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The Hard Choices Ahead on Sports Injuries and CTE

The recent CTE Study released to the public had some serious flaws and some methodologies that beg for a more complete study, but the numbers of the selected group do not lie. CTE is a problem for football players and the sport is at stake.

Looking at the Hokie Village just before the opener. How long will this last?
John Schneider - SB Nation

Hokie Fans, let’s take a step aside from the regular pump of information leading up to a new football season, and pause to think about something of critical importance to football players, parents, families, and fans.

Chronic Traumatic Encephalopathy (CTE) is currently the sports medicine challenge of the early 21st century. The study as posted by CNN and other sites, at first glance and scare headlines is damning. There is no sugar coating the seriousness of the findings. Well, except as you dig deeper into the study you begin to see something that should have been dealt with within the study and upon its publication.

The CTE study suffers from quite a few weaknesses that threaten to steer the conclusion to some preconceived desired result. The most major of the flaws in this is the selection bias of the test/study group. Obviously the concept of donating a brain from a diseased loved one is a major decision for many people there are cultural issues with funerary rites and personal proprieties at stake for the survivors of the decedents. These were the brains of players whose families who chose to donate, so nearly 100% of the sample stood a good chance of demonstrating a high probability of long term injury.

There was no control group, of regular folks of similar ages. There was no significant sampling of other athletes who play sports where concussions and head trauma often occur, Hockey, Lacrosse, Soccer, etc. However; and that’s a big however. The reality that the autopsies and tissue measurements of the subjects presented in that group showed a seriously concerning affect. Enough of one to cause an increasing number of people to stop participating in the sport.

That’s the issue, and that’s the way most regular folks are going to look at the problem. Life is a terminal enterprise. We don’t like to admit it, and facing our mortality is one of the most difficult challenges. In fact it’s so frightening for most of us that we chose to ignore it instead of dealing with it honestly.

One would hope that this study would be supplemented by responsible companion studies that perform the exact same tests on similar numbers of athletes and non-athletes from across a spectrum of behaviors. There should not be a rush to judgement or an over-reaction; but there will be.

We are nothing if not predictable in our extreme aversion to risk. Playing any sport is a risk. Playing a heavy contact sport is an even greater risk. The current head protection technology cannot prevent all concussive events, it’s just not possible. The brain floats around in the cranium without buffer or suspension systems. If you are running, trip and fall, smacking your head into the ground is going to cause your brain to slam up against the inside of your skull. So will sudden deceleration without even hitting your head on something. And that’s what’s important to study, here. I don’t think that there are too many people who think that football doesn’t increase the risk of developing such lifelong brain injuries.

Jay has posted up the story about the future non-conference schedules for games between BYU and Tech. They are to be played in 2026 and 2030.

Not only are the athletes that will play the first game in elementary school and those playing the second in pre-school, but there is the distinct taste that American rules football as we know it, today, may not even exist in 2030 for the 2nd game. The additional rules about contact are becoming unworkable. The pressure to remove young boys and teens from, specifically, football programs will increase. The cascade effect of insurance, lack of young talent to develop, and the image of a sport seeming like it’s turning its back on players will all weigh heavily on the next decade.

Football is a collision sport, and most of us who played it always knew we weren’t going to walk away unscathed. Will there be a time when football isn’t played because its risks are more than the society is willing to bear? I cannot answer that question. I can say that this first study, flawed and limited as it is, begs hard for a more complete set of studies using all of the appropriate scientific and statistical methods. Virginia Tech is in the forefront of measuring the effectiveness and developing equipment that does as much as possible to protect football players on the field. Will that be enough, fast enough, to keep the sport alive? We just don’t know the answer to that question.