The tragic death of Junior Seau on May 2nd reminded us that the titans of the NFL gridiron are human, all too human. But a neurological defect that results from repeated head trauma could have been a contributing factor.
Seau was a vibrant human being who loved playing football. By all accounts, he was a loving and kind individual. He won the Walter Payton Man of the Year award in 1994, which is given to the player who best combines humanitarian excellence with on-the-field excellence.
While it is still too early to speculate on the factors which led Seau to take his own life, it is undeniable that many former NFL players struggle without the thrill of playing football. And many former players also struggle with the agonizing physical traumas inflicted by the game.
Seau's family has decided to donate his brain to research so they can study the effects of the head trauma he sustained during his 20-year career in the NFL.
According to the Mayo Clinic, post-concussion syndrome includes such symptoms as headaches, dizziness, fatigue, irritability, anxiety, insomnia and memory loss. The experience of these symptoms can often lead to depression as well.
Professional athletes are typically very proud individuals, and may be reluctant to accept treatment like psychotherapy for the anxiety associated with after-effects of head trauma.
But for all the advancements of science, there is still relatively little known about head trauma and concussions. As an increasing amount of research mounts up, one wonders whether football as we know it will look the same in a decade.
Moreover, concussions are not just a concern for professional athletes, but for the hundreds of thousands of student-athletes around the country. Studies show there are somewhere between 1.6 million and 3.8 million sports-related concussions in the U.S. every year.
Surprisingly, concussions are not only a concern in "violent" sports like football and hockey, but also in soccer, basketball and even cheerleading. While no one wants to look like a "wuss," there is obviously a need to continue to improve safety equipment and tailor rules toward the interests of player safety.
Less than 20 years ago, there were still NHL players skating around without helmets. Less than two years ago, it was still legal for a tackler in the NFL to leave his feet and level a defenseless receiver.
While the NFL had used spectacular hits to promote the sport up until recently, the concept of player safety has quickly moved to the forefront of the league's agenda.
And it's a horrible but significant coincidence that Seau's suicide came on the same day the league handed down harsh suspensions to New Orleans Saints players for their participation in the bounty scandal. Player safety has to be paramount because it concerns the quality and longevity of human life.
A brief analysis of rule changes in the NFL over the last 10 years shows that many were in direct response to notable injuries that occurred, for example the ban on low hits to the quarterback (Tom Brady's knee injury in 2008) and "horse-collar" tackles (broken legs suffered by Terrell Owens, Donovan McNabb and Musa Smith in 2004).
There have also been steps towards removing the kickoff altogether, in the interests of player safety.
But what rule could be put in place to prevent concussions? They appear to be an inherent risk within the design of many sports, but especially football.
Considering the nature of the game, only marginal steps can be made to avoid vicious blows to the head from occurring. So diagnosis and treatment of concussions should continue to be a point of intense focus for the NFL, all the way down to Pop Warner leagues.
In addition to rule changes, there have also been steps taken to improve helmet design so that the risk of concussion is reduced, but the NFL has stopped short of mandating a particular helmet, perhaps over liability concerns.
But there are different companies that make helmets which reduce the risk of concussion. And there are also proponents of helmets with exterior padding, like the one worn by Mark Kelso.
But the more we learn about concussions, the scarier it gets. Unlike orthopedic injuries, neurological damage often cannot fully be rehabilitated. Hall of Fame quarterbacks Steve Young and Troy Aikman both retired with plenty of talent left in the tank because they had suffered multiple concussions.
And recent research suggests that some concussions may not be the result of massive hits alone, but also the accumulation of many small traumas over time.As Dr. Robert Cantu told the Associated Press:
It’s the total brain trauma. Tens of thousands of subconcussive blows all add up. ...You can’t draw a line between number of concussions and risk for CTE. You have to factor in the subconcussive trauma. It’s equally, if not more, important.
CTE is chronic traumatic encephylopathy and is cause by repeated head trauma, whether big or small. According to the Center for the Study of Traumatic Encephalopathy at Boston University:
CTE is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head. CTE has been known to affect boxers since the 1920s. However, recent reports have been published of neuropathologically confirmed CTE in retired professional football players and other athletes who have a history of repetitive brain trauma. This trauma triggers progressive degeneration of the brain tissue, including the build-up of an abnormal protein called tau. These changes in the brain can begin months, years, or even decades after the last brain trauma or end of active athletic involvement. The brain degeneration is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and, eventually, progressive dementia.
What is the best way to prevent concussions in the NFL?
Obviously, that sounds pretty awful. And it raises the question of whether the risks of CTE outweigh the thrills of professional football. After all, it is an entertainment industry, so it seems foolish to mortgage the future of human lives for the sake of a game.
And scientists are just beginning to learn about CTE. According to Cantu: "It is not yet known how common CTE is. It cannot be diagnosed during life and there are no known treatments."
But numerous former NFL players have been diagnosed with CTE in the past decade, including Mike Webster, Terry Long, Andre Waters, Justin Strzelczyk, Tom McHale, John Grimsley and Chris Henry. Each of these players exhibited mental deterioration and erratic behavior which concluded with tragic death.
And it's not just NFL players. In April 2010, University of Pennsylvania lineman Owen Thomas hanged himself. He was 21 years old. Though he had never suffered a concussion, an autopsy found he suffered from CTE.
And it doesn't just affect athletes who are boxers and football players. In 2007, pro wrestler Chris Benoit murdered his wife and seven-year-old son before hanging himself. Benoit had a history of head trauma and steroid use. Benoit's father submitted his brain for testing.
According to ABC News, "The tests, conducted by Julian Bailes of the Sports Legacy Institute, show that Benoit's brain was so severely damaged it resembled the brain of an 85-year-old Alzheimer's patient."
In 2009, wrestler Andrew "Test" Martin died from an overdose of oxycodone. His brain was also found to have sustained severe damage from concussions.
In 2011, the NHL lost three players in a four-month span. In May, Derek Boogaard died from an overdose of alcohol and the pain killer oxycodone, but had suffered from post-concussion syndrome and depression.
In August, Rick Rypien took his own life. Just 16 days later, Wade Belak died in what has variously been reported as a suicide and an accidental strangulation. But Belak had suffered from severe depression as well.
In February of 2011, former NFL player Dave Duerson committed suicide in a manner similar to Seau. He shot himself in the chest in order to leave his brain intact. He sent a text message to his family that day, which said, "PLEASE, SEE THAT MY BRAIN IS GIVEN TO THE NFL’S BRAIN BANK."
Duerson knew that his change in behavior and chronic depression could very well be linked to his years spent playing football. His tragic suicide also contained a sad martyrdom, in that Duerson hoped science could learn something about the long-term effects of head trauma by studying his brain.
Like Seau, Duerson also won the NFL's Man of the Year Award, and even in death, his humanitarian spirit endured as he sought to help others avoid the suffering he went through.
The brain bank he referred to is the same Center for the Study of Traumatic Encephalopathy at Boston University referred to earlier. The Center has over 70 brains in their bank for research of CTE and the signature tau protein.
Seau's brain has actually been promised to a rival research center, the Brain Injury Research Institute at West Virginia University, co-founded by forensic pathologist Bennet Omalu (who discovered CTE in Mike Webster's brain) and Julian Bailes, chair of neurosurgery at WVU's School of Medicine.
They also have Mike Webster's son, Garrett, in their employ as an administrator and player liaison. An article by ESPN The Magazine's Peter Keating details the sad competition for players' brains. But that is another issue entirely.
As we learn more about head injuries and brain trauma, medical technology will hopefully get better at diagnosing and treating concussions and subconcussive blows. And equipment design should continue to evolve with the paramount goal of safety in mind. But ultimately, each player, coach, executive, owner and fan will have to run their own cost-benefit analysis.
Is an entertaining sport that is shortening the lives of its players and turning the twilight years of veterans into nightmare scenarios really worth it?
At very least, it's worth considering drastic changes to the sport in terms of preventing head trauma, greatly improving equipment and making diagnosis and treatment of concussions a focus of sports medicine. Progress has been made in all of these areas, but much more is needed.
The link that some have seen between the suicides of Duerson and Seau underscores the horrible issues that follow from playing football. Long after the final whistle has blown, long after the players leave the locker room, the lingering effects of playing a game are eroding and ending lives.