HEALTH MATTERS: Contact sports and chronic traumatic encephalopathy: what we (still dont) know – The State Journal-Register

Approximately 100 million Americans watched the Super Bowl yesterday. Each year, this is the highest rated TV broadcast in the U.S. Our eyes track the swift movement of world-class athletes across the screen, our hearts pound at the yards gained and lost, and were immersed in both the excitement and brutality of the matchup.

At the same time, we cant help but wonder what impact these athletes feel from such a tough and competitive sport. Here, we want to reflect on something that pervades our playing fields: brain injury and contact sports.

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease characterized by brain atrophy and abnormal accumulation of tau proteins. CTE can only be diagnosed definitively by pathology after death. Clinically, patients tend to experience symptoms of psychiatric disturbances and cognitive deficits, including:

Depression

Extreme behaviors (e.g., bursts of anger, aggression)

Poor memory and judgment

Loss of control of language or body movements

Originally called punch drunk or dementia pugilistica, CTE was first reported in 1928 in boxers who had sustained repeated blows to the head. Only in 2005 was CTE recognized to exist in other occupations, led by a series of high-profile autopsies on the brains of ex-National Football League players. Subsequently, similar findings were noted in military veterans and athletes of ice hockey, soccer, lacrosse and wrestling.

Among the 200+ cases of CTE published to date, half were football players. In light of this, famous athletes started to pledge to donate their brains for research.

Class action suits were filed against the NFL and other professional and collegiate sports leagues for compensation for neurological damages. These events covered in the media brought intense scrutiny to the practice of contact sports.

CTE is considered a long-term manifestation of repetitive assault to the head. American athletes suffer 3.8 million concussions per year. Depending on the position, an NFL player may receive as many as 1,500 hits to the head every season. However, its unclear how often these injuries result in CTE, which usually doesnt manifest until 5-10 years after retirement. While all CTE patients share the common history of repeated head injuries, not all who sustain such injuries develop CTE. Due to a lack of long-term data, the incidence and prevalence of CTE among professional athletes remains unknown. The mechanism connecting the pathology to the symptoms also awaits further investigation.

Despite the controversy, CTE incited calls for policy and culture reform. In an effort to eliminate potentially dangerous games and reduce the risk of injuries, the NFL has made 50 rule changes since 2002 to protect players, improve practice methods, better educate players and personnel on concussions and strengthen the league's medical protocols.

The NFL deploys roughly 30 medical professionals on the sidelines for each game. The National Collegiate Athletic Association (NCAA) followed suit. Standards for protective gear were updated and innovations in helmet technology resulted. The NFL also established the 88 Plan to pay for the care of former players with neuropsychiatric disabilities. Locally, the Illinois General Assembly passed the Youth Sports Concussion Safety Act in 2015, requiring concussion education for all athletic coaches and marching band directors. The Illinois High School Association has developed specific protocols for identifying and intervening on concussions.

You may wonder what to make of all of this when deciding on whether you or your children should participate in contact sports. Here are some things to consider:

Avoid exposing young children to activities with a high risk of traumatic brain injury. Age 9-12 is considered a crucial period of neural maturation, making the brain most vulnerable.

Use protective gear and follow best practices and clear rules that are intentionally written to promote safety.

Insist on the use of referees and objective supervision of the activity to prevent unsafe playing conditions.

Follow established concussion protocols to report the injury and seek prompt treatment to maximize the chance of recovery.

Keep in mind that a single isolated concussion will likely not cause long-lasting harm. While both the severity and frequency of injuries should be considered, the decision to join or continue a sport should be made holistically in the grand scheme of life.

Qing Yang and Kevin Parker are a married couple and live in Springfield. Dr. Yang received her medical degree from Yale University School of Medicine and completed residency training at Massachusetts General Hospital. She is an anesthesiologist at HSHS Medical Group. Parker has helped formulate and administer public policy at various city and state governments around the country. He is formerly the group chief information officer for education with the Illinois Department of Innovation and Technology. This column is not intended to substitute for professional medical advice, diagnosis or treatment. The opinions are those of the writers and do not represent the views of their employers.

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HEALTH MATTERS: Contact sports and chronic traumatic encephalopathy: what we (still dont) know - The State Journal-Register