In a sport played by over 5.2 Million people and watched worldwide, a problem looms to potentially hinder it’s future.(Outdoor Participation) Chronic Traumatic Encephalopathy (CTE) is a degenerative brain disease found in people with repeated brain trauma. The disease has been an epidemic that football organizations have been trying to deal with for the past few years. The National Football League (NFL) has dealt with many lawsuits over the past few years which involved former players who have multiple ailments because of CTE brought forth by playing football. The NFL dealt with this problem by settling with each player by giving them all five million each. The NFL has also funded programs like USA football that aim to teach young football players the proper ways to tackle to make the game safer. Meanwhile, doctors from around the world have decided to deal with the disease by trying to find the effect of the age of first exposure in regards to getting CTE in football players. The age of first exposure is exactly as it sounds, the age that someone started playing football and potentially started experiencing repeated head trauma. The goal in their study was to see if there was any correlation with this and CTE.
Their study was based off of 246 brains and previously completed interviews of now deceased football players. The disease can only be identified and examined when the person is deceased, but the doctors had to gain certain information before the players passed away. All of the players had to provide an interview or complete an online questionnaire on the topic of when they started playing football and when the symptoms were noticeable. Those symptoms can include: memory loss, confusion, personality changes, erratic and aggressive behavior and difficulty with motor skills (Alzheimer’s Association). The interviews were another way they monitored the health of each individual. For example, some of the interviews carried out by the doctors were on telephones. These conversations on the phone can be good indicators of whether or not problems of behavior or cognitive exist. Once told what symptoms the person is dealing with, the doctors would ask when the symptoms became prominent. The interviews provided more information like demographics, levels of education, position played, levels played at and any other brain injuries. It wouldn’t be a good idea to ask someone with memory loss to recite their memory if the goal was to gain accurate information. Almost every interview had the person being interviewed accompanied by someone else. These people varied in their relationship from spouse to close friend, with the goal to have someone knowledgeable about the subject’s history with football and their injuries from it. The study itself is rooted in these interviews but must be paired with the actual diagnosis of CTE.
After conducting the proper tests, doctors concluded that out of the 246 brains, only thirty-five were free of CTE. After doctors found the status of CTE in each brain, they would use the interview and or online questionnaire answers provided by the subject to link and file the results together. It is important to acknowledge that because these tests had to be done with deceased football players, therefore the results are in large part focused on players who started playing in the 40’s and 50’s.
Once the CTE diagnosis was complete and the brains were matched up to the interviews the doctors were able to piece together their findings. The mean starting age of playing football who also had CTE linked to them was eleven, compared to the median of the starting age of everyone combined of twelve. Divided into these two groups, those who started playing before age twelve and those who started at or after age twelve, the results gave way to more conclusions. Those who had started playing prior to age twelve, died sixteen years earlier on average compared to those who started at or after age twelve. Those same players played an average of three years more than those who started later. The severity of CTE varied and there seemed to be no link to the age of first exposure. However, another possible link was the position they played. The positions that were more involved in tackling and contact, like linebackers and running-backs, had more severe CTE. This links up with other studies done in regards to positional impact on concussions and thus, CTE. (Baugh)
In conclusion, the results of this study accurately describe the link of starting age to frequency of acquiring CTE. The study, however, cannot place a connection between severity of CTE and starting age. The study does seem hindered by the mix of player positions as that could sway the results based on the different amounts of head contact and trauma experienced. It is hindered by the era in which most of their subjects played in. It isn’t unreasonable that the sport has gotten safer in many regards; such as rule changes and better equipment. According to the NFL’s rules and operations website, the past three years have brought five new player safety rules. Taking away or adjusting things like the kickoff or blindside blocks limits the amount of head to head hits tremendously. There was no conflict of interest in play but like most CTE and Concussion based studies, a lot of the scientists have links to Boston University, who has conducted many concussion based studies. The best way to further validate these claims would be to involve more universities or research institutions, get a more modern group and account for the different positions played. There are multiple benefits of continuing the study of CTE in football players in multiple phases like age of first exposure, including possible rule changes, expansion of football’s reach and better understanding the situation in its entirety allowing families to make informed decisions on the pros and cons of playing.
Michael A, Jesse M, Yorghos Tripodos, 2018. Age of first exposure to tackle football and chronic traumatic encephalopathy. Annals of Neurology 83:886-901.
Steve A, 2015. Judge approvals NFL concussion lawsuit settlement. CNN.
Baugh CM, Kiernan PT, Kroshus E, 2015. Frequency of head-impact-related outcomes by position in NCAA division I collegiate football players. J Neurotrauma. 32(5):314–326.