Ray Easterling, former player for the Atlanta Falcons, died Thursday at age 62 of an apparent self-inflicted gunshot wound. According to an article in The New York Times, Easterling was part of a group of former NFL players who sued the league, claiming that it had failed to treat players for concussions, and for attempting to conceal links between football concussions and long-term brain injuries.

An article on USAToday.com reported that the 61st concussion lawsuit was filed in federal court in Philadelphia by 28 former NFL players. In total, more than 1,260 players have filed concussion-related suits against the NFL. The suits blame that the players suffered long-term damage from concussions due to the league’s “carelessness, negligence, intentional misconduct, and concealment of information.”

As we wrote in previous blogs last year, multiple concussions can result in a brain disorder known as chronic traumatic encephalopathy, or CTE. This progressive, incurable condition leads to memory loss, depression, and dementia. Unfortunately, the only way to definitively diagnose CTE is after death, by autopsy. Boston University’s Center for the Study of Traumatic Encephalopathy has been researching the link between football and CTE. Of the brains of 15 former NFL players, 14 showed signs of CTE.

Concussion Safety

According to The New York Times, Easterling’s widow, Mary Ann Easterling, will continue to pursue the lawsuit on behalf of her husband, and she is urging the league to establish a fund for players with traumatic brain injuries related to their playing days.

“Half the time the player puts themselves back in the game, and they don’t know what kind of impact it has,” she said. “Somehow this has got to be stopped.”

Friends and Easterling’s attorney, Larry Coben, said that Easterling had not been himself for about the past six months. According to Coben:

“I could tell he was not on his game. He kept repeating himself and getting confused. It’s pretty tough, pretty tough.”

To read the full story in The New York Times, click here: Ray Easterling, of Atlanta’s Gris Blitz, Dies at 62

To read the full story on USAToday.com, click here:  Easterling’s death will impact concussion lawsuit

To learn more about the NFL lawsuits, click here:  NFLConcussionLitigation.com

To watch our video about concussion, click here:  Concussion Safety

About 18 months ago, we wrote with great excitement about the National Football League (NFL) and the new attention they were bringing to the crisis of concussion. The 2010 football season began with new concussion awareness posters in the locker rooms. As quoted in The New York Times, the Baltimore Ravens’ center, Matt Birk, said:

“To put it out there in writing in locker rooms, at least it’s publicly acknowledging that, ‘Hey, this is real.’ There’s risks in everything you do, and this one is real. You can’t sweep it under the rug anymore.

Unfortunately, there didn’t seem to be much change in the culture of the sport: Players were not removed from play after either giving or receiving hard head hits—the kind that are likely to cause concussion. The concussion prevention program was little more than words on a page, talk with no back-up action.

Now, a new scandal has rocked the NFL, and this one is difficult to understand, under any circumstance.

An investigation has revealed a “Pay for Pain” bounty program in the New Orleans Saints. Head coach Sean Payton and general manager Micky Loomis have taken full responsibility. According to a Reuters news article, under the bounty program, players were reported with payments of thousands of dollars for hard hits that knocked opponents out of games. Supposedly, players were paid $1,000 for a “knockout hit” and another $1,000 if a player were to be carried off the field.

The program was administered by former Saints defensive coordinator Gregg Williams, who issued a statement acknowledging his involvement:

“It was a terrible mistake, and we knew it was wrong while we were doing it. Instead of getting caught up in it, I should have stopped it,” said Williams. “I take full responsibility for my role. I am truly sorry. I have learned a hard lesson and I guarantee that I will never participate in or allow this kind of activity to happen again.”

This seems like quite a cold-blooded apology for such a heinous and injurious program. Oops, sorry, won’t do it again. Perhaps he and everyone else who actively or passively condoned this program shouldn’t be allowed a chance to do it again…perhaps they should lose their jobs…perhaps they should pay restitution of some sort to the players who were seriously injured by this program.

As Charles P. Pierce wrote on the website Grantland.com:

“What we shave here now is the face of organized savagery, plain and simple…. These events were not incidental to the playing of the game. They were an essential part of it. The players who participated in the program did not do so accidentally. The coaches who designed the program did not do it without knowing full well what it entailed, including the possibility of retaliation if the story ever got out, and a subsequent football arms race that would end up with someone dead on the field.

How much violence and physical damage is too much before we start to realize that our national pastime needs to change the unwritten rules of the game? We have a crisis of concussion… players dying young due to chronic traumatic encephalopathy (CTE) and dementia… players committing suicide as they experience catastrophic declines in their physical and mental health… and now aggression bounties. As Mr. Pierce wrote:

Gradually, football has seen its appeal slip at the most basic levels. Pediatricians are advising parents not to let young children play organized football too early in life. Local high schools are looking at skyrocketing insurance rates and wondering, in a time when school budgets are being squeezed to a pulp all over the country, whether this particular game is worth the candle. Major college programs have all the economic problems present in the high schools combined with all the workplace-safety issues with which the NFL is grappling. Football may be losing some of what once appeared to be its unbreakable purchase on the country’s soul.

I’ve always been one of those people who cringe and look away when aggressive football hits are replayed in slow motion, so maybe I’m out of touch with what football fans are willing to bear. But I’ll never again be able to enjoy the pure sport of football without wondering exactly what nefarious plays are being planned in the huddle or the locker room. And I’ll never be able to assume that any on-the-field injury was due to an accident, rather than a calculated hit.

And maybe it’s time for the New Orleans team to change its name. “The Saints” just doesn’t seem to fit anymore.

RESOURCES

To read the full Reuters article, click here:  Saints coach and GM take blame for bounties

To read the full article on Grantland.com, click here: The Saints, Head-hunting, and (Another) Disaster for the NFL

To read more about the scandal on ESPN, click here:  Saints coach, GM sorry for bounties

On July 21, 2011, we posted a blog about the lawsuit brought by former pro football players against the National Football League (NFL) for concealing information about the harmful effects of concussion from players, coaches, and trainers. And not only did the NFL drop the ball (pun intended) on its duty to inform players of the risks, they also failed to protect players from known risks.

According to a recent article in The New York Times, the lawsuit may become the first concussion-related class action against the NFL. A group of players is seeking damages for injured players, but also changes in the medical monitoring of players. The latter is the groundbreaking part of the lawsuit. According to the group’s lawyer, Larry Coben, while there have been improvements in the way concussions are analyzed and treated, there is much room for improvement in identifying injuries.

Specifically, Coben cited the use of blood tests as a way to diagnose concussions, saying the United States military has already begun using the technique and contending that such tests would increase player safety in the N.F.L.

Coben also asserted that the N.F.L. should be using testing procedures that examine genetic markers for indications of whether a player may be more at risk for developing chronic traumatic encephalopathy later in life.

“Modern technology is advancing,” Coben said in a telephone interview. “We need to get past just using doctors on the sideline and in the locker rooms to see if a player has been hurt.”

Class action lawsuits are tricky stuff, but the medical side of this lawsuit may be even more difficult. Some experts don’t believe that blood testing for head injuries is not quite ready for widespread use. But monitoring seems like a wonderful idea in a sport where the injury rate is 100 percent. However, according to the article in The New York Times, not everyone agrees that extra monitoring is important, or even necessary.

Jets linebacker Josh Mauga, who sustained a concussion last season, said the current concussion management program was thorough and sufficient. Mauga described the series of tests he had to pass (including balance and visual exams) before he could resume exercising after his concussion. And, when he felt symptoms during light jogging, he said he was sent back to the beginning of the process each time.

“I did those balance and vision tests so many times,” he said. “Because any time I started to feel anything, I had to start all over again. It took me three weeks.”

Still, it’s a lot to put the entire load of concussion recognition on young, eager-to-please athletes who might not be willing to sit on the sidelines while his teammates play to glory. But, as we’ve been reporting for months now, concussion is not a small or insignificant injury. Repeated concussions can lead to chronic traumatic encephalopathy, which is a progressive neurologic condition. Football players have a right to be concerned. We’ll be watching the status of this lawsuit, and will report back when there is news.

To read the entire article in The New York Times, click here:  Concussion Suit Seeks Better Health Monitoring

On July 21, 2011, we posted a blog about the lawsuit brought by former pro football players against the National Football League (NFL) for concealing information about the harmful effects of concussion from players, coaches, and trainers. And not only did the NFL drop the ball (pun intended) on its duty to inform players of the risks, they also failed to protect players from known risks.

According to a recent article in The New York Times, the lawsuit may become the first concussion-related class action against the NFL. A group of players is seeking damages for injured players, but also changes in the medical monitoring of players. The latter is the groundbreaking part of the lawsuit. According to the group’s lawyer, Larry Coben, while there have been improvements in the way concussions are analyzed and treated, there is much room for improvement in identifying injuries.

Specifically, Coben cited the use of blood tests as a way to diagnose concussions, saying the United States military has already begun using the technique and contending that such tests would increase player safety in the N.F.L.

Coben also asserted that the N.F.L. should be using testing procedures that examine genetic markers for indications of whether a player may be more at risk for developing chronic traumatic encephalopathy later in life.

“Modern technology is advancing,” Coben said in a telephone interview. “We need to get past just using doctors on the sideline and in the locker rooms to see if a player has been hurt.”

Class action lawsuits are tricky stuff, but the medical side of this lawsuit may be even more difficult. Some experts don’t believe that blood testing for head injuries is not quite ready for widespread use. But monitoring seems like a wonderful idea in a sport where the injury rate is 100 percent. However, according to the article in The New York Times, not everyone agrees that extra monitoring is important, or even necessary.

Jets linebacker Josh Mauga, who sustained a concussion last season, said the current concussion management program was thorough and sufficient. Mauga described the series of tests he had to pass (including balance and visual exams) before he could resume exercising after his concussion. And, when he felt symptoms during light jogging, he said he was sent back to the beginning of the process each time.

“I did those balance and vision tests so many times,” he said. “Because any time I started to feel anything, I had to start all over again. It took me three weeks.”

Still, it’s a lot to put the entire load of concussion recognition on young, eager-to-please athletes who might not be willing to sit on the sidelines while his teammates play to glory. But, as we’ve been reporting for months now, concussion is not a small or insignificant injury. Repeated concussions can lead to chronic traumatic encephalopathy, which is a progressive neurologic condition. Football players have a right to be concerned. We’ll be watching the status of this lawsuit, and will report back when there is news.

To read the full article in The New York Times, click here:  Concussion Suit Seeks Better Health Monitoring

If you have been following our blogs about football and concussion risks, then you know that this was bound to happen.

According to an article on CNN.com:

Seventy-five former professional football players are suing the National Football League, saying the league knew as early as the 1920s of the harmful effects of concussions on players’ brains but concealed the information from players, coaches, trainers and others until June 2010.

Not only did the NFL fail to inform the players of the risks, but they failed to protect the players from known risks.

Multiple concussions can lead to long-term brain injury, memory loss, depression, dementia, and a neurologic condition known as chronic traumatic encephalopathy (C.T.E.), which mimics Lou Gehrig’s disease. The condition has become so wide-spread among football players that retired player Dave Duerson, who committed suicide at age 50, donated his brain to Boston University’s brain bank. (To read our blog about this, click here: Football Player Donates Brain to Research)

According to an article in The New York Times, published February 11, 2011:

Players who began their careers knowing the likely costs to their knees and shoulders are only now learning about the cognitive risks, too. After years of denying or discrediting evidence of football’s impact on the brain — from C.T.E. in deceased players to an increasing number of retirees found to have dementia or other memory-related disease — the N.F.L. has spent the last year addressing the issue, mostly through changes in concussion management and playing rules.

The N.F.L. has also donated $1 million to Boston University’s Center for the Study of Traumatic Encephalopathy [known to players as the "brain bank"], the research group that will soon examine Duerson’s brain.

At the brain bank, brains of 15 former NFL players have been studied — 14 of them show signs of degenerative C.T.E.

What the Suit Is About

According to the CNN.com article, the players contend that members of the NFL’s Brain Injury Committee denied knowledge of a link between concussion and cognitive decline. In addition:

“When the NFL’s Brain Injury Committee anticipated studies that would implicate causal links between concussion and cognitive degeneration it promptly published articles producing contrary findings, although false, distorted and deceiving, as part of the NFL’s scheme to deceive Congress, the players and the public at large,” the suit says.

“The defendants acted willfully, wantonly, egregiously, with reckless abandon, and with a high degree of moral culpability,” the former players charge in court documents.

Due to multiple and severe concussions, some former players have died…many currently suffer from post-concussion syndrome…and nearly all now have cause for serious concern. We’ll be watching how this suit proceeds and report back with news. We wish the players luck in their pursuit of justice and the truth, for their own sake, and the sake of future players.

To read the full article on CNN.com, click here:  Former NFL Players: League Concealed Concussion Risks

Terry Bradshaw is one of the most celebrated football players in NFL history. He played 14 seasons as a quarterback with the Pittsburgh Steelers. He is a four-time Super Bowl champion–including leading the Steelers to their first Super Bowl win during Super Bowl IX. In 1996, he was voted into the Football Hall of Fame.

By all measures, Bradshaw has had a dream career.

But now, Bradshaw is setting the record straight, as that dream is slowly turning into a nightmare.

On a blog on MSN’s Fox Sports website, Terry Bradshaw himself wrote about his struggles with the aftermath of too many concussions. He is, as he says, “rehabbing his brain” on the advice of his doctors, trying to improve his hand-eye coordination (with a ping-pong table) and doing brain puzzles to keep his mind active. And he has decided to go public to potentially save the brains of the current generation of players.

I was a quarterback. I know how much my late center Mike Webster suffered. I can only imagine what a lot of defensive players from my era are going through. I’ve talked with Howie Long about this. He understands what I’m going through. I just thought it would good for them to hear what I had to say. I also think other players should speak up and say what they’ve been experiencing. It’s good for the soul and your brain.

Bradshaw talks openly about his memory difficulties…and about how he has reacted emotionally to his losses.

The memory loss made me jittery at times. It was driving me crazy that I couldn’t remember something that I studied the night before. All it did was trigger my anxiety and all of sudden everything would snowball on me. I know I have depression and it’s a horrible disease. This memory loss just made my depression worse.

Bradshaw has devoted his life to football. Even after his pro career was over, he was able to continue on as a sports commentator. More than anyone, football is in Bradshaw’s blood. Which makes it all the more remarkable that he is speaking out.

I know the NFL has done a lot to help us and also to improve the conditions for today’s players in regards to helmets and head injuries. But it’s nowhere where it needs to be…. I really think it is important for players to talk about what they are going through after their playing days are over.

He supports brain research, and he supports shedding light on the mystery of brain injury through science and communication, through players revealing how much they hurt and how they have been affected. With luck, Bradshaw be able to see changes in his lifetime.

Decades ago, everyone knew that boxers had brain problems from taking too many hits to the head. The average person called it being punch drunk. Doctors called it dementia pugilistica, or dementia of fighters. Now, we understand that permanent brain injury can happen to anyone who takes a lot of hits to the head–people such as football, hockey, soccer, and rugby players. In fact, the problem has gotten so big that a new term has been coined: Athletes’ Dementia.

The medical term for Athletes’ Dementia is chronic traumatic encephalopathy, or CTE.

According to a Johns Hopkins Health Alert, the earliest symptoms of CTE are memory problems, disorientation and difficulty concentrating.

As chronic traumatic encephalopathy progresses, people begin to show poor judgment, erratic behavior, significant memory loss and some degree of Parkinson’s disease (impaired speech, difficulty with motor skills, slow movement and a loss of balance). In more advanced stages of CTE, patients experience tremors, full-blown Parkinsonism, a staggering gait, deafness and dementia.

Chronic traumatic encephalopathy is also commonly associated with psychological problems like depression, agitation, aggression and violence, loss of inhibitions, sexual compulsiveness, euphoria, drug and alcohol abuse and suicide.

Most of the time, the worst symptoms don’t appear until after the athlete has retired from professional play, and a 2009 study showed that the average lifespan of people with CTE is 51. Disturbingly young.

In February, we wrote about former football great Dave Duerson, who committed suicide. by shooting himself in the chest, not the head. That’s because Duerson’s final wish, expressed in his suicide note and in a voicemail message to his ex-wife, was that his brain would be given to the National Football League’s (NFL) brain bank.

The “brain bank” is the nickname of the Boston University Center for the Study of Traumatic Encephalopathy (CSTE). The CSTE was created in 2008 as a collaborative venture between Boston University School of Medicine and Sports Legacy Institute (SLI). Its is to conduct state-of-the-art research on chronic traumatic encephalopathy. Duerson shot himself in the chest so that his brain could be donated intact. (To read the full blog, click here:  Football Player Donates Brain to Research)

With a new name that is easier for the public to remember (and pronounce), Athletes’ Dementia will open the dialog about the long-term effects of sports on the brain–effects that previously had been underestimated. No doubt we’ll be hearing about dementia symptoms in players from a variety of sports. Let’s hope we hear about some real solutions and preventions before there are “brain banks” for all hard-hitting sports.

The National Football League (NFL) has issued new guidelines about concussion diagnosis during games. Basically, team doctors will use a new standardized assessment protocol on the sidelines if concussion is suspected. This tool allows immediate evaluation of injury so that athletes with concussion or other serious brain trauma so that players can be removed from the game.

The new concussion protocol combines a symptom checklist, a limited neurologic examination (including a cognitive evaluation), and a balance assessment.

According to an article on Bloomberg.com:

“This tool provides a standardized format for evaluating head injury that medical staff can use on the sideline,” Margot Putukian, chairwoman of the NFL’s Return-to-Play Subcommittee and head team physician for Princeton University, said in the statement. “It incorporates the most important aspects of a focused exam, so that injury is identified and athletes with concussion and more serious head and spine injury can be removed from play.”

Maybe it’s just me, but it seems remarkable that this relatively simple, standardized test hasn’t been incorporated earlier. Or perhaps it’s a sign that the NFL is now finally willing to recognize that concussions are dangerous. According to an article in The Atlanta Journal-Constitution, Falcons general manager Thomas Dimitroff agrees that the protocol is a welcome change:

“It takes a little bit of the gray area out of it in my mind,” Dimitroff said. “It makes sure that we have some checks and balances. I think it’s positive for both sides …. I remember that many years ago when we were saying, ‘you have to go back in there no matter how you feel,’” Dimitroff said. “Now, I think we are just playing a lot smarter. I think that’s good.”

We think that’s good, too. Better a little caution, a missed game or two, than more cases of dementia or player suicides. All brain trauma is potentially serious. If the protocol is actually used, all football players could have Golden Years that are actually, well… golden.

In a series of articles, The New York Times has been telling the story of Dave Duerson, a 50-year-old former Chicago Bear and father of four who killed himself earlier this month. Duerson’s final wish, expressed in his suicide note and in a voicemail message to his ex-wife, was that his brain would be given to the National Football League’s (NFL) brain bank.

Duerson’s death, and his final gift, will likely expand the national conversation about the effects of repeated concussion on football players’ brains…and what should be done to protect athletes of all ages.

The “brain bank” is the nickname of the Boston University Center for the Study of Traumatic Encephalopathy (CSTE). The CSTE was created in 2008 as a collaborative venture between Boston University School of Medicine and Sports Legacy Institute (SLI). Its is to conduct state-of-the-art research on chronic traumatic encephalopathy (CTE)—a form of progressive dementia—through the study of neuropathology, pathogenesis, clinical presentation, disease course, genetic and environmental risk factors and prevention. It’s research is done on donated brain and spinal cord tissue, with the hope that scientists can develop tests for diagnosing CTE in living people, and treatments for people who show signs of disease.

When Duerson took his own life, he shot himself in the chest, not the head, so that his brain could be donated intact.

According to The New York Times:

Players who began their careers knowing the likely costs to their knees and shoulders are only now learning about the cognitive risks, too. After years of denying or discrediting evidence of football’s impact on the brain — from C.T.E. in deceased players to an increasing number of retirees found to have dementia or other memory-related disease — the N.F.L. has spent the last year addressing the issue, mostly through changes in concussion management and playing rules.

Duerson was active in helping ex-footballers with disability. He served on a panel that helped administer the NFL’s disability plan and the 88 Plan, a care fund for families of players with dementia. There is no doubt that Duerson knew of the link between repeated head injury and dementia and neurologic disability…and it is likely that he believed he suffered from CTE. Friends say he had memory problems, and sometimes had a difficult time thinking of or writing the correct words.

Again, from The New York Times:

Duerson sent text messages to his family before he shot himself specifically requesting that his brain be examined for damage, two people aware of the messages said. Another person close to Duerson, who spoke on the condition of anonymity, said that Duerson had commented to him in recent months that he might have C.T.E., an incurable disease linked to depression, impaired impulse control and cognitive decline.

It will be awhile before we know whether Duerson suffered from CTE, or if he was suffering from depression without brain damage. Regardless of the outcome of the autopsy, Duerson’s death puts new focus on the effects of football on brain health and brain function. Pro athletes play under great risk, but some say the greatest risk is reserved for youth athletes, whose still-developing brains may suffer bigger consequences from smaller hits.

The conversation about how to prevent brain damage in athletes of all ages will be difficult. Fans love the raw aggression of the game, and those with money at stake may balk at taking the danger out of the game for fear of losing viewers and revenue. Will we see new safety equipment? New helmet designs? A change in the rules? This should be an interesting year for parents, coaches, football players, and the N.F.L.

Our hope is that Dave Duerson’s tragic death has meaning, that safety becomes the paramount concern, and that this is the last time a football player dies as the result—directly or indirectly— of what really is just a game.

Resources

Links for the two articles from The New York Times:

N.F.L. Players Shaken by Duerson’s Suicide Message (February 20, 2011)

A Suicide, a Last Request, a Family’s Questions (February 22, 2011)

To learn more about brain injury, check out the HensonFuerst website: http://www.lawmed.com/

Last fall, the National Football League (NFL) unveiled new guidelines regarding concussions, encouraging players to recognize symptoms, report them to coaches, and  follow treatment suggestions. The announcement was met with cautious optimism that the culture of head-cracking aggression might be softened.

The culture is as thick-skulled as ever, but the NFL is making another attempt, this time via a website.

The new website www.NFLHealthandSafety.com is dedicated to spreading information about the link between football and concussions, and about effects of mild traumatic brain injuries (MTBI).

The site is another good step forward for health in sports. There is information about safety rules and regulations…medical studies…links to other online resources…videos about football safety, and other information.

Various bits of information on the website are not particularly easy to find—the navigation is not intuitive. Still, there’s always time for improvement, and it is a nice start for a new initiative. If you or your kids play sports, check it out!

http://www.NFLHealthandSafety.com/