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Top medical journal urges doctors to cut all ties with football - from treating college players to sponsoring NFL teams - because of its links to brain injury

  • Springer is a leading medical journal, specializing in orthopedics
  • The authors have published an editorial slamming American football
  • They tell doctors to stop treating players and sponsoring teams
  • It comes after a report which analyzed 111 deceased players' brains and found 110 of them had signs of CTE, a football-linked disease which causes dementia

A top medical journal has urged surgeons to cut all ties with football – from NFL to high school level – due to the growing swell of research showing the sport causes devastating brain injuries.

The senior editors of Springer, an orthopedics journal, said doctors should not perform physicals for college players and institutions should not sponsor professional teams. 

The call comes in the wake of Boston University's landmark study on deceased players' brains, showing 110 of the 111 they examined had signs of CTE, a neurodegenerative disease which causes dementia. 

'Football is not consonant with the best values of our profession,' lead author of the report Seth S. Leopold, a professor at the University of Washington School of Medicine, concluded. 

'Is it right for us to support a game—through our presence on the sidelines or in the form of marketing and advertising dollars that splash orthopedic logos on practice jerseys and football stadiums—that causes grave harm to at least 9 percent of those who play it professionally?' 

The senior editors of Springer said doctors should not perform physicals for college players and institutions should not sponsor teams since football has been linked to brain injury

The senior editors of Springer said doctors should not perform physicals for college players and institutions should not sponsor teams since football has been linked to brain injury

WHAT IS CTE? 

Chronic traumatic encephalopathy (CTE) is a degenerative brain disease that is caused by repeated hits to the head. 

Over time, these hard impacts result in confusion, depression and eventually dementia.

There has been several retired football players who have come forward with brain diseases.

They are attributing their condition to playing football and the hits they took. 

More than 1,800 former athletes and military veterans have pledged to donate their brains to the Concussion Legacy Foundation for CTE research.

CTE was usually associated with boxing before former NFL players began revealing their conditions.  

Earlier this year, the journal said children should not play football. 

'At the time, we wondered whether our recommendation went too far,' Leopold wrote. 'New evidence suggests that perhaps we did not go far enough.'

They say that, while CTE is prevalent in other sports such as MMA and boxing, football 'merits special attention' since orthopedic surgeons are so entrenched in the sport.

Dealing with diagnosis, treatment, prevention and rehabilitation of injuries, they are heavily relied on by players to keep them in shape during the season. 

This involvement includes performing preseason physicals on school players, covering games from the sidelines, and marketing campaigns in stadiums.

'We have no particular axe to grind against football, and we are attentive to the research being published about other sports that may eventually be proven to cause as much harm, or more,' the authors write. 

But they add: 'In the meantime, we feel obliged to deal with the compelling data from the study about American football, which are consistent with earlier epidemiological reports. The pieces all fit, and they clamor for a response.'

The editorial comes amid a boom in research on football's ties to brain injuries – in both the NFL and amateur leagues.  

Last month, St Michael's Hospital in Canada found contact sports have a significant impact on young athletes' brain structure and function.

Researchers found that body contact and brain damage are directly correlated – with sports that involve more contact causing more significant changes.

The research team looked at preseason brain scans of 65 total varsity athletes. 

Of those 23 athletes played collision sports, meaning that players have routine and purposeful body-to-body contact. 

Another 22 played contact sports, meaning contact is allowed but isn't an integral part of the game. And the final 20 played non-contact sports. 

None of the participants were otherwise unhealthy. 

The team found that the athletes who played collision and contact sports had visible differences in structure, function and chemical markers than typically associated with brain injury.

Their brains also looked considerably different than athletes who did not play contact sports. 

THE STUDY THAT SHOWED CTE IN 99% OF PLAYERS' BRAINS – AND DROVE THE NFL TO CUT TIES WITH RESEARCHERS 

Last month, the NFL cut ties with the National Institutes of Health study into concussion after years of feuding over critical researchers.

Despite vowing in 2012 to invest $30 million in brain injury research, the football league has only paid $18 million, and its contract will expire at the end of August.  

The move came two years after a huge row between the two organizations over Boston University neuroscientist Robert Stern, who is a vocal critic of the NFL and received a chunk of the NIH grant to examine former players.

Just days before the NFL and NIH announced the end of their partnership, Dr Stern's research team published the explosive report, revealing 110 out of 111 deceased NFL players had signs of CTE in post-mortem examinations.

Dr Stern's Boston University team is leading the groundbreaking and ambitious research project to identify whether there is a direct link between concussions on the field and neurodegenerative diseases in players – including the late Aaron Hernandez.

Junior Seau
Aaron Hernandez

Boston University's famed CTE team has released major findings from post-mortems on 202 deceased players' brains. The study included Junior Seau (left), the Patriots player who committed suicide in 2012. The team will soon also analyze the brain of Aaron Hernandez (right), the Patriots player who took his own life this year, and is believed to have had CTE

They are focusing on chronic traumatic encephalopathy (CTE), a little-understood condition a progressive neurodegeneration associated with repetitive head trauma. It has been linked to ALS (also called 'locked-in syndrome') and Alzheimer's.

Now, the team has released their first major findings from post-mortem examinations on 202 deceased players' brains, which were donated to research.

The study included a number of former NFL players, including Bubba Smith, Ken Stabler, Frank Wainright, Dave Duerson, and Junior Seau.

They also interviewed next-of-kin to learn about each player's clinical symptoms, to compare with their findings.  

The players, who lived to an average of 66 years old, had all played for a median of 15 years – from high school to professional leagues.

Overall, 177 of the brains they analyzed (87 percent) had CTE. 

It was by far the most prevalent among NFL players: they found 110 of the 111 NFL players in the study (99 percent) had the hallmarks of CTE. 

College players had the second-highest rate, with 48 out of 53 college players' brains (91 percent) diagnosed with CTE. 

They also diagnosed CTE in seven out of eight Canadian Football League players (88 percent), nine out of 14 semi-professional players (64 percent), and three out of 14 high school players (21 percent). 

All three of the high school players had mild CTE.

The majority of all the other players had severe pathology. 

Among those with mild CTE pathology, 96 percent had behavioral and mood symptoms, 85 percent had cognitive symptoms, and 33 percent had signs of dementia. 

In those with severe CTE pathology, 89 percent had behavioral or mood symptoms or both, 95 percent had cognitive symptoms, and 85 percent had signs of dementia.

'In a convenience sample of deceased football players who donated their brains for research, a high proportion had neuropathological evidence of CTE, suggesting that CTE may be related to prior participation in football,' the article concludes.   

FORMER PLAYERS PLEDGING THEIR BRAINS

Retired NFL stars Leonard Marshall and Matt Hasselbeck announced in May they would be donating their brains to CTE research. 

Marshall, a two-time Super Bowl winner and defensive lineman for the New York Giants, said the sport has left him struggling with short-term memory loss and erratic behavior at age 55. 

More than 1,800 former athletes and military veterans have pledged to donate their brains to the Concussion Legacy Foundation for CTE research. 

Aaron Hernandez, a former Patriots player, committed suicide in his prison cell in April. His family has donated his brain the Boston team to see whether he was suffering from CTE.

Nick Buoniconti said earlier in May he wouldn't have played football if he had known about the risks it posed to his brain health.

The 76-year-old former middle linebacker for the Patriots and Dolphins was diagnosed with dementia in October 2016.  

STUDIES SHOW SPORTS INJURIES COULD CAUSE BRAIN DISEASES

1. CLEAR LINK BETWEEN LOW-IMPACT INJURY AND ALZHEIMER'S

Research published last week confirmed the strongest ever link between sports concussions and Alzheimer's disease. 

Until now, doctors only considered severe traumatic brain injury a key risk factor for developing neurodegenerative diseases.

But the new study by Boston University School of Medicine (BUSM) has – for the first time – shown even low-impact injuries like concussion could have life-threatening consequences.   

They reached their conclusion by scanning the brains of 160 wounded war veterans after tours in Iraq and Afghanistan.

Using MRI imaging, the researchers measured the thickness of their cerebral cortex in seven regions that have been pegged at the 'ground zero' for Alzheimer's disease.

They also scanned seven control regions – regions that tend not to be affected. 

They found that having a concussion was associated with lower cortical thickness in brain regions that are the first to be affected in Alzheimer's disease.

Lead author, Dr Jasmeet Hayes, said: 'Our results suggest that when combined with genetic factors, concussions may be associated with accelerated cortical thickness and memory decline in Alzheimer's disease relevant areas.' 

2. BRAIN CHANGES IN HIGH SCHOOL PLAYERS AFTER JUST ONE SEASON

A study at Wake Forest School of Medicine has been examining the brains of high school football players.

One of the participants is the son of former Minnesota Vikings player Greg DeLong. 

The study published in the journal Radiology found measurable brain changes in teen players after a single season of ball – even without a concussion diagnosis.

Now DeLong is speaking out to say he would have seriously reconsidered his football career if he had known the risks.

'Football's important to us, but there are other things out there that are more important,' DeLong told Good Morning America. 

3. CDC BUILDING DATABASE ON SPORTS-RELATED CONCUSSIONS

The CDC has estimated that up to 3.8 million concussions occur in sports and recreational activities each year.

But some experts wonder if those numbers underestimate total brain injuries, as some individuals may not seek treatment for mild or moderate symptoms.

The agency has applied for federal funding to create a database in order to investigate sport injuries and brain diseases more in-depth. 

Meanwhile, the state of Texas has embarked on the largest ever study into concussions. 

State officials hope to track brain injuries among high school sports to discover whether more needs to be done to improve player safety and protect athletes.

The University Interscholastic League, Texas' governing body for public high school sports, is partnering with the O'Donnell Brain Institute at UT Southwestern Medical Center for the project.

A state as large as Texas, which has more than 800,000 public high school athletes, would be a key step in developing a national database of brain injuries in youths, officials say. 

 

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Journalist, writer and broadcaster, based in London and Paris, her latest book is Touché: A French Woman's Take on the English. Read more articles from Agnes.

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