Release the documents, Roger Goodell; if you do not release these documents, players and the public should boycott the NFL. Do not let Roger Goodell hide any more information from former NFL players and the public, #tellthetruth.

I created a video that summarizes the link between concussions and the NFL. This video helps tie together the link between concussions, the NFL, Roger Goodell hiding important documents that document the rise of CTE, and how Roger Goodell can stop the spread of CTE.