CTE and it’s Spot on the NFL Roster

An estimated 14.9 million viewers in 2020 witness and encourage their famed icons to tackle one another straight into a future medical research program; that we have only begun to scratch the surface of. Tackling Chronic Traumatic Encephalopathy was the most consistent statistic for the late Andre Waters.

Andre Waters, Philadelphia Eagles #20 Safety (1993)

A medical research paper summarizes CTE as an “Abstract Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease thought to be caused, at least in part, by repetitive brain trauma, including concussive and subconcussive injuries.” This is a brain disease thought by many as something no more than a hoax to prevent Americans from witnessing the greatest game on Television. The truth is that CTE is an invisible disease that affects an individual in many different ways such as; cognitive impairment, impulsive behavior, short-term memory loss, difficulty completing tasks and depression. This is something that has become more and more of a reality from famed athletes, post-career from physical contact sports.

This graph provides the results found in 111 players post career from the NFL and the side effects they experience from CTE based on a series of controlled cognitive skill tests.

“The data suggest that there is very likely a relationship between exposure to football and risk of developing the disease,” says Jesse Mendez (MD with Boston University). As more athletes and most individuals who practice contact sports continue to endure physical contact on a frequent basis then we can see a clear relationship between physical and mental injuries. When a player makes contact with another player, we mostly only see them roll their eyes and get up to continue the play. What we do not see is the fine neurological links that are being broken on each collision. When an individual loses that link, it is impossible for it to be reconnected or regenerate and perform at the same level of productivity. Due to these links being broken, it causes a chain reaction for other functions and skills to be lost. The most common symptoms of CTE are loss of cognitive functions, rapid behavioral mood changes, dementia and motor difficulties.

Most of us may be wondering, how can the doctors see a sign of CTE developing? The answer is identifying the signs of tau proteins clustered around blood vessels in the brain. “I think the data are very surprising, … We’ve sort of become accustomed to it, but it is very shocking.” says Ann McKee ,(MD professor of neurology from Boston University)

A sample of normal brain tissue (left), alongside samples showing mild and severe CTE. The brown stain indicates tangles of tau protein. Defective tau is associated with CTE, as well as Alzheimer’s disease and Parkinson’s disease. The bottom row shows microscopic images of tau, stained red, embedded in brain tissue. Photo by Ann McKee

While the NFL is a fun and entertaining sport, the NFL should educate players on the impact CTE has in their lives current and post career because it causes behavioral changes, damages the nervous system, and leads to other invisible disabilities. There have been many players who were loved amongst teammates while in the peak of their careers but then relationships quickly tarnished post career. This has been due to the side effects of CTE and it affecting their relationships with those teammates. This is based on uncontrollable mood changes causing rage or acts of aggression towards someone who was once thought to be a friend.

The ability to live a normal life after the NFL has become more and more of a difficulty for players as they find the game becoming faster, more physically demanding and more aggressive. Eric Dickerson is a former Running Back for the Los Angeles Rams and has stated on many occasions that when he would run through the offensive line, he felt a part of him was being left behind the line of scrimmage.

“You are supposed to be tough. You are supposed to play through pain. You are not supposed to cry. We are taught that early on in the game as kids. Tough sport. Brutal sport. It’s like the gladiator. People want to see the big hits. They wind up on Sports Center. And as a player, you don’t want to admit you are injured.”
(Eric Dickerson after being advised he may have CTE)

Shannon Sharpe and Ray Lewis respond to Jamal Adams’ comments on CTE | UNDISPUTED

Many have heard from the current and past NFL players on their thoughts of CTE or the post career depression that looms the empty locker rooms at night. What we as an audience fail to recognize is the medical research being done behind the scenes to bring more awareness onto this neuro-disease. Many Medical Doctors believe that NFL players lack information due to lack of education on the subject. They hope with the current rise in mental wellness being advocated as a muscle that should be exercised and treated with care that we will see a new age of sports, an age that could be watched by all. When Dr. Bennet Omalu was asked if he watches football his response was; “No, no, I don’t watch football. The last time I tried watching was the last Super Bowl. The problem I have is, you know, the graphic nature of my imagination; when I watch and see them meeting head onto head, helmet onto helmet, what flashes through my mind is what’s going on in their brains. It’s like torture to me.”

Digital graphic to reference brain trauma post contact

The current research that is being done is only in early stages but growing at a rapid pace due to more and more players asking for this information to be broadcasted for the younger generation to hear. Rebecca J. Frey in “Chronic Traumatic Encephalopathy” describes caused of CTE as “Although it is not yet completely understood how the rupture of axons and blood vessels, inflammation, and p-tau accumulation lead to progressive deterioration of the patient’s brain, researchers do know that the length of an athlete’s playing career, the age at which he began to play, and concurrent abuse of alcohol or drugs are factors in the rate of p-tau accumulation.” If this trauma occurs in a pattern or repeatedly over a period of time it can cause a disease that later breaks down the proteins in the brain and affects the neurons in the brain. This will then lead to other mental illnesses such as alzheimer's, parkinson's and post-concussion syndrome.

To bring our journey we must take examples such as Andre Waters as an opportunity to educate, react and be proactive in communicating this mental illness to all. While the NFL is a fun and entertaining sport, the NFL and all involved should educate players on the impact CTE has in their lives current and post career to allow for all of us to make an educated and informed decision before committing to a future invisible disability. This mental illness is not something most talk about due to it being a part of an American staple with the NFL. The goal of this research is to find a suitable long term therapy but also to spread awareness.

Works Cited:

“Bennet Omalu Quotes.” BrainyQuote.com. BrainyMedia Inc, 2021. 11 March 2021. https://www.brainyquote.com/quotes/bennet_omalu_756460

Frey, Rebecca J. “Chronic Traumatic Encephalopathy.” The Gale Encyclopedia of Medicine, edited by Jacqueline L. Longe, 6th ed., vol. 2, Gale, 2020, pp. 1197–1202. Gale eBooks, link.gale.com/apps/doc/CX7986600429/GVRL?u=mc c_chandler&sid=GVRL&xid=3d9f535f. Accessed 4 Mar. 2021.

Jesse Mez, MD. “Evaluation of Chronic Traumatic Encephalopathy in Football Players.” JAMA, JAMA Network, 25 July 2017, jamanetwork.com/journals/jama/fullarticle/2645104.

Ruth, Dave, et al. “BU Researchers Find CTE in 99% of Former NFL Players Studied.” Boston University, 26 July 2017, www.bu.edu/articles/2017/cte-former-nfl-players/#:~:text=Of%20the%20202%20brains%20studied,school%20players%20(21%20percent).

Gough, Christina. “NFL Average TV Viewership per Game 2020.” Statista, 11 Feb. 2021, www.statista.com/statistics/289979/nfl-number-of-tv-viewers-usa/.

Li MD, Charles. “CTE in 2018: Understanding Football Brain Damage in 5 Charts.” CTE: The Hidden Epidemic in 5 Charts | Visualized, www.clearvuehealth.com/cte/football/.

Phillips, Stone. “Quotes from Players and Experts.” Stone Phillips Reports, stonephillipsreports.com/2012/01/quotes-from-players-and-experts/.

Baugh, Christine M., et al. “Chronic Traumatic Encephalopathy: Neurodegeneration Following Repetitive Concussive and Subconcussive Brain Trauma.” Brain Imaging and Behavior, vol. 6, no. 2, 2012, pp. 244–254., doi:10.1007/s11682–012–9164–5.