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Power of Patients - Head Injuries in Football

As the excitement builds for the upcoming Super Bowl, the thrill of football season is at its peak. Yet, amidst the electrifying plays and intense competition, a sobering concern remains: head injuries. Join us as we delve into the intricacies of head injury prevention in football, offering a playbook for safety that incorporates the resources and support provided by Power of Patients.


Head Injuries In Football

Understanding the Impact: Football's Collision Culture and the Risk of Head Injuries


Football, often hailed as America's favorite pastime, is a sport characterized by its intense physicality, adrenaline-fueled plays, and bone-jarring collisions. Unlike many other sports, where the primary objective is to outmaneuver opponents with agility and finesse, football embraces the full-contact nature of the game, where players collide with each other at high speeds in pursuit of victory. From bone-rattling tackles to fierce blocks, every play in football is an orchestrated collision between opposing forces, where strength, strategy, and skill intersect in a symphony of controlled chaos.


It is within this collision culture that the risk of head injuries looms large. In football, players are not only encouraged but often celebrated for their ability to deliver and withstand punishing blows to the head and body. Helmet-to-helmet collisions, once glorified as displays of toughness and resilience, are now recognized as significant contributors to the prevalence of head injuries in the sport. The sheer force generated by these impacts can exceed the limits of the human body's ability to absorb and dissipate energy, resulting in concussions, traumatic brain injuries (TBIs), and, potentially, the long-term consequences of chronic traumatic encephalopathy (CTE).


Compared to other sports, football's collision culture sets it apart as one of the most physically demanding and high-risk activities for head injuries. While sports like soccer and basketball may involve incidental contact or occasional collisions, football embraces contact as an integral part of its gameplay, with every player on the field tasked with delivering and enduring hits as part of their role. The combination of speed, size, and force in football amplifies the risk of head injuries, making player safety a paramount concern for coaches, medical staff, and governing bodies alike. 


As we delve deeper into the complexities of head injury prevention in football, it is essential to recognize the unique challenges posed by the sport's collision culture and physicality. By understanding the nature of football's collisions and their implications for player safety, we can better appreciate the need for proactive measures to mitigate the risk of head injuries and promote a culture of accountability, respect, and well-being on and off the field.


Understanding Chronic Traumatic Encephalopathy (CTE) in Football


Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative brain disease that is believed to be caused by repeated blows to the head and concussions. Unlike traumatic brain injuries (TBIs), which are acute events resulting from sudden impacts or trauma to the head, CTE develops over time as a result of cumulative exposure to head trauma. In CTE, a protein called tau accumulates in the brain after repeated head impacts, resulting in brain damage similar to Alzheimer's disease and potentially leading to dementia and death (National Institute of Health 2023). While TBIs may cause immediate symptoms such as headaches, dizziness, and confusion, CTE is characterized by long-term changes in brain structure and function that can manifest years or even decades after the initial injuries occur. 


In the context of football, CTE has garnered significant attention due to its association with the repetitive head impacts and collisions that are inherent to the sport. The history of CTE in football dates back several decades, with early reports of cognitive and behavioral changes observed in retired players. As awareness of the long-term consequences of head injuries has grown, so too has the recognition of CTE as a significant health concern within the football community.


Symptoms of CTE can vary widely and may include cognitive impairment, mood disturbances, and behavioral changes. These symptoms may initially be subtle and go unnoticed, but they can progress over time and significantly impact an individual's quality of life. Unlike TBIs, which may improve with time and rest, CTE is a progressive and irreversible condition that currently has no cure. While some treatments may help manage symptoms and improve quality of life, there is no known way to reverse the underlying brain damage associated with CTE.


Chronic Traumatic Encephalopathy In Football

The Latest Findings in CTE Research


To better understand the relationship between head impacts and CTE, researchers led by Dr. Daniel Daneshvar and Dr. Jesse Mez collected data from previous studies of helmet accelerometers used in football players (National Institute of Health 2023). They created a positional exposure matrix (PEM) to estimate the average number and types of head impacts players experienced during a season based on their position and level of play.


Analyzing data from 631 male brain donors who had played football, the researchers found that every additional year playing football was associated with a 15% increased odds of a CTE diagnosis and a 14% increased odds of severe CTE. Additionally, every 1,000 additional estimated blows to the head increased the odds of a CTE diagnosis by 21% and the odds of severe CTE by 13%.


These findings suggest that reducing the number and force of head impacts in practice and games could lower the risk of developing CTE. The study highlights the importance of addressing non-concussive head injuries in preventing CTE and promoting player safety in football.


Another recent study at Boston University CTE Center confirms similar findings by studying former NFL players in comparison to non-football populations. Out of 376 former players studied, a staggering 345 individuals, representing 91.7% of the sample, were diagnosed with CTE. Among those diagnosed in the past year are two former players associated with teams competing in Super Bowl LVII: Rick Arrington of the Philadelphia Eagles and Ed Lothamer of the Kansas City Chiefs.


This prevalence of CTE starkly contrasts with previous studies examining CTE in non-football populations. For instance, a 2018 study of brains donated to the Framingham Heart Study found only one case of CTE out of 164 individuals, reflecting a population rate of 0.6%. Such disparities underscore the unique risks faced by athletes participating in contact sports like football, where repetitive head impacts are prevalent and contribute to the accumulation of misfolded tau protein in the brain, a hallmark of CTE.


Despite the high prevalence observed among former NFL players, it's crucial to interpret these findings with caution. Brain bank samples, such as those used in this study, are subject to selection biases and may not fully represent the broader population of current and former NFL players. Moreover, CTE can only be definitively diagnosed post-mortem, making it challenging to determine the true prevalence of the condition among athletes during their lifetimes.


However, amidst these concerning statistics, there is a glimmer of hope. Dr. Ann McKee, director of the BU CTE Center, emphasizes that while the most severe outcomes of CTE often dominate headlines, they represent the minority of cases. Many symptoms associated with CTE can be treated, and individuals experiencing symptoms can get help with medical treatment.


The implications of CTE for football players, both current and former, are profound. The recognition of CTE as a potential consequence of participation in contact sports has sparked conversations about player safety, rule changes, and the ethical considerations surrounding the sport. Efforts to minimize head trauma, improve concussion protocols, and prioritize player well-being are ongoing, but the long-term impact of CTE on football and its participants remains a topic of significant concern and debate. As research continues to advance our understanding of CTE and its relationship to football, it is essential for players, coaches, and stakeholders to remain vigilant in their efforts to promote a culture of safety and accountability within the sport.


TBI and CTE Causes in Football

Tackling and Collisions:

  • The physical nature of football, with its emphasis on tackling and blocking, significantly increases the risk of head injuries. Impactful hits, particularly those involving helmet-to-helmet contact, can result in concussions and other forms of head trauma.

Helmet-to-Helmet Contact:

  • Despite advancements in equipment technology and rule changes aimed at minimizing dangerous play, helmet-to-helmet contact remains a concern in football. Such collisions can lead to severe head injuries and necessitate proactive measures to mitigate their occurrence.


Repetitive Head Trauma:

  • Prolonged exposure to repetitive head impacts, even those that may not initially result in symptoms, can have cumulative effects on players' brain health. Awareness of the risks associated with repeated head trauma, including CTE, is essential for promoting player safety.


Brain Injury Prevention Strategies in Football

Proper Equipment and Fitting:

  • Wearing appropriate protective gear, including well-fitted helmets designed to absorb impact forces, is paramount for reducing the risk of head injuries in football. Ensuring that equipment is regularly inspected and maintained enhances its effectiveness in safeguarding players.


Technique and Training:

  • Coaches and players must prioritize safe and controlled tackling techniques during practices and games. Emphasizing proper form and tackling fundamentals reduces the likelihood of high-impact collisions and minimizes the risk of head injuries.


Rule Enforcement:

  • Strict enforcement of rules prohibiting targeting, spearing, and other forms of dangerous play is essential for promoting player safety. Officials play a pivotal role in penalizing infractions and upholding regulations that prioritize player well-being.


Post-Injury Care for Football Brain Injuries

Recognizing Symptoms:

  • Educating players, coaches, and medical staff about the signs and symptoms of concussions and other head injuries is critical for prompt identification and intervention. Common symptoms include headache, dizziness, confusion, and sensitivity to light or noise.


Seeking Medical Attention:

  • Players who experience head injuries should undergo comprehensive evaluation by qualified medical professionals. Prompt diagnosis and appropriate management are essential for ensuring optimal outcomes and preventing further injury.


Gradual Return to Play:

  • Following a head injury, players should adhere to a structured return-to-play protocol under the guidance of healthcare providers. Gradually reintroducing physical activity while monitoring symptoms allows for safe and effective rehabilitation.


Partnering with Power of Patients to Make Football Safer

The Power of Patients platform, affectionately named Sallie®, goes beyond traditional symptom tracking by providing a virtual therapy dog to help individuals injured by concussions, TBIs, and post-concussive syndrome identify and track symptoms and triggers that exacerbate their condition. Developed with a patented AI algorithm, the platform analyzes user data to identify unique patterns and signals, enabling the classification of new treatment protocols for people with TBIs. This innovative approach empowers football players, coaches, and medical staff to take proactive steps towards mitigating the risk of TBIs and promoting player safety on and off the field.


Power of Patients has garnered significant recognition for its innovative platform and its role in enhancing player safety in football. In 2022, The NFL Alumni Association awarded the Power of Patients platform a thumbs-up endorsement, highlighting its efficacy in aiding research and furthering medical understandings of traumatic brain injuries (TBIs). Former NFL players are now reaching out to Power of Patients to learn how they can be proactive in caring for their brain health, underscoring the platform's value in promoting player safety and well-being.


By leveraging the Power of Patients platform, individuals can document symptoms, share experiences with the community, and access relevant resources to make informed decisions about their health. Whether tracking symptoms, coordinating care, or facilitating communication with healthcare providers, Power of Patients empowers users to prioritize their well-being and contribute to a culture of safety in football. With the NFL endorsement and ongoing advancements in technology and research, Power of Patients continues to play a vital role in enhancing player safety and promoting proactive approaches to managing TBIs in football.


Empowering Change on and off the Field

As we navigate the complexities of head injury prevention in football, it's crucial to translate knowledge into action. Here are some practical steps you can take to promote player safety and advocate for positive change within your community:


Attend Safety Workshops and Training Programs:

  • Participate in safety workshops and training programs that focus on concussion recognition, proper tackling techniques, and equipment fitting. These educational opportunities empower players, coaches, and parents with the knowledge and skills necessary to minimize the risk of head injuries on the field.

Advocate for Rule Changes and Policy Reform:

  • Advocate for rule changes and policy reform at the organizational, league, and governmental levels to prioritize player safety in football. Support initiatives that aim to reduce helmet-to-helmet contact, enforce strict penalties for dangerous play, and implement comprehensive concussion protocols. Your voice can make a difference in shaping the future of the sport.


Promote Cultural Shifts and Attitude Changes:

  • Foster cultural shifts and attitude changes within the football community by promoting a culture of safety, respect, and accountability. Encourage teammates, coaches, and officials to prioritize player well-being over winning at all costs. By shifting the focus from toughness to smart play, we can create a safer and more inclusive environment for all participants.


Engage in Community Outreach and Education:

  • Engage in community outreach and education efforts to raise awareness about head injuries in football and promote preventive measures. Organize informational sessions, distribute educational materials, and collaborate with local schools, youth organizations, and healthcare providers to ensure that players and families have access to accurate information and support resources.


Participate in Medical Research: 

  • To further advance our understanding of CTE and develop effective treatments, the research centers like those at Boston University are actively recruiting former athletes, including women, for research studies. Projects like Project S.A.V.E. are investigating the long-term effects of repetitive head impacts from contact sports and may provide valuable insights into preventing and treating symptoms associated with CTE. As research on CTE continues to evolve, it's essential to acknowledge the contributions of donor families and researchers worldwide in advancing our knowledge of this complex condition. By supporting ongoing research efforts and advocating for player safety in contact sports, we can work towards mitigating the risks of CTE and improving the lives of athletes at all levels of competition.


Together, we can take proactive steps to defend against head injuries and ensure that the thrill of football is matched by a commitment to safety, integrity, and inclusivity. Your actions today can shape a brighter and safer future for football players of all ages and abilities.Thus, as we gear up for the excitement of the Super Bowl, let's not forget it’s imperative to prioritize player safety and well-being. By understanding the risks, implementing preventive strategies, and leveraging resources like Power of Patients, we can defend against head injuries and ensure that the thrill of football is matched by a commitment to safety. Together, let's champion a culture of informed decision-making and proactive injury prevention in football. Visit our website to learn more and register today.

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