CTE

January 10, 2013

It was revealed today that Junior Seau, the hard hitting linebacker of yesteryear, died due to self-inflicted gunshot to the chest with chronic traumatic encephalopathy (CTE). This is a brain disease that causes physical changes on the brain due to brain injury.

Concussions are a hot topic. Part of the reason that they are such a hot topic is because of the long term effects that concussions can have. CTE is the reality for many athletes. In fact there has been a brain of an 18 year old football player who died with evidence of CTE. This is someone who never player hard hitting college or professional football. High school football player.human-brain

We know that concussions in youth are more of a problem than in the fully developed brain of a twenty year old. The symptoms can last longer, the effects can be longer lasting, and it can set them up for second impact syndrome (a second injury that can cause permanent neurological problems or death).

What can be done? I would suggest that we need to do everything that we can to prevent these injuries. Certainly not all of them are preventable, but many can be. If football rules were enforced it would decrease incidence. There are plenty of examples that the rules are not enforced appropriately. Equipment is not checked properly or was never fitted properly. Tackling is often not addressed adequately, especially in the lower levels. Let me state very clearly though, helmets are not the answer. Helmets do not prevent concussions. The purpose of helmets are to prevent skull fracture.

Soccer is a whole other area. How can we prevent head injury in a sport that encourages and promotes head contact? The force of the ball to the head does, and I am not pulling punches here, cause brain injury. If you watch or play soccer, how many times do some players head the ball in a half, in a game, in a season? It is sometimes too many to count. Some players purpose is to head corners and redirect using their head. At what point will we understand the degree to which CTE affects soccer players?

If you are a parent, you should be concerned about brain injury. You should be concerned about taking the time to rest the brain after it is injured. You should see a physician who is qualified to evaluate and manage these injuries. And you should require your athletic department to have an athletic trainer who is knowledgable on head injuries and able to take them through a conservative gradual return to play progression. These are all things that are necessary.

If you are a physician, do not do anyone a “favor” and clear someone to return early. You are not doing them a favor, you are doing them an injustice. You are setting them up for more brain injury. Let them heal. Don’t return them until they are actually ready. Remember your oath: Do no harm.

We will hear more about CTE in the coming years as it will become a common buzzword just like MRSA. There is continued research going on about brain injuries and CTE. We do not have the answers yet. We don’t know exactly what is the cause of CTE. There are theories out there though. Is there a way to prevent, stop, or reverse it?

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