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Derrick Z. Jackson

It’s time to sideline players with head injuries

By Derrick Z. Jackson
Globe Columnist / October 13, 2009

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IN A perfect world of public health, millions of parents would blitz football fields with the Hall of Fame fury of Ray Nitschke and Dick Butkus, storming sidelines to haul their precious babies away from bone-crunching tragedy. That is what should have happened after the National Football League’s own study found retired players age 30 to 49 have dementia at a rate 19 times that of normal men that age. Retirees 50 and older were five times more likely to have memory-related disease. This news comes four years after a University of North Carolina study found that retired players who had multiple football concussions had several times more prevalence of cognitive impairment than players who never had a concussion.

But Americans are so obsessed with the game that they are not about to strip the pigskin out of their children’s hands. The NFL is the nation’s most popular spectator sport, with mayors, governors, and taxpayers giving stadiums away to team owners, and incurable Cheeseheads like me who own DirecTV for the sole purpose of getting every Green Bay Packer game. College presidents addicted to bowl bids and billions of television dollars are role models for the 1.14 million youths playing high school football and 3.2 million youth age 6 to 14 scrumming around in youth leagues.

My wife and I banned our youngest son from playing high school football five years ago based on the potential damage. But in August, I watched my nephew play in a youth football jamboree in suburban Tampa. At the opening ceremonies, hundreds of boys in uniforms and pads lined up perfectly along the yard lines, applauded by coaches, parents, and girls in color-coordinated team polo shirts and cheerleading outfits. It was heartening to see such a community. It was heartbreaking to think if my nephew would be one of the boys who decades from now will be unable to remember his family.

So if we are not going to relegate the gridiron to the cultural backwaters boxing now resides in, we at least must undertake the illogical task of making violence as safe as possible. The first place to start is the concussion. In this month’s issue of the journal Brain Injury, researchers from Nationwide Children’s Hospital in Columbus, Ohio, found that perhaps as many as 40.5 percent of high school athletes play too soon after a concussion. In football, a whopping 16 percent of high school players who lost consciousness returned to play the same day. Study coauthor Dawn Comstock said no data exist for concussions in youth football and the vast majority of high school football teams probably play without a certified athletic trainer on the sidelines.

This is unconscionable. “Everything is left up to the coaches, the parents, the student athletes themselves,’’ Comstock said by phone. “That is a little bit of a scary combination. Playing that Friday night football game is the most important thing in that kid’s life.’’

Michael Levy, a pediatric neurosurgeon at the University of California at San Diego and a former collegiate sideline physician, said, “There has to be a zero tolerance policy about players with any kind of memory problems or headaches. They probably shouldn’t play for a week or two, period. There is no data out there on when or whether they should return to that sport or not after a concussion.’’

It ought to tell us something that sports concussions are studied by the military to help deal with brain trauma in soldiers. Marc Weisskopf, a Harvard epidemiologist who serves on the Institute of Medicine’s committee on Gulf War brain injuries, said the NFL should use all of its fabled replay cameras to help scientists determine what collisions cause the worst trauma and modify playing rules accordingly.

“If they have rules to protect quarterbacks and Tom Brady can scream at refs to get ticky-tack penalty calls for players going after his legs, they can do things to better protect the head.’’ Weisskopf said. “Kids playing football take their cues from the pros, so the NFL has to take the lead.’’

Julian Bailes, a West Virginia University neurosurgeon who has advised the NFL and the NCAA on head injuries, said progress is being made on preventing head-to-head collisions. “I think they called illegal use of the head about six times in the first game,’’ he said. He believes a discussion is needed over a “threshold number’’ of concussions a player can suffer in sports like football and soccer before being removed from the sport.

But the discussion is still too shallow. The nation’s most talked-about concussion belongs to Florida quarterback Tim Tebow. He recently suffered multiple blows in a single play when he was first slammed in the chest by Kentucky’s Taylor Wyndham. But few are wondering what more hits like that will do to Wyndham’s brain. He hit Tebow at full speed with his head and shoulder. All that a Kentucky coach said afterward of Wyndham was, “He needs to continue to get bigger and stronger.’’

Meanwhile, Ann McKee and Robert Cantu of Boston University’s Center for the Study of Traumatic Encephalopathy are seeing degenerative brain disease in football players as young as 18. Cantu said better helmets ironically may not be the answer as they already do an almost perfect job of preventing skull fractures. Anything more, Cantu said, and “we might have something that breaks hips or busts spleens or other parts of the body.’’

McKee said, “I love football, but I think it’s going to have to change. Kids brains aren’t finished and maturation goes on into their 20s. Anything we can do to take the head out of the game, we probably should do.’’

The first step is taking our heads out of the sand. Football may be ingrained in our culture for decades to come. It does not mean we have to completely lose our minds as our gridiron heroes lose theirs.

Derrick Z. Jackson can be reached at jackson@globe.com.

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