Thursday, October 22, 2015

Football: The Greatest or Most Dangerous Sport in the World? Or Is It Both?

Football is the most popular sport in this country, having emphatically snatched away the undisputed title of “America’s favorite pastime” from baseball.  It is a tremendously entertaining game and an incredibly lucrative industry.  Yet, recent years have seen it come under fire for its inherent health risks.  Basic awareness of concussions has increased exponentially and with it has come increased scrutiny about the role that repetitive head trauma plays in the long (and short) term health of football players young and old, from the pee wee level to the National Football League. 
As the spotlight on the dangers of the game has grown substantially, so too have the number of questions being asked.  It is no longer just about college or professional athletes being grinded through a so-called exploitative system, but whether or not kids should ever be allowed to participate in youth leagues. 
Concussions had once thought to have been limited to trauma so substantial that it caused players to be knocked unconscious and, thus, restricting the population most susceptible to being concussed to the high school, college, and professional levels.  Now, however, a greater understanding has developed which acknowledges that concussions come in varying levels of severity.  A minor concussion may exhibit symptoms on a smaller scale.  Seeing stars, headaches, blurry vision, auditory or visual sensitivity, and dizziness are just a few of the common reactions to a concussive force to the head; be their duration a mere few minutes or sustained over several days or weeks, these symptoms are indicative of some sort of concussion. 
Justifiably, parents are more worried about their children.  The human body does not fully develop until the late teenage years.  Structural stability is established over many years, particularly the skull and vertebral column that surrounds and protects the brain, brainstem, and spinal cord, the integrity of which governs our basic core functions.  A child’s development could be stunted – structurally and internally – as a result of playing football. 
Controversy reigns over the sport.  It was back in 2011 when a retired NFL player sued the league for its supposedly "concerted effort of deception and denial" about the long-term damage that the sport could do to the human body.  That lawsuit eventually awarded former players a settlement of $765 million.  Nary has a month gone by these last four years without the latest wrinkle added to the developing story of concussions vs. football.  Chris Borland, a former University of Wisconsin All-American who had a fantastic rookie season as a linebacker for the San Francisco 49ers last year, made waves this spring when he abruptly retired from the NFL in an effort to avoid future brain damage.  For a burgeoning star to quit football at age 24 was perhaps the start of a trend and the biggest sign of the changing times.  It was a bold move that inadvertently made Borland the de-facto face of the movement that believes football may not be around in another twenty or thirty years. 
Borland also represents a fascinating dichotomy that has emerged since traumatic brain injuries became such a prevalent water cooler topic: people who have deeply rooted passion for the game – players, coaches, and fans - are finding themselves torn between their love of football and the progressively clearer evidence that it is ruining peoples’ lives.  In a feature story in an August edition of ESPN The Magazine, Borland said he was reluctant to even watch football anymore and, when asked whether or not he would someday allow his kids to play, he responded, “I don’t know.  I don't think it's black-and-white quite yet.”
It certainly is not.  Family bonds are forged over football.  Important values are taught through it.  Fortunes are made from it.  Memories are created by it that last a lifetime.  So, attempts are being made to find a common ground; to better recognize its hazards and to use that attentiveness to make football safer.  Dr. Alex Powers is a neurosurgeon who works for Wake Forest University.  He is also an avid football fan.  His research and his passion for the sport are often at odds because Powers is one of the leading physicians exploring the topic of brain trauma as it relates to football.  According to an ESPN The Magazine article last fall, Labor Day weekend 2014 was a classic example of his plight.  He was in the lab, examining the charts of high school football players the week prior and then flew out with his two sons - both youth players - for a family vacation on the west coast to see the Oregon Ducks play on Saturday and the Seattle Seahawks on Sunday.
According to Dr. Powers’ data, a single season of high school football does potentially irreversible damage to the brain in proportion to the severity and number of hits taken.  His stance has created widespread panic amongst football people.  Shawn Springs, a former Pro Bowl NFL player and the co-founder of a company that designs football helmets with greater safety measures, has told Powers that his research is going "to scare everyone to death...and kill football."  Doctors and researchers have told Powers, “You have to kill the game. There's no way, as a physician, that you can condone the data." 
All of us that have any interest in football are being forced to reevaluate our positions and form updated opinions based on the data that has become available, especially when determining whether or not to let our kids participate.  "I was totally naive about it,” Dr. Powers told ESPN The Magazine.  “I thought people would see the data and say, ‘This is awesome. No one has ever looked at it this way.’”  Instead, it seemed to explicitly point out the sad truth about football: that there may not be a way to make a violent game safe.
Imagine building a home on a tiny island in the middle of the most common area in the world to be affected by hurricanes.  Even if you constructed the sturdiest house on the planet, why would you voluntarily build it in a place where you knew – for a fact – that it was going to be subjected to high winds and flying debris for four months per year?  Is not football the equivalent for the human body?  Is it logical to subjective oneself to a game so intrinsically brutal (especially for kids)?
Of course, repetitive trauma during the first ten years of life is very common, extending beyond the realm of youth football.  Though a study was recently released suggesting that 1 in 30 pee wee football players would have at least one concussion per season, another study stated that bicycle accidents were twice as likely as football to cause concussions. 
The scope of this discussion needs to expand even further.  In many cases when we are young, symptoms that result from trauma do not immediately set in; oftentimes, traumas start a domino effect, which quietly takes its toll and produces the gradual onset of symptoms long after the fact.  Noticeable, subjective complaints like pain or Migraines or numbness may not happen, for instance, until a year (or many years) after an incident, and most doctors do not make the connection to trauma at that point.  To this day, concussions are a microcosm of a common problem in modern healthcare that only associates symptoms with trauma when the proximity of it can be tied to immediate effects. 
Knowing of a concussion and its detrimental effects is only half the battle.  Proper concussion detection should stimulate the advancement of education toward how to appropriately help the concussed heal and recover.  One of the most overlooked aspects of repetitive trauma is its affect on the upper neck area, where the lower brainstem responsible for regulating your organs, muscles, and tissues resides and where cerebrospinal fluid flows in a loop between the brain and the spinal cord.  The hits, tackles, and falls have a greater impact on the upper neck than any other body part because of its unique, more mobile but less stable structural design.  The head and neck protect your life line.  Helmets do not protect that vital head-neck junction, the misalignment of which can affect the brainstem, decrease the flow of cerebrospinal fluid, and throw off the body’s structural balance. 
Super Bowl-winning quarterback, Jim McMahon, is one of the higher profile concussion victims.  For years, he suffered from debilitating headaches, memory loss, and the early signs of dementia.  Dr. Scot Rosa, an Upper Cervical Chiropractor in New York, corrected McMahon’s upper neck misalignment.  Since then, McMahon noted in a recent article, “I haven’t had any headaches.”  Numerous noteworthy personalities from Montell Williams to Sidney Crosby to Jerry Rice have had the same procedure and achieved similar success.  The correction does not reverse the damage accumulated over decades in cases like McMahon’s, but it can halt the downward spiral and remove one of the major obstacles to concussion recovery.  In kids, however, the chances for full recovery are much greater; the earlier the problem is identified and addressed, the better the odds of getting back to normal. 
Frankly, this is a scary topic.  As fans of the game, are we to ignore the ever more prevalent dangers?  “It's an American pastime, but it's hurting people,” points out Chris Borland’s mother, Zebbie, in the ESPN The Magazine piece.  “I’m conflicted,” adds Borland.  Can we be passionate football fans, simultaneously denounce the sport as too dangerous for our kids to play, but then condone it for other kids?  One thing is certain: we can no longer bury our heads in the sand and pretend that there is no discussion to be had; there is a wide-ranging conversation to be had about ethics, safety, prevention, treatment, etc.  So, enjoy the season, but join the debate too.
Sources: ESPN The Magazine, ESPN Outside The Lines, Institute of Medicine and National Research Council, The Deseret News

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