Doherty | No rest for stories on brain health

Last week, we learned “the rest of the story” regarding two former football players, one who played at a Chicago high school more than a decade ago and the other who was an NFL Hall of Famer. In neither case was there much inspiration to be found.

In 2013, Drew Williams was arguably Lane Tech’s best football player. During an October game with Chicago Dunbar, though, he collapsed with what turned out to be a subdural hematoma. Emergency brain surgery saved his life, but after months of hospitalization, he returned home needing constant care from nurses and family.

On July 22, with his story largely forgotten by all but family, friends and teammates, Williams died at the age of 30. On Friday, his family held a celebration of life event that was covered by ABC 7 reporter Leah Hope. Interviewed during Hope’s report, Williams’ former coaches remarked about how much safer the game has become since Williams was injured.

“There's more safety precautions being taken,” said Williams mother, Jodi. “So that's a little solace for us — that there is some good out of all of this.”

But is there really?

A study published in the American Journal of Public Health in 2017 by researchers at the University of Colorado in the American Journal of Public Health was optimistic. It looked at the effect state concussion laws, passed between 2009 and 2014, had on recurrent concussions in high schoolers. The investigation found that, within 2 ½ years of such a law being passed in a state, the rate of repeat concussions dropped significantly.

However, a study published in Sports Health in 2023 considered whether or not those same laws had any effect on the number of sport-related structural brain injuries. They are the catastrophic type -- such as the one Williams suffered -- that usually require surgery, are typically permanently disabling, and often fatal.

Among the authors was retired University of Oklahoma head athletic trainer Scott Anderson, who was featured in this space a week ago for his more recent research on heat illness in football linemen.

He and his colleagues found the incidence of such severe head injuries, roughly 13 per year, remained unchanged among high school and college players from year to year between 2002 and 2022. They concluded that, when it comes to injuries such as Williams’, state legislation and rule changes intended to reduce head injuries had had no effect.

The day before Williams’s celebration of life took place, the Pro Football Hall of Fame kicked off a celebration of its own — for its latest class of five inductees — with a press conference. Drew Brees, Larry Fitzgerald, Luke Kuechly, and Adam Vinatieri were there but, oddly, former San Francisco 49er Roger Craig was absent.

During Saturday’s induction ceremonies, we found out why. Craig, 66, was in attendance but delivered his acceptance speech via a previously recorded video, during which he revealed he has vascular dementia. Furthermore, he acknowledged football was likely to blame.

Still, he was not bitter. “Football gave me opportunities beyond anything I could imagine,” he said. “It helped shape the man I became.”

Craig went on to say, “We know more today about brain health than when I played, and I hope sharing my story encourages people to pay attention to their health and seek help when something doesn't feel right."

But by the time “something doesn’t feel right,” it is too late. The damage to the brain, caused by a career as long as Craig’s — 11 years in the NFL after three years at Nebraska, has already been done.

On July 30, the Boston-based Concussion & CTE (chronic traumatic encephalopathy) Foundation joined with the National Athletic Trainers’ Association (NATA) to present a webinar entitled “CTE: The Role of the Athletic Trainer in Education and Risk Reduction.”

According to research presented during the webinar, CTE is caused by repeated brain injuries, essentially the thousands experienced during a career that are not severe enough to cause a concussion. In fact, number of concussions is not a risk factor for developing CTE, but the number of years of playing is.

One study cited during the lecture may illustrate that seeming paradox better than any other. Published in JAMA Neurology in 2021, it found that soccer goalies had the highest rate of concussion in the sport but that fullbacks had the highest rate of CTE — presumably from all the headers they experience in a career.

In addition to soccer and football, the other activities at risk listed during the webinar were boxing, hockey, lacrosse, military service, mixed martial arts and rugby.

Yet, the affliction is not inevitable. Not all those who play contact sports will develop CTE, as was reported during the presentation. On the other hand, the odds of developing CTE are roughly twice as high for professional soccer players whose careers last 6-10 years in comparison to those who play five years or less. For football players, the risk increases 15% with each year played. In hockey, the jump is a remarkable 34% per year.

To reduce those risks, the NATA and the Concussion & CTE Foundation recommend the following interventions (Concussion-CTE-Foundation_Parents.pdf) :

1. Reform practices.

2. Reform gameplay.

3. Institute a minimum age for repetitive head impacts.

4. Educate athletes and coaches on CTE.

In football, that means delaying tackle until high school, limiting contact in practice, and learning not to make initial contact with the head. In hockey, the steps should be similar; just substitute “checking” for “tackling.” And in soccer, the culprit is heading and every effort should be made to modify the game to minimize that one aspect.

Until those changes are made, the stories about head trauma will not be getting a rest.