110 N.F.L. Brains(nytimes.com)
nytimes.com
110 N.F.L. Brains
https://www.nytimes.com/interactive/2017/07/25/sports/football/nfl-cte.html
205 comments
They didn't say that. Here's the quote I believe you skimmed and misinterpreted.
"About 1,300 former players have died since the B.U. group began examining brains. So even if every one of the other 1,200 players had tested negative — which even the heartiest skeptics would agree could not possibly be the case — the minimum C.T.E. prevalence would be close to 9 percent, vastly higher than in the general population."
They're being honest about the selection bias, but they're saying the absolute minimum threshold is 9%. That's high number one, and it's almost certainly much higher than nine percent because they only tested a few of the brains. 1300 is every former pro player that died. Not every one they tested.
"About 1,300 former players have died since the B.U. group began examining brains. So even if every one of the other 1,200 players had tested negative — which even the heartiest skeptics would agree could not possibly be the case — the minimum C.T.E. prevalence would be close to 9 percent, vastly higher than in the general population."
They're being honest about the selection bias, but they're saying the absolute minimum threshold is 9%. That's high number one, and it's almost certainly much higher than nine percent because they only tested a few of the brains. 1300 is every former pro player that died. Not every one they tested.
As I said before, that's in the 10th paragraph of the article. The first line people read is:
> A neuropathologist has examined the brains of 111 N.F.L. players — and 110 were found to have C.T.E.
It's incredibly disingenuous to lead with that. It makes readers think that the rate of CTE is almost 100%. Readers have to get through nine more paragraphs (including profiles of two NFL players) before the truth shows up. Yes, NFL players have absurdly high rates of CTE compared to the general population. Nobody in this thread is saying otherwise. But disingenuity makes your side easier to dismiss and discredit, even if it's right. That's why I criticized the article.
> A neuropathologist has examined the brains of 111 N.F.L. players — and 110 were found to have C.T.E.
It's incredibly disingenuous to lead with that. It makes readers think that the rate of CTE is almost 100%. Readers have to get through nine more paragraphs (including profiles of two NFL players) before the truth shows up. Yes, NFL players have absurdly high rates of CTE compared to the general population. Nobody in this thread is saying otherwise. But disingenuity makes your side easier to dismiss and discredit, even if it's right. That's why I criticized the article.
110/111 testing positive for CTE is insanely high, even with selection bias. This is a big, big deal, and should be treated like a big, big deal. This is not hyperbolic in the slightest. If a chemical plant was suspected of causing cancer, and you got those test results, same experimental bias and all, it would be shut down instantly.
Boyoga!
Boyoga!
If I picked a sample of 5 cherries and I made sure they were all rotten, it sort of reduces the amount of statistical inference you can do about the true distribution of the cherries to zero. Your use of "even with selection bias" doesn't really make sense here.
If you picked 9% of all cherries in whatever way you like, and found 98% of them rotten it still means that at least 8.8% of cherries are rotten. While not even close to 98% it's still a huge number in regard to CTE.
To say nothing of the many potential causes for potential cognitive decline in later life. I would expect the vast majority of cases of dementia in life to not include CTE.
Except for NFL players.
I'm honestly puzzled at the people coming out of the woodwork to troll this post. What is driving these people and their abandonment of reason?
Except for NFL players.
I'm honestly puzzled at the people coming out of the woodwork to troll this post. What is driving these people and their abandonment of reason?
> Playing football is almost certainly bad for your brain
It's bad for you in general. I used to go a gym with some ex-NFL guys, and they literally could barely move most days. All of them told me they would never let their kids play football. Every single one had life long lasting ailments, and none of them were the guys who made millions.
It's bad for you in general. I used to go a gym with some ex-NFL guys, and they literally could barely move most days. All of them told me they would never let their kids play football. Every single one had life long lasting ailments, and none of them were the guys who made millions.
Minimum salary is $450,000$ / year and average career is 2.66 years. So most people are making at least 1 million today. https://www.si.com/nfl/2016/03/01/nfl-careers-shortened-two-...
The problem is not so much the NFL IMO, it's the 4 years of collage + 1-4 years of high school before that. Means most people get hurt without any real benefit.
The problem is not so much the NFL IMO, it's the 4 years of collage + 1-4 years of high school before that. Means most people get hurt without any real benefit.
Minimum salary increased relatively recently. About a decade ago you could find NFL benchwarmers on not much more than 50k.
For some context, it appears that the minimum salary in 2007 was $275k/year nominally ($325k/year inflation-adjusted) for rookies, increasing by $75k/year each year until the fifth.
My research suggests that the minimum salary first hit $50k/year nominally in 1988 (which is $100k/year inflation-adjusted). The minimum salary has always been at least $60k/year inflation-adjusted since the first collective bargaining agreement in 1968.
My research suggests that the minimum salary first hit $50k/year nominally in 1988 (which is $100k/year inflation-adjusted). The minimum salary has always been at least $60k/year inflation-adjusted since the first collective bargaining agreement in 1968.
Hrm. I remember looking up the minimum salaries about a decade or so ago and was surprised to see that they were so low. Maybe my source was out of date.
I was around an ex NFL player at a restaurant once and he also was having trouble walking already. In contrast I played tennis a few times with Trent Tucker after he retired from the Chicago Bulls, and he was still really athletic and could even beat good D1 tennis players.
9% chance, the best possible case given the current data, of a horrible, slow, lingering death 20 years later is still unacceptable. What's the rate for getting mesothelioma after working with asbestos?
I can't put together a simple number based on the papers I'm finding, especially if we're limited to mesothelioma. Cancer risks are reported in units of f/mL.yr (fibers per milliliter of air per year) or f/g (embedded fibers per gram of dry lung tissue). And there's a huge range to occupational exposure, which I'm not capable of relating back to the risk numbers. (I don't have the numerical skills.)
But suffice it to say that, surprisingly, AFAICT for even exceptionally heavy occupational exposure (e.g. mining asbestos or removing asbestos insulation) lifetime risks of developing mesothelioma seem to be well below 10%, and possibly even below 1%.
But suffice it to say that, surprisingly, AFAICT for even exceptionally heavy occupational exposure (e.g. mining asbestos or removing asbestos insulation) lifetime risks of developing mesothelioma seem to be well below 10%, and possibly even below 1%.
That's the modern risk, right? Taking into account all the things those professions do to mitigate the risk? If you've seen someone remove asbestos in the past 20 years, it's obviously not as if they're just wearing jeans and a t-shirt and hauling armloads of the stuff.
That's the risk deduced from the study of cohorts going back to at least mid-century. But it's specific to mesothelioma, not all cancers resulting from exposure. Mesothelioma seems to have a long lag time between exposure and presentation, suggesting to me that many of the cases being studied would relate back to exposure before modern occupational safety regulations.
Also, there are several kinds of asbestos fibers (broadly serpentine and amphibole), and the most lethal kind seem to be present typically as only a small fraction. Which makes it harder to relate risk (typically in units of f/mL.yr of a specific fiber type) to occupational exposures (often, AFAICT, in units of f/mL.yr of mixed fibers).
I suppose some of the horror stories about insane cancer incidences are from areas with peculiar asbestos deposits. Most of these studies I found were looking at averages of various cohorts (based on occupation, mix of fiber, etc), so wouldn't reflect those peculiar environments. Which I think is fair when comparing to CTE, otherwise you can cherry pick to exaggerate or minimize the relative harm of CTE. Ultimately there's a limit to the comparison.
But be skeptical. I'm gleaning this from some some quick Google searches and a superficial parsing of research papers, trying to create a 10,000' picture from claims and statements that are couched in very specific and narrow terms.
Also, there are several kinds of asbestos fibers (broadly serpentine and amphibole), and the most lethal kind seem to be present typically as only a small fraction. Which makes it harder to relate risk (typically in units of f/mL.yr of a specific fiber type) to occupational exposures (often, AFAICT, in units of f/mL.yr of mixed fibers).
I suppose some of the horror stories about insane cancer incidences are from areas with peculiar asbestos deposits. Most of these studies I found were looking at averages of various cohorts (based on occupation, mix of fiber, etc), so wouldn't reflect those peculiar environments. Which I think is fair when comparing to CTE, otherwise you can cherry pick to exaggerate or minimize the relative harm of CTE. Ultimately there's a limit to the comparison.
But be skeptical. I'm gleaning this from some some quick Google searches and a superficial parsing of research papers, trying to create a 10,000' picture from claims and statements that are couched in very specific and narrow terms.
Now we have ceramic wool which doesn't have regulations like asbestos does but is still a known carcinogen and the handling of it is done without any PPE.
Right, but the comparison being made here is between football and asbestos removal, which is a profession people have today.
The subtext was, "even asbestos removal has a lower risk of health problems than football".
But I think that comparison may be confounded by the fact that the modern asbestos removal profession is organized around safety. In other words, that asbestos removal is not a good comparison point for high-risk professions.
The subtext was, "even asbestos removal has a lower risk of health problems than football".
But I think that comparison may be confounded by the fact that the modern asbestos removal profession is organized around safety. In other words, that asbestos removal is not a good comparison point for high-risk professions.
I was specifically thinking about historical methods for asbestos installation. I don't know the numbers exactly. I know that modern methods for handling hazmats like asbestos are good enough that it's basically not a risk factor. However, I suspected, based on the lack of "My grandfather got X and died" stories, that even old-timey asbestos handling protocols did not have a particularly huge rate. A visible rate, yes, but not something like coal mining sans PPE, mercury, or tritium, where the occupation effectively guarantees your cause of death. I chose asbestos because it was the most visible example that came to mind of something that had a relatively low rate but that most people would agree needed to be shut down for the health and safety of the workers involved with it.
I'll note that the "lifetime risk" numbers in the first response are almost certainly historical. I'd expect the studies he's looking to have been published around the time modern handling standards were developed, and they may have even contributed to their implementation. The symptoms also take decades to manifest, so I'd expect modern rates to be good indicators of the safety of the industry circa 20-30 years ago and nearly useless for indicating modern standards. 50 years ago probably not, but 20 years is probably still good.
I'll note that the "lifetime risk" numbers in the first response are almost certainly historical. I'd expect the studies he's looking to have been published around the time modern handling standards were developed, and they may have even contributed to their implementation. The symptoms also take decades to manifest, so I'd expect modern rates to be good indicators of the safety of the industry circa 20-30 years ago and nearly useless for indicating modern standards. 50 years ago probably not, but 20 years is probably still good.
Everything is unacceptable nowadays. The word has lost meaning.
It's fine to inform someone of the risks. An informed society is better than a society that doesn't let you play football.
It's fine to inform someone of the risks. An informed society is better than a society that doesn't let you play football.
That's like saying an informed society is better than a society that doesn't have OSHA regulations... You can't dangle millions of dollars in front of (often poor, often minority) college students and say "well you were informed of the risks" and then wash your hands of all responsibility.
I could inform you that you'll die 1/6 times you play russian roulette, but that doesn't mean that it should be ethically sound (or legal) to pay you to take that chance.
I could inform you that you'll die 1/6 times you play russian roulette, but that doesn't mean that it should be ethically sound (or legal) to pay you to take that chance.
IIRC, the calculations from NASA says that for a trained individual, the value of a human life is around $50 million. 1/6 of that is $8.3 million.
It may be unethical to play russian roulette, but is it still unethical to choose to play if you were paid $8.3 million (given that much worth in utility) first? Why not?
On the other hand, mining for minerals also has risk. Miners in Australia are highly compensated for it, getting paid over $100,000 per year.
What difference is there between the scenarios, assuming everyone involved is fully informed?
It may be unethical to play russian roulette, but is it still unethical to choose to play if you were paid $8.3 million (given that much worth in utility) first? Why not?
On the other hand, mining for minerals also has risk. Miners in Australia are highly compensated for it, getting paid over $100,000 per year.
What difference is there between the scenarios, assuming everyone involved is fully informed?
I feel like it boils down to options a bit.
If I don't take the opportunity to work in Australian mines, will I have a reasonable opportunity to find work and provide a comfortable living for my family?
If that answer would change whether or not I'd work in a mine, I'd consider that the work may be exploitative of a regional work shortage. At that point someone might feel as though sacrificing their health is their only option, and an informed decision is much harder to make.
Like many ethical questions, it warrants discussion even though there may not be a "right" answer either way.
If I don't take the opportunity to work in Australian mines, will I have a reasonable opportunity to find work and provide a comfortable living for my family?
If that answer would change whether or not I'd work in a mine, I'd consider that the work may be exploitative of a regional work shortage. At that point someone might feel as though sacrificing their health is their only option, and an informed decision is much harder to make.
Like many ethical questions, it warrants discussion even though there may not be a "right" answer either way.
You're welcome to your opinion but I find it un-goddamned-American. This country was built on the ability to do risky things for a chance at a payout!
Everything is unacceptable nowadays.
Nothing is unacceptable. Except faulty generalizations like the above.
An informed society is better than a society that doesn't let you play football.
Is anyone here saying we shouldn't "let" people play football?
Nothing is unacceptable. Except faulty generalizations like the above.
An informed society is better than a society that doesn't let you play football.
Is anyone here saying we shouldn't "let" people play football?
>What's the rate for getting mesothelioma after working with asbestos?
That's a bad comparison. You don't just get a little bit of cancer. You get it or you don't and when it gets caught is what matters. Cognitive decline is not binary like that.
With asbestos it depends on how much exposure, how often and how long. PPE for use with high temperatures used to be asbestos before that was a liability. You don't see "served in an artillery unit in 'nam" on the TV commercials for the lawyers who litigate that stuff because only occasionally wearing asbestos gloves as part of your day job for a few years isn't a big deal. The same goes for doing brake jobs on your own vehicles since the '60s. It's not enough exposure. The advice for people who find it in their houses is to make sure it's not getting disturbed. Low levels of exposure = low risk. Sure, you can come up with an average decrease in life expectancy per some amount of exposure (this is popular with cigarettes) but it's not very meaningful when the result of the exposure to asbestos is a coin toss with worse odds years down the line.
Regardless, I'd take a slow death from age 45 to 65 if it meant that my family shot to the top of the economic ladder over the course of my career. Unless you really, really screw up wealth doesn't go away between generations.
That's a bad comparison. You don't just get a little bit of cancer. You get it or you don't and when it gets caught is what matters. Cognitive decline is not binary like that.
With asbestos it depends on how much exposure, how often and how long. PPE for use with high temperatures used to be asbestos before that was a liability. You don't see "served in an artillery unit in 'nam" on the TV commercials for the lawyers who litigate that stuff because only occasionally wearing asbestos gloves as part of your day job for a few years isn't a big deal. The same goes for doing brake jobs on your own vehicles since the '60s. It's not enough exposure. The advice for people who find it in their houses is to make sure it's not getting disturbed. Low levels of exposure = low risk. Sure, you can come up with an average decrease in life expectancy per some amount of exposure (this is popular with cigarettes) but it's not very meaningful when the result of the exposure to asbestos is a coin toss with worse odds years down the line.
Regardless, I'd take a slow death from age 45 to 65 if it meant that my family shot to the top of the economic ladder over the course of my career. Unless you really, really screw up wealth doesn't go away between generations.
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Unacceptable to whom? Is the US a free country or not?
Well, we already ban:
* Selling cigarettes to children
* Building buildings that burn to the ground with everyone trapped inside
* Murder
So... I guess that America isn't a free country? If everyone was a perfectly informed perfectly rational expectation maximizer we wouldn't have any of these problems. But since none of those things are true, there're all sorts of predatory and greedy-counterproductive practices that are, yes, unacceptable, things that we have to ban for our civilization to continue to improve. I submit that american football, in its current form, is likely one of them. Too much glamour, too much money, too much tradition, too good at messing with people's heads, both in the way it sucks everyone into it (high school football!) and with the brain damage thing.
* Selling cigarettes to children
* Building buildings that burn to the ground with everyone trapped inside
* Murder
So... I guess that America isn't a free country? If everyone was a perfectly informed perfectly rational expectation maximizer we wouldn't have any of these problems. But since none of those things are true, there're all sorts of predatory and greedy-counterproductive practices that are, yes, unacceptable, things that we have to ban for our civilization to continue to improve. I submit that american football, in its current form, is likely one of them. Too much glamour, too much money, too much tradition, too good at messing with people's heads, both in the way it sucks everyone into it (high school football!) and with the brain damage thing.
We don't ban selling cigarettes to adults, and tobacco use has plummeted since 1965. Building codes affect the general public. There is a clear and direct link between owner negligence and public harm. Building codes also help to reduce fraud and sheer incompetence among builders. It is easy to describe situations where fraud and criminal negligence leads to death and property damage to other people (not just yourself).
Meanwhile there are plenty of dangerous occupations, truck drivers, for example, that are not deemed unacceptable and banned by authoritarian morality police.
> If everyone was a perfectly informed perfectly rational expectation maximizer we wouldn't have any of these problems
This standard is hardly necessary. All that is necessary is to have sufficient information to take responsibility for decisions you make and their consequences. That is known as agency. Of course it's different if your decisions affect others. I could certainly see holding certain people or organizations (like the NFL) responsible if there has been some kind of cover-up about the long-term effects of concussions. But that's far different from a crude authoritarian ban.
> I submit that american football, in its current form, is likely one of them. Too much glamour, too much money, too much tradition, too good at messing with people's heads, both in the way it sucks everyone into it (high school football!) and with the brain damage thing.
In other words, you don't like football and you don't like the tradition, so you see no problem banning it. For you there's no downside, only upside.
No, banning is not necessary, at least not some kind of national ban issued from on high. It starts with education. Parents stop letting their children play Pop Warner. High schoolers in most of the country decide not to take the risks of playing football. HS football programs decline. College recruiting pools dry up, leading to a decline in the quality and popularity of College football. From there, it's anyone's guess how the NFL will survive.
Sure, it won't happen overnight. But I can assure you that the consequences of trying to issue an overnight ban of the most popular sport in the US would not be pretty.
Meanwhile there are plenty of dangerous occupations, truck drivers, for example, that are not deemed unacceptable and banned by authoritarian morality police.
> If everyone was a perfectly informed perfectly rational expectation maximizer we wouldn't have any of these problems
This standard is hardly necessary. All that is necessary is to have sufficient information to take responsibility for decisions you make and their consequences. That is known as agency. Of course it's different if your decisions affect others. I could certainly see holding certain people or organizations (like the NFL) responsible if there has been some kind of cover-up about the long-term effects of concussions. But that's far different from a crude authoritarian ban.
> I submit that american football, in its current form, is likely one of them. Too much glamour, too much money, too much tradition, too good at messing with people's heads, both in the way it sucks everyone into it (high school football!) and with the brain damage thing.
In other words, you don't like football and you don't like the tradition, so you see no problem banning it. For you there's no downside, only upside.
No, banning is not necessary, at least not some kind of national ban issued from on high. It starts with education. Parents stop letting their children play Pop Warner. High schoolers in most of the country decide not to take the risks of playing football. HS football programs decline. College recruiting pools dry up, leading to a decline in the quality and popularity of College football. From there, it's anyone's guess how the NFL will survive.
Sure, it won't happen overnight. But I can assure you that the consequences of trying to issue an overnight ban of the most popular sport in the US would not be pretty.
Parents, perhaps?
I've seen plenty of articles headlined with something along the line of "should my kid play football?" If you knew your kid would have a 10% chance of developing CTE by playing the sport... well, I would think many parents would pause and reconsider. Certainly I would.
It's still a free country. Football is nowhere near the state of being "banned" or anything close to that. Plenty of other sports with probable worse concussion issues are also popular (see: MMA)
American football's huge prominence merely puts a bigger spotlight on this issue. In my opinion, the most likely outcome is equipment and/or rules changes. American football has changed rules and/or mandated equipment in the name of safety before.
I've seen plenty of articles headlined with something along the line of "should my kid play football?" If you knew your kid would have a 10% chance of developing CTE by playing the sport... well, I would think many parents would pause and reconsider. Certainly I would.
It's still a free country. Football is nowhere near the state of being "banned" or anything close to that. Plenty of other sports with probable worse concussion issues are also popular (see: MMA)
American football's huge prominence merely puts a bigger spotlight on this issue. In my opinion, the most likely outcome is equipment and/or rules changes. American football has changed rules and/or mandated equipment in the name of safety before.
I thought this was pretty obvious. The OP was implying that it's comparatively unacceptable given what's happened for other professions.
Also, let's not forget that there's accusations of a cover up by the NFL.
Also, let's not forget that there's accusations of a cover up by the NFL.
What pure drivel. What does it mean to be a "free country"? Many things in the US are illegal. Does that mean we aren't "free"?
The pure drivel is this response. I strongly object to bland appeals to authority to shut down things you don't like. There are strong arguments associated with the banning of most illegal behavior. Usually these arguments are also very specific, lead to very specific restrictions, and are implemented at the most relevant jurisdiction.
I don't want football to be illegal. But I also want the NFL to own up to and be fully transparent and forthcoming about the risks of the sport.
For example, it would be great if there was a short message before each game is aired that said "the sport you are about to watch is know to cause X in players. X is an extremely painful and debilitating condition." Then play a short clip of patients suffering from X.
Similarly, anyone who wants to become a player should be required to watch such a video educating them about the risks.
For example, it would be great if there was a short message before each game is aired that said "the sport you are about to watch is know to cause X in players. X is an extremely painful and debilitating condition." Then play a short clip of patients suffering from X.
Similarly, anyone who wants to become a player should be required to watch such a video educating them about the risks.
I think that's still a bit heavy-handed, but it's much better than what the parent to my original comment had implied.
This response, "is the US a free country?" is a thought-terminating cliche.
It doesn't actually contribute to the discussion, it just derails it. "free country" is too vague to be meaningful; we have our freedoms curtailed in big and small ways all day every day. Wanna test this? Go ignore traffic lights. Go walk into someone else's house. Traffic laws and property rights are acceptable constraints on freedom, but they are still constraints on freedom.
Please, if you're going to contribute, make it a useful contribution.
It doesn't actually contribute to the discussion, it just derails it. "free country" is too vague to be meaningful; we have our freedoms curtailed in big and small ways all day every day. Wanna test this? Go ignore traffic lights. Go walk into someone else's house. Traffic laws and property rights are acceptable constraints on freedom, but they are still constraints on freedom.
Please, if you're going to contribute, make it a useful contribution.
It doesn't actually contribute to the discussion, it just derails it.
You did not quote my post in its entirety. Before the saying anything about the US being a free country, I asked a pointed, important question that the parent had left undefined. The OP glibly asserted that this was "unacceptable." I asked: "unacceptable to whom?" The glib question about US being a free country was rhetorical and intended to provide some context for interpreting the first, more important question.
In retrospect, I probably should have left it off, given that only one of six responses even attempted to address the more important question. It's no surprise that soundwave106's comment is far and away the most thoughtful and interesting response. (https://news.ycombinator.com/item?id=14851330.) I intended the 1st question to be literal and the 2nd question to be rhetorical. Instead everyone appears to have read the 2nd question to be literal and the 1st one to be rhetorical.
For a more detailed version of my own thoughts on the matter, feel free to review this follow-up: https://news.ycombinator.com/item?id=14851549
You did not quote my post in its entirety. Before the saying anything about the US being a free country, I asked a pointed, important question that the parent had left undefined. The OP glibly asserted that this was "unacceptable." I asked: "unacceptable to whom?" The glib question about US being a free country was rhetorical and intended to provide some context for interpreting the first, more important question.
In retrospect, I probably should have left it off, given that only one of six responses even attempted to address the more important question. It's no surprise that soundwave106's comment is far and away the most thoughtful and interesting response. (https://news.ycombinator.com/item?id=14851330.) I intended the 1st question to be literal and the 2nd question to be rhetorical. Instead everyone appears to have read the 2nd question to be literal and the 1st one to be rhetorical.
For a more detailed version of my own thoughts on the matter, feel free to review this follow-up: https://news.ycombinator.com/item?id=14851549
Football pays better than mesothelioma settlements.
Does it pay better than a career as a dockworker or insulation installer over the course of each career?
Did it when the people being impacted by CTE today played?
I think most people overestimate the career earnings of the average football player and especially don't discount for the dramatic increase in pay that happened in the last 20 years?
Did it when the people being impacted by CTE today played?
I think most people overestimate the career earnings of the average football player and especially don't discount for the dramatic increase in pay that happened in the last 20 years?
Or the fact that an overwhelming majority of football players don't ever collect a paycheck. It isn't like all of these NFL players just started receiving brain damage once they reached the NFL at the age of 22. They probably started playing football in their early teens. Odds are no one else on that player's middle or high school teams and only a hand full of people on their college team made the NFL. Yet they were all subject to the same type of head trauma.
Something like 6% of HS students play football. If 9% of them get CTE, that'd be a huge number of people.
Well presumably the risks are much less after 1-3 years vs 10+.
With that percentage - which is considered the unlikely minimum - there is at least one player developing CTE on the field for every team in the league right now.
I want to push back on the "every sport is dangerous" argument I'm seeing in here.
There's a difference between "you might die right in the middle of this very fun activity" and "you might die slowly and horribly years from now when you're retired and in the midst of raising a family."
I ski pretty aggressively, and of course I might die doing that. But every day I go home and know, "well it wasn't today! Today was just great clean fun." If I had a nagging thought of "but today might give me a mental disorder in 20 years" then I'd be much less inclined to participate in the sport.
There's a difference between "you might die right in the middle of this very fun activity" and "you might die slowly and horribly years from now when you're retired and in the midst of raising a family."
I ski pretty aggressively, and of course I might die doing that. But every day I go home and know, "well it wasn't today! Today was just great clean fun." If I had a nagging thought of "but today might give me a mental disorder in 20 years" then I'd be much less inclined to participate in the sport.
There's also a big difference between "you might die right in the middle of this very fun activity, here are the fatality stats from the past 30 years, here are the things you can do which are proven to reduce your risk" versus "this sport is Totally Safe, and to prove it we're going to resist every attempt to investigate long-term injuries so that you'll never really know."
Sports, as a fun hobby is one thing, but the article discusses the NFL; big business in and for the USA. Rather than say hey, this is hurting people, maybe we could change the rules some, the NFL is doubling down and is the one pushing the "all sports are dangerous" emotional narrative to mother's of children, in order to get them to play, all so they can pad their bottom line.
http://highline.huffingtonpost.com/articles/en/nfl-football-...
http://highline.huffingtonpost.com/articles/en/nfl-football-...
The study is about NFL players, but the harm starts in high school and college. Wait for more studies...
But you have absolutely no idea if aggressive skiing is giving you CTE because no one has ever looked to investigate it.
In football, as in boxing, the original investigation began because head trauma is obvious, but as the study broadened some of the worst cases of CTE were actually offensive linesmen. These are generally not the players who dish or receive hard hits, and many had never had a suspected concussion in their career. That led to the dominant theory that it isn't concussions -- the big hits -- that are the main cause of CTE, but instead many small traumas (in that case the o-line engaging with the d-line) that add up to CTE.
There is every reason to suspect that many other sports yield these sorts of recurring sub trauma, and aggressive skiing seems a probable candidate [edit - note that it does not require that you hit your head, have an accident, etc. If enough of a high-G event is transmitted to the brain, that can be a subconcussion]. It just isn't terribly common to do an intensive brain study of people after death to find these correlations.
In football, as in boxing, the original investigation began because head trauma is obvious, but as the study broadened some of the worst cases of CTE were actually offensive linesmen. These are generally not the players who dish or receive hard hits, and many had never had a suspected concussion in their career. That led to the dominant theory that it isn't concussions -- the big hits -- that are the main cause of CTE, but instead many small traumas (in that case the o-line engaging with the d-line) that add up to CTE.
There is every reason to suspect that many other sports yield these sorts of recurring sub trauma, and aggressive skiing seems a probable candidate [edit - note that it does not require that you hit your head, have an accident, etc. If enough of a high-G event is transmitted to the brain, that can be a subconcussion]. It just isn't terribly common to do an intensive brain study of people after death to find these correlations.
I don't think this comparison stands up, at least not for most reasonable interpretations of "aggressive skiing". It might not involve any crashes at all.
I think there's a fair distinction to be drawn between sports that might cause head trauma if you make a mistake, and sports in which head trauma is practically the defining characteristic (see also: boxing). I am three weeks away from having a son, and while I've got some years, I'll eventually have to make some decisions about what activities I want to encourage and discourage. It at least seems possible to learn to ski without repeatedly bashing your head. Not so for football.
I think there's a fair distinction to be drawn between sports that might cause head trauma if you make a mistake, and sports in which head trauma is practically the defining characteristic (see also: boxing). I am three weeks away from having a son, and while I've got some years, I'll eventually have to make some decisions about what activities I want to encourage and discourage. It at least seems possible to learn to ski without repeatedly bashing your head. Not so for football.
I don't know about GP, but I'm an aggressive skier and very, very rarely hit my head. I have maybe a dozen falls a season, wear a helmet and am not colliding with anything. This is a silly comparison.
It's sort of silly but it's sort of not. The evidence suggests that a few really big hits doesn't do it, it's repeated medium sized head traumas that does. (ie: it happens to line men more frequently out of footballers) Quantifying the size of that head trauma is really key. Does it have to be a "hit?" I mean repeatedly hitting mogul runs put shock on your whole body, you may not hit your head but you're absorbing that up and down shock and moving side to side fairly abruptly; more so that you do just running around and your brain absolutely experiences some amount of that. Age might have a factor too, age when this trauma or shock happen.
I ski and snowboard and I'm not planning on stopping, I think the benefits outweigh the risks. I'd say that about most sports but I'm not about to let either of my kids play football or box.
We need to study this stuff a lot more.
I ski and snowboard and I'm not planning on stopping, I think the benefits outweigh the risks. I'd say that about most sports but I'm not about to let either of my kids play football or box.
We need to study this stuff a lot more.
A sub-concussion doesn't require that you hit your head. It simply requires a g-force event -- like skiing quickly over rough terrain -- that shakes the brain around, building up the scar tissue that we know as CTE. Offensive linesmen engage with the opponent via their body/arms, seldom hitting with their head, but that rapid g-force of the body stopping is enough.
Again, someone studied football players because the impact is obvious. As it reaches out, players in even relatively low-g sports like soccer are being found with CTE.
Again, someone studied football players because the impact is obvious. As it reaches out, players in even relatively low-g sports like soccer are being found with CTE.
Having played the game for years, I can assure you the impact being generated on the line is very real. These folks do interact with their body/arms, but head on head contact is a very real part of the game, and that is the part that really affects the brain.
And the part of soccer that seems to cause concern is heading the ball, not the running around part.
Comparing helmet to helmet impacts to skiing over rough terrain feels like a real stretch here.
And the part of soccer that seems to cause concern is heading the ball, not the running around part.
Comparing helmet to helmet impacts to skiing over rough terrain feels like a real stretch here.
And the part of soccer that seems to cause concern is heading the ball
But we don't know what the concern is in soccer. Heading is immediately looked at because it's an impact, but the actual cause may be something altogether different.
I mentioned the g forces measured in skiing elsewhere. They are absolutely in the range of subconcussion.
But we don't know what the concern is in soccer. Heading is immediately looked at because it's an impact, but the actual cause may be something altogether different.
I mentioned the g forces measured in skiing elsewhere. They are absolutely in the range of subconcussion.
Maybe the aggressive compressions of slalom cause the brain to bounce around a bit? In any case, I'm sure it's much less than the sudden stops caused by running into a 300 pound lineman.
The Earth weighs a good deal more than a 300lb lineman, and it's the Earth that skiiers are repeatedly running into while carrying an enormous amount of inertia.
Have you ever been skiing? It's your feet that are running into the earth, and hardly even that - they're skating smoothly over it unless you really mess up. On good mogul run,your head hardly moves off a straight line while your legs and hips adjust to keep your skis moving smoothly. In a similar comparison, walking does not produce head trauma.
I've been skiing plenty of times. Runs where I'm at a high rate of speed and hitting countless variation changes (not moguls, just normal skiing) and my head is shaking so much that my vision is blurry. Landing a jump at best (when you absorb with your legs) is a 19G+ event. Every minor mistake in absorbing can tenfold increase that. Walking is not a relevant comparison.
We evolved to walk with a limited brain suspension that just wasn't adapted for 100kph wax shoe runs.
We evolved to walk with a limited brain suspension that just wasn't adapted for 100kph wax shoe runs.
That's the forward component of the velocity vs the component that's normal to the ground, though - the collision with the Earth is much lower speed than the lateral motion (sliding along the surface after the fall). If you're skiing aggressively, you're frequently quite close to the ground, and a fall is frequently where you end up grazing it because you lean further than the centripital force can maintain. You fall a much shorter distance toward the Earth than a timid skier does.
If you're skiing at the level I'm talking about, falls are probably not that frequent, though.
In my earlier comment I was talking more about the explosive vertical compression-expansion cycle that characterizes skiing really hard with very tight turns on short radius skis. Those are much less violent than hitting a lineman though.
If you're skiing at the level I'm talking about, falls are probably not that frequent, though.
In my earlier comment I was talking more about the explosive vertical compression-expansion cycle that characterizes skiing really hard with very tight turns on short radius skis. Those are much less violent than hitting a lineman though.
> But you have absolutely no idea if aggressive skiing is giving you CTE
Where are you skiing that results in you receiving repeated blows to your head?
The comparison doesn't hold up at all, and OP's original point still stands against yours.
Where are you skiing that results in you receiving repeated blows to your head?
The comparison doesn't hold up at all, and OP's original point still stands against yours.
In an edit to the original comment -- an edit that shouldn't even be necessary -- I made it painfully clear quite some time ago that it has positively nothing to do with "blows to the head". Yet still people keeps rushing to post these noise replies.
... except "Blows to the head" has everything to do with this from the article to OP's point.
When you have a number of HN commenters correcting you, it's not them it's you.
When you have a number of HN commenters correcting you, it's not them it's you.
endorphone(1)
Multiple people in one place can still be completely wrong. Concussive events are what matter when it comes to CTE; many of them occur without physical contact to the head just as impacts to the skull may not have concussive effects on the brain. What matters is sudden acceleration, not contact to the head.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995699/
[2] http://www.uwhealth.org/sports-medicine/clinic/concussion/11...
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995699/
[2] http://www.uwhealth.org/sports-medicine/clinic/concussion/11...
It's even worse when it's "you will die slowly and horribly years from now", which is what football is starting to look like. There's no "risk"; you're just storing up your consequences for later.
Well, at least of nearly all the dead NFL players whose families suspected they had CTE, they did. As noted in the article, "there’s a tremendous selection bias".
Hm, is it true that everyone with CTE dies "horribly"? I think that might be overstating things a bit.
Not every single person with CTE dies horribly. As I understand it, some simply live decades happily forgetting their children's names and what day of the week it is.
This is currently happening to my grandfather. He played football most of his life and up through adulthood for the Philadelphia Eagles before leaving the sport to pursue his passion for flying (eventually becoming a captain for Delta).
He's had a charmed life. Lots of great experiences, like a real-life Tom Sawyer or Huck Finn, and the stories to go along with them.
Now's he battling (and losing) with the late-stage effects of dozens of concussions, which is manifesting itself as severe short-term memory loss, increasingly poor long-term recall, and eventually the inevitable situation where he doesn't recognize his own children, only grandchild, and only great grandchild. My father also played football most of his life (but not at the same level), and I'm concerned the same thing will eventually happen to him.
I'm very thankful to have had my grandfather in my life for so long (I'm now 37), and I have so many really wonderful memories and experiences that I can attribute to him (sitting in the cockpit of a 727 as a toddler, flying in the family little Piper Cub, countless lovely tailgate parties, a huge loving extended family of his long-time friends, etc), and I want to make sure that in the short window that's left where he's able to be at-least present in the moment that myself and my young son spend ample time with him.
It's difficult to watch the decline, but I can't imagine how difficult it must be for him to be living it.
He's had a charmed life. Lots of great experiences, like a real-life Tom Sawyer or Huck Finn, and the stories to go along with them.
Now's he battling (and losing) with the late-stage effects of dozens of concussions, which is manifesting itself as severe short-term memory loss, increasingly poor long-term recall, and eventually the inevitable situation where he doesn't recognize his own children, only grandchild, and only great grandchild. My father also played football most of his life (but not at the same level), and I'm concerned the same thing will eventually happen to him.
I'm very thankful to have had my grandfather in my life for so long (I'm now 37), and I have so many really wonderful memories and experiences that I can attribute to him (sitting in the cockpit of a 727 as a toddler, flying in the family little Piper Cub, countless lovely tailgate parties, a huge loving extended family of his long-time friends, etc), and I want to make sure that in the short window that's left where he's able to be at-least present in the moment that myself and my young son spend ample time with him.
It's difficult to watch the decline, but I can't imagine how difficult it must be for him to be living it.
I'm basically your age and my grandmother passed away from Alzheimers almost 10 years ago. It was another 5 before that when she last recognized anyone in our family. She neither played football nor had any history of concussion that any of us are aware of.
The point being, from what I've seen on the subject, there's no way to diagnose CTE until the patient has passed away and you can slice open their brain. It's possible that your grandfather's symptoms are related to his concussions, but it's also very possible that it would have happened anyways. CTE usually manifests 8-10 years after these brain injuries and has a lot of symptoms beyond the dementia you list, so it could be garden-variety Alzheimers.
Regardless, you have my sympathies. Alzheimers-type dementia is truly a terrible way to lose a loved one. The anti-climactic nature of it makes it really difficult to get closure in the way that you do when someone's death is more abrupt. Instead, they slowly fade away in the "boiled frog" fashion and you're left at whatever funeral you end up having realizing that they died a long time before their body expired and you never got to grieve. Be sure that you're intentional in remembering the person he used to be and don't let the empty shell of a person that exists now replace that in your memory. I didn't do that enough and it made grieving for my grandmother very difficult.
If there's a silver lining to my story, my mother is now past the age when her mother was diagnosed with Alzheimers and is, thus far, not showing signs of the disease. Given some of the research that's tying Alzheimers to particulate air pollution, I'm hopeful that the strides made by the EPA and others in reducing our air pollution will mean that she won't have to go through that ordeal and I won't have to lose her the way I lost my grandmother. If your dad is more than a decade past his football-playing days and symptoms haven't shown up, there's a good chance that he won't either.
The point being, from what I've seen on the subject, there's no way to diagnose CTE until the patient has passed away and you can slice open their brain. It's possible that your grandfather's symptoms are related to his concussions, but it's also very possible that it would have happened anyways. CTE usually manifests 8-10 years after these brain injuries and has a lot of symptoms beyond the dementia you list, so it could be garden-variety Alzheimers.
Regardless, you have my sympathies. Alzheimers-type dementia is truly a terrible way to lose a loved one. The anti-climactic nature of it makes it really difficult to get closure in the way that you do when someone's death is more abrupt. Instead, they slowly fade away in the "boiled frog" fashion and you're left at whatever funeral you end up having realizing that they died a long time before their body expired and you never got to grieve. Be sure that you're intentional in remembering the person he used to be and don't let the empty shell of a person that exists now replace that in your memory. I didn't do that enough and it made grieving for my grandmother very difficult.
If there's a silver lining to my story, my mother is now past the age when her mother was diagnosed with Alzheimers and is, thus far, not showing signs of the disease. Given some of the research that's tying Alzheimers to particulate air pollution, I'm hopeful that the strides made by the EPA and others in reducing our air pollution will mean that she won't have to go through that ordeal and I won't have to lose her the way I lost my grandmother. If your dad is more than a decade past his football-playing days and symptoms haven't shown up, there's a good chance that he won't either.
In my opinion, the most horrible death is the one where someone else starts living in your body, and no one is even aware that you have gone.
Senile dementia, Alzheimers, brain cancers, and TBI frighten me even more than being flung 100m across the pavement in an automobile accident, or getting dragged into the gap by a commuter train. With those, you know you're dead, and so does everyone else. When you slowly lose your mind, no one can ever really be sure when you stopped being you, not even yourself.
Senile dementia, Alzheimers, brain cancers, and TBI frighten me even more than being flung 100m across the pavement in an automobile accident, or getting dragged into the gap by a commuter train. With those, you know you're dead, and so does everyone else. When you slowly lose your mind, no one can ever really be sure when you stopped being you, not even yourself.
Is that really best-case scenario? So you're saying that among the retired football players who do TV today, Terry Bradshaw, Howie Long, Michael Strahan, Cris Collinsworth, etc. 90% of these players have CTE and will have decades-long dementia? So for the older players we should start seeing that very soon, no?
I'm being a little tongue-in-cheek, of course.
The article implies a selection bias -- that the actual number of football players with CTE could be as low as 9%. It also notes cases where CTE effects really become "horrible" much later in life, for men who are older than the guys you list.
Guys who self-select to be television personalities also might have a lower incidence of CTE. There's also a chance that some odd behavior on TV will be interpreted as "quirky" or "goofy" and not "experiencing brain damage."
At any rate... Of course the answer is: No, not everyone with CTE dies "horribly." But it's seeming increasingly likely that CTE can have major unexpected consequences on the later lives of football players. And the worst case scenario of CTE (Junior Seau, Jovan Belcher) is exceptionally horrible and exceptionally tragic.
The article implies a selection bias -- that the actual number of football players with CTE could be as low as 9%. It also notes cases where CTE effects really become "horrible" much later in life, for men who are older than the guys you list.
Guys who self-select to be television personalities also might have a lower incidence of CTE. There's also a chance that some odd behavior on TV will be interpreted as "quirky" or "goofy" and not "experiencing brain damage."
At any rate... Of course the answer is: No, not everyone with CTE dies "horribly." But it's seeming increasingly likely that CTE can have major unexpected consequences on the later lives of football players. And the worst case scenario of CTE (Junior Seau, Jovan Belcher) is exceptionally horrible and exceptionally tragic.
> as low as 9%
Which is still disgustingly high.
Which is still disgustingly high.
Thanks for the reply. This is what I'm trying to understand myself. I didn't see the 9% number in the article. I did see the mention about selection bias. So I wonder what the true numbers are here. If it's 9% then that explains well enough why so many ex-players don't show strong signs of CTE (by strong I mean long-term memory loss or worse).
The 9% is assuming that 100% of unknown cases are in fact negative.
This study showed that 110 of 111 players tested had CTE. But many of their families consented because they suspected CTE already, so it's not a random sample and therefore you can't generalize that to the rest of the population. 110 is 9% of the population of 1300 deceased players for the given time period. CTE is normally extremely rare.
This study showed that 110 of 111 players tested had CTE. But many of their families consented because they suspected CTE already, so it's not a random sample and therefore you can't generalize that to the rest of the population. 110 is 9% of the population of 1300 deceased players for the given time period. CTE is normally extremely rare.
Why is the total population deceased players and not all players?
The only test for it requires dissection of the brain
because you can't test the living ones
How do you know we aren't seeing the slow onset of dementia for some of these guys? Isn't the whole schtick with Bradshaw that he's a "little off in the head"?
I don't think that it's fair to look at these former players that go into broadcasting and "diagnose" them in anyway. We don't see inside the private lives of these guys and we don't know what struggles they may or may not live with everyday.
I don't think that it's fair to look at these former players that go into broadcasting and "diagnose" them in anyway. We don't see inside the private lives of these guys and we don't know what struggles they may or may not live with everyday.
I think you are misinterpreting my posts. I'm just trying to make sense of all of this, myself. This report is eye opening to me and I just don't understand it. I understand and accept that the CTE rate for football players is quite high.
What I don't understand is what that means exactly. Are there degrees of CTE? Might some of these players have CTE but hardly ever show much of a symptom in their lives? Or is everyone, as the people who I was responding to suggested, doomed to some sort of dementia where they forget who they are their families are? And if that's the case, shouldn't we see this more often among ex-players who are still in the public? Or are the former players who take these jobs all in the 10% that don't get CTE? Just trying to make sense of the conflicting data here.
What I don't understand is what that means exactly. Are there degrees of CTE? Might some of these players have CTE but hardly ever show much of a symptom in their lives? Or is everyone, as the people who I was responding to suggested, doomed to some sort of dementia where they forget who they are their families are? And if that's the case, shouldn't we see this more often among ex-players who are still in the public? Or are the former players who take these jobs all in the 10% that don't get CTE? Just trying to make sense of the conflicting data here.
Yes, this is why the "but many other things are dangerous and people do them knowing full well that [...]"
Of course the problem is that you can go half a life time doing this thing, and then it sneaks up on you and there's no reversing the damage. The danger isn't presented as clear or present as with anti-smoking messaging, or with something like solo free climbing which needs no warning.
Of course the problem is that you can go half a life time doing this thing, and then it sneaks up on you and there's no reversing the damage. The danger isn't presented as clear or present as with anti-smoking messaging, or with something like solo free climbing which needs no warning.
It seems likely that some activities are orders of magnitude more dangerous than others for CTE.
Maybe you'd rather your kid play football or learn boxing than lay on the couch. If the risk is 10x that of baseball, and 50x that of track and field, however, you might steer them to different activities.
Maybe you'd rather your kid play football or learn boxing than lay on the couch. If the risk is 10x that of baseball, and 50x that of track and field, however, you might steer them to different activities.
> I ski and snowboard and I'm not planning on stopping, I think the benefits outweigh the risks. I'd say that about most sports but I'm not about to let either of my kids play football or box.
That's interesting because the accidental insurance (that I took out during the football years) had separate premiums for skiers and snowboarders. The most serious concussion that I ever got was from snowboarding.
> There's a difference between "you might die right in the middle of this very fun activity" and "you might die slowly and horribly years from now when you're retired and in the midst of raising a family."
It's kinda arbitrary to draw these lines of "my dangerous sport is superior to your dangerous sport." It's all risks and benefits. Skiing/snowboarding is pretty dangerous for catastrophic accidents AND it still has a high concussion rate.
0.37 = American football concussion rate per 1,000 athletic exposures
0.2 = Skiing/snowboarding closed head injury rate per 1,000 mountain visits
You're not incredibly far behind football in terms of risk, my friend.
That's interesting because the accidental insurance (that I took out during the football years) had separate premiums for skiers and snowboarders. The most serious concussion that I ever got was from snowboarding.
> There's a difference between "you might die right in the middle of this very fun activity" and "you might die slowly and horribly years from now when you're retired and in the midst of raising a family."
It's kinda arbitrary to draw these lines of "my dangerous sport is superior to your dangerous sport." It's all risks and benefits. Skiing/snowboarding is pretty dangerous for catastrophic accidents AND it still has a high concussion rate.
0.37 = American football concussion rate per 1,000 athletic exposures
0.2 = Skiing/snowboarding closed head injury rate per 1,000 mountain visits
You're not incredibly far behind football in terms of risk, my friend.
>"but today might give me a mental disorder in 20 years" then I'd be much less inclined to participate in the sport.
what if you were paid millions of dollars to do it and treated as a living god? i think a lot of people would still take that deal even knowing the risks.
what if you were paid millions of dollars to do it and treated as a living god? i think a lot of people would still take that deal even knowing the risks.
Most serious football players never get paid millions of dollars, or are treated like a living god. They do get the injuries, though.
very well said
I think people take for granted now how good the Times is at these interactive, zine-like layouts for their feature articles. I just want to say another job well done on this one. Each one of these I see is a work of art that clearly took a lot of time across the team.
You can tell there are many devs and designers on their team that take pride in their work! Have you seen those articles that say, "guess what the rate is for X over the years", and you fill out the graph with your mouse, and once you are done you can see what the actual data looks like? It's refreshing
I guess to each their own. I found it unnecessarily difficult to read the grey text on black background. It always seems strange to only use a 30% of a monitor for the main content and fill the rest with pictures.
Yeah, at one point I stumbled upon the portfolio of a dev who does their interactive content and loved it.
I have so much appreciation for people who have a good sense for design that is intuitive/effortless for the user. Especially in this case, when it means cutting the learning curve that a user experiences when they are presented with a bunch of new data.
I have so much appreciation for people who have a good sense for design that is intuitive/effortless for the user. Especially in this case, when it means cutting the learning curve that a user experiences when they are presented with a bunch of new data.
It only loads the first paragraph on my Nexus, and desktop mode on Nexus shows just a bunch of icons.
My dad played both college and professional football. He had early signs of dementia 15 years ago, but it became really bad about 10 years ago. After a long struggle, he died just earlier this year.
It's hard to deal with
It's hard to deal with
How old was he when the early signs began?
It was just this past week that was reading up on Alzheimer's and texted my brothers (all of us played football) that I'm glad we all stopped when we did. I think there are twenty-six cumulative football-years between us, all on the line too.
That being said, football is football. After seven seasons I knew my IQ had dropped some points. But if I could go back in time, I'd do it all over again. What I would give for just one more play. When people say football will eventually become this archaic sport because of the risks, I just laugh.
Head injury concerns are the single reason I am not playing right now. I've had a good run, but it's important to know when to stop and prioritize the latter half of your life.
That being said, football is football. After seven seasons I knew my IQ had dropped some points. But if I could go back in time, I'd do it all over again. What I would give for just one more play. When people say football will eventually become this archaic sport because of the risks, I just laugh.
Head injury concerns are the single reason I am not playing right now. I've had a good run, but it's important to know when to stop and prioritize the latter half of your life.
(N of 1 anecdote warning)
I started playing football at 6 years old. Tackle football came about two years later. In my junior year of high school, my back problems and knee problems were so bad, I had to quit. It was the best day of my life. In recent years, I've become an ultrarunner and am generally very healthy.
I'm 41 now and about 5 years ago, I passed out after cutting my hand (vagal response to the sight of my blood) and suffered a 10 minute long seizure after passing out. So, I spent the next few days doing EEGs and MRIs on my noggin.
There was nothing definite but the neurologist noticed some lesions on my brain in various places. First thing he asks me, "Did you play football as a child?" I said yes, and he said, "You should have an MRI at least every 5 years to see if these things get any bigger."
Recently, my memory has gotten worse. I've found myself rocking or nodding my head for no discernible reason. Control over my lower legs is variable. As a runner, I'm fairly in tune with my body. I can tell that things are not going as they should.
Who knows if I'll get CTE (or some other neurological problem) and if I do, if it's related to the 10 years of football I played. What I do know is that this experience is not one I'd want my children to have when it's most decidedly not necessary.
All that to say that there might be a LOT of people like me in the US who never even got close to college football or the NFL that could potentially suffer this same fate.
I started playing football at 6 years old. Tackle football came about two years later. In my junior year of high school, my back problems and knee problems were so bad, I had to quit. It was the best day of my life. In recent years, I've become an ultrarunner and am generally very healthy.
I'm 41 now and about 5 years ago, I passed out after cutting my hand (vagal response to the sight of my blood) and suffered a 10 minute long seizure after passing out. So, I spent the next few days doing EEGs and MRIs on my noggin.
There was nothing definite but the neurologist noticed some lesions on my brain in various places. First thing he asks me, "Did you play football as a child?" I said yes, and he said, "You should have an MRI at least every 5 years to see if these things get any bigger."
Recently, my memory has gotten worse. I've found myself rocking or nodding my head for no discernible reason. Control over my lower legs is variable. As a runner, I'm fairly in tune with my body. I can tell that things are not going as they should.
Who knows if I'll get CTE (or some other neurological problem) and if I do, if it's related to the 10 years of football I played. What I do know is that this experience is not one I'd want my children to have when it's most decidedly not necessary.
All that to say that there might be a LOT of people like me in the US who never even got close to college football or the NFL that could potentially suffer this same fate.
Has helmet technology improved in the last 25 years? It will be a few years before my son could play tackle football (and I would probably try to gently steer him towards real football), but the helmets I see at sporting goods stores today look pretty much indiscernible from that which I wore for one fall season in the early 2000s.
Helmet technology has improved but not at the rate that humans have improved weightlifting/training. You've got bigger people running faster into collisions (and as we all know, momentum = mass * velocity).
Perhaps to reduce injury of the head, force all players to wear no padding except for a helmet.
It will change the dynamics but if you do something crazy to tackle someone, you too will get badly hurt.
It will change the dynamics but if you do something crazy to tackle someone, you too will get badly hurt.
"better helmets" only mean you take bigger internal hits.
There's always been the possibility of selection bias in finding CTE in football players' brains. Many of the brains are studied at the request of the family of the deceased player, presumably because they had noticed symptoms of mental degeneration. And there are cases where the player themselves requested the scans in their will. Junior Seau didn't leave behind a suicide note, but he did kill himself in a way that left his brain physically intact.
The NYT piece notes that even if none of the other ~1,300 NFL players (who have since died since this research began) have brains affected by CTE, "the minimum C.T.E. prevalence would be close to 9 percent, vastly higher than in the general population.".
The NYT piece notes that even if none of the other ~1,300 NFL players (who have since died since this research began) have brains affected by CTE, "the minimum C.T.E. prevalence would be close to 9 percent, vastly higher than in the general population.".
Isn't that still selection bias? Presumably CTE sufferers have a higher risk of dying — their healthy peers may still be alive and thus not included in that 1,300.
From 1960-2013 there were about 23,000 players[1]. I don't know much about the growth of the NFL over time, let's say there were 30,000 ever.
[1] https://opendata.stackexchange.com/questions/5875/get-season...
[1] https://opendata.stackexchange.com/questions/5875/get-season...
The NFL isn't a 10 years old league, there's plenty of players who passed away. If anything there would be more examples since equipment was worse before and there were less rules that protected players, especially top/crown helmet leading tackles which started getting penalized with 15yd only in 2013.
I think the prevalence of concussions in football compared to rugby is proof that "better equipment" doesn't prevent concussions. It has the paradoxical effect of causing them. Better shoulder pads allow for people to launch their bodies without fear of separating their shoulders. Conversely, helmets are not designed to protect the brain, only to prevent skull fractures. Thus, I don't think your argument holds water.
You are right about the equipment (even though obviously only concussion vs concussion + skull fracture is a step forward!), but the difference between football and rugby goes way beyond the equipment. In the former there's no lateral passing, which means that the ball carrier will always be a target for the whole defense. In rugby you can pass the ball, which makes the defense spread wider and doesn't allow them to overcommit to a single player/tackle.
Precisely. In rugby, it is much more stressed and emphasized to make secure tackles.
In football, at any given point and time there is one person with virtually a huge bullseye on them and it is sometimes a valid tactic to lay down a more punishing hit (cause a fumble, make a statement, scare your opponent to make a mistake or drop the ball next time, etc) at the expensive of not making a "secure, form tackle"
Ironically, if I am remembering correctly, the Seahawks and coach Pete Carroll teach more of a "rugby" style tackle, and that's why they consistently have one of the best tackling defenses.
In football, at any given point and time there is one person with virtually a huge bullseye on them and it is sometimes a valid tactic to lay down a more punishing hit (cause a fumble, make a statement, scare your opponent to make a mistake or drop the ball next time, etc) at the expensive of not making a "secure, form tackle"
Ironically, if I am remembering correctly, the Seahawks and coach Pete Carroll teach more of a "rugby" style tackle, and that's why they consistently have one of the best tackling defenses.
I've played both sports, can verify this is 100% correct. Couple other notes.
Football is a game of inches. There is huge incentive to slam someone as hard as you can to stop their forward progress and ultimately deny the first down. There's incentive for the ball carrier fight for the inches and "fall forward" (which makes your head more vulnerable). In rugby you don't care about fighting for the inches and hell, your teammates will shove you down once they're set up to ruck over you. Fighting for inches in rugby is a quick way to start a maul and nobody wants a maul.
Furthermore, football is played with greater momentum (mass * velocity). Those breaks between plays equates to six seconds of full blown sprinting followed by forty seconds of rest. In rugby you're running about constantly so you simply don't have the energy most of the time for those massive hits. As for the mass side of the equation, football players are on average bigger than ruggers.
People think rugby is so hardcore for playing without pads (and it still is) but the hardest hits I ever took were in football (and I played defense, for goodness sakes). This is the consensus between everyone I've met that's played both. You can play multiple rugby games in a weekend (happens all the time at fests) but more than one football game a week is unsustainable.
Football is a game of inches. There is huge incentive to slam someone as hard as you can to stop their forward progress and ultimately deny the first down. There's incentive for the ball carrier fight for the inches and "fall forward" (which makes your head more vulnerable). In rugby you don't care about fighting for the inches and hell, your teammates will shove you down once they're set up to ruck over you. Fighting for inches in rugby is a quick way to start a maul and nobody wants a maul.
Furthermore, football is played with greater momentum (mass * velocity). Those breaks between plays equates to six seconds of full blown sprinting followed by forty seconds of rest. In rugby you're running about constantly so you simply don't have the energy most of the time for those massive hits. As for the mass side of the equation, football players are on average bigger than ruggers.
People think rugby is so hardcore for playing without pads (and it still is) but the hardest hits I ever took were in football (and I played defense, for goodness sakes). This is the consensus between everyone I've met that's played both. You can play multiple rugby games in a weekend (happens all the time at fests) but more than one football game a week is unsustainable.
Football does have lateral passing, but yes, tactically it is much rarer.
It exists technically but it doesn't in practice, there's probably 15-20 lateral passes per season (I'd say 0 before the 4th unless it's garbage time and there's some trick plays happening on a punt return) vs hundreds of thousands of plays.
Similar to how boxing gloves don't protect the punched as much as it allows the puncher to go full throttle without fear of breaking their hands: https://www.economist.com/news/international/21639765-bare-k...
Same with headgear- it's there to prevent cuts, not to cushion blows, but some people feel safer wearing headgear to spar in boxing.
In my experience it makes my head a larger target than I'm used to, plus it affects my peripheral vision, making me take more shots to the head than I would have otherwise.
Plus, put on some headgear, let me punch you, and tell me how cushioned you felt.
In my experience it makes my head a larger target than I'm used to, plus it affects my peripheral vision, making me take more shots to the head than I would have otherwise.
Plus, put on some headgear, let me punch you, and tell me how cushioned you felt.
Won't the headgear just make your head a larger target to glancing blows, not the big direct hits?
Also, the worst part of the headgear, in my opinion, is I find it way harder to breath when it's on and I can confirm that I've felt punch drunk up to an hour or two after catching a bad direct hit while sparing with headgear.
Also, the worst part of the headgear, in my opinion, is I find it way harder to breath when it's on and I can confirm that I've felt punch drunk up to an hour or two after catching a bad direct hit while sparing with headgear.
Its not the equipment thats the difference, its the rules, even the craziest/biggest rugby player couldnt "hit" (launching shoulder first from your comment) like they do in football, because its illegal, they must make wrapping tackles according to the rules. These can still be devestating tackles but nothing like the impact in football tackles, especially when players are prone to hits without seeing them.
Also you dont have these monsters continually running full speed and colliding to make blocks because blocking is also illegal in rugby.
Also you dont have these monsters continually running full speed and colliding to make blocks because blocking is also illegal in rugby.
I would be careful here. The prevalence of CTE in former rugby players is unknown but there have been documented cases. This is all pretty new ground and we may be surprised to find that rugby poses similarly unconscionable risks.
Historians will look back at American Football as our analog to the Roman's gladiatorial games. A lot of people don't realize that during the Imperial era of Rome fights to the death had become uncommon.[0] The games were watched in an arena and primarily sold hard-hitting violence between members of the lower castes of society and sometimes people got killed or horribly maimed....sound familiar? I stopped watching American football last year once I could no longer consciously watch men destroy themselves for money and the amusement of a country that largely despises/fears them in any other setting.
0: https://en.wikipedia.org/wiki/Gladiator#Victory_and_defeat
0: https://en.wikipedia.org/wiki/Gladiator#Victory_and_defeat
Honestly (as a former football player) I find this opinion to reek of pseudo-academic snobbery. You know why football is such a popular sport? Because people love football. More importantly, people love playing football. I understand that not everyone sees the appeal of the sport and it's their right to have their own preferences. But to simply dismiss the passionate pursuits of hundreds of thousands of players across the globe as some engineered gladiator battle by the upper class is absurd. There was football before there was television. If the NFL shut down tomorrow and televised broadcasts were banned, there would still be football. You can condemn the exploitation of players' health in the NFL without creating these gross overgeneralizations of the sport.
Moreover I think it's offensive to imply football is this caste regime as if the rich people are watching the poor people play. Football pervades all income levels. Your rich prep high schools still have a football team. Ivy league schools still have football teams. If anything it is an equalizer because your rich suburban prep school guy lines up next to a dude that grew up in the inner city all the same. And their standing in the team, along with compensation, will be dependent on their performance as opposed to race or economic background. Where else in society is there this level of parity?
Moreover I think it's offensive to imply football is this caste regime as if the rich people are watching the poor people play. Football pervades all income levels. Your rich prep high schools still have a football team. Ivy league schools still have football teams. If anything it is an equalizer because your rich suburban prep school guy lines up next to a dude that grew up in the inner city all the same. And their standing in the team, along with compensation, will be dependent on their performance as opposed to race or economic background. Where else in society is there this level of parity?
I'm not really accosting the sport itself - which I played as well and have always enjoyed. The NCAA and the NFL are the primary targets of my ire as at least the NFL has long known about this and has only begun to pay lip service to fixing what it can because of public scrutiny. So based on that, yes rich old white guys paying young poor (mostly black) guys to go brain themselves for America's entertainment does feel like en exploitative "caste regime" as you put it.
So this exact thought has crossed my mind on several occasions in regards to the NFL and NCAA. There's something about the optics of the rich white sports owner looking down from their box office as teams of mostly African American men smash each other to bits. That being said, just because something creates a visual analogy of a caste system, it doesn't mean that the actual workings of that system are in fact, caste-like.
First, NCAA and NFL is composed of a range of races and economic backgrounds. Your third-generation legacy QB is getting sacked all the same as your QB from the projects. And the rich white patrons don't care either way.
Fact #1: Most NFL players are black. Fact #2: Most NFL owners are white.
Does this speak more about systemic issues at the player level, or the owner level? I'd say the owner level. There is no lack of white athletes trying to make it into college and pro ball. I don't think recruiters are recruiting a disproportionately high amount of black players compared to white players because they want to spare the white race from long-term injuries. They're just picking the best athletes. In contrast, it's easy to explain why there are less black NFL team owners.
Secondly, I'm a bit confused as to why "poor" seems to be equated with "black" in your scenario. Yeah, we can easily look at NCAA players on TV and visually confirm that over 50% are black. But how do you know what percentage of players is poor? There are lots of poor rural white kids in the NCAA. There are lots of suburban middle class black kids. And by the time you're playing in the NFL, no one is poor.
First, NCAA and NFL is composed of a range of races and economic backgrounds. Your third-generation legacy QB is getting sacked all the same as your QB from the projects. And the rich white patrons don't care either way.
Fact #1: Most NFL players are black. Fact #2: Most NFL owners are white.
Does this speak more about systemic issues at the player level, or the owner level? I'd say the owner level. There is no lack of white athletes trying to make it into college and pro ball. I don't think recruiters are recruiting a disproportionately high amount of black players compared to white players because they want to spare the white race from long-term injuries. They're just picking the best athletes. In contrast, it's easy to explain why there are less black NFL team owners.
Secondly, I'm a bit confused as to why "poor" seems to be equated with "black" in your scenario. Yeah, we can easily look at NCAA players on TV and visually confirm that over 50% are black. But how do you know what percentage of players is poor? There are lots of poor rural white kids in the NCAA. There are lots of suburban middle class black kids. And by the time you're playing in the NFL, no one is poor.
There's a big difference between cheering on people killing each other and a popular sport remaining popular after the long term consequences became known.
I don't feel like you read my comment before posting.....
Most of the time, they didn't kill eachother.
why do people take issue with highly paid nfl players getting injured doing something they enjoy, but have no problem with military members getting killed and maimed for 20k/year? some people are just more violent/aggressive than others, football provides a relatively peaceful outlet for that.
There is a lot of money going into TBI research for the military. I think DOD is one of the biggest funders. No trying to mask the issue like the NFL (that I'm aware of).
I don't really know what a normal brain looks like. A sidebar (middlebar?) about halfway through the article describes what we're looking at:
The trauma of repetitive blows to the head triggers degeneration in brain tissue, including the buildup of an abnormal protein called tau. Thin slices of tissue are dyed and the tau shows up as these darker areas.
The trauma of repetitive blows to the head triggers degeneration in brain tissue, including the buildup of an abnormal protein called tau. Thin slices of tissue are dyed and the tau shows up as these darker areas.
Yes. The site needs to show a normal brain. I don't have anything to compare to. Really bad omission.
So the punter had CTE too? And all the quarterbacks? Obviously these players can get concussions, but don't we expect them to have a much lower rate of repeated, sub-concussive impacts that are supposed to result in CTE?
(They don't say so, but 110 of 111 were diagnosed, and if the only brain tested without it was the punter I can't imagine them not emphasizing that. I don't think this conflicts with the family's request to not identify the player.)
Presumably there is some sort of way to quantify the extent of disease besides yes/no. I'd really like to see the the extent vs. player position. Is there a write up for this, or was it a direct to NY Times deal?
Look, football is a violent sport, and it's certainly plausible that this induces a chronic, difficult-to-detect but serious disease over years of playing, and that the organization making billions from it would fight against that conclusion. But it's hard to square the smugness and outrage in this thread with the observation that NFL players have a lower rate of all-cause mortality than the general population.
http://www.nytimes.com/2012/05/09/sports/football/nfl-player...
Obviously that's consistent with the NFL having a significant net-negative impact on the health of athletes, who are a special sub-population that is likely to be of above-average health. (Although note that the average body weight of their pool is also very high, which would almost assuredly still be true even if they hadn't played, and that increases baseline death rates from things like heart disease.) And that impact could be so negative as to outweigh the benefits of playing, possibly necessitating rule changes, compensation, etc. But there is no ghastly epidemic of NFL players dying by the droves.
I don't think there's been a neurological performance test of retired players, but one will probably be done and I'm willing to bet that NFL players again do better than the general population (which, again, does not mean that playing in the NFL doesn't make you dumber). Anyone want to bet against me?
(They don't say so, but 110 of 111 were diagnosed, and if the only brain tested without it was the punter I can't imagine them not emphasizing that. I don't think this conflicts with the family's request to not identify the player.)
Presumably there is some sort of way to quantify the extent of disease besides yes/no. I'd really like to see the the extent vs. player position. Is there a write up for this, or was it a direct to NY Times deal?
Look, football is a violent sport, and it's certainly plausible that this induces a chronic, difficult-to-detect but serious disease over years of playing, and that the organization making billions from it would fight against that conclusion. But it's hard to square the smugness and outrage in this thread with the observation that NFL players have a lower rate of all-cause mortality than the general population.
http://www.nytimes.com/2012/05/09/sports/football/nfl-player...
Obviously that's consistent with the NFL having a significant net-negative impact on the health of athletes, who are a special sub-population that is likely to be of above-average health. (Although note that the average body weight of their pool is also very high, which would almost assuredly still be true even if they hadn't played, and that increases baseline death rates from things like heart disease.) And that impact could be so negative as to outweigh the benefits of playing, possibly necessitating rule changes, compensation, etc. But there is no ghastly epidemic of NFL players dying by the droves.
I don't think there's been a neurological performance test of retired players, but one will probably be done and I'm willing to bet that NFL players again do better than the general population (which, again, does not mean that playing in the NFL doesn't make you dumber). Anyone want to bet against me?
Ahh, found the actual paper:
http://jamanetwork.com/journals/jama/fullarticle/2645104
Incredibly, they list the number of each position type who have mild and severe CTE (their only degree of gradation) but apparently don't list the total number of players at each position, and hence I can't tell how many brains didn't have CTE by position. Nonetheless, we can confirm that both the punter and placekicker were diagnosed with mild CTE (a placekicker!) and the severe:mild ratio was higher among quarterbacks than lineman (11:2 for QBs vs. 29:8 and 27:8 for offensive and defensive linemen respectively).
http://jamanetwork.com/journals/jama/fullarticle/2645104
Incredibly, they list the number of each position type who have mild and severe CTE (their only degree of gradation) but apparently don't list the total number of players at each position, and hence I can't tell how many brains didn't have CTE by position. Nonetheless, we can confirm that both the punter and placekicker were diagnosed with mild CTE (a placekicker!) and the severe:mild ratio was higher among quarterbacks than lineman (11:2 for QBs vs. 29:8 and 27:8 for offensive and defensive linemen respectively).
Is no one curious about the one brain that didn't get CTE? there could be some insight into how to prevent Alzheimer's for example, since oxidative inflammatory responses are invoked in both conditions as a possible mechanism.
I'm more interested in what happens to the brain with youth soccer. Bigger problem than a couple hundred pro athletes.
I agree. Heading soccer balls is proven to at least temporarily reduce IQ. I've never let my kids play that sport.
https://www.washingtonpost.com/news/to-your-health/wp/2016/1...
http://www.cnn.com/2017/02/01/health/soccer-headers-concussi...
https://www.washingtonpost.com/news/to-your-health/wp/2016/1...
http://www.cnn.com/2017/02/01/health/soccer-headers-concussi...
So what are the safer competitive team sports for kids to participate in?
Ironically, thanks to the potentially lethal weaponry used as equipment, archery and target shooting.
Swimming is also relatively safe. Distance running might result in repetitive stress injury, but it won't kill you.
Slow-pitch softball eliminates most of the risks from baseball. Hit by pitch and RSI from pitching are the dangers there.
Cycling removes some of the RSI risk from distance running, but replaces it with higher-speed impacts, usually into hard surfaces.
Edit: It depends on your definition of "team sport", really. If you define it such that you can't meaningfully separate out any individual performances, you're cutting out all relay-type competitions from the start. If you say archery is not a team sport, then neither is a swimming relay race. Where do you draw the line? What's the minimum number of participants that have to work together to qualify as a team?
Swimming is also relatively safe. Distance running might result in repetitive stress injury, but it won't kill you.
Slow-pitch softball eliminates most of the risks from baseball. Hit by pitch and RSI from pitching are the dangers there.
Cycling removes some of the RSI risk from distance running, but replaces it with higher-speed impacts, usually into hard surfaces.
Edit: It depends on your definition of "team sport", really. If you define it such that you can't meaningfully separate out any individual performances, you're cutting out all relay-type competitions from the start. If you say archery is not a team sport, then neither is a swimming relay race. Where do you draw the line? What's the minimum number of participants that have to work together to qualify as a team?
not really team sports though.
One of the safest sports I've seen is oddly flag football. Especially for youth. There's typically no blocking allowed at the youth level, and obviously no tackling.
Of the youth sports I'm involved with flag football and baseball are the two safest (especially if you're not a pitcher). Then basketball sits in the middle as pretty safe. The main worry in basketball is running into someone going for the ball. I'd put soccer and tackle football as the most dangerous (tackle football being more dangerous). If they eliminate heading out of youth soccer, it would move it into the basketball level of safety.
I'm not sure there is any way to change tackle football to make it reasonably safe for kids.
Of the youth sports I'm involved with flag football and baseball are the two safest (especially if you're not a pitcher). Then basketball sits in the middle as pretty safe. The main worry in basketball is running into someone going for the ball. I'd put soccer and tackle football as the most dangerous (tackle football being more dangerous). If they eliminate heading out of youth soccer, it would move it into the basketball level of safety.
I'm not sure there is any way to change tackle football to make it reasonably safe for kids.
I don't think basketball comes with a lot of TBI, and baseball is pretty safe if you don't get hit in the head by pitches. That's 2 out of big 3 in America.
Really? There's a bunch of non-contact or limited-contact sports.
Crew, tennis, baseball, swimming, golf, all of track and field, etc.
Crew, tennis, baseball, swimming, golf, all of track and field, etc.
Volleyball is fun and challenging when played well. I'm not sure how easy it generally is to find good competition to learn from -- southern California where I grew up was a good place for it.
Baseball is definitely up there; catching and pitching can be a lot of strain on knees/shoulders but for the most part it's safe long term.
Basketball.
Daniel Amen recommends against soccer for kids for the reason of heading the ball. The brain in its live state is something more like very soft jello than the rubbery thing we see in science class. Do we really want to be shaking a jellylike thing around at all? Probably not.
Bit extreme of a reaction to two severely flawed click-bait studies and relevant to that "fear as a product" article from yesterday.
Washington Post: 14 men participating in the study. Each was asked to perform a rotational header — redirecting the soccer ball — 20 consecutive times during 10-minute sessions.
tiny sample size + 20 consecutive headers in 10 minutes is astronomically rare occurrence in soccer, 3 headers in 10 minutes is incredibly rare. Even with this methodology they report *the alterations appeared to clear within 24 hours.
CNN: "Concussions in soccer mostly occur from player-to-player and player-to-ground contact. Heading is involved in only 15% to 25% of concussions in soccer, and most of those are a result of poorly executed headers where two players hit heads,"
So most concussions are from bumping heads, which is a possibility in any contact sport.
Washington Post: 14 men participating in the study. Each was asked to perform a rotational header — redirecting the soccer ball — 20 consecutive times during 10-minute sessions.
tiny sample size + 20 consecutive headers in 10 minutes is astronomically rare occurrence in soccer, 3 headers in 10 minutes is incredibly rare. Even with this methodology they report *the alterations appeared to clear within 24 hours.
CNN: "Concussions in soccer mostly occur from player-to-player and player-to-ground contact. Heading is involved in only 15% to 25% of concussions in soccer, and most of those are a result of poorly executed headers where two players hit heads,"
So most concussions are from bumping heads, which is a possibility in any contact sport.
> 20 consecutive headers in 10 minutes is astronomically rare occurrence in soccer
For what it's worth, this is a completely reasonable number. In a game situation, sure, headers aren't that common. But during my youth soccer days, we practiced at least twice as often as we played and practice with headers was quite common. Ironically, they were trying to teach us the proper technique so that we wouldn't hurt ourselves. I can easily imagine practice sessions in which we headed the ball at least 3 times as often as that 20 per 10 min number.
For what it's worth, this is a completely reasonable number. In a game situation, sure, headers aren't that common. But during my youth soccer days, we practiced at least twice as often as we played and practice with headers was quite common. Ironically, they were trying to teach us the proper technique so that we wouldn't hurt ourselves. I can easily imagine practice sessions in which we headed the ball at least 3 times as often as that 20 per 10 min number.
I don't really think of avoiding head injuries as being an example of reacting to "fear as a product". The fact is we know so little about what constitutes brain injury that we might as well err on the side of caution even if it seems a little extreme. There's a term for this "the precautionary principle": http://www.precautionaryprinciple.eu/
Do you let your kids play football?
Honest question, bc at the end of the day, beyond all scientific studies, it is parents who will define which sports are popular and actually played.
Honest question, bc at the end of the day, beyond all scientific studies, it is parents who will define which sports are popular and actually played.
Football is also no. Also probably no to rugby and contact hockey. I would prefer to avoid all sports that involve a lot of knocks to the head. They are just sports, it isn't worth it.
Kids playing casual soccer almost never use their heads. Let them have fun.
This article may be about nfl players but concussions in youth football is also a huge problem. It’s been linked to declines in learning aptitude, among other things, so as you start expanding this issue to a problem of diminished quality of life you get an even crazier picture.
Honestly I think the most important thing is to help a kid find a sport they love that will motivate them to stay active. My concern about TBI in kids heading soccer balls is far less than childhood obesity and inactivity. We can push kids toward "safe" sports with minimal risks, but that doesn't guarantee they will enjoy it. A kid that grows up playing contact sports is still going to have better health on average than the sedentary kid.
I wonder, is there headgear that would fix that?
I gave up youth soccer after a season or two at least partly because heading hurts.
I gave up youth soccer after a season or two at least partly because heading hurts.
[deleted]
The bodies were all donated with the vast majority of them having symptoms of CTE while they were alive.
Essentially, it's not even close to a representative sample of former NFL players.
It would be the same as people who had knee problems, then were found to have arthritis in their knees after an autopsy.
I would be very careful to say that all (or almost all) NFL players will have CTE when they finish football.
I have seen more research on people's brains where they categorize them in two types, ones that recover from brain trauma and others that don't. For me, that seems more likely.
If you are an NFL player with the type of brain that recovers well, you probably will be fine later in life. If you have a brain that just doesn't seem to do well with that, then you could develop CTE. That would be my guess.
Essentially, it's not even close to a representative sample of former NFL players.
It would be the same as people who had knee problems, then were found to have arthritis in their knees after an autopsy.
I would be very careful to say that all (or almost all) NFL players will have CTE when they finish football.
I have seen more research on people's brains where they categorize them in two types, ones that recover from brain trauma and others that don't. For me, that seems more likely.
If you are an NFL player with the type of brain that recovers well, you probably will be fine later in life. If you have a brain that just doesn't seem to do well with that, then you could develop CTE. That would be my guess.
The JAMA data tables [1] also covered military service, with a high incidence of CTE there (5 mild, 45 severe). Both of the kicker/punters in the study also had mild CTE (did they kick with their heads?). Really leads to wonder about the prevalence in the general population, for sport and laborers at large, in addition to football players. The average years of play was 15.1, which is a really long time to play the sport.
The authors are playing to a theme here, rather than objectively reporting results.
[1] http://jamanetwork.com/journals/jama/fullarticle/2645104
The authors are playing to a theme here, rather than objectively reporting results.
[1] http://jamanetwork.com/journals/jama/fullarticle/2645104
i wish they would outlaw head slapping, from teammates. when i played hs football, after every play, players would slap teammates on the head (usually the back) to show support - i hated it.
i also think players are too big today, more weight at higher velocities only makes things worse for the head. the only reasonable thing I can think of is a 'salary cap' based on player weight as well.
i also think players are too big today, more weight at higher velocities only makes things worse for the head. the only reasonable thing I can think of is a 'salary cap' based on player weight as well.
Chronic Traumatic Encephalopathy in American football has been getting lots of media attention over the past few years, and the counterpoints to whether or not this is a serious issue will rely mostly on emphasizing the survivorship bias of those who enjoyed a high quality of life despite possibly (or assuredly) suffering such injuries, but in many ways almost all athletic sports represent feats of corporeal risk to the player, and I don't think the face of the game, or its popularity will change very much.
In many sports, people face death itself, and pay the ultimate price for competing. CTE, while made plain by studies such as this, might only change youth and amateur level competition. Professional leagues will probably continue apace, even amid full disclosure of well-known hazards.
This particular hazard wasn't previously well understod, but now it is, so, like boxing, it's still an improvement to the sport, to have players enter competition properly informed of the risks they are undertaking, so that they understand the choice they are making when they decide to play this game.
tl;dr The point of any given sport is usually to step into harms way, on some level, in a controlled arena and to test your abilities against other people in a contest of skill and endurance. That's how this works.
In many sports, people face death itself, and pay the ultimate price for competing. CTE, while made plain by studies such as this, might only change youth and amateur level competition. Professional leagues will probably continue apace, even amid full disclosure of well-known hazards.
This particular hazard wasn't previously well understod, but now it is, so, like boxing, it's still an improvement to the sport, to have players enter competition properly informed of the risks they are undertaking, so that they understand the choice they are making when they decide to play this game.
tl;dr The point of any given sport is usually to step into harms way, on some level, in a controlled arena and to test your abilities against other people in a contest of skill and endurance. That's how this works.
Today's youth and amateur level competitors are tomorrow's professionals. I think there's a decent chance that in 50 years, American football will no longer be America's dominant sport simply because the player base may dry up. And I'm okay with that. I think it's telling when former NFL players discourage their own kids from playing football.
It will?
As long as there are poor people with some athletic ability and fans willing to watch them, there will be grid iron football players.
As long as there are poor people with some athletic ability and fans willing to watch them, there will be grid iron football players.
I did not say it will; I said it might. And the existence of people willing to play does not guarantee the surrounding market and culture necessary to make a sport the dominant sport in the US. I think that depends a lot on that sport's pervasiveness in our culture, and in particular in high schools and colleges which are effectively our professional feeder system. If less players start going into youth football, and then less players are going into high school and college football, I think less people in our culture will pay attention, decreasing its market size and culture significance. Again, I'm not saying this will happen. I'm saying it might.
Sure but boxing gives us a historical precedent. Boxing used to be the professional sport. It was also a sport that many youth across all spectrums of society participated in.
Today it is confined to a niche professionally and is almost totally absent from most youth sport systems.
Today it is confined to a niche professionally and is almost totally absent from most youth sport systems.
But isn't part of that the perceived corruption in boxing? MMA has stepped in and there are youth MMA "academies" all over the place.
I know MMA fans might take exception but I think I'd lump them in with boxing fans of the past. Maybe there is some clear delimiter between MMA fans and boxing fan of the past; I can't think what it would be though.
I know MMA fans might take exception but I think I'd lump them in with boxing fans of the past. Maybe there is some clear delimiter between MMA fans and boxing fan of the past; I can't think what it would be though.
Well one of the pitches of MMA is that its safer than boxing, especially in its modern incarnations and particularly when it comes to repeated head trauma.
Lots of the kids MMA events don't even allow head strikes and especially not the particularly dangerous elbow strikes while on the ground.
Boxing makes it hard to have that distinction. My prediction is that MMA will also go through this when people start realizing that the head trauma stuff is nearly as bad in MMA as boxing.
Lots of the kids MMA events don't even allow head strikes and especially not the particularly dangerous elbow strikes while on the ground.
Boxing makes it hard to have that distinction. My prediction is that MMA will also go through this when people start realizing that the head trauma stuff is nearly as bad in MMA as boxing.
A strong component of what's perceived as traditional American subculture is broadly inflexible, even in the face of glaring evidence. You might be right, but then again, we've been surprised before by the persistence of this sort of cultural undertow, no?
>might only change youth and amateur level competition. Professional leagues will probably continue apace, even amid full disclosure of well-known hazards.
You don't see a direction link between the grassroots levels to the pro level? If you kill the interest, or participation at the grassroots level, there will never be a compelling pro league to source from.
Good riddance to a lame game of consisting of mostly low skilled athletes
You don't see a direction link between the grassroots levels to the pro level? If you kill the interest, or participation at the grassroots level, there will never be a compelling pro league to source from.
Good riddance to a lame game of consisting of mostly low skilled athletes
I feel like you're really not giving credit where it is due.
Yes, the trope is that football consists entirely of meatheads. The infamous movie The Blind Side comes to mind where they falsely treat Michael Oher like moron in spite of his capability does nothing to put this to rest. However there is a lot of strategy from the coach picking the play to the individual match-up right on the field.
And to say that it is low skill - that's just a plain insult. Find me a 6'5", 325 lbs person who can deftly keep someone of equal or larger size from encroaching upon the quarterback's territory. Find me an Average Joe capable of consistently catching passes against two defenders. Find me another Average Joe capable of ball placement when their receiver has two defenders guarding them.
Yes, the trope is that football consists entirely of meatheads. The infamous movie The Blind Side comes to mind where they falsely treat Michael Oher like moron in spite of his capability does nothing to put this to rest. However there is a lot of strategy from the coach picking the play to the individual match-up right on the field.
And to say that it is low skill - that's just a plain insult. Find me a 6'5", 325 lbs person who can deftly keep someone of equal or larger size from encroaching upon the quarterback's territory. Find me an Average Joe capable of consistently catching passes against two defenders. Find me another Average Joe capable of ball placement when their receiver has two defenders guarding them.
It looks like average IQ in the NFL is lower than among programmers, but not too low, by this proxy: https://en.wikipedia.org/wiki/Wonderlic_test#Median_score_by...
Google shows some online Wonderlic tests if you'd like to find your own score. (I haven't tried any.)
Google shows some online Wonderlic tests if you'd like to find your own score. (I haven't tried any.)
I have to strongly disagree that American football is a "lame game consisting of mostly low skilled athletes", I think the athleticism and skill involved is tremendously high across all positions.
But I will agree with you otherwise and say that the NFL has a strong incentive to dissuade youth, amateur, and semi-pro football players from adjusting their play to avoid CTE and dangerous play. The game is more physical now than ever, the players are bigger, they run faster, they hit harder, and that contributes to the popularity of the sport.
If the NFL can figure out a way to regulate dangerous hitting out of the game and preserve the appeal of the game, that would immediately trickle down to all levels and make the game safer.
But I will agree with you otherwise and say that the NFL has a strong incentive to dissuade youth, amateur, and semi-pro football players from adjusting their play to avoid CTE and dangerous play. The game is more physical now than ever, the players are bigger, they run faster, they hit harder, and that contributes to the popularity of the sport.
If the NFL can figure out a way to regulate dangerous hitting out of the game and preserve the appeal of the game, that would immediately trickle down to all levels and make the game safer.
Football is only 5th on this list of dangerous sports: https://www.thetoptens.com/most-dangerous-sports/ The real issue is that football trauma has effects over longer time periods and the long term effects are discounted in the near term.
>Good riddance to a lame game of consisting of mostly low skilled athletes
Having played up to college, it's tremendous fun and has roles for a range skillsets. While not necessarily very intelligent, everyone is very skilled.
>Good riddance to a lame game of consisting of mostly low skilled athletes
Having played up to college, it's tremendous fun and has roles for a range skillsets. While not necessarily very intelligent, everyone is very skilled.
I liked that football has a role for a large variety of body types from lean and fast to just big. Height is usually an advantage but not everywhere.
As for the mental part there is so much crap going on on large parts of the field that you have to remember at a moment's notice.
Much of football at lower levels relys on tons of memorization but this is the argument I made to my o line coach:
"So every year we face around 4 standard defenses. We play carnagie which runs a oddball one and you have us defending the zone blitz as well because you think a team is going to use it. So that's 6 defenses. Every d lineman can shade at least 3 ways but let's just call that 12 and not go permutations and let's skip the line backers that also covers mirroring of the d. We run essentially 15 run plays each direction for the purposes of the linemen rembering and 10 special plays so 25 plays... And we run them both ways so 50.
So we have 61250 = 3600. So basically you want me to memorize, recognize and recall and use within 1/2 of a step's notice 3600 things with 2 weeks of practice.
And every week you throw in 3 special plays and sub optimizing changes because of special players which ends up being 200-1200 changes.
Do you see how that might be difficult?"
But this is what most places do till you get up higher. After teaching my coach permutations math I said:
"Can you just tell us for each play what is the most dangerous thing to it and specifics for that week? That's really only 50*3 things total and about 12 things extra a week."
Reply "so you want me to teach you to be coaches basically"?
Me: "we are at a top ten University who plays football against carnagie and University of Chicago... I think we can use our brains pretty well"
Anyway yes it requires a ton of mental. I did as much studying each season of football in college as I did to pass orgo 1&2.
As for the mental part there is so much crap going on on large parts of the field that you have to remember at a moment's notice.
Much of football at lower levels relys on tons of memorization but this is the argument I made to my o line coach:
"So every year we face around 4 standard defenses. We play carnagie which runs a oddball one and you have us defending the zone blitz as well because you think a team is going to use it. So that's 6 defenses. Every d lineman can shade at least 3 ways but let's just call that 12 and not go permutations and let's skip the line backers that also covers mirroring of the d. We run essentially 15 run plays each direction for the purposes of the linemen rembering and 10 special plays so 25 plays... And we run them both ways so 50.
So we have 61250 = 3600. So basically you want me to memorize, recognize and recall and use within 1/2 of a step's notice 3600 things with 2 weeks of practice.
And every week you throw in 3 special plays and sub optimizing changes because of special players which ends up being 200-1200 changes.
Do you see how that might be difficult?"
But this is what most places do till you get up higher. After teaching my coach permutations math I said:
"Can you just tell us for each play what is the most dangerous thing to it and specifics for that week? That's really only 50*3 things total and about 12 things extra a week."
Reply "so you want me to teach you to be coaches basically"?
Me: "we are at a top ten University who plays football against carnagie and University of Chicago... I think we can use our brains pretty well"
Anyway yes it requires a ton of mental. I did as much studying each season of football in college as I did to pass orgo 1&2.
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As someone who played 3 years of football in middle school and 3 years in high school and sustained 2 concussions along with tons of sub-concussive hits, I just hope that by there will be a cure for CTE sometime in the next few decades. Crossing my fingers for Johnson's Kernel or Musk's neural lace to succeed.
Head gets hit repeatedly. That's the most complex and delecate organ in your body. I don't know live appendages that can take hits repeatedly without any long term side effects. Money talks in the NFL, so as long as that gets passed around, they are not taming it down unless the govt steps in
the 110/111 stat is incredibly misleading. The article even says that "many families have donated brains specifically because the former player showed symptoms of C.T.E.". Its unfortunate that the NYTimes sentimentalizes like this. I think it's pretty clear that football causes C.T.E but the title and lead 110/111 statistic is dangerously disingenuous.
If we really want to determine how dangerous or unhealthy football is, we should consider the full picture.
As part of this thought exercise, let's take as a given that CTE doesn't exist and brain injuries are unimportant.
After that, let's look at the prevalence of diabetes, heart disease, and other long-term degenerative diseases in the NFL player population.
Then, let's look at the shortened earning potential of the NFL player. Yes, for a year, maybe more, they are highly paid but lifetime earnings might not be what you'd expect. How do the stresses of many men who leave the NFL with no skills and often an abandoned college degree affect them and their families?
Next, let's consider the lifestyle the NFL envisions for its fans. Spending at least a full day each week sitting and eating unhealthy food while consuming alcohol. Spend the rest of the week gambling on the outcomes of the games (or individual players). Much of the time, this fandom is done as a family leading to impacts on children in the home. There's a societal health impact here.
The list goes on if we follow this thinking. So, if we go back and remove our given, we end up with a spectacle that unduly endangers its participants, encourages unhealthy behavior in its fans, and indoctrinates our youth to be accepting of all the above. Meanwhile, a very few wealthy families get even wealthier on the backs of all that.
As part of this thought exercise, let's take as a given that CTE doesn't exist and brain injuries are unimportant.
After that, let's look at the prevalence of diabetes, heart disease, and other long-term degenerative diseases in the NFL player population.
Then, let's look at the shortened earning potential of the NFL player. Yes, for a year, maybe more, they are highly paid but lifetime earnings might not be what you'd expect. How do the stresses of many men who leave the NFL with no skills and often an abandoned college degree affect them and their families?
Next, let's consider the lifestyle the NFL envisions for its fans. Spending at least a full day each week sitting and eating unhealthy food while consuming alcohol. Spend the rest of the week gambling on the outcomes of the games (or individual players). Much of the time, this fandom is done as a family leading to impacts on children in the home. There's a societal health impact here.
The list goes on if we follow this thinking. So, if we go back and remove our given, we end up with a spectacle that unduly endangers its participants, encourages unhealthy behavior in its fans, and indoctrinates our youth to be accepting of all the above. Meanwhile, a very few wealthy families get even wealthier on the backs of all that.
I agree with your early points, but I don't think we need to take the typical Hacker News stance of "everything is killing everybody and people need to start behaving more like me and less like themselves."
> Next, let's consider the lifestyle the NFL envisions for its fans. Spending at least a full day each week sitting and eating unhealthy food while consuming alcohol. Spend the rest of the week gambling on the outcomes of the games (or individual players). Much of the time, this fandom is done as a family leading to impacts on children in the home. There's a societal health impact here.
Won't somebody please think of the children! They might grow up to watch FOOTBALL!!
> Next, let's consider the lifestyle the NFL envisions for its fans. Spending at least a full day each week sitting and eating unhealthy food while consuming alcohol. Spend the rest of the week gambling on the outcomes of the games (or individual players). Much of the time, this fandom is done as a family leading to impacts on children in the home. There's a societal health impact here.
Won't somebody please think of the children! They might grow up to watch FOOTBALL!!
That wasn't my stance. My stance was one of examining the full societal cost of any activity. Football is certainly not alone in the impacts it has on families. It's just the one we are talking about in this forum.
But, if one is seriously trying to determine sociological trends, these are the kinds of questions one must examine. It might be a similar line of thought, with different details, for the increased use of digital devices in our society.
Lastly, you're being facetious but their watching football might well be part of the problem. Without participants or an audience, the NFL ceases to exist thereby removing the negatives AND positives that its existence might create.
But, if one is seriously trying to determine sociological trends, these are the kinds of questions one must examine. It might be a similar line of thought, with different details, for the increased use of digital devices in our society.
Lastly, you're being facetious but their watching football might well be part of the problem. Without participants or an audience, the NFL ceases to exist thereby removing the negatives AND positives that its existence might create.
As much as I love boxing and other sports, they are terrible for one's brain. The worst thing one can do is cause any damage to your brain as that dramatically effects quality of life.
This study was made possible because of autopsies. If autopsies were standard practice in the US this would have been discovered years, if not decades ago.
Even if autopsies were standard practice for all Americans you wouldn't see docs running tau-staining tests on every cadaver they received.
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Do we have any idea what the baseline incidence of CTE, using the same criteria used in this study, might be in the general population?
Apparently not. The criteria for what counts as evidence of CTE is still being fleshed out, at least as of 3 years ago.
> The neuropathology of CTE is increasingly well defined. In 2013, McKee and colleagues published the largest case report to date of individuals with neuropathologically confirmed CTE, presenting proposed criteria for four stages of CTE pathology based on the severity of the findings [9••]. Formal validation of the reliability of these criteria and the staging system are currently being performed by a team of nine neuropathologists, funded by a National Institutes of Health (NIH)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255271/
> The neuropathology of CTE is increasingly well defined. In 2013, McKee and colleagues published the largest case report to date of individuals with neuropathologically confirmed CTE, presenting proposed criteria for four stages of CTE pathology based on the severity of the findings [9••]. Formal validation of the reliability of these criteria and the staging system are currently being performed by a team of nine neuropathologists, funded by a National Institutes of Health (NIH)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255271/
Well that's a big surprise. But the NFL is a gigantic cult, people are not going to boycott it just to improve the well being of the gods players.
The prevalence of CTE in the NFL brains is irrelevant until we can compare it to the prevalence in the general population. And the issue is it's being more closely examined in the NFL brains currently. General population prevalence estimates are likely underestimated.
From the article:
"So even if every one of the other 1,200 players would have tested negative — which even the heartiest skeptics would agree could not possibly be the case — the minimum C.T.E. prevalence would be close to 9 percent, vastly higher than in the general population."
Where are you getting your information that estimates of CTE in the general population are low?
"So even if every one of the other 1,200 players would have tested negative — which even the heartiest skeptics would agree could not possibly be the case — the minimum C.T.E. prevalence would be close to 9 percent, vastly higher than in the general population."
Where are you getting your information that estimates of CTE in the general population are low?
CTE is a post-mortem phenotype. Dementia related to degenerative brain disease is common but not often measured (autopsies aren't done very often for senile patients with an obvious cause of death, especially for autopsies that disfigure the skull).
The idea that <9% of the general population at death have degenerative brain disease is highly implausible. Especially since we know AD has a prevalence which is multiples of 9%. Of course, I am not claiming CTE is not a problem in contact sports; merely that this headline is ridiculous. It's more important to estimate an odds ratio and confidence interval for the point estimate. My back of the envelope estimate for the OR would be ~3 (still concerning and large!).
There are related common problems in my field of biomedical research. I am a published author in Alzheimer disease, although it is no longer my primary focus. :)
The idea that <9% of the general population at death have degenerative brain disease is highly implausible. Especially since we know AD has a prevalence which is multiples of 9%. Of course, I am not claiming CTE is not a problem in contact sports; merely that this headline is ridiculous. It's more important to estimate an odds ratio and confidence interval for the point estimate. My back of the envelope estimate for the OR would be ~3 (still concerning and large!).
There are related common problems in my field of biomedical research. I am a published author in Alzheimer disease, although it is no longer my primary focus. :)
"The idea that <9% of the general population at death have degenerative brain disease is highly implausible. " If you consider dementia explicitly, than the epidemiology suggests a potential rate as high as 20-40% - which is much higher than the lowest possible CTE rate.
(In fact, it's possible that all CTEs diagnosed in this report would be classified as purely dementia in the general population).
(In fact, it's possible that all CTEs diagnosed in this report would be classified as purely dementia in the general population).
Yes exactly.
I also think the general population prevalence estimates for dementia are too low, for reasons not worth going into here.
I also think the general population prevalence estimates for dementia are too low, for reasons not worth going into here.
> The set of players posthumously tested by Dr. McKee is far from a random sample of N.F.L. retirees. “There’s a tremendous selection bias,” she has cautioned, noting that many families have donated brains specifically because the former player showed symptoms of C.T.E.
This is equivalent to finding NFL players who showed signs of cancer, and then testing them for cancer. Of course you're going to get a rate close to 100%. The article takes 10 paragraphs before pointing out that the rate of CTE among former NFL players is much lower.
This sort of sloppy journalism is counterproductive. It makes it much easier for football fans to discredit and ignore the problem. At best, it causes people to endorse good policies for bad reasons.