Posts Tagged ‘CTE’

Researchers studying soccer concussions and links to CTE

Science focusing on how many hits, not just how hard

We frequently write about concussion prevention, usually in connection to football. But concussions are a concern in soccer, too, and scientists are turning their attention to the sport.

Most people don’t think of soccer as a contact sport. But repeated player-on-player impacts and headers can result in concussions. Soccer is played by millions of kids at all age levels, so concussion education and research related to prevention is critical.

A good starting point is the U.S. Soccer Federation’s policy that strictly limits headers in youth soccer. Set in 2015, it prohibits players under age 10 from heading the ball and reduces headers during practice for players aged 11 to 13.

Concussions and CTE

Talk of concussions always leads to talk of CTE, or chronic traumatic encephalopathy. CTE is a progressive degenerative brain disease found in people with a history of repetitive brain trauma. It can only be diagnosed by conducting an autopsy. To date, there is no definitive proof that CTE is caused by concussions.

However, research suggests that repeated, less violent sub-concussive hits football and soccer players take may trigger CTE.  Current research being conducted by Michael Lipton, a neuroscientist at the Albert Einstein College of Medicine, is seeking to identify what triggers CTE. His research seeks an answer to the question of how much impact it takes for brain function to be affected.

Measuring the impact scientifically

Lipton hopes to find the answer by tracking about 400 recreational soccer players for Concussions in youth sportsseveral years. The study participants get a brain scan and blood work done. To test cognitive abilities, they participate in brain games on a tablet. Changes in brain function are mapped through diffusion tensor magnetic resonance imaging.

Lipton found in an earlier study of about 37 players that heading the ball is associated with cognitive setbacks and changes to the brain structure. This was the case even when no concussion was diagnosed. Observation of the players revealed that they head the ball an average of six to 12 times each game. These balls are traveling missile-like at speeds up to 50 mph. Players headed balls up to 30 times during practice drills. The study suggests that memory problems set in at about 1,800 headers.

Looking ahead

Conducting such a study on a larger group of players could help researchers find the point at which players should cease playing or back off heading the ball.

Other medical researchers hope to eventually isolate a biomarker that signals the onset CTE. That information would enable players to determine if and when it’s time to hang up their cleats.

In my opinion

I’m a bit confused about Lipton’s research methods. I seriously doubt he will find much heading of the ball in his new study of recreational soccer players. In his earlier study, the number of headers cited per practice seem too high for even the average club-level team. In watching my daughters’ club and high school practices over the past 10 years, I’ve never seen anything close to 30 repetitive header practices with high speed balls. The only heading-specific drills are low speed. The entire team may practice high-speed headers off of corner kicks, but the hits are spread out among the entire team.

You can read further articles about concussions on our blog.


Source: ERIC NIILER, “Brain Trauma Scientists Turn Their Attention to Soccer.” wired.com. 27 July 2017

The Concussion Risk in High School Football

The science behind the statistics

Grantland.com published an insightful blog post,  “The Fragile Teenage Brain: An In-depth Look at Concussions in High School Football.” The post explains why teenage brains are so susceptible to injury and provides a glimpse into exactly what happens inside the brain during a concussion. It also provides an excellent explanation of how the head injury problem in football in the 1960s and early 1970s was addressed by the National Operating Committee on Standards for Athletic Equipment (NOCSAE) standard, which established guidelines for sports equipment including football helmets.

The following excerpts from the article are especially revealing:

The compromises of helmet design help explain why there will be no quick technological fix for football concussions. Last October, Jeffrey Kutcher, chairman of the American Academy of Neurology’s sports section, told a committee of United States senators that all the current concussion prevention products being sold were largely useless. “I wish there was such a product (that could prevent concussions) on the market,” he said. “The simple truth is that no current helmet, mouth guard, headband, or other piece of equipment can significantly prevent concussions from occurring… Is extremely unlikely that helmets can prevent concussions the way they prevent skull fractures.” He went on to criticize numerous claims by helmet manufacturers suggesting otherwise, noting that even Riddell’s specialized anti-concussion helmet has only been shown to reduce the rate of concussions by 2.6%.

Coach Rollinson echoes the skeHigh school athletespticism. “Every year, we get more and more parents showing up with some fancy helmet and telling us that this is the one their kid has to use,” he says. “I’m sure they spent a lot of money on that helmet. I know it makes them feel better. So we always say, sure, your kid can use that helmet, but we have to do the fitting. And you know what happens? The helmet doesn’t fit. They spend $1000 on it because the manufacturer makes some crazy claim, but it’s way too big. And then when you fit it properly, the kid says it’s too tight, that it’s not comfortable anymore. But that’s the way it needs to be.

This is a recurring theme among the coaches and trainers at Mater Dei. According to the football staff, the most important helmet factor has little to do with the helmet itself. Instead, it has to do with the way the helmet fits the head. In theory, this is an easy problem to solve: Every NOCSAE approved helmet is fully adjustable. Teenagers, however make the fitting process surprisingly difficult. “Most of the time, the problem is forgetfulness,” says Fernandez. “That’s why we are always reminding the players to check air levels. We tell them that before every single game. But sometimes they leave it loose on purpose, just because he can get hot and sticky in there.”

Concussion Lawsuits Won’t End Football

How insurance and the law impact the concussion concerns

Will Oremus writes a well thought out explanation why concussion lawsuits will not end football. The main reasons cited are:

  • The initial medical expenses resulting from concussions and CTE are often not that high in most cases and symptoms take years to materialize. Therefore, the Accident Medical insurance carried by colleges, schools, and youth football organizations will not be hit hard since such policies limit payouts for medical bills to those that are incurred within one or two years from the date of the injury in most cases. Most CTE symptoms will show up years after a football career is finished and the Accident policy will be off the hook by that time. Therefore, these Accident carriers won’t take a big hit, which means that significant premium increases and market withdrawals are not likely.
  • The General Liability policies carried by schools and universities cover all the liability exposures such as slip-and-fall accidents, kids falling off playground equipment,  injuries at school sponsored events, etc., and concussion lawsuits are only a small portion of the overall risks. In 2011, only 13 catastrophic brain injuries were reported out of 4.2 million football participants nationwide.
  • The concussion and CTE-related lawsuits in the NFL are currently covered under Workers’ Compensation insurance (which overall allows for the collection of lower benefits as compared to civil lawsuits which would be filed under a General Liability policy) even though some 1500 former NFL players have filed lawsuits challenging Workers’ Compensation as the exclusive remedy.
  • The links between concussions and CTE to depression and suicide are not yet rock solid, even though some limited studies show a connection between NFL participation and CTE.
  • In order to win a lawsuit, a player will need to prove negligence (1. Duty owed to act as reasonable governing bodies, administrators, trainers, coaches, etc. in protecting football players, 2. Breach of that duty by not following accepted safety standards, 3. Breach was proximate direct cause of the injury, and 4. Damages resulted). As a result of the difficulty in proving negligence, the NFL lawsuits are alleging that the league knew about the dangers of CTE, but hid it from the players.
  • In lawsuits against colleges and high schools, no one is claiming that they hid evidence that football resulted in CTE. As a result, the lawsuits against colleges high schools are based on failure to follow accepted safety standards on not removing possibly concussed players from games and allowing too early return to play which may result in second concussion syndrome.
  • Even if a public school or university as an entity, or a coach or other school employee is negligent, many states have governmental or sovereign immunity statutes that protect against liability or at least limit liability to an amount such as $300,000, $500,000, or $1,000,000, depending on the state’s version of the law. These immunity statutes can be defeated upon proving gross negligence.
  • Some state concussion statutes also limit the liability of coaches, trainers, and other medical professionals when complying with the requirements of the statute unless they are grossly negligent.
  • The assumption-of-risk defense to negligence can be a powerful tool if the players receive an adequate and documented risk warning of the dangers of concussions.
  • If universities and high schools follow the concussion safety standards outlined by state statutes or their state or national sanctioning/governing body, they have a high level of built-in protection.
  • The governing bodies such as the NFL, NCAA, and National Federation of State High School Associations will implement rule changes to provide more protection as more research results become available.

We encourage you to read Oremus’ full article and our article, “The End of Youth Football? Not so fast.”


Source: Will Oremus. “After Further Review, Why Concussion Lawsuits Won’t Bring An End To Football,” www.slate.com. May 10, 2012.