Brain Trust

Emily Holbrook


December 1, 2009

Andre Waters, a former NFL defensive back, committed suicide three days before Thanksgiving in 2007. Terry Long, a former Pittsburgh Steelers lineman, took his life in 2006 by drinking antifreeze. Tom McHale, a former Tampa Bay Buccaneer who was in and out of rehab after his NFL career ended, died last year from an overdose of oxycodone and cocaine.

These men all had something in common other than football-they all suffered from chronic traumatic encephalopathy (CTE), a form of traumatic brain injury. In Waters' case, an autopsy revealed brain tissue that would be expected in an 85-year-old, along with characteristics of early-stage Alzheimer's disease, both of which are symptoms of CTE. He was 44.

These are just three examples. There are many more stories of ex-NFL players who have suffered through retirement due to the side effects of receiving so many blows to the head during their gridiron heyday. According to a recent University of Michigan study, a staggering 6.1% of NFL retirees aged 50 and older reported being diagnosed with dementia, Alzheimer's or other memory-related problems, compared to 1.2% of all American men in that age group. This eye-opening report has reignited the debate about how football can better protect its players from incurring brain trauma-a fate that is increasingly being viewed as a common byproduct of playing such a brutal sport.

Dr. Kevin Guskiewicz, director of the University of North Carolina's Center for the Study of Retired Athletes, has been studying the effects of head trauma on professional football players since 2001, and his findings suggest that there is a strong association between recurrent concussions and diagnoses of depression. Guskiewicz's 2007 study found that, compared to retired players without a history of concussion, retired players reporting three or more concussions (24% of the players studied) were three times more likely to be diagnosed with depression. "The findings emphasize the importance of understanding the potential chronic neurological consequences of recurrent concussion," he said.

But CTE is not only prevalent in retired NFL players. A disturbing announcement made recently by Boston University's Center for the Study of Traumatic Encephalopathy stated that the disease had been found in a former college athlete who never stepped foot on the grass as a professional player. Mike Borich, a former wide receiver for Western Illinois University, died this year at the age of 42 from an overdose after battling years of depression and substance abuse. In an interview after his son's death, Borich's father stated that Mike had had up to 10 diagnosed concussions during his short career, though the actual number of "dings" is likely much higher.

Evidence that even an amateur athlete can suffer the same devastating brain trauma as professional players has raised eyebrows. The issue has gone as far as Capitol Hill, where NFL commissioner Robert Goodell was grilled about the league's responsibility for player health. "I believe you are an $8 billion organization that has failed in your responsibility to the players," said Representative Maxine Waters (D-CA) in a hearing. "I know that you dearly want to hold on to your profits. I think it's the responsibility of Congress to look at your antitrust exemption and take it away."

For its part, the NFL has mandated tests of brain function for each player, so that doctors and trainers can more accurately diagnose concussions in players. Rule changes in recent years have also focused on protecting players such as quarterbacks and wide receivers whose in-game functions often leave them more prone to big hits from roving defenders.

Equipment improvements have hit the market as well, including the Xenith X1 helmet that is designed to guard against concussions. The new helmet adapts to impact energy and direction, reduces the sudden movement of the head during impact and combats the cumulative effect of every hit. Critics argue that its introduction has had the inverse effect, however, as some players seemingly see the helmet as a license to hit even harder. And a recent New Yorker article on the issue quoted one expert who said that further technological helmet innovations that would make a real difference were likely more than a decade away.

Until then, the sport will have to either adopt some other creative solutions or accept the reality laid out in the aforementioned article by author Malcolm Gladwell: "What football must confront, in the end, is not just the problem of injuries or scientific findings. It is the fact that there is something profoundly awry in the relationship between the players and the game."
Emily Holbrook is the founder of Red Label Writing, LLC, a writing, editing and content strategy firm catering to insurance and risk management businesses and publications, and a former editor of Risk Management.