Thoughts about CTE

[jeremy q public]

I just read this take on CTE, and how the football protocols are really not protecting against it. I can't say for sure how accurate it is... it generally matches with the info I can find elsewhere, but it's also clear that CTE is not very well understood yet.

I feel like the NFL has done a pretty great job of confusing the public on the dangers of CTE by making most people think it's a result of too many major concussions, like what quarterbacks and wide receivers get, when that is not what causes CTE (although getting a dozen or so concussions is also a problem).

CTE is a calcification (hardening) of brain tissue as a result of repeated sub-concussion trauma, the kind that is inflicted on basically every football player at the line of scrimmage on every single play of every single game. The ball is snapped and every player lined up at the line immediately slams forward into another player, often leaning forward with their helmets.

This is not much different than putting on a helmet and standing next to a wall and just launching yourself with all your force head first into it over and over (except that a wall isn't also launching itself at you the way an opposing player is, but instead is just stationary). The helmet protects the exterior of your head, but inertia thrusts your brain forward only to slam against the inside of your skull, over and over and over. This repeated trauma day after day, year after year, causes brain tissue to harden and that's CTE, which leads to dementia and even insanity in former players, often as young as in their late 30s and early 40s.

So the measures the NFL has taken to address concussions, like late hits against quarterbacks, or tackles leading with your helmet, don't really address CTE at all. The reason the NFL muddied the water on this is because to truly address CTE you'd have to eliminate all the contact going on at the line of scrimmage on every single play. And how can you do that and still have tackle football? The answer is that you can't. And so, the NFL continues to create brain damage in most of its players on every single play of every single game, but people accept this because of the popularity of the sport.

I'm curious what people think. Personally I'm conflicted. Ethically it feels like I should just stop supporting tackle football at all, but I kind of want to just enjoy it while we still have it, cause I'm pretty sure football is going to be forced to change significantly at some point. It's just a question of when that will be.

[bryan35]

Not accurate to say linemen are ramming their heads together every play. Proper blocking and tacking is being taught with the head not being used.

[VictorRomano]

Rugby player/coach here.  Want to stop players from "headhunting" and leading with the head during contact?  Take away their plastic helmets, and apply a "must wrap" rule to tackles, eliminating uncontrolled shoulder hits.

Helmets don't prevent concussions or CTE - you still get those regardless of what kind of helmet you wear if you make contact wit the head.  Helmets only stop you from fracturing your skull.  If you tackle/block properly, there is already a demonstrably significant reduction in concussions and fractured skulls.  Maybe just have a padded helmet (like a scrum cap in rugby) to protect a jumping receiver who is tackled mid-air or a lineman who is in someone's face every play?

"Must wrap" requirements on anyone initiating a tackle prevents people from recklessly endangering other players by flinging their uncontrolled bodies around the field at high speed.  If you have to wrap, you need to slow down, plant your feet, and enter contact in a controlled manner.

[bryan35]

Rugby player/coach here.  Want to stop players from "headhunting" and leading with the head during contact?  Take away their plastic helmets, and apply a "must wrap" rule to tackles, eliminating uncontrolled shoulder hits.

Helmets don't prevent concussions or CTE - you still get those regardless of what kind of helmet you wear if you make contact wit the head.  Helmets only stop you from fracturing your skull.  If you tackle/block properly, there is already a demonstrably significant reduction in concussions and fractured skulls.  Maybe just have a padded helmet (like a scrum cap in rugby) to protect a jumping receiver who is tackled mid-air or a lineman who is in someone's face every play?

"Must wrap" requirements on anyone initiating a tackle prevents people from recklessly endangering other players by flinging their uncontrolled bodies around the field at high speed.  If you have to wrap, you need to slow down, plant your feet, and enter contact in a controlled manner.

Hawk/Gator similar to rugby tackling is becoming more common in football. Safer and effective way of tacking.

[LXTSN]

I'm curious what people think. Personally I'm conflicted. Ethically it feels like I should just stop supporting tackle football at all, but I kind of want to just enjoy it while we still have it, cause I'm pretty sure football is going to be forced to change significantly at some point. It's just a question of when that will be.

You're probably right. There are significant long term damage to football players, but I think that almost everything possible has been done to fix the game to make it safer.
>We've penalized defenseless hits to the head (more specifically hits on QB's and WR's)
>We have started teaching kids more proper tackling technique early on
>Eliminated crack-back blocks

Football is a violent and physical game. The truth is that 99% of us would not be watching the sport if this was touch football.
Is it ethical? While it's always been a dangerous sport, both sides understand what they signed up for.

[Jesse]

Not accurate to say linemen are ramming their heads together every play. Proper blocking and tacking is being taught with the head not being used.

I feel like this is the propaganda talking.

Does it matter if the head is used? The brain is still smacking against the inside of your skull with the sudden starts/stops of line play.

[Jesse]

You're probably right. There are significant long term damage to football players, but I think that almost everything possible has been done to fix the game to make it safer.
>We've penalized defenseless hits to the head (more specifically hits on QB's and WR's)
>We have started teaching kids more proper tackling technique early on
>Eliminated crack-back blocks

Football is a violent and physical game. The truth is that 99% of us would not be watching the sport if this was touch football.
Is it ethical? While it's always been a dangerous sport, both sides understand what they signed up for.

This doesn't seem true.

Do you really think everyone who plays football, even now, understands the negative outcomes of CTE?

Much less anyone who played more than 10 years ago when it wasn't known or discussed at all.

[the paw]

I just read this take on CTE, and how the football protocols are really not protecting against it. I can't say for sure how accurate it is... it generally matches with the info I can find elsewhere, but it's also clear that CTE is not very well understood yet.

I'm curious what people think. Personally I'm conflicted. Ethically it feels like I should just stop supporting tackle football at all, but I kind of want to just enjoy it while we still have it, cause I'm pretty sure football is going to be forced to change significantly at some point. It's just a question of when that will be.

I feel much the same way.  I started feeling really ethically squishy since Drew Edwards did some really in-depth work in this issue as part of the old Scratching Post blog. I guess I have kind of put my head in the sand over it since then.  The subconcussive thing is definitely the meat of the matter though.

While I think the idea of rugby style tackling is an incremental improvement in the right direction, it is far from a solution.  There are concussion and CTE issues with both rugby and soccer players (heading the long balls especially).

I think the move to reduce the number of full contact practices with pads is the most significant preventative step in terms of reducing subconcussive impacts.  There are some university programs that basically don't do full contact practice at all.  The concussion protocol is a positive thing, but not a panacea for sure. 

[bryan35]

I feel like this is the propaganda talking.

Does it matter if the head is used? The brain is still smacking against the inside of your skull with the sudden starts/stops of line play.

To some degree yes but dramatically less if your head is not directly hit. Many sports have sudden stops, falls, and collisions. Football is one of them.
If you feel strongly that the sport is wrong or barbaric then you have a choice not to support it or watch it.

[blue_or_die]

To some degree yes but dramatically less if your head is not directly hit. Many sports have sudden stops, falls, and collisions. Football is one of them.
If you feel strongly that the sport is wrong or barbaric then you have a choice not to support it or watch it.

Right, but if the truth is that if something is, in fact, unethical or verifiably "bad", then telling people to just "do you" does nothing to solve it. While the CTE topic is debatable at the moment, once the dust is settled on the science and there's social consensus, telling people it's a choice to allow it is irresponsible and damaging overall.

Just saying "it's my choice to support something verifiably bad" shouldn't be an acceptable or tolerable response. Of course, that extends beyond CTE.

[LXTSN]

Right, but if the truth is that if something is, in fact, unethical or verifiably "bad", then telling people to just "do you" does nothing to solve it. While the CTE topic is debatable at the moment, once the dust is settled on the science and there's social consensus, telling people it's a choice to allow it is irresponsible and damaging overall.

Just saying "it's my choice to support something verifiably bad" shouldn't be an acceptable or tolerable response. Of course, that extends beyond CTE.

You're right CTE is objectively bad.
They have taken steps to avoid this long term right? What else needs to be done? I'm sure in 10 years the game might look a little different but I'm really curious to see how.

[Jesse]

You're right CTE is objectively bad.
They have taken steps to avoid this long term right? What else needs to be done? I'm sure in 10 years the game might look a little different but I'm really curious to see how.

I think the most important thing right now is education. Make sure players do know what they're signing up for.

Are parents aware of the risks when they're signing up their kids? When you look across the United States, where football is a religion, are people educated about these risks, or are they still mostly shrugged off?

Personally, I'm happy I don't have boys and need to have this conversation with myself. The wife is already hesitant in allowing our girls join hockey.

[LXTSN]

I think the most important thing right now is education. Make sure players do know what they're signing up for.

Are parents aware of the risks when they're signing up their kids? When you look across the United States, where football is a religion, are people educated about these risks, or are they still mostly shrugged off?

Personally, I'm happy I don't have boys and need to have this conversation with myself. The wife is already hesitant in allowing our girls join hockey.

I think most parents are aware that there are potential long term effects, but probably don't know what the extent of these effects could be.
Just my opinion but most parents shrug it off or make light of it. If their kids are having fun playing then it's all fine.

If I had kids, I wouldn't really be comfortable signing them up for football either.

[Throw Long Bannatyne]

Right, but if the truth is that if something is, in fact, unethical or verifiably "bad", then telling people to just "do you" does nothing to solve it. While the CTE topic is debatable at the moment, once the dust is settled on the science and there's social consensus, telling people it's a choice to allow it is irresponsible and damaging overall.

Just saying "it's my choice to support something verifiably bad" shouldn't be an acceptable or tolerable response. Of course, that extends beyond CTE.

There is no debate and the science is settled, getting knocks to the head repeatedly is obviously bad for the brain.  It's up to people to decide whether they want to participate in these activities or not, I for one would not allow my kids to participate in tackle football even if they wanted to.

Whether you spectate such events is up to you, obviously MMA fighting and boxing are worse cases of brutality.  The NFL will do everything in their power to keep the money flowing, and with their vast capital they should be able to influence public opinion and buy political immunity for many decades to come. Nothing is going to change much in 20 years.

[VictorRomano]

I for one would not allow my kids to participate in tackle football even if they wanted to.

Guess you're not gonna let your kids play ice hockey either, since the concussion ratio for hockey players is almost triple that for football players (1.2 per 1000 for hockey, .53 per 1000 for football.

https://completeconcussions.com/concussion-research/concussion-rates-what-sport-most-concussions/