Wednesday, October 21, 2009

Should football be illegal?

Two neuropathologists are prominently spotlighted in an article by Malcolm Gladwell in the October 19 issue of The New Yorker. The article explores a provocative question raised by autopsy results on football players: namely, should football be illegal? Featured are Dr. Ann McKee (pictured), neuropathologist at the Veterans Hospital in Bedford, Massachusetts and Dr. Bennet Omalu, forensic neuropathologist and San Joaquin Valley (CA) chief medical examiner. Drs. McKee and Omalu have done some interesting autopsy work which suggests that the tau-positive chronic traumatic encephalopathy suffered by football players is much more common, even among high school players, than previously realized. As an example, McKee provides photomicrographs from a case of an 18-year-old high school football player and says: "He's got all this tau. This is frontal and this is insular.... This is completely inappropriate. You don't see tau like this in an 18-year-old. You don't see tau like this in a fifty year old."

You might counter that this is simply the result of a few bad-luck hits on the field, but research involving the University of North Carolina football team suggests otherwise. Players at UNC wear impact sensors in their helmets throughout the season. Results from these investigations suggests that even routine hits during practice can add up to cause concussions and, theoretically, set the stage for chronic traumatic encephalopathy. (On the first day of training camp one UNC lineman was recorded as having been hit in the head thirty-one times!)

Back in 1905, Gladwell reports, the question of whether football should be played in our nation's schools was raised to the level of the White House, when President Theodore Roosevelt called an emergency summit to discuss the issue. At the time, a professor at the University of Chicago called football a "boy-killing, man-mutilating, money-making, education-prostituting, gladiatorial sport". And in December of 1905, presidents of twelve prominent colleges met in New York and came within one vote of abolishing the sport at their institutions.

What does this mean for football in America? Nothing. Fans are willing to spend a lot of money to see men slam into each other's heads on the field. But, as a parent, you can do something. You can forbid your son from playing football.

7 comments:

Adam King said...

Last week, on ESPN's PTI, there was a neurologist that said that football players (especially lineman) tend to develop some form of dementia about ten years earlier than the average person in the population. He stated that even high school and college players tend to have traumatic injury causing neurological compromise, so professional players (people playing for years longer and in higher-impact games) are not the only athletes affected. Helmets were said to be safer today but not able to be improved enough to reduce injury to players' brains. He noted that the lineman are getting larger every year and suffer the greatest amount of trauma. Finally, he said that he thinks there will be a change in football rules within the next 10-20 years to reduce traumatic brain injury.

Brian E. Moore, MD said...

Interesting, Dr. King. I wonder whether there will be enough support to change the rules of football in the face of the huge economic forces encouraging harder hitting for the pleasure of the fans. I hope this TV neurologist is right and things do change.

Craig said...

Being in Pittsburgh while I did my neuropathology fellowship, I saw some of the autopsy slides from several former pro football players, plus former wrestler Chris Benoit. And I just recently read that Kyle Turley, retired from the Saints just a few years ago, is suffering daily from dreadful neurologic symptoms. Every single one of these guys has suffered horribly. But I wonder whether any of them would have given up their football careers, and all the money and adulation that comes with it, to avoid this. And young men today won't pay attention because they think they're indestructible. Especially if they think their only other options are bagging groceries or flipping burgers.

Adam King said...

Here is the link to the PTI Podcast with Malcolm Gladwell that I spoke of in my prior comment if you are interested (the interview starts at 9:24):

http://sports.espn.go.com/espnradio/player?id=4566643

Also on ESPN's Page 2, Tim Keown talks about the risks vs the rewards for playing football:

http://sports.espn.go.com/espn/page2/story?page=keown/091027&sportCat=nfl

Adam King said...
This comment has been removed by the author.
Adam King said...

Check out this article from the Wall Street Journal:

http://tinyurl.com/yjgmjbs

Just thought that this fit with the other articles that were posted on the topic.

Brian E. Moore, MD said...

Thanks for keeping us updated on media coverage of the football head injury issue, Dr. King. The WSJ article is interesting. Since I have written about the issue, people have asked me whether improving the helmet technology would make a difference. This article supports my position that it would not make much difference in the rate at which players sustain concussive and sub-concussive injurious hits to the head.