You Better Believe We Must Do More

8/8/2019 You Better Believe We Must Do More

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You Better Believe We Must Do More

about Head Injuries in Sports

By John M. Phillips

Amyotrophic lateral sclerosis, or ALS, is a disease of the nerve cells in thebrain and spinal cord that control voluntary muscle movement. It is alsoknown as Lou Gehrig's disease. Despite bearing his name, medical journalshave questioned whether Gehrigs demise -and that of some other athletesand soldiers that have long been thought to have ALS- might have beencatalyzed by concussions and other brain trauma. We now have at least a14th NFL veteran victim (my friend Kevin Turner), 50,000 to 150,000head injuries per year to the children of America, and it is now time tohave controlled panic.

This is very important because patients with significant histories of braintrauma can be considered for different types of treatment, perhaps leadingtoward new pathways for prevention or a cure. Meanwhile, ALS has noknown cause and no known cure. This new species might have moreoptions. Doctors at the Veterans Affairs Medical Center in Bedford,Massachusetts and the Boston University School of Medicine, the primaryresearchers of brain damage among deceased National Football Leagueplayers, said that markings in the spinal cords of two players and oneboxer who also received a diagnosis of ALS indicate that those men did nothave ALS at all. They had a different fatal disease, doctors said, caused byconcussion-like trauma, that erodes the central nervous system in similarways. For the first time in my life I have decided I wanted my unborn childto be anything other than the all-star Quarterback for my alma mater, ortake the punishment that guys that I represent and fight for are sopassionate about, and that made me realize that we have a big problem onour hands. We are spending billions and have not been using our brainswhile these players are having theirs beaten to death literally

ALS

According to the ALS Association, up to 30,000 people in the United Statescurrently have ALS, an incurably fatal disease among primarily 40- to 70-year-old men that results in the swift and steady atrophy of all voluntary

muscle movements. The other statistic cites is that ALS affects 1 or2:100,000 people. Symptoms can begin with ticks or breakdowns in thenervous system, such as shaking or immobilization of limbs and extendsover the course of a few months or years to quadriplegia, paraplegia anddeath. Many people with ALS retain their full mental capacity, which atfirst is a blessing but later on becomes a real curse, as they are trapped in ashell of a body, communicating by computer generated speech guided byeye movement. The British astrophysicist, Stephen Hawking, is such an


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example. He has lived longer than most with a fully functioning, and somesay genius brain, inside a body that has wasted away.

Lou Gehrig

Baseball legend, Lou Gehrig wasits first prominent alleged victim,dying two years after his 1939diagnosis. The Yankee's legendhad a well-documented history ofsignificant concussions on thebaseball field, and perhaps otherssustained as a battering-ramfootball halfback in high schooland at Columbia University.Given that, its possible thatGehrigs renowned commitmentto playing through injuries likeconcussions, which resulted inhis legendary record streak ofplaying in 2,130 consecutivegames over 14 years, could haveled to his condition.

Treatment

There is no known cure for ALS. The first drug treatment for the disease is

a medicine called Riluzole. Riluzole may prolong life, but does not reverseor stop the disease from getting worse. The goal of treatment is to controlsymptoms. Baclofen or diazepam may be used to control spasticity thatinterferes with activities of daily living. Trihexyphenidyl or amitriptylinemay be prescribed for people with problems swallowing their own saliva.Physical therapy, rehabilitation, use of braces or a wheelchair, or otherorthopedic measures may be needed to maximize muscle function andgeneral health. Choking is common. Patients may decide to have a tubeplaced into their stomach for feeding. This is called a gastrostomy. Anutritionist is very important to help prevent weight loss. The illness itselfappears to increase the need for food and there is usually limited ability to

swallow. The use of devices to assist in breathing includes machines thatare only used at night as well as constant mechanical ventilation. Patientsshould discuss their wishes regarding artificial ventilation with theirfamilies and doctors. It can be horrible and is expensive.


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Causes

In about 10% of cases, ALS is caused by a genetic defect. In other cases, thecause is unknown. Nerve cells (neurons) waste away or die and can nolonger send messages to muscles. This eventually leads to muscle

weakening, twitching, and an inability to move the arms, legs, and body.The condition slowly gets worse. When the muscles in the chest area stopworking, it becomes hard or impossible to breathe on one's own.

ALS versus CTE

Researchers have found pathological evidence that repetitive head trauma-such as that experienced by football players- may result in a motor neurondisease similar to Amyotrophic Lateral Sclerosis (ALS), or "Lou Gehrig'sdisease." It is often identified with CTE - Chronic TraumaticEncephalopathy, a degenerative brain damage. CTE actually progresses

undetected for years, silently eating away at brain cells, until it causesdementia and other cognitive problems.

A unique pattern of protein deposits has been found during autopsy studiesof brains from 12 professional athletes who had played contact sports.Researchers have discovered CTE in the brains of more than 50 deceasedformer athletes, including more than a dozen NFL and college players, prowrestler Chris Benoit and NHL player Reggie Fleming.

Known Victims

The media has published an estimate that 14former NFL players since 1960 have beengiven diagnoses of ALS, a total about eighttimes higher than what would be expectedamong men in the United States of similarages. However, we found that list and it israther crudely generated. The truth is wehave little idea how many have been affected.Worse still, how many guys played in highschool and college only to vanquishmysteriously?

The known victims thus far are: Eric Scroggins(Linebacker at USC who played 3 games forthe 49ers in 1982), O.J. Brigance (Linebackerout of Rice who played 11 years in CFL andNFL from 1996-2002)(featured on ESPNsOutside the Lines, a must-watch story),GlennMontgomery (Defensive Tackle out of Houston


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who played 7 years in NFL), Pete Duranko (Notre Dame Defensive Endwho played 7 seasons in AFL and NFL), Peter Demmerle (WR at NotreDame who was drafted but did not play in NFL),Steve Smith (Penn StateFullback who played from 1987-1995 in NFL),Tony Proudfoot (DefensiveBack from 1971-1982 in CFL),Bob Waters (former 49ers Quarterback, one

of 3 members of the same team to get ALS, along with Matt Hazeltine andGary Lewis),Matt Hazeltine (15 year Linebacker out of California),GaryLewis (running back and 7 year NFLer),Orlando Thomas (6 year NFLerfrom 1995-2001, who played Safety),Wally Hilgenberg (Iowa Linebacker,who played 16 seasons in NFL), and now, Kevin Turner (Fullback out ofthe University of Alabama, who played 7 years in the NFL). This list couldgo on for pages.

A few foundations have been formed and most of the athletes are workingor worked to help the understanding and fund raising for ALS before theiruntimely demise, including the Glenn Montgomery Foundation and the

Brigance Brigade.

Bigger Problem

The cognitive effects of brain trauma affect hundreds of formerprofessionals and perhaps thousands of boys and girls across many youthsports, the NCAA and professional leagues. High school athletes reportedhaving 50,000 to150,000 concussions per year across our country.Younger brains are more vulnerable to injury and unlike in the NFL,there's often no one on the sidelines trained to diagnose brain injuries.These individuals often release liability, dont experience manifestations or

symptoms until their 30s, and have little or no insurance to address thisproblem. What have we done?

Not only is brain trauma in sports can be a risk factor for this ALS-likeCTE, but is causing early onset recurrent headaches, dementia, depressionand other mental and physical problems For example, a 2005 paper foundthat Italian professional soccer players had developed ALS (now known asCTE) at rates about six times higher than normal. Studies have also linkedservice in the United States military to higher risk for ALS, possiblybecause of battlefield collisions and blast injuries.

The NFL

Recently, the NFL indicated it is considering providing aid to help carefor former players who are now suffering from Lou Gehrig's disease. It isreported that Steve Smith received a lump sum form the NFL. They muststep up now. The NFLPA must, as well.

After spending years doing considerably less about head injuries,


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concussions and sub-concussive blows, there has been more effort recentlyincluding requiring an independent neurologist to decide whether a playercan go back to a practice or to a game. Head injuries were, and in someways still are, treated no differently than a high-ankle sprain in someinstances. Little lifetime protection and care is offered.

Future

More than 150 former athletes,including 40 retired NFLplayers, have joined the Centerfor the Study of TraumaticEncephalopathy's braindonation registry. Studies willcontinue.

Meanwhile, advances intechnology must beimplemented. A new helmetsupposedly is aimed to prevent

concussions. The company claims 15,000 helmets sold in 2009. 12 ofthose went to a high school in Alabama, according to a story in theAnniston Star. One of the wears indicated it, makes his head feel like afootball compressed under a school bus tire, but the school also reports noconcussions. At $350 per helmet, it is an expensive proposition at thatlevel. However, there is no reason why the NCAA, Conferences and NFLarent chipping in to make sure the best measures are taken. I know I will

be giving these to everyone of my clients in the future.

Victims of this plague have not even begun to be known. We all like thathard hits, but remember what brought the most tears during EmmittSmith's Hall of Fame speech? It was when he thanked Moose, his full back,his battering ram, that brought the most tears. It is the job of the fullbackto sacrifice his body to open up holes and take the punishment on almostevery play. At what cost we must now ask? The orthopedic injuries aren'tthe half of the problem. We must do more.

You Better Believe We Must Do More

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