Glaring Shortfall of Catastrophic Casualties Grows in Ongoing Review 

Spinal Cases Might Reach Hundreds Annually in American Football

Mueller and Cantu Gathered Mere 24 Catastrophic Cases for Year 2010 

News commentary by Matt Chaney

ChaneysBlog.com

Posted Wednesday, January 4, 2012

 

Football-funded researchers Frederick Mueller and Dr. Robert Cantu are ignoring interview requests concerning their under-reporting of catastrophic casualties in the American sport, injuries they classify as severe trauma involving brain, skull, vertebral column and/or spinal cord.

Or Mueller and Cantu aren’t talking to me, at least, perhaps understandably from their perspective, facing now their likely decades of bad data in cases shortfall, erroneous rates, and even baseless claims about trending “safer” football in the United States.

And all because my electronic searches through Google banks continue to produce cases and rates of catastrophic football injury that bury Mueller-Cantu numbers, which are widely accepted and republished at face value, including by medical journals and the CDC.

Mueller and Cantu work under auspices of the National Center for Catastrophic Sport Injury Research, University of North Carolina. The NCAA provides major funding.

Most importantly, America faces prospect the large majority of catastrophic football injuries go unreported in public, besides a minor portion emerging in news information, the stream fished heavily by Mueller and Cantu for cases they catch.

In the class of vertebral fractures involving no paralysis, for example, there’s probability at least hundreds such “walking” cases go unreported or missed every year in American football, based on sound estimates and etiology outside UNC, along with expert and witness opinion on injuries.

For survivors of all catastrophic categories, I’ve now collected almost a hundred candidate cases for 2011 and should find more. For 80 annotated cases and further discussion, see my Dec. 21 post.

My final qualified number for 2011 should far exceed any on record by Mueller and Cantu, whose 2008 tally of 63 cases is apparently their high mark.

For 2010, the current Mueller-Cantu report lists mere 24 survivors of catastrophic football injury nationwide, including 13 in “complete” recovery.

By stark contrast, my ongoing searches have located some 70 survivors for 2010 football, including over 20 in the past week, and I expect to hit more cases through Google.

About 50 cases I’ve gathered for 2010 remain omitted from the current UNC data.

I have at least 7 detected brain bleeds missed by Mueller and Cantu, of 2010, along with about 35 reported spinal fractures, some cases involving lasting paralysis.

Epidemiologist Charles Yesalis empathizes with Mueller and Cantu. Yesalis, ScD, a professor emeritus of health policy and administration at Penn State University, says challenges are immense for producing representative or accurate accounting on bodily catastrophes in vast American football, a high-risk population of upwards five million active participants.

“I think the key thing is this notion that they (Mueller and Cantu) are only picking up a small percent of cases,” Yesalis said in a phone interview. “And given my experience as an epidemiologist, that just doesn’t surprise me at all.”

“When you go farming for these data—and that’s a good a term as any—boy, it’s a lot of hit and miss.”

The Mueller-Cantu approach for gathering catastrophic cases is characterized in annual UNC reports, depicting a patchwork of football sources and other spotters, coaches, trainers, organizers, doctors and media like me, who forward candidate finds such as online news stories.

Granted, the Mueller-Cantu method picks up some information, but little else is certain beyond invalidity as epidemiological study, pending revisions.

For briefing on the research team, Mueller is director and a former football coach who’s compiled injury cases since the 1970s. “Dr. Mueller,” as Cantu addresses him, holds a PhD in education and works as a UNC professor of sport administration and science. Cantu, the well-known neural sport surgeon and researcher based in Boston, is medical director of the studies.

Yesalis has not performed scholarly critique of the Mueller-Cantu reports at UNC, but he says the inexact approach for gathering football’s worst injuries is nothing new in aspiring research.

“When you’re dealing with (data) as what might get reported in the news, versus trying to identify accurately what’s reported in emergency rooms, or hospital records, that’s problematic,” says Yesalis, co-author of acclaimed national surveys on steroid use by teenagers, among his scientific credits on sport doping and more epidemic disease.

“You’re trying to glue all this together, which is what it appears they’re doing (at UNC),” Yesalis says. “And they’re not the first people to do this on a variety of disease states, and emergency-room conditions, injuries and all that.”

Heavy limitations virtually quash the Mueller-Cantu approach at outset, for bearing solid data and rates, and the absolute numbers they typically present or imply are impossible. Their documents always contain a pair of obscured same sentences, disclaimers for inadequate data, but there’s no formal statement of study limitations. Scant literature review doesn’t mention pertinent research, including studies outside UNC on spinal injuries in general population that rank the sport of football among causes.

An informed schoolteacher would revise the Mueller-Cantu study at first draft, proposal stage, and apparently the UNC readers of graduate and doctoral theses never have the opportunity, given shoddy final data and presumptions that are published and disseminated worldwide, thanks to witless journal editors, government officials and news media.

Obstacles for Mueller and Cantu begin on likelihood that most catastrophic football cases remain unreported in any fashion, for factors such as injured players’ ignorance or resistance of seeking treatment. Cases are also withheld for patient privacy, doctor misdiagnoses and faulty medical coding.

“And if you rely on the fact that it might be in the news?” Yesalis poses. “Well, you know…”

Attritional effects on information don’t end with a case’s publicity by news reporters. Much daily print and broadcast content is culled out before reaching online posting, and cyber pages are routinely taken down in as soon as weeks. Subscription-only access blocks readers from many online news publications, particularly of rural areas.

Indeed, I cannot declare that my vigilant Google review, based on revolving Boolean word searches over hundreds of hours, produces a representative sampling of catastrophic football casualties for a given year. No known reference can affirm, and I find that even news of football fatalities slips by, a few cases, through cross-checking my own lists and those of Mueller-Cantu.

Meanwhile, Yesalis confirms medical databases are no catchall method, no resolution for limitations, and the human variable can skew electronic data in translation.

“If you’re using in any way of automated medical records, then (the question becomes): How is a condition diagnosed?” Yesalis says. “You may have a condition that should be included that is not… That would be a false-negative (case).”

“You could have a false-positive. You might count something as an athletic injury, having to do with (brain injury) or the like, that isn’t. Again, (problems) because of miscoding, or you have diagnosis that’s in gray area.”

“That can be affected by what the physician writes,” Yesalis adds. “Somebody might be (hospitalized) and it may not even be in the report that it had to do with football. What you’re picking up, in an electronic medical-records search, is the primary diagnosis and the cause. If it’s a trauma, it wouldn’t surprise me if often football, or the cause, is left off the chart.”

“Trying to harvest (epidemiological data), looking at medical records and diagnoses, it’s not a walk in the park to be sure.”

Football Spinal Cases Become Black Hole for Disclosure, Research

Based on my intuition of e-searching and -sifting countless thousands of news texts involving football health issues, conducted since graduate study in 1996—along with my experience in football as player, coach and journalist since 1976—I believe Google currently accesses the large majority in actual game cases of death, survivor brain bleeds requiring surgery, and spinal-cord traumas causing permanent paralysis. Those represent the sensational or “newsworthy” casualties of American football.

Bets are off for other categories, though, particularly football cases of severe injury to vertebral column without paralysis, like bone fracture. If anything, I’d wager that hundreds of these casualties are missed every year, if not more, given various insurmountable factors, correlating studies outside North Carolina, and the fact I’ve found 50 and counting for year 2011.

After the untold amount of football spinal injuries undisclosed, the cases involving treatment often require CT or MRI radiology and subjective judgment for rendering diagnosis—“What is one specialist’s picture of a cervical vein is the next one’s image of stress fracture,” a technician tells me—then the variable of prominence influences public revelation or silence.

Starting football players on school teams comprise the majority of publicized spinal cases through all levels, especially prep standouts at the offensive “skill” positions of quarterback, running back and receiver. The story of a juvenile backup player with mere vertebral fracture rarely reaches public airing, from youth levels encompassing about 98 percent of football population. Sportswriters and editors don’t qualify such non-paralysis cases as newsworthy, if even alerted.

Thus news quantity is no vetted indicator of spinal injury’s scope in athletics, but credible estimates suggest how big the problem might manifest for tackle football in the United States.

Data sets of the National Spinal Cord Injury Statistical Center at University of Alabama-Birmingham suggest American football could annually produce 36 to 72 paralyzing injuries, defined for database criteria as “temporary or permanent sensory and/or motor deficit.”

I base that range on the UAB system’s intake of about 13 percent of the estimated 12,000 cervical-cord traumas each year in the United States, and football’s ranking as 15^th in etiology for 27,526 patients in the database, having caused 0.5 percent of the injuries to lead all sports.

By contrast, Mueller and Cantu list 8 total spinal-cord traumas for football 2010, along with 12 for 2009 and 17 for 2008.

For all vertebral fractures, an estimated 700,000 occur in the general population, with as many as two-thirds undiagnosed. The field is dominated by people with degenerative bone conditions, but football’s ranking in etiology of spinal-cord trauma signals it could produce thousands of cases with vertebral fracture.

In comparison, the Mueller-Cantu 2010 report lists 13 cases of vertebral fracture in football, cases ranging from quadriplegia to no paralysis and strong recovery.

Juvenile players comprise 9 of the cases, for an injury rate of about 1-in-500,000 athletes by UNC data, despite other literature indicating rate closer to 1-in-1,000.

Meanwhile, among NFL players in 2011, known catastrophic spinal casualties occurred at rate of about 1-in-200 players or less. And that accounts for only the cases in news media.

Sportswriters certainly miss severe neck and back injuries of the high-profile NFL, for communication blocks ranging from  no diagnosis to privacy. Unreported catastrophic spinal injury likely occurred in 2011 among NFL players, beyond at least 6 known candidate cases requiring operations and 1 of non-surgical neck immobilization lasting three months for the athlete.

Browns linebacker Scott Fujita, a 10-year NFL veteran, wonders of true epidemiological scope for his notorious work environment. “A lot of us (players) are walking around with so much damage to our necks, and our spines, and you never know what might turn up,” he said, speaking in a phone interview.

Much of the damage to NFL players is likely residual, dating back to college and prep football. Fujita had neck surgery as a college player at Cal, for his severe case of stenosis or narrowing of the spinal canal that crimped the nerve-bundle cord. Not only was surgery imperative for continuing his playing career, but for resuming normal lifestyle as well.

“I was getting (nerve) stingers pretty much every time I hit somebody “ in football, Fujita recalls. “Then I’d be typing a term paper and turn my head too fast, and give myself a stinger. I was starting to have significant (muscle) atrophy on my left side, over my trap and delts and down my arm. It was noticeable in pictures.”

For a year of football news online, I’ll find a few cases like the collegiate Fujita’s, severe spinal stenosis leading doctors to recommend corrective surgery. Some players take the option, others don’t.

Mueller-Cantu annuals list a single case in recent years, a “complete” recovery of 2009, but Fujita and I believe there are undisclosed severe cases. And symptoms of minor spinal stenosis affect a football multitude, as many as 50 percent of players, studies find.

Myself, nearing 52 years old and 28 removed from battering collisions in college football, I experience symptoms of neck stenosis, the shooting numbness, radiating pain and trademark interior “coldness” overtaking my C5 to C7 vertebrae range. The episodic inflammation strikes regularly, often weekly, especially while driving or at a computer, and I gobble ibuprofen for the discomfort, or agony.

“(Spinal) stenosis is extremely common,” Fujita says of pro players. “Most guys get a stinger here and there. I imagine once you get a few, then it becomes worse and worse, then it becomes chronic.”

At least 8 NFL players had neck surgeries in 2011, including the aforementioned 6 solid cases for catastrophic designation. Sometimes a surgery is driven by the player’s desire to continue his career, but I find most are necessary for stabilizing spinal damage that acutely threatens nerves and normal function.

“Throughout my playing career, college and pros, I occasionally hear about a guy with a broken neck that requires surgery,” Fujita says. “I’d say more often than not, if it is a pretty serious break or operation, I don’t seem to recall those guys coming back and playing. But that’s just me shooting from the hip.”

“Yeah, I would kind of put the neck and spine in same (regard) as head injury,” Fujita continues, focusing on the NFL. “There’s a lot of gray area involved, and no one knows exactly how to diagnose it, how to describe it, how to talk about it. They know it’s serious, they just almost don’t want to touch the issue.”

Fujita, 32, is an intelligent and thoughtful athlete, husband and father. He holds a master’s degree in education from UC-Berkeley and serves on the NFL players union executive committee.

But Fujita currently wears a cast on his right hand, after shattering bones of two knuckles and fingers while hitting ground in a game last month. Complicated surgery pieced together the bone fragments in Fujita’s fingers, hopefully, lashing everything back in place with steel screws, 22 tiny bolts. This season Fujita also spent two weeks on the Cleveland disabled list for diagnosed concussion. That’s his brutal job however lucrative, until further notice.

Fujita treks the jungle of pro football in America, long has, and he always runs. Physical threat and unspoken boundary are everywhere, like stiff resistance to report bodily damages of the NFL. The stillness stands pragmatically for every insider concerned, all parties, league, management, union, players, families, agents, with fortunes riding the line over health risk, outcome, and especially liability, who ends up paying.

“A lot of times when guys are having neck stingers, or even some back issues, in many cases the clubs won’t even want to take a good look at it, especially on the MRI,” Fujita says. “And I know a lot of times the player doesn’t want to take a good look, either, because you don’t want to know what’s going on.”

“Maybe that’s stupid and irresponsible, but I think that’s the reality that a lot guys are living with right now.”

So-called safer football is wholly unrealistic, meanwhile, a national joke that nevertheless occupies national dialogue for the game’s epic health crisis at hand, blowing up over brain-injury revelations and lawsuits compounding for all levels.

Thus the data of catastrophic injury enter play, and inadequate numbers serve to nurture a popular, resilient myth, the one how an individual player faces just “rare” chance for sustaining “freak” violent mishap resulting in death or permanent dysfunction.

Parents and novice players buy that falsehood by the millions. I did as a boy.

Actually, catastrophic football injury—which by definition must be expanded to include lethal categories such as heatstroke, blood clotting, organ destruction, artery rupture, staph infection and peripheral paralysis that comprise scores of survivor cases I’ve located for 2011—is quite predictable and possibly occurring daily on average, somewhere.

The American gridiron’s goriest, most risky stretches are the regular season from late summer into winter and “spring practice,” when many states allow full-contact drills and scrimmaging at schools, along with collegiate programs nationwide. Conditioning and weightlifting sessions of January and February also kill and severely wound players, particularly at colleges.

Yet some American opinion leaders say it isn’t really so, this picture of brutal football, not any longer. People like NFL commissioner Roger Goodell, who promotes neo-fandom terms like “culture change” and “concussion awareness.”

Today, football advocates insist they’re seeing a safer brand of tackle football, and Mueller and Cantu join Goodell at campaign front, citing their decades of catastrophic-injury numbers as evidence.

Mueller and Cantu claim their data have been instrumental in a game trend since the 1970s, steering players away from head contact.

Ridiculous, retorts Fujita, the NFL linebacker who’s flabbergasted the foolishness is mentioned in straight face. “Absolutely not, if anything I would say there’s more head contact in football today.”

“There’s increased emphasis on trying to clean up the game,” Fujita acknowledges. “You know, coaching guys up in ‘proper technique’ and all these catch phrases, and paying lip-service to everything. So when it comes down to it, this remains a violent game.”

Pro players certainly grasp their risks, and the genetic violence of football for all ages. And helmet or head-to-head colliding is the rule rather than exception for modern football, particularly with skull-preserving helmet technology among forces that channel combatants into zero contact, every player, from “Tiny Mite” to NFL linebacker.

Fujita has to laugh when I ask whether he feels safer playing football these days, definitely a stupid question.

“Um, no, I don’t feel any safer,” he replies. “I think in some respects you see the game changing. Some ways. Like a guy (of the NFL) coming across the middle, catching a pass for a 15-yard dig, and the safety will pull off (for the cameras), whereas before, more likely, the safety would blow the guy up.”

“It’s just a brutal game, and I don’t think you can technique—using ‘technique’ as a verb here—you can’t technique the game into becoming safer. You can’t even (player) fine the game into becoming safer. And that’s just the reality.”

Human Toll, Medical Damages, ‘Public’ Football and Vital Statistics

Independent journalist Irvin Muchnick laughs, too, when I broach the theory of safer football, the central talking point of football advocates for their increasing problems over injury epidemic and monetary damages.

“Anyone with two eyes on a Sunday afternoon can see that’s not so,” he says, dismissing assertions a fundamental reduction is possible for football risk and casualty.

Muchnick, the author, alternative columnist and indie blogger with cunning for banging on sport-entertainment conglomerates, bristles at the idea of faulty research, funded by football, as a catalyst for safer sport over 34 years of publication.

“If Cantu and the North Carolina people are claiming some credit here, about what their data have wrought, that’s so patently a false claim,” says Muchnick, a leading voice of our growing faction against “public” football financed by government, schools and colleges and largely carried for damages by general insurance consumers of health and liability coverage.

Muchnick said, speaking with me by phone, that UNC’s glaring under-reporting of football injury makes news on two levels.

“One is the statistics themselves, knowledge is power, and the information is important,” he says. “For a sport system out of control, I don’t know exactly at what point the (germane) statistics move people, to take our master points seriously, but clearly it’s part of it.”

“Which brings us to the second point, the process,” Muchnick continues, “and the idea that these kind of data are being collected by people who aren’t doing the job right. Not so much that they’re doing it in bad faith, but that it’s not a priority and it’s supporting some agenda other than getting everything out there.”

Muchnick sees football advocates in stall tactic amid dread crisis, recalcitrant to accept looming reform of their blood sport, if not abolishment. He scoffs at supporters’ rhetoric overall but does detect a shift in public conscience, related to their talk.

“One good thing about ‘concussion awareness’ is that it is pointing the markers in only one direction,” Muchnick says. “Even if people are not buying into this football problem as speedily and as conscientiously as we would hope, there’s only one place this story is going. And it’s not going toward reduced deaths, reduced disability, reduced public-health costs for our country.”

“Even if the NFL threads the PR needle in all this stuff, and they do a pretty good damn job on that, it still doesn’t add up to answering for the feeder levels of this activity, amateurs in public high schools, colleges and so forth. The economic numbers just can’t sustain themselves.”

“Football,” Muchnick says, “still doesn’t get its arms around the fact that seven- and eight-figure lawsuits, and imbalanced budgets, are going to be inevitable as our public awareness increases.”

Finally, of the data mess at UNC on catastrophic football injuries, Muchnick wants real response from the researchers, besides their short email replies to me, thanking me for my "interest" and noting they're busy evaluating their data for 2011.

Right. Mueller and Cantu are presently bombarded by about 95 cases I’ve dropped on them, including over a dozen since my Dec. 21 post.

Mueller and Cantu also cannot yet address their second overdue task, revising their bad data and assumptions of 2010, while also gauging the infestation back through decades of their reports.

For 2010, I’m still awaiting Mueller’s green light for loading them with the 70-some survivor cases I’ve pulled from Google, surely to obliterate their paltry year data currently posted at www.unc.edu/depts/nccsi.

Muchnick is bored already, seeking open discussion on the matter, quickly.

“It’s very important for Cantu and Mueller to talk about why their methodology failed to catch these cases that you did catch, as a lone, independent, unfunded researcher and journalist,” he told me.

“I’m not qualified to say everything you’ve written is perfect, but I’ve seen enough of your work to know that it’s conscientious and it’s based on a coherent method. And it’s found things that are at odds with what the public’s being told, so we need to resolve those contradictions.”

Matt Chaney is a writer, editor, teacher and restaurant worker living in Missouri, USA. His 2001 graduate thesis for an MA degree at the University of Central Missouri is qualitative media analysis of 466 football reports, historical print coverage of anabolic steroids and HGH in American football, largely based on electronic search among thousands of news texts from the 1970s through 1999. Email him at mattchaney@fourwallspublishing.com. For more information, including about his 2009 book,Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com. 

2011 Survivor Cases Likely High Mark for Modern American Game

E-Search Also Finds Error in Catastrophic Data Reported Last Year

Prominent UNC Report Far Short on Grave Casualties of Football 2010

By Matt Chaney

Posted Wednesday, December 21, 2011

The rate of catastrophic injuries in American football could be a record in 2011, with more than 70 survivor cases of conditions such as brain hemorrhage and spinal fracture, according to an intensive electronic survey by this reporter.

See the complete annotated list of cases below, with juveniles comprising the large majority of victims.

The findings belie talk of “culture change” by football officials, their popular claim of “safer” football in America, and raise question whether catastrophic injuries of the inherently brutal sport are significantly under-reported in record-keeping of the present and past.

Last year the National Center for Catastrophic Sport Injury Research (NCCSI) logged only 24 survivor cases—barely half the 2010 cases still available online, including players with brain bleeds and spinal paralysis missed in the report.

Now stronger accounting is assured for 2011, standing on results of my daily searching of Google banks that's garnered a solid 70 survivor cases for verification as catastrophic football injuries, defined by the NCCSI as affecting the brain, skull, spinal cord and/or vertebral column.

My cases include the following:

*1 comatose preschooler, a 5-year-old “Tiny Mite” player hospitalized with brain trauma of full-contact football.

*23 head injuries such as brain hemorrhage and skull fracture, cases including surgery for 16 players suffering cerebral bleeding.

*41 spinal traumas, the vast majority fractures, including 17 cases requiring surgery and at least 5 involving continuing paralysis.

*1 case of MRSA infection of the spinal column apparently triggered by football contact.

*6 cases of cardiac arrest, including 5 players revived by portable defibrillator and CPR.

*1 case of heart attack.

In addition:

*7 reported brain and spinal casualties require expert consideration for catastrophic data, including the football-related trauma of a Tennessee schoolteacher hospitalized in an ICU, after she was struck in the head sitting along a sideline, by helmet of a diving player.

My basic approach is regular filtering of Google content, utilizing Boolean command terms such as football and hospital, football medical center, football brain, football head injury, football spine and football vertebra, along with substituting main adjectives like “player” for “football,” to recycle search on terms like player hospital, player brain and so forth.

Every 2011 incident I have found requires expert follow-up and verification as football catastrophic injury, but available data indicate about 90 percent are locks for the classification by the national center based at the University of North Carolina.

At the NCCSI, funded primarily by the NCAA, two of football’s associate experts have co-authored annual injury reports for a quarter-century: Frederick Mueller, who holds a PhD in education, is a professor of sport administration at the university and a former football coach, and Dr. Robert Cantu, of Boston, is the renowned sport neurosurgeon who leads NFL-funded research documenting permanent brain damage in deceased athletes, primarily football players.

Since the 1970s, Mueller and Cantu have been key figures in the modern movement for “safer” football in America, which promotes initiatives such as rule changes, injury awareness, helmet standards, “concussion testing” and anti-concussion law, along with “behavior modification” of players that teaches theoretical “proper contact,” collisions supposedly avoiding head impacts.

Roger Goodell, NFL commissioner and associate of Cantu, has taken up the safer football campaign since fall 2009, when a congressional committee lambasted him for the league’s deplorable record on brain trauma in active and retired players.

In recent years, the Mueller-Cantu research on catastrophic injuries is cited as evidence of a trend toward less risky football in America, especially for youths.

For 2008, the NCCSI logs 63 survivor cases, adding updates, which is the highest mark among UNC reports available online. The center’s same numbers drop to a current 44 for 2009 and the 24 last year.

These figures are recognized as authoritative epidemiology on American football’s worst casualties, the cases most lethal and costly, with many survivors requiring lifetime care.

This year’s alarming amount of brain-bleed injuries alone translates to tens of million dollars for healthcare in the present and future, perhaps a nine-figure cost for long-term inflation, according to an expert I consulted. And the estimate accounts for this year’s brain-injured players who recover functionally, as some already have.

Risk assessors, obviously, are among parties relying on catastrophic-injury data, as they in turn represent interests in healthcare and insurance, the co-op industries that essentially carry medical and liability damages for American football.

But information gathering and presentation have been problematic for the Mueller-Cantu team at North Carolina, beginning with reporting language that presents data in absolute terms rather than accompanied by qualifiers like at least 24 survivors for the football year and among available reports.

The UNC documents do contain disclaimers for inadequate data or gathering, but the notes are brief and buried with no prominence in methodology passages. There is no formal declaration of study limitations.

News media, meanwhile, parrot the annual UNC numbers as hard facts of American football, disseminating worldwide the misinformation and erroneous injury context.

In reality, no epidemiological method is proven for reliably assessing rates of catastrophic injury in American football, and the recognized Mueller-Cantu approach also lacks consistency of definitions and breadth in categories. The final UNC data on survivors ignore football-related injuries such as peripheral paralysis, heatstroke, blood clots, kidney rupture, staph infection and “compartmental syndrome.”

No collection approach is yet validated for producing a representative sampling or thorough accounting of grave injuries in football, with promising e-search like mine notwithstanding.

Indeed, multiple teams for annual comparison and pooling of data might become sound strategy, if any method could prove reliable. For example, I find cases missed by Mueller and Cantu and vice versa; they have sources in medicine and athletics for information I cannot get.

Regardless, the UNC research needs year-round, state-of-art collection for finding catastrophic injuries in football, particularly through electronic search. Far too many injuries are presently missed in Google alone, inexcusably.

Regarding 2010, for example, the Mueller-Cantu report online lists merely 14 spinal injuries, ranging from paralysis victims to cases of “complete recovery,” another dubious term.

Cross-checking those cases with mine, I find twice their number online and at least 30 catastrophic spinal injuries are now known to exist for 2010, thanks to a pair of cases reported by the UNC team, of a 12-year-old youth-league player with transient paralysis and a 13-year-old rendered quadriplegic of contact at a school football practice.

Overall, the Mueller-Cantu reports for 2010 omit some 15 spinal cases I have for American football, including 3 paralyzed school players who have largely recovered motor function and touch sensitivity through surgery, healing and rehabilitation.

Mueller and Cantu likewise underreport cases of brain hemorrhages in football 2010, logging 7 presently while missing at least 5 teen victims currently reported online. Also overlooked is the NFL “chain-gang” official struck by a speeding player along a sideline in New Orleans; the middle-aged man suffered a severe head injury and was hospitalized for weeks.

At least 2 apparent cardiac cases, survivors, are missed in the UNC report for last year: a 50-year-old Texas man who collapsed while playing flag football and a Hawaii teenager stricken during practice at school. Both were revived by bystanders who employed CPR and portable automated external defibrillators (AEDs).

Bottom line, the Mueller-Cantu report for 2010 presently omits at least 22 catastrophic-injury survivors—along with omitting known football fatalities such as a youth player killed of contact in Philadelphia, Quadaar White, and a college player in Minnesota, Ben Bundy, dead of brain aneurysm suffered during a team workout.

Tough critique of research by Mueller and Cantu aside, I commend them for assembling a foundation for catastrophic-injury information on modern American football.

Foremost, limitations dog any collection effort, including my review based in tapping the jet streams of Internet search mode.

The problems of locating information on bodily catastrophe in American football begin with the incalculable cases never reported publicly, by any medium, for reasons including privacy concern, medical misdiagnosis, and even victim ignorance of injury like “walking” spinal fracture, of which an untold number occurs.

Moreover, media of all types will not or cannot report every grave injury in the vast domain and populace of American football, encompassing about five million players among tens of thousand programs across 50 states.

For injury events made public or emerging in even scantest detail, attritional effects weigh further on the communication.

A significant portion of local print and broadcast news in America does not reach posting online, and then cyber flow is divided among content providers like subscription databases and Google, the monster search engine that nevertheless cannot access everything Internet. Finally, many online pages are removed after a period of posting.

This report continues with my annotated list of 2011 survivor cases in catastrophic injury of American football.

I am forwarding these cases to medical authorities and other parties with interest in the focus, such as risk assessors, for soliciting their review and comment. Dr. Cantu and Professor Mueller are on the list of recipients.

I urge other media to do the same, contact experts regarding the cases below, which are public information.

Look for updates on this blog and elsewhere.

73 Survivor Cases of Catastrophic Injury in American Football 2011

From Reports Retrieved in Google Search Through December 21

By Matt Chaney, mattchaney@fourwallspublishing.com

Note: List below does not include 17-20 football-related fatalities in 2011, retrieved from online thus far, such as 4 deaths of head injuries from contact, along with more than 50 player survivors of grave conditions such as blood clots, femoral artery rupture, heatstroke, internal organ rupture/laceration, staph infection or MRSA, and peripheral nerve damage/paralysis.

 

Online Report of Comatose Youth Player, Preschooler, American Football 2011

Sept. 29, circa: An unidentified“Tiny Mite” player, 5-years-old, Hawaii, reportedly fell comatose at a hospital following a head injury. The child was injured while participating in “Tiny-Mite” division of Oahu Pop Warner football, for ages 5, 6 and 7, according to KHON-TV. Oahu doctor Josh Green said, “Five might be a little young. I’m concerned about it."

Online Reports of Brain Hemorrhage and Surgery, American Football 2011

March 19:  Logan Weber, 21, Iowa, offensive guard for Coe College, experienced severe headaches while stretching for weightlifting. Weber was hospitalized within 24 hours for brain bleeding linked to “arteriovenous malformation,” or AVM, a congenital condition. Surgery was performed to insert a shunt and Weber was hospitalized for 20 days. He recovered, returned to college, but ceased playing football, serving instead as student coach for the Coe team. Source: Cedar Rapids Gazette.

May 18:  Josh Mercer, teenager, Louisiana, senior-to-be linebacker for Alexandria Senior High School, was injured while tackling a teammate in spring practice. Hospitalized for brain bleeding, Mercer was initially released after a few days but his condition worsened and he was readmitted to intensive care. Surgery was performed 10 days post-injury and Mercer began recovery, quickly completing physical therapy. He was released from hospital then completed a scheduled 12 weeks of speech therapy in half the time. Mercer could not play football this year but serves as a student coach for the school, according to TheTownTalk.com.

Aug. 5:  Brennan Barber, 17, South Carolina, defensive lineman for Mid-Carolina High School, was injured by a reported “routine” helmet hit during a scrimmage and collapsed minutes later. Surgery was performed for brain bleeding. Barber began walking three days later and was released from the hospital within a week. He is undergoing therapy and is expected to make strong recovery. Source: The State.

Sept. 2:  Tucker Montgomery, 17, Tennessee, receiver/linebacker for Tri-Cities Christian School, was injured in helmet-to-helmet contact while running the football during a 6-man game. Surgery was performed for brain bleeding. Montgomery remained comatose for more than a month. Still hospitalized on Oct. 25, Montgomery was conscious and responding to some commands, according to reporter Preston Ayres. Montgomery faced “a long road to recovery,” Ayres reported. Sources: WCYB-TV, TriCities.com, Johnson City Press.

Sept. 10:  Dominic Morris, 21, Nebraska, running back for Chadron State College, injured by reported “glancing” contact from an opponent’s facemask during a game. Surgery was performed on brain bleeding that had caused a blood clot. “Following the operation… Morris was alert and showed no signs of any ill effects from the injury,” states a CSC release. Morris was discharged from hospital on Sept. 12 for recovery at home in California. Sources: Chadron State College, Omaha World.

Sept. 16:  Robby Mounce, 17, Texas, running back/receiver and honors student at Community Christian School, suffered brain bleeding and collapsed during a 6-man game. Surgery was performed and Mounce began therapy while in critical care. Progress has been slow but steady and Mounce was recently able to return home for a period, including the Thanksgiving holidays. He wears an eye patch and has difficulty moving his right side, and on Dec. 7 the teen was admitted to a rehabilitation facility for daily therapies. “One of the things they will work on with Robby is stabilizing his walking and balance,” his mother Janet Mounce reports. Lengthy recovery remains. Sources: KDFW-TV, Mineral Wells Index, and Janet Mounce on CaringBridges.com.

Sept. 16:  Zeth Shouse, 17, Nevada, tight end/defensive end for Elko High School, suffered brain bleeding during a game and collapsed. Multiple surgeries were performed.  The honors student remained hospitalized on Oct. 21, when his father, Todd Shouse, reported that Zeth was able to swallow and had begun therapies. Sources: KENV-TV, Reno Gazette-Journal.

Sept. 16:  Adrian Padilla, 17, California, safety for Oxnard High School, collapsed following head contact during a game. Surgery was performed for brain swelling of a reported severe concussion. Padilla was released from hospital on Oct. 4 and attended the Oxnard football game days later; he walked onto the field for the opening coin flip wearing street clothes and protective helmet. Padilla told media he suffered a concussion in football two weeks prior to the Sept. 16 injury. The teen continued schoolwork at home for remainder of the semester. Sources: Ventura County Star, Concussion Inc. blog, and ESPN.com.

Sept. 16:  Adam Ingle, 17, Kansas, quarterback/linebacker for Valley Center High School, was injured in helmet-to-helmet contact during a game. Surgery was performed for brain bleeding. Family members say Ingle likely was concussed three days before game injury, during football practice, but the player did not inform anyone of his headaches, reported blogger Irvin Muchnick. By early October Ingle was home and attending school events, with recovery work remaining. Sources: Concussion Inc. blog, Wichita Eagle, and KSN.com.

Sept. 30:  Bobby Clark, 17, Idaho, lineman/linebacker for Priest River Lamanna High School, collapsed while leaving the field during a game. Surgery was performed for brain bleeding. District superintendent Mike McGuire said Clark might have mentioned headaches in the week leading to his injury, unbeknownst to coaches and school officials. At least 9 players on the team have been diagnosed with concussion this season, among 45 players in the small school, officials said. A local TV station reported Clark was among 3 diagnosed concussion cases on the team the night he was airlifted for emergency surgery. Clark was hospitalized about six weeks then transferred to a rehabilitation facility for therapies that will continue through December, at least. His mother, Julie Clark, writes a detailed, vivid journal online about Bobby’s ordeal, and she reports he is talking, eating, socializing and re-acclimating to school subjects such as math; he walks regularly, although with assistance for difficulty in moving his right side. Bobby and family members hope for his release from inpatient therapy by early January, to coincide with pending surgery to replace the piece of skullcap removed at injury, then he could return home. “So today I am praying that his mental status and physical status come together quickly in the next 3 weeks,” Julie Clark posted on Dec. 8, “and that surgery will happen at the right time when his body and mind are ready. I have patience. It’s what has gotten me this far, so I’m not impatient; I just want for everything to fall into place at the same time for his well-being. This is something too important to rush.” Sources: Julie Clark on CaringBridge.org, WASWX-TV, Spokane Spokesman-Review, and Bonner County Daily Bee.

Sept. 30:  Shelton Dvorak, 17, Nebraska, fullback/linebacker for Pierce High School, collided with multiple opponents while running the football during a game. Moments later he collapsed, suffering a brain bleed. A week after surgery, Dvorak was released from ICU and hospital to a rehabilitation center, where he progressed markedly in a few weeks, solo walking, exercising, eating and conversing with visitors. Dvorak returned home on Oct. 27 in strong recovery mode, resuming activities such as attending football games and going hunting with family members. Follow-up surgery replaced the skullcap piece and Dvorak continued his comeback, returning to school in mid-November. “Shelton is a living miracle,” a family member posted on Nov. 21. “He is doing things that everyone prayed he would do.” Sources: Dvorak Family on CaringBridges.org, KETV.com, Lincoln Journal Star and Norfork Daily News.

Sept. 30:  Dillon Lackhan, teenager, Arizona, senior lineman/linebacker for Valley Christian High School, suffered brain bleeding of a headshot during a game. Surgery was performed and Lackhan was conscious within a few days, eating and conversing. “Dillon shows positive signs for recovery, but a long-term prognosis is not clear,” school athletic director Marlin Broek stated in an Oct. 6 email, reported sportswriter Richard Obert. Sources: AZCentral.com, MyFoxPhoenix.com and East Valley Tribune.

Oct. 1:  An unidentified teenager, Massachusetts, a wide receiver for Sandwich High School, complained of wooziness following contact during a game and a trainer called for medical attention. “The player later underwent emergency surgery to remove a blood clot in his brain,” reported Michael J. Rausch, on Oct. 14. “The boy is now home and recovering well from his injury.” Source: Sandwich Enterprise.

Oct. 13:  Dennis Pena, teenager, California, sophomore player for Los Angeles High School, suffered a head injury and collapsed during a junior varsity game. Surgery was performed for a brain hemorrhage, and David Craft, LAHS athletic director, said Pena’s prognosis was “supposed to be good.” Source: Los Angeles Times.

Online Reports of Vessel Rupture and Stroke, Surgery in American Football 2011

Sept. 6:  Connor Laudenslager, teenager, Pennsylvania, senior offensive/defensive tackle for Line Mountain High School, was stricken of a blood clot at beginning of indoor practice, causing stroke. Laundenslager, 6-foot, 270 pounds, was hospitalized for emergency brain surgery then made “remarkable progress,” said coach Mike Carson, moving quickly through therapies and returning to school. By mid-October Laudenslager was working out with teammates and hoping to be cleared to resume football, although that did not occur in 2011. Laudenslager wants to play football in college. Sources:  NewsItem.com, TNonline.com and Pottsville Republican Herald.

Sept. 23:  Dylan Mercadante, 16, Vermont, receiver/defensive back for Montpelier High School, suffered a ruptured blood vessel in his neck during the second half of a game, causing strokes. The injury possibly stemmed from contact on his team’s first kickoff of the game. Following surgery, Mercadante was hospitalized for month then continued therapies as an outpatient. “His recovery has been faster than expected, but he faces a lengthy rehab,” reported Tom Herzig, on Nov. 3. Mercadante plans to graduate with his class and attend college. Sources: Montpelier Bridge and Barre-Montpelier Times Argus.

Online Reports of Brain Bleeding or Swelling, No Surgery, American Football 2011

Feb. 14:  Neiron Ball, 19, linebacker for the University of Florida, experienced headaches following a workout and was hospitalized the following day for a burst blood vessel of the brain linked to a congenital malformation of arteries known as AVM. Ball was released from ICU after five days and in March began “radial” treatment described as a non-intrusive procedure, similar to radiation for cancer. Ball did not play football last season, and a relative said his future in the game was uncertain. Sources: Orlando Sentinel and YardBarker.com.

Aug. 19:  Alan Mohika, 17, Hawaii, quarterback for Damien Memorial High School, was injured by contact during a game, rose and walked off, then fell into seizure. Mohika suffered brain bleeding and was hospitalized in ICU for a reported severe concussion. No surgery was necessary and the teen was discharged from hospital after five days. Mohika returned to school in mid-September but did not play football. He hoped to return to sports. Sources: Honolulu Star-Advertiser, HawaiiNewsNow.com and KITV.com.

Sept. 9:  Matt Ringer, 15, California, running back for Central Catholic High School, suffered an apparent concussion during a tackle. Later he was hospitalized for a detected brain bleed, although fully conscious. No surgery was necessary and Ringer was released from hospital within 48 hours. He returned to school but not football. Source: Modesto Bee.

Oct. 7:  Jadon Adams, 16, Kansas, running back for Beloit High School, collapsed during a game and was hospitalized for brain swelling. Doctors sedated Adams as treatment and discontinued the drugs as swelling subsided within 24 hours, and no surgery was necessary. The teen entered a rehabilitation hospital on Oct. 21 and made steady progress, according to updates by family friend Steph Barrett. Adams was released on Dec. 2 and is continuing therapies at home, where he has resumed schoolwork with a tutor, according to reports. Sources: Salina Journal, KAKE-TV, and Steph Barrett on CarePages.com.

Online Reports of Skull Fracture in American Football 2011

April 2:  Lamont Baldwin, 17, Washington, D.C., touted receiver for Carroll High School, suffered a fractured skull and other injuries in a four-player collision during  private camp without pads and helmets in Virginia. Baldwin was hospitalized in ICU for two days and could not return to school for the remaining semester, facing months of recovery. When injured, Baldwin was a top college prospect reportedly being recruited by several major programs; he did not play football in 2011. Sources: Washington Post and NBCWashington.com.

Online Report of Head and Neck Injury With Nerve Damage in Football 2011

Sept. 12:  Spencer Eller, 14, Missouri, wide receiver/cornerback at Lee’s Summit North High School, was struck in back of his neck by a teammate’s helmet during a practice drill. Eller was hospitalized with paralysis through his right side and legs. “The doctors diagnosed Spencer with a brain injury, a spinal cord injury, vertigo and muscle and nerve damage,” reported Miranda Wycoff. Imaging tests were negative for cranial swelling, and Eller was released to go home with outpatient therapy. Six weeks after injury, the teen was walking but with a cane while still experiencing numbness through his right side; pain radiated everywhere, including migraine headaches preventing his sleep. At October’s end, Eller’s family hoped for his condition to improve enough for a return to school, but doctors remained cautious of his complex injury. “When he went in for the CAT scan and the MRI nothing was broken and there was no bleeding in the brain,” said Cheryl Eller, the teen’s mother, in a report of Oct. 26. “It makes it harder to understand because you can’t even see it.” Source: Lee’s Summit Journal.

Online Reports of Spinal Injury Requiring Surgery, American Football 2011

May 7:  Rob Marrero, 31, Pennsylvania, semi-pro player for the Mountain Top Reapers, suffered a broken neck and severed spinal cord during a game. Friends reported after surgery that Marrero is paralyzed permanently from chest down. Marrero, married and a father of two, continues treatment and therapy. Source: Lehighton Times News.

May 27:  Jeremy Bingham, 34, Arizona, fractured cervical and thoracic vertebrae during a game in pads and helmets between alumni of two local high schools. He was injured colliding with another player. Doctors diagnosed no paralysis in Bingham and surgery was performed to stabilize the C7 and T1 vertebrae. Bingham is married and the father of four. Sources: Eastern Arizona Courier and the Bingham Family on Blogspot.com.

Sept. 1: Torell Troup, 24, New York, defensive lineman for the Buffalo Bills, sustained a reported “minor fracture” in his spine during an NFL preseason game. Troup missed several games while playing in about six before placed on injured reserve for the season. Troup was reportedly scheduled for surgery on Dec. 16; Google had no further update at time of this blog posting.

Sept. 18:  Nick Collins, 28, Wisconsin, free safety for the Green Bay Packers, ruptured a lumbar disc during a collision in an NFL game. Cervical-fusion surgery was performed and Collins faces lengthy rehabilitation. Doctors expect full recovery for normal lifestyle, but Collins hopes to resume pro football. Sources: Milwaukee Journal Sentinel and Channel3000.com.

Sept. 23:  Corpio Dennard, 16, Alabama, receiver/running back for Saks High School, suffered a broken neck during a game while being tackled from behind, pinning his arms and sending him into ground headfirst. Dennard experienced no paralysis and walked to the sidelines, but coaches did not return him to the game. The next day his mother sent him for a doctor’s exam and Dennard was hospitalized, with X-rays showing fractures in his 5th and 6th cervical vertebrae. Surgery was performed on Sept. 25, for stabilizing the spine with plate and screws. “The doctors that saw him were just amazed that he got up and walked off the field,” Saks coach Clint Smith told reporter Joe Medley. Dennard said, “If I had gone back in the game, I don’t know where I’d be right now. I’d probably be paralyzed or even dead.” Dennard has begun 6-to-12 months rehabilitation and doctors expect he can return to sports, although probably not football. Source: Anniston Star.

Sept. 29:  Luis Morales, teenager, Texas, junior player for Vega High School, suffered fracture of the C6 vertebra while colliding with bleachers during a junior varsity game. Surgery was performed in Texas, and Morales was flown to California for specialized rehabilitation on Oct. 13. Reports state the teen is paralyzed from waist down while also hardly able to move his arms. Sources: Amarillo Globe-News, High Plains Observer and ConnectAmarillo.com.

Oct. 1: Shontrelle Johnson, 19, Iowa, running back for Iowa State University, suffered a reported “neck injury” in a game and was sidelined for the season, with no paralysis reported. Surgery was performed on Nov. 22 and Johnson faced lengthy recovery, according to ISU coach Paul Rhoads, who said the player’s possible return to football was uncertain.

Oct. 7:  Porter Hancock, 16, Utah, running back/linebacker for South Summit High School, suffered a broken neck and paralysis while making a tackle in a game. “Porter finished off the tackle. It was nothing big,” said South Summit coach Jerry Parker. “He turned his head the wrong way.” During surgery on Oct. 8, doctors removed two cervical discs and inserted a stabilizing plate. Hancock was released from hospital on Dec. 16 and remains paralyzed from chest down. Sources: Deseret News, Salt Lake Tribune, Park City Record, KSL.com.

Oct. 20:  Hunter Casebolt, 13, Arkansas, defensive player for Elkins Junior High School, fractured two cervical vertebrae in a helmet-to-helmet collision during a game. No paralysis occurred and surgery was performed to stabilize the fractures. Casebolt was released from hospital after one week, wearing a collar brace. Sources: WriteForArkansas.org, 4029TV.com and KFSM-TV.

Oct. 21:  Anthony Conner, 23, Kentucky, cornerback for the University of Louisville, fractured a cervical vertebra when his helmet struck the knee of an opponent during a game. No paralysis occurred and surgery stabilized the fracture. Conner was released from hospital within days, wearing a collar brace. Sources: Louisville Courier-Journal, Syracuse Post-Standard and WDRB-TV.

Oct. 22:  Aaron Smith, 35, Pennsylvania, defensive end for the Pittsburgh Steelers, was diagnosed with damage to cervical discs and placed on NFL injured reserve for the season. Surgery was performed around Nov. 15, fusing the damaged discs, and Smith’s future in football is unknown. Sources: ESPN.Go.com, Steelers.com and Pittsburgh Post-Gazette.

Oct. 26:  Joe Aulisio, adult, Ohio, a sports reporter for WKBN-TV, suffered fractures of two cervical vertebrae of accidental contact with football players during practice at Liberty High School. No paralysis occurred and surgery stabilized the neck column, according to The Warren Tribune Chronicle.

Oct. 29:  Carlton Downs, adult, West Virginia, senior safety for Concord University, fractured his C5 vertebra during a game. No paralysis occurred and surgery stabilized the cervical break. Downs was released from hospital within days and wore a neck brace to begin therapy, according to The Bluefield Daily Telegraph.

Nov. 4:  Christian Hurt, teenager, North Carolina, quarterback/defensive back for Starmount High School, suffered CV fracture while being tackled in a game. No paralysis occurred and surgery stabilized the fracture. Hurt was released from hospital within days and wears a halo brace, according to The Yadkin Ripple.

Nov. 5:  Tyler Vitiello, 17, New Jersey, running back/defensive end for Saddle Brook High School, suffered a fractured CV while returning a kickoff during a game. Initially paralyzed in his lower body, Vitiello underwent surgery and was standing with assistance after a week, then walking two weeks post-injury. He was released from a rehabilitation hospital in December and wears a collar brace, according to The Bergen Record.

Nov. 6:  Donnovan Hill, 13, California, running back/linebacker for the Lakewood Lancers of the Lakewood Pacific Junior Football and Cheer program, fractured his C4 vertebra while trying to make a tackle. Surgery stabilized the injury, paralysis remained in Hill’s extremities. Doctors predict incomplete recovery. Sources: KTLA-TV, KCAL-TV, KNBC-TV and LakewoodFootball.com.

Dec. 8:  Chris Hoke, 35, Pennsylvania, nose tackle for the Pittsburgh Steelers, was diagnosed with a reported “neck injury” and placed on NFL injured reserve for the season. Surgery was performed on Dec. 14, and Hoke’s football future is uncertain. Sources: Pittsburgh Post-Gazette and The Associated Press.

Dec. 18:  Johnny Knox, 25, Illinois, wide receiver for the Chicago Bears, suffered fracture of a reported vertebra “facet joint” in his back during contact in an NFL game. Surgery stabilized the injury and Knox faces at least four months of rehabilitation, according to The Chicago Tribune.

Online Reports of Spinal Fracture Without Surgery, American Football 2011

Note: Football cases of spinal fracture often involve no displacement of vertebrae or puncture of spinal cord, resulting in no paralysis or other acute alert, and in fact unknowing victims can function normally for long periods after injury, including playing tackle football. For such injury that is diagnosed and treated, recovery is often strong to complete. Among severe or catastrophic injuries in tackle football, diagnosed spinal fracture without displacement qualifies among least serious types, and undoubtedly a portion each year will never be reported or associated with the sport. Some spinal-injured football players return to full contact in the same season, even quickly, as did several in 2011, youths and adults. For this section, available details are fewer and less precise, and no case involves mention of surgery. No paralysis was reported in a case unless otherwise noted.  Additional cases of spinal fracture for the football year, yet unpublicized, will become public in the future.

March, circa:  Kendric Cook, 20, Mississippi, tight end for Mississippi State University, was diagnosed with stenosis of the cervical spine, narrowing of the neck column encasing the spinal cord, which could be adversely affected by football contact, including death. Cook ceased playing football and became a student coach in the program, according to The Clarion Ledger.  

April, circa: John Goode, 22, Illinois, fullback for Southern Illinois University-Carbondale, was injured while blocking a teammate in a drill during spring practice. Doctors diagnosed bulging discs in the lumbar spine, along with damage to a pelvis joint, and Goode could not return to football. In mid-September he began a 14-week rehabilitation program that effectively ended his playing career, according to The Carbondale Southern.

June 25:  Evan Gray, teenager, California, senior running back for Poway High School, suffered three fractured vertebrae during a fall in pass-league competition. Following rest and rehab, Gray returned for Poway’s football season but was sidelined for a reported fractured kneecap. Sources: Damian Gonzalez on MaxPreps.com and Poway News Chieftan.

Aug. 9:  Jeff Wozniak, teenager, Indiana, sophomore quarterback for Morton High School, suffered fractured vertebrae, broken neck bones and bruised spinal cord in practice when “hit under his chin during a drill and driven backward,” initially leaving him paralyzed, reports sportswriter Steve Hanlon. Doctors fitted Wozniak with a steel halo head brace, requiring drilling of screws but not open surgery. In ICU he progressively regained feeling and motor function and in two weeks left the hospital for a rehabilitation facility, where he was also released after two weeks. He continues outpatient therapy and hopes to play football again. Source: NWTimes.com.

Aug. 10, circa:  Mario Crawford, 21, Virginia, running back for Old Dominion University, sustained fracture of the C1 vertebrae in a preseason practice, striking his helmet on a medicine ball in a drill. A CT scan revealed the injury, two weeks post-injury, and Crawford was likely sidelined for the season, wearing a collar brace, according to The Hampton Roads Virginian-Pilot.

Aug. 20, circa:  Devin Mahina, adult, Utah, redshirt sophomore tight end for Brigham Young University, sustained a fractured vertebrae in a preseason scrimmage. Initially the injury was not diagnosed and Mahina practiced football for about 10 days, until doctors found it by CT scan on Aug. 30, sidelining him for the year. Mahina wore a collar brace. Sources: Deseret Sun and Salt Lake Tribune.

Aug. 25:  Will Rishell, teenager, Connecticut, junior quarterback/safety/kicker for RHAM High School, suffered fractures of lumbar vertebrae in a preseason scrimmage. Rishell was sidelined until Oct. 22, when he played in a game and re-injured his lower back. Rishell did not play football again in 2011, according to The Norwich Bulletin.

Aug. 26:  Dustin Newman, teenager, Alabama, junior player for Pike Liberal Arts Academy, sustained a fractured thoracic or T5 vertebrae during a kickoff. He wore a collar brace for three months, reportedly. Sources: Troy Messenger and WAKA.com.

Sept. 1:  Kellen Bernard, 15, Texas, running back/linebacker for Palmer High School, sustained a fractured lumbar vertebra on a hit while returning a punt. He reportedly had temporary paralysis and was expected to recover. Sources: Ennis Daily News and WFAA-TV.

Sept. 2: Jerram Rojo, 17, Texas, quarterback/linebacker for Marfa High School, was injured running the ball in a game, with his heading striking the ground. He walked off the field then was hospitalized, where a CT scan revealed fracture of the C6 vertebrae. Rojo wore a collar brace and did not resume football in 2011. Sources: Jerram Rojo on Facebook.com and The Big Bend Sentinel.

Sept. 2, circa:  Sam Scholting, teenager, Missouri, junior offensive tackle for Mexico High School, suffered a broken vertebrae and was sidelined, coach Nick Hoth told The Mexico Ledger.

Sept. 9:  Frank de Braga, teenager, Nevada, senior running back/safety for Fallon High School, suffered a fractured T3 vertebrae and brain concussion while making a tackle. Initially unconscious, the teen had movement before transport to hospital, where he spent the overnight under observation. De Braga was cleared to return to play two weeks later and finished the season in the Fallon lineup, according to The Lahontan Valley News.

Sept. 10:  Brian Tyms, 22, Florida, receiver for Florida A&M University, sustained a fractured vertebra during a game. He returned to playing football on Oct. 1 and finished the season. Sources: Tallahassee Democrat and The Associated Press.

Sept. 11:  Ron Bartell, 29, Missouri, cornerback for the St. Louis Rams, sustained fractures of the C7 vertebrae in an NFL game. Bartell wore neck braces for three months and was declared healed by doctors. He expects to return to football. Sources: 101Sports.com and The St. Louis Post-Dispatch.

Sept. 16:  Scott Thibeault, teenager, Maine, senior running back/linebacker for Mountain Valley High School, suffered two fractured vertebrae and was sidelined. He returned to playing football on Oct. 14 and finished the season. Sources: Portland Press Herald and Scarborough Leader.

Sept. 17, circa:  Matt Lindamood, 21, West Virginia, fullback for Western Virginia University, had a recurring neck injury of “stingers” and numbness checked out by MRI, and doctors found stenosis of the cervical vertebrae, narrowing of the spinal canal that affects many football players while threatening only a few with potential grave consequences of added impacts. One doctor determined Lindamood should cease playing football and consider surgery, but another examining specialist concluded the athlete could still compete, finding no degeneration in his motor and sensory function. Lindamood returned to the team and finished the season, according to The Charleston Daily Mail.

Sept. 24:  Derek Hayden, 22, Georgia, safety for Georgia Southern University, fractured his C1 vertebra during helmet-to-helmet contact in a game. Hayden was fitted with a halo brace and released from hospital within days. He did not return to football in 2011, according to The Savannah Morning News.

Sept. 30:  Deangelo Peete, 17, Michigan, linebacker for Livonia Franklin High School, fractured his C1 vertebrae in three places during a helmet-to-helmet collision in a game. A halo brace was fitted to stabilize the injuries and Peete was released from hospital within days, according to WJBK-TV.

Sept. 30:  Cody Ashcraft, teenager, Missouri, senior receiver for Scott City High School, sustained a fractured cervical vertebra in a game, according to The Southeast Missourian.

Oct. 8:  Chris Thompson, 20, Florida, running back for Florida State University, suffered fractures of the T5 and T6 vertebrae while being tackled in a game and was hospitalized overnight. Thompson wore a collar brace as he began rehab, sidelined for the season. He hopes to play football again, according to The Orlando Sentinel.

Oct. 14:  Sean Walsh, teenager, California, senior offensive guard/defensive tackle for Saratoga High School, suffered a reported “broken back” in a game. Walsh was sidelined for remainder of the football season. Sources: Saratoga Falcon and Saratoga News.

Oct. 28, circa:  Ronald Tolbert, teenager, Georgia, sophomore defensive tackle for Mt. Zion High School, suffered a reported “cracked vertebrae” playing football and was sidelined, according to The Times-Georgian.

Nov. 4:  Andrew Barr, teenager, Michigan, senior running back for Portland High School, suffered fracture of his C1 vertebra and a concussion during a hit in a game. Barr was fitted with a neck brace and released from the hospital within days, sidelined for the football season, according to The Lansing State Journal.

Nov. 4:  Hunter Harden, teenager, Tennessee, junior running back for Munford High School, suffered a fractured CV during a game, reportedly “dumped onto his head and shoulders” while trying to catch a pass, according to The Paris Post-Intelligencer.

Online Report of Staph Infection in Spinal Column, American Football 2011

Sept. 10:  Aaron Thibodeaux, 19, Louisiana, defensive lineman for University of Louisiana-Lafayette, sustained a concussion in helmet-to-helmet contact during a game. Moreover, the collision injured Thibodeaux’s back and reportedly “reawakened” dormant methicillin-resistant staphylococcus, or MRSA, which had infected the player’s elbow in the preseason, and it formed a cyst in his spinal canal. Hospitalized a week in intensive care, Thibodeaux survived the infection and did not suffer paralysis like an Arkansas teen football player in 2010. Doctors determined Thibodeaux should cease playing football, according to The Shreveport Times.

Online Reports, Survivors of Cardiac Arrest and Heart Attack, Football 2011 

May 19:  Teddrick Lewis, 15, Louisiana, player for Breaux Bridge High School, collapsed on the sidelines during a spring football scrimmage, his heart stopped. Coach Paul Broussard employed a portable automated external defibrillator, or AED—after having trained in a mock drill with his team and school personnel weeks earlier—to restart the heartbeat and save Lewis’ life. “Because we had a plan in place, we knew exactly what to do,” Broussard said. Lewis was hospitalized for a week and has since recovered for normal activity, but doctors advise he not return to contact sport. Sources: KATC-TV and ZOLL Medical Corporation.

Aug. 22:  Unidentified teenager, Missouri, eighth-grade player for Waynesville Middle School, collapsed of cardiac arrest during afternoon practice. Local fire and ambulance personnel responded and restored the boy’s heartbeat. “The defibrillator devices were absolutely what saved him,” said Mike McCort, of the ambulance district. Source: Pulaski County Daily News.

Aug. 30:  Ross Palmer, 17, Idaho, receiver/cornerback for American Falls High School, collapsed of apparent cardiac arrest while running wind sprints at practice. Two coaches began CPR while another fetched a portable defibrillator, then they correctly ignored a directive not to use the device, from responding paramedics, reports journalist Patty Henetz. “If [the stricken player] had not been shocked, no way would he have come out of that,” said cardiac surgeon Dr. Brian Crandall. Three days post-incident, surgeons implanted a self-activating stimulator in Palmer’s chest. Henetz reported “if Ross’ heart goes into ventricle fibrillation arrest—quivering instead of beating—the implantable cardiac defibrillator, or ICD, will shock his heart back into action.” Source: Salt Lake Tribune.

Sept. 2:  David Wilganowski, 17, Texas, touted lineman for Rudder High School, collapsed of cardiac arrest during a game. Rudder certified athletic trainer Jamie Woodell revived the heartbeat with an AED and staff performed CPR, saving the teen. Wilganowski was hospitalized 10 days, and surgery placed an ICD device in his chest. An honors student, aspiring engineer, Wilganowski is formerly a prized football recruit at 6-foot-5, 240 pounds and athletic. He will not play football again, but Rice University reportedly pledges to honor its scholarship offer. Sources: KBTX-TV, KCEN-TV and Bryan-College Station Eagle.

Sept. 9:  Brett Greenwood, 23, Iowa, former University of Iowa safety just released by the Pittsburgh Steelers of the NFL, suffered a reported heart attack during an individual workout at his former high school in Bettendorf. Personnel of Pleasant Valley High were present and likely kept the athlete alive until paramedics arrived, media report. School athletic director Randy Treymer said, “The school nurse ran a defibrillator where our athletic trainer was working on Brett. … They kept pushing with the defibrillator and CPR. If they weren’t around, who knows what could have happened?” Doctors placed Greenwood in medically induced coma and on life support, and he was hospitalized in ICU for about two weeks. Greenwood was transferred to a specialized care facility where he remains, reportedly awake, talking and walking. Lengthy recovery work remains. Sources: Quad City Times and Daily Iowan.

Sept. 20:  Alex Templeton, 13, Texas, a linebacker for Azle Junior High School, went into cardiac arrest of contact during a game. Templeton chased down an opponent near the sideline, making the tackle from behind, and the player’s cleat jabbed his chest. The seventh-grader stood up, looked at the grandstands and collapsed. A coach performed CPR while a nurse who was a spectator administered a portable AED owned by the school; Templeton lay still until the defibrillator restored heartbeat, rousing him. “Seeing the boy spring back to life was an emotional experience for all those involved,” Edwin Newton reported. Templeton is recovering and hopes to play football again in about two years, when doctors might grant permission, but his dad, Matt Templeton, may not: “I don’t want him to play, but we will have to make the decision later,” the father said. Azle school officials, meanwhile, have ordered 11 additional defibrillators, intending to station one for every athletic activity of the district.  Sources: Azle News, WFFA-TV and DFWCBSLocal.com.

Oct. 1:  Ty Egan, 8, Illinois, youth-league player in LeRoy, was sprinting open for a touchdown when he slowed and collapsed, his heart having stopped. An ambulance was on site and medical personnel were watching as spectators, and they scrambled in response. But only oxygen was administered before the grade-schooler revived, resuming normal pulse and heartbeat. An electrophysiologist later told the parents their son was in cardiac arrest and a miracle saved him, not oxygen. Doctors are restricting Egan from all sports except golf in the future, reports Randy Kindred, The Bloomington Pantagraph.

Additional Reports of Injury for Expert Review as Catastrophic, American Football 2011

July 16:  Regina Pickel, adult, Tennessee, a teacher in the Bradley County School District, suffered a severe head injury during her son’s football scrimmage at Bradley Central High School. Pickel was sitting along the sideline when struck by the helmet of a diving player, causing profuse bleeding of a head laceration. Pickel was conscious and hospitalized in intensive care, according to The Cleveland Daily Banner.

Sept. 23:  Ikenasio Nuku, teenager, Washington, senior running back for Mount Ranier High School, sustained a reported serious injury of contact during a game. Nuku was removed from the field strapped on a long board and hospitalized, but his parents have not allowed release of further information, according to The Seattle Times.

October, circa:  Jesse Winn, teenager, Utah, senior running back for Emery High School, sustained a reported neck injury that sidelined him for the season, according to The Emery County Progress.

Oct. 10:  Josh Inhof, 15, Wisconsin, a center/defensive end for West Bend East High School, sustained a likely concussion, undiagnosed, during a collision at practice. Three days later, during a game, Inhof sustained one or more hits that rendered him unresponsive on a sideline. The unconscious teen was airlifted to a hospital, where he remained two days and was released, according to The Milwaukee Journal Sentinel.

Oct. 14:  Sam Casinelli, teenager, California, junior wide receiver/defensive back for La Costa Canyon High School, sustained a neck injury during a game and was hospitalized, with no paralysis, according to CHS-TV.

Oct. 14:  Keegan Speas, teenager, Oklahoma, sophomore wide receiver for McGuinness High School, sustained a contact injury during a game that left him prone on the field for about 30 minutes. No paralysis occurred and Speas was transported to a hospital, according to IrishOnDeck.com.

Oct. 24:  Alton Brunson, 13, Florida, player on a youth-league team in Miami, suffered temporary paralysis of a helmet-to-helmet hit during a game. Brunson regained complete mobility while hospitalized for about a week, according to WSVN-TV.

Matt Chaney is a writer, editor, teacher and restaurant worker living in Missouri, USA. His 2001 graduate thesis for an MA degree at the University of Central Missouri is qualitative media analysis of 466 football reports, historical print coverage of anabolic steroids and HGH in American football, largely based on electronic search among thousands of news texts from the 1970s through 1999. For more information, including contact numbers and his 2009 book, Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com. 

Posted Wednesday, November 2, 2011

I recently enjoyed answering questions from Stefan Fatsis, of Slate, in an email Q&A with the journalist and author, his queries regarding the current NFL debate over HGH testing. The text of our prepared discourse follows here. Meanwhile, follow Stefan on his football-season co-op with Deadspin writers, as they debate the issues in NFL roundtable; listen for him on NPR, for sports comments and reports; and check out Stefan’s acclaimed book A Few Seconds of Panic: A Sportswriter Plays in the NFL, recounting his Plimptonian quest as kicker for the Denver Broncos.  Matt Chaney

Fatsis: Q. In layman's terms, why do you believe the WADA HGH test that the NFL is pushing is “suspect”? 

Chaney: Well, suspicion begins on the real problem for HGH blood testing as it stands today: The fact that American medicine and credible medical bodies abroad have yet to see a democratic, scientific, straight-up independent peer review of this purported breakthrough in doping detection—a WADA scientist’s patented immunoassay for GH-isoform ratios in human blood—or this potential goldmine “test” that generates from closed European research and secretive WADA engineers who remain virtually inaccessible.

Even WADA associates like HGH-testing pioneer Dr. Peter Sonksen, London, hardly know what’s up. Sonksen, creator of the GH-biomarker test that is open to independent review but WADA yet avoids, told me he hasn’t associated with former colleague Dr. Christian Strasburger since about 1999. Sometime around the Sydney Olympics, Strasburger, having become a full-time scientist of WADA, patented the assay for GH isomers. From the start, Sonksen says, Strasburger’s insurmountable problem has been a detection window of only hours, requiring drug informants and Draconian “whereabouts” tracking of athletes to typically log a positive result for use of bio-cloned or recombinant human growth hormone. “You have to take a blood sample within 24 hours of their injecting it,” Sonksen told me.

Dr. Don Catlin, endocrinologist and our foremost American expert on anti-doping methodology and tools, can’t get access to Strasburger and the in-house WADA studies allegedly establishing validity and reliability of the GH-isoform test. WADA officials in Canada say to just trust them, but Catlin doesn’t yet in America. “You’ve got to have hard-core evidence…,” Catlin told me. “ ‘Here’s the study. Here’s what we did. Here’s what we found. Here’s the [data on] false-positive [results]. Here’s the false-negative.’ ”

Catlin and Sonksen say WADA would likely be challenged to prove validity and reliability of Strasburger’s test in American trial court—and the anti-doping agencies know it. Sonksen is a longtime associate of WADA and the IOC, a charter member of the anti-doping establishment worldwide, yet he hammers anti-doping officials and their disregard for transparent scientific protocol: “I think there’s a certain fear among the, ah, [WADA] politicians that if it comes to a case in court [against the GH-isoform], they won’t win it,” Sonksen told me.

Q. Can every scientist drafted to work for WADA (or USADA) be in the bag somehow, or simply be willing to compromise scientific standards? Why, given the legitimate public concern and outcry over doping in sports, would they move forward with an unreliable test or tests?

You kiddin’ me? These are sports medicine people—or else they’re “independent scientists” directly hired, paid, funded, whatever, by the anti-doping agencies and sports organizations. Do you think they have a contract or association with powerful sport and anti-doping if they speak sensibly, telling us anti-doping will never turn back rampant drug use among athletes? These are the same type of people who tell us we can properly detect and manage football’s inherent brain injuries through “concussion testing.”

So-called scientists and doctors have pandered to politics of anti-doping and sport since the 1980s at least in America. The NFL’s hireling or associate “experts” have become dime a dozen, selling us their false hopes for preventing systemic drug use and brutality. These people come from everywhere anymore, and shamelessly. And if you don’t play ball, like Catlin won’t, then you scrounge for funding in your research, like he does now. Or you’re just a sports idiot with a doctorate who wants to believe the complex, irreversible problems of athletics can be fixed. And dumb media parrot the mere talk. It’s all become a pathetic joke, an American travesty of truth and public perception.

And the public does not care about doping in sport, especially American football, the sport perhaps most conducive to drug use on earth, from steroids and Growth to speed and painkillers.

The moral bleating of grandstanding politicians and ill-informed media does not qualify as public outcry. We bitch as a public about gas prices, not drugs in our football.

Q. If you were the NFL and the players union, what would you do on this matter? Wait for a test? Or is testing, for HGH anyway, futile and beside the point? 

All of the silliness can end immediately if WADA and the NFL will do what the players and union demand: Practice simple American scientific transparency so Dr. Stasburger’s HGH test for WADA can be independently vetted for validity and reliability—or not.

Catlin and Sonksen, for example, both make their validating research available for peer review, including to scientists of player unions. The documents of Sonksen’s GH-biomarker and Catlin’s carbon-isotope ratio scan for synthetic testosterone are available for peer analysis and replication. Any American worker would demand as much for undergoing a blood test, especially if a positive result meant loss of work and pay.

All that said, yes and repeating, I think anti-doping as it stands for now and in the foreseeable future is hopeless for turning back muscle doping in American football. The historical and contemporary evidence is clearly laid out in my 2009 book, Spiral of Denial. If I were a football player today, for example, especially of the NFL, I would be utterly confident in beating Catlin’s CIR and I would find the ways to beat Sonksen’s biomarker, were it deployed by WADA and the league. Strasburger’s isoform would be of non-consequence for stopping my HGH use, and if chopsticks ever caught a fly in me, so to speak, I would crush that test in trial court.

Q. Where do you stand on the efficacy of HGH? The reliability of existing tests aside, should sports organizations even bother testing for it? 

Clinical studies have found rHGH injections can change fat to muscle, among some measurable effects, but my belief of the drug’s performance-enhancing nature is based on anecdotal evidence offered by users I’ve known and in published accounts. College and pro athletes testify of recuperative effects for injecting bio-tech growth hormone while weightlifters and football players say the substance builds mass when used in complement with androgenic chemicals, synthetic testosterone and/or anabolic steroids. Also note the bio-tech GH analogues available today, such as IGF-1 and growth-hormone-releasing peptides, which athletes and bodybuilders readily use and the anti-doping agencies are hopeless to fight.

Q. Given your anecdotal conclusions that HGH has some effects, do you believe it would be good to remove the drug from football were it possible?

Absolutely, prevention of synthetic performance-enhancing substances is my foremost goal, which is often lost, about me, in my points on lousy testing to-date and in the foreseeable future.

Listen, I’ve waited for effective anti-doping in football since about 1980, when I seriously wanted to try college football and was seriously afraid of all the drug-using players in the game by then, covering the big-school rosters in particular.

The problem, testing of blood or urine isn’t working, isn’t close to working, and will surely never work, and the people selling this crap know that! But you think some yak from WADA or USADA will admit as much, still intending to hold his or her job?

Now, to credit of such people, they’re told to stop a Death Star and given a pop gun. The anti-doping efforts, from teen studies to testing, have never had a chance for pitiful funding to start, as Dr. Catlin can attest, as Penn State epidemiologist Charles Yesalis can attest, along with so many other researchers and officials. We haven’t seen the billions of dollars needed in mere startup for anti-doping, just to plausibly develop and deploy some of these ideas for success or failure. As we stand, anti-doping operates on about $300 million to $400 million annually, U.S. dollars, covering research and development to detection applications, worldwide.

Q. And one non-HGH question: Briefly tell me your backstory again. How'd you get so involved in the issue? And why does it matter so much to you?

I don’t know why I’m still around the football issues of doping and injuries, to be frank, and I likely won’t be much longer. I’m 51 with a family and don’t get paid or funded by anyone, and my former vocation of sportswriting is no help; American football’s partner media want little to do with my work, from TV networks down to the smallest newspapers. Sales of my book are horrendous. I drive old cars, wear old clothes and clip coupons. My only source of income presently is kitchen jobs.

What sort of thrust me here today is my background as an athlete and coach. I injected synthetic testosterone to gain size and power as a college football player, at Southeast Missouri State in 1982, and later as a student coach I helped a player obtain testosterone—and really didn’t want to commit any of the acts. I felt I had to for remaining in football.

Within a few years, as a sportswriter, I decided that any real reform must begin with open discussion, among all parties and without punishing anyone. I'm still waiting for that moment. And my prime concern is athletes, especially kids; I want the truth declared for them, about football's terrible dangers, if not their parents. Lousy, hopeless testing, for our discussion here, only serves to cover football's 50-year-old doping problem, and only players suffer the consequences.

Q. And, here's a left-field question: How do you feel about NFL football as a sport—not as a business run by Goodell, not vis a vis HGH or brain injury—but as a sport, as an entertainment?

I think the NFL and big-time NCAA football together constitute the single-most valuable entertainment vehicle in America. And the essential reason is sport violence. Football is “contact ballet” set amid a social spectacle, says Michael Oriard, former NFL lineman and renowned cultural analyst. Football is athleticism in the face of annihilation. That’s why we play and why we watch, damn the casualties, largely kids. My advice, if anybody really wants to “save kids” from drugs in football, or head injuries, don’t let them play this crazy game. Forget the football mythology, especially quick fixes.

Email me at mattchaney@fourwallspublishing.com. For more information, visit the homepage at www.fourwallspublishing.com.

Review of Survivor Cases Online Confirms Unusually High Rate


By Matt Chaney

Posted Sunday, October 16, 2011

Amid the second autumn of America’s neo-campaign for Safer Football, the extreme sport is lethal as ever in 2011 and on pace for its worst year in decades, confirms a review of casualty reports online.

As usual, teenagers constitute the large majority of football victims, among at least 60 cases of catastrophic injuries striking players since February—fatalities and survivors of subdural hematoma, stroke, paralysis, cardiac arrest and more emergencies—documented by this writer through search of Google banks under numerous Boolean word commands.

Comparing football numbers of a year ago, 41 catastrophic cases were logged for all of 2010 by the National Center for Catastrophic Sport Injury Research, a think tank funded by football organizations that compiles data recognized as authoritative.

And there’s more mayhem online this year, including at least 5 survivor cases of heatstroke or heat-related collapse that may meet criteria for inclusion in the National Center survey, results to be posted online next spring by the University of North Carolina.

Heatstroke fatalities are included in annual catastrophic data, for example, while worst-scenario survivors can sustain brain damage if body cooling does not commence soon enough.

See my annotated list of survivor cases below.

Reports of at least 125 emergency cases in football this year are available online, with the large majority involving ambulance or life-flight transport.

My numbers are likely conservative, too, given limitations of this review including the following: a) online databases do not include a significant portion of daily print and broadcast news; b) magazines and newspapers increasingly charge subscription rates for online access, especially small-market or rural publications; c) many online news pages are taken down after short posting; d) Google does not access all daily news online; e) and an unknown amount of football survivor cases are publicized in scant detail or not at all [although burgeoning social media are closing much of the blackout, with blasts of texts, Tweets and Facebook posts, for example, as emergencies occur at football sites].

Even football fatalities slip by reviewers employing electronic search, like one collision death in 2010, youth-league player Quadaar White, 15, whose case remains omitted from the National Center report online.

I focus here on survivor players of grave football injuries in 2011, based on my list of 61 cases online already, with 11 weeks remaining in the calendar year.

My documented cases include about 45 that appear strong for meeting catastrophic criteria of the National Center, pending follow-up and qualification by lead researcher Dr. Robert Cantu, the Boston neurosurgeon and NFL expert on brain trauma.

That 45 catastrophic number would almost double Cantu’s survivor tally of a year ago.

Cantu and NFL commissioner Roger Goodell team to champion “safer football”—an old term first employed for so-called game reform a century ago—through rule changes, penalty enforcement, “concussion testing,” statutory law and “behavior modification” of players that allegedly teaches “proper” hitting without head contact.

In 2010, first year of the modern campaign, Dr. Cantu logged 24 survivors of catastrophic injuries in football, including 13 who made so-called complete recoveries. His 2009 report lists 42 survivors, while he gathered 57 such cases in 2008, the high mark for the National Center’s posted reports since 1984.

In coming days I’ll solicit injury researchers and other experts for their responses to my review, including Dr. Cantu.

For additional notes on the list below, foremost and repeating, it does not include football fatalities in 2011, like 16-year-old Ridge Barden, lineman for Phoenix High School in New York, killed on Oct. 14 by subdural hematoma of "blunt force" trauma incurred that Friday night in a game upstate. The teen is American football's third collision death confirmed by autopsy this year [thus far I have found reports of 16 deaths of players, mostly teenagers but including a 7-year-old, to likely qualify for Dr. Cantu’s confirmation as football-related fatalities, along with an additional 3 or 4 meriting his consideration].

For football survivor cases, The National Center for Catastrophic Sport Injury Research classifies such casualty as either non-fatal, involving “permanent severe” functional disability, or serious, with no permanent functional disability.

Beyond the list below, search online for additional cases of serious football injury that could qualify as catastrophic in 2011, such as spinal bruising and transient paralysis and head injuries causing comatose states longer than concussion.

And check out the National Center’s website, http://www.unc.edu/depts/nccsi/, for information and context—if not injury qualifications that altogether jibe—among reports on decades of the catastrophic events ever-looming, for tackle football and more contact sport of modern America.

 

Survivors of Catastrophic or Grave Injury in American Football, Cases 2011

From reports retrieved in Google Search through October 15, 2011

By Matt Chaney, mattchaney@fourwallspublishing.com

Online Report of Comatose Youth Player, Age 5, American Football 2011

Sept. 29, circa: Unnamed “Tiny Mite” player, 5-years-old, Hawaii, reportedly fell comatose at a hospital following a head injury. Child was injured while participating in division of Oahu Pop Warner football for ages 5, 6 and 7, Brianne Randle reports for KHON-TV. Oahu doctor Josh Green said, “Five might be a little young. I’m concerned about it.”

Online Reports of Brain Hemorrhage and Surgery, American Football 2011

March 19:  Logan Weber, 21, Iowa, offensive guard for Coe College, experienced severe headaches while stretching for weightlifting. Weber was hospitalized within 24 hours for brain bleeding linked to “arteriovenous malformation,” or AVM, a congenital condition. Surgery was performed to insert a shunt and Weber was hospitalized for 20 days. He has recovered but no longer plays football, serving instead as student coach for the Coe team. Source: Cedar Rapids Gazette.

Aug. 5:  Brennan Barber, 17, South Carolina, defensive lineman for Mid-Carolina High School, was injured by a reported “routine” helmet hit during a scrimmage and collapsed minutes later. Surgery was performed for brain bleeding. Barber began walking three days later and was released from the hospital within a week. He is undergoing therapy and is expected to make strong recovery. Source: The State.

Sept. 2:  Tucker Montgomery, 17, Tennessee, receiver/linebacker for Tri-Cities Christian School, injured in helmet-to-helmet contact running the football during a 6-man game. Surgery was performed for brain bleeding. On Oct. 3, a hospital spokesman reported Montgomery remained comatose with a “very, very long road to recovery.” Sources: TriCities.com, Johnson City Press.

Sept. 10:  Dominic Morris, 21, Nebraska, running back for Chadron State College, injured by reported “glancing” contact from an opponent’s facemask during a game. Surgery was performed on brain bleeding that had caused a blood clot. “Following the operation… Morris was alert and showed no signs of any ill effects from the injury,” states a CSC release. Morris was discharged from hospital on Sept. 12 for recovery at home in California. Sources: Chadron State College, Omaha World.

Sept. 16: Robby Mounce, 17, Texas, running back/receiver for Community Christian School, suffered brain bleeding during a 6-man game and collapsed. Surgery was performed. Mounce, an honors student, remains under critical care while undergoing therapy in a rehabilitation facility. Progress is slow and a long recovery is expected. Sources: KDFW-TV, Mineral Wells Index, and Janet Mounce on CaringBridges.com.

Sept. 16:  Zeth Shouse, 17, Nevada, tight end/defensive end for Elko High School, suffered brain bleeding during a game and collapsed. Multiple surgeries were performed.  Shouse, an honors student, remained hospitalized in a coma on Oct. 8. Source: Reno Gazette-Journal.

Sept. 16:  Adrian Padilla, 17, California, safety for Oxnard High School, collapsed following head contact during a game. Surgery was performed for brain swelling of a reported severe concussion. Padilla was released from hospital on Oct. 4 and attended the Oxnard football game days later; he walked onto the field for the opening coin flip wearing street clothes and protective helmet. Padilla told media he suffered a concussion in football two weeks prior to the Sept. 16 injury. The teen, with more surgery pending, is continuing schoolwork at home for remainder of the semester. Sources: Ventura County Star, Concussion Inc. blog, and ESPN.com.

Sept. 16:  Adam Ingle, 17, Kansas, quarterback/linebacker for Valley Center High School, was injured in helmet-to-helmet contact during a game. Surgery was performed for brain bleeding. Family members say Ingle likely was concussed three days before game injury, during football practice, but the player did not inform anyone of his headaches, reports blogger Irvin Muchnick. Ingle is progressing well at home and attending school events, but lengthy recovery is expected. Sources: Concussion Inc. blog, Wichita Eagle, and KSN.com.

Sept. 30:  Bobby Clark, 17, Idaho, lineman/linebacker for Priest River Lamanna High School, collapsed while leaving the field during a game. Surgery was performed for brain bleeding. District superintendent Mike McGuire said Clark might have mentioned headaches in the week leading to his injury, unbeknownst to coaches and school officials. At least 9 players on the team have been diagnosed with concussion this season, among 45 players in the small school, officials say. A local TV station reports Clark was among 3 concussion cases diagnosed on the team the night he was airlifted for emergency surgery. The teen remains hospitalized in critical care but a ventilator was removed and he is alert and improving, undergoing physical therapy, his mother reports online. A long recovery is expected. Sources: Julie Clark on CaringBridge.org, WASWX-TV, Spokane Spokesman-Review, and Bonner County Daily Bee.

Sept. 30:  Shelton Dvorak, 17, Nebraska, fullback/linebacker for Pierce High School, collapsed during a game. Surgery was performed for brain bleeding. Dvorak was released from ICU a week later and entered a rehabilitation center, where he’s progressing markedly, including solo walking, exercising—such as free lunges, squats—eating and conversing with visitors. But swelling remains along with complications like headaches, and Dvorak faces more surgery. Sources: Dvorak Family on CaringBridges.org, Lincoln Journal Star and Norfork Daily News.

Sept. 30:  Dillon Lackhan, teenager, Arizona, senior lineman/linebacker for Valley Christian High School, suffered brain bleeding of a headshot during a game. Surgery was performed and Lackhan was conscious within a few days, eating and conversing. “Dillon shows positive signs for recovery, but a long-term prognosis is not clear,” stated school athletic director Marlin Broek, in an Oct. 6 email to sportswriter Richard Obert. Sources: AZCentral.com, MyFoxPhoenix.com and East Valley Tribune.

Oct. 13:  Unnamed teenager, California, sophomore player for Los Angeles High School, collapsed during a junior varsity game. Surgery was performed for a brain hemorrhage and the teen remained hospitalized in critical condition the following day, according to The Los Angeles Times.

Online Reports of Vessel Rupture and Stroke in American Football 2011

Sept. 6:  Connor Laudenslager, teenager, Pennsylvania, senior offensive/defensive tackle for Line Mountain High School, was stricken of a blood clot at beginning of indoor practice, causing stroke. Laundenslager, 6-foot, 270 pounds, was hospitalized for emergency brain surgery then made “remarkable progress,” said coach Mike Carson. A Sept. 30 report states Laudenslager could be cleared to resume football this season. Sources:  NewsItem.com, TNonline.com and Pottsville Republican Herald.

Sept. 23:  Dylan Mercadante, 16, Vermont, receiver/defensive back for Montpelier High School, suffered a ruptured blood vessel in his neck during the second half of a game, causing strokes. The injury possibly stemmed from contact on his team’s first kickoff of the game. Coach John Murphy said Mercadante passed a “concussion test” administered by athletic trainer Jennifer Lahr before his collapse and she still attempted to sideline the player; Lahr said the player reentered the game against her command, reports sportswriter Anna Grearson. Mercadante spent a week in ICU then was moved to a rehabilitation facility, where he remains. Long recovery is expected. Source: Barre-Montpelier Times Argus.

Online Reports of Brain Bleed or Swell, No Surgery, American Football 2011

Feb. 14:  Neiron Ball, 19, linebacker for the University of Florida, experienced headaches following a workout and was hospitalized the following day for a burst blood vessel of the brain linked to a congenital malformation of arteries known as AVM. Ball was released from ICU after five days and in March began “radial” treatment described as a non-intrusive procedure, similar to radiation for cancer. Ball is not playing football this season. A relative says Ball is healthy but his football future remains uncertain. Sources: Orlando Sentinel and YardBarker.com.

Aug. 19:  Alan Mohika, 17, Hawaii, quarterback for Damien Memorial High School, was injured by contact during a game, rose and walked off, then fell into seizure. Mohika suffered brain bleeding and was hospitalized in ICU for a reported severe concussion. No surgery was necessary and the teen was discharged from hospital after five days. Mohika, who returned to school in mid-September, reportedly sustained a concussion last year and isn’t playing football this season. He hopes to return to sports. Sources: Honolulu Star-Advertiser, HawaiiNewsNow.com and KITV.com.

Sept. 9:  Matt Ringer, 15, California, running back for Central Catholic High School, suffered an apparent concussion during a tackle. Later he was hospitalized for a detected brain bleed, although fully conscious. No surgery was necessary and Ringer was released from hospital within 48 hours. He is not playing football this season, but apparently recovery is strong thus far. Source: Modesto Bee.

Oct. 7:  Jadon Adams, 16, Kansas, running back for Beloit High School, collapsed during a game and was hospitalized for brain swelling. Doctors sedated Adams as treatment and discontinued the drugs as swelling subsided within 24 hours, determining that no surgery was necessary. The teen has not fully regained consciousness while making inconsistent responses to verbal and physical stimulation, but family members see positive signs in his eye openings and body movements. And he was moved from ICU into his own room a week after injury. Doctors are unsure why Adams remains mostly unresponsive, but they believe his brain swell wasn’t caused by a football collision, reports journalist Gary Demuth. “They felt a previous problem, perhaps with the addition of the football game, could have caused this health issue to surface,” said Steph Barret, a nurse and friend of the player’s family. Several specialists are examining Adams. “Based on his CAT scan, he should be sitting up and talking,” Barrett said. Sources: Salina Journal and Steph Barrett on CarePages.com.

Online Reports of Skull Fracture, American Football 2011

April 2:  Lamont Baldwin, 17, Washington, D.C., touted receiver for Carroll High School, suffered a fractured skull and other injuries in a four-player collision during  private camp without pads and helmets in Virginia. Baldwin was hospitalized in ICU for two days and could not return to school for the remaining semester, facing months of recovery. When injured, Baldwin was a top college prospect reportedly being recruited by several major programs. Baldwin is not playing football presently, and available information is limited. Doctors were optimistic for Baldwin’s return to football as of last report in April: Washington Post and NBCWashington.com.

Online Reports of Spinal Fracture With Surgery, American Football 2011

May 7:  Rob Marrero, 31, Pennsylvania, semi-pro player for the Mountain Top Reapers, suffered a broken neck and severed spinal cord during a game. Friends reported after surgery that Marrero is paralyzed permanently from chest down. Marrero, married and a father of two, continues treatment and therapy. Source: Lehighton Times News.

May 27:  Jeremy Bingham, 34, Arizona, fractured cervical and thoracic vertebrae during a game in pads and helmets between alumni of two local high schools. He was injured colliding with another player. Doctors diagnosed no paralysis in Bingham and surgery was performed to stabilize the C7 and T1 vertebrae. Bingham is married and the father of four. Sources: Eastern Arizona Courier and the Bingham Family on Blogspot.com.

Sept. 23:  Corpio Dennard, 16, Alabama, receiver/running back for Saks High School, suffered a broken neck during a game while a tackler grabbed from behind, pinning his arms and sending him into ground headfirst. Dennard experienced no paralysis and walked to the sidelines, but coaches did not return him to the game. The next day his mother sent him for a doctor’s exam and Dennard was hospitalized, with X-rays showing fractures in his 5th and 6th cervical vertebrae. Surgery was performed on Sept. 25, for stabilizing the spine with plate and screws. “The doctors that saw him were just amazed that he got up and walked off the field,” coach Clint Smith told reporter Joe Medley. Dennard said, “If I had gone back in the game, I don’t know where I’d be right now. I’d probably be paralyzed or even dead.” Dennard has begun 6-to-12 months rehabilitation and doctors expect he can return to sports, although probably not football. Source: Anniston Star.

Sept. 29:  Luis Morales, teenager, Texas, junior player for Vega High School, suffered fracture of the C6 vertebrae while colliding with bleachers during a junior varsity game. Reports state the teen is paralyzed from waist down while hardly moving his arms. Surgery was performed in Texas, and Morales was flown to California for specialized rehabilitation on Oct. 13. Sources: Amarillo Globe-News, High Plains Observer and ConnectAmarillo.com.

Oct. 7:  Porter Hancock, teenager, Utah, running back/linebacker for South Summit High School, suffered a broken neck and paralysis while making a tackle in a game. “Porter finished off the tackle. It was nothing big,” said South Summit coach Jerry Parker. “He turned his head the wrong way.” Surgery on Oct. 8 removed two discs and inserted a stabilizing plate. Hancock remained paralyzed from chest down as of news reports on Oct. 10. Prognosis is uncertain. Sources: Deseret News, Salt Lake Tribune, Park City Record, KSL.com.

Online Reports of Spinal Fracture, No Surgery, American Football 2011

Note: Football cases of spinal fracture often involve no displacement of vertebrae or puncture of spinal cord, resulting in no paralysis or other acute alert, and in fact unknowing victims can function normally for long periods after injury, including playing tackle football. For such injury that is diagnosed and treated, practically complete recoveries are frequent. Among severe or catastrophic injuries in tackle football, diagnosed spinal fracture without displacement qualifies among least serious types. Some injured players rehabilitate and return to full contact in the same season, even quickly, such as a few high-school players this year. For this section, available details are fewer and less precise in some cases.

June 25:  Evan Gray, teenager, California, senior running back for Poway High School, fractured three vertebrae in a fall during pass-league competition. Following rest and rehab, Gray returned for Poway’s football season but is currently sidelined with a reported fractured kneecap. Sources: Damian Gonzalez on MaxPreps.com and Poway News Chieftan.

Aug. 9:  Jeff Wozniak, teenager, Indiana, sophomore quarterback for Morton High School, suffered fractured vertebrae and neck bones and a bruised spinal cord in practice when “hit under his chin during a drill and driven backward,” initially leaving him paralyzed, reports sportswriter Steve Hanlon. Doctors fitted Wozniak with a steel halo head brace, requiring drilling of screws but not open surgery. In ICU he progressively regained feeling and motor function and in two weeks left the hospital for a rehabilitation facility, where he was also released after two weeks. He continues outpatient therapy and hopes to play football again. Source: NWTimes.com.

Aug. 10, circa:  Mario Crawford, 21, Virginia, running back for Old Dominion University, sustained fracture of the C1 vertebrae in a preseason practice, striking his helmet on a medicine ball in a drill. Doctors could not determine a diagnosis for two weeks, until CT scan revealed the injury. Crawford expects to wear a neck brace 6-to-8 weeks and will not return to football this year, according to The Hampton Roads Virginian-Pilot.

Aug. 15-20:  Devin Mahina, adult, Utah, redshirt sophomore tight end for Brigham Young University, sustained a fractured vertebrae in a preseason scrimmage. Initially the injury was not diagnosed and Mahina practiced football for about 10 days, until doctors found it by CT scan on Aug. 30, sidelining him for the year. At last report, Mahina will wear a neck brace until further evaluation. Sources: Deseret Sun and Salt Lake Tribune.

Aug. 26:  Dustin Newman, teenager, Alabama, junior player for Pike Liberal Arts Academy, sustained a fractured thoracic or T5 vertebrae during a kickoff. He will wear a neck brace until about November’s end. Sources: Troy Messenger and WAKA.com.

Sept. 1:  Kellen Bernard, 15, Texas, running back/linebacker for Palmer High School, sustained a fractured lumbar vertebrae on a hit while returning a punt. He reportedly had temporary paralysis and at last report was expected to recover. Sources: Ennis Daily News and WFAA-TV.

Sept. 2: Jerram Rojo, 17, Texas, quarterback/linebacker for Marfa High School, was injured running the ball in a game, his heading striking ground. He walked off the field then was hospitalized, where a CT scan revealed fracture of the C6 vertebrae. As of diagnosis, Rojo would wear a neck brace for six weeks then be examined for possible surgery, Sterry Butcher reports for BigBendNow.com.

Sept. 2, circa:  Sam Scholting, teenager, Missouri, junior offensive tackle for Mexico High School, suffered a broken vertebrae and was expected to be sidelined six weeks, coach Nick Hoth told The Mexico Ledger.

Sept. 9:  Frank de Braga, teenager, Nevada, senior running back/safety for Fallon High School, suffered a fractured T3 vertebrae and brain concussion while making a tackle. Initially unconscious, the teen had movement before transport to hospital, where he spent the overnight under observation. De Braga was cleared to return to play two weeks later and remains in the Fallon lineup, according to The Lahontan Valley News.

Sept. 10:  Brian Tyms, 22, Florida, receiver for Florida A&M University, sustained a fractured vertebrae during a game. He returned to football and played in a game on Oct. 1. Sources: Tallahassee Democrat and The Associated Press.

Sept. 11:  Ron Bartell, 29, Missouri, cornerback for the St. Louis Rams, sustained  fractures of the C7 vertebrae in an NFL game. He is recovering wearing a neck brace and will undergo months of rehab, hopeful of playing again, according to The St. Louis Post-Dispatch.

Sept. 16:  Scott Thibeault, teenager, Maine, senior running back/linebacker for Mountain Valley High School, suffered two fractured vertebrae and was expected to miss at least four weeks of play. Source: Portland Press Herald.

Sept. 18:  Nick Collins, 28, Wisconsin, free safety for the Green Bay Packers, ruptured a lumbar disc during collision in an NFL game. Cervical-fusion surgery was performed and Collins faces lengthy rehabilitation. Doctors expect full recovery for normal lifestyle, but Collins hopes to resume pro football. Sources: Milwaukee Journal Sentinel and Channel3000.com.

Sept. 30:  Deangelo Peete, 17, Michigan, linebacker for Livonia Franklin High School, fractured his C1 vertebrae in three places during a helmet-to-helmet collision in a game. He was hospitalized, a head halo brace was fitted to stabilize the injury, and within days Peete was walking. The teen will wear the halo brace for three months, according to WJBK-TV.

Sept. 30:  Cody Ashcraft, teenager, Missouri, senior receiver for Scott City High School, sustained a fractured cervical vertebrae in a game, according to The Southeast Missourian.

Oct. 8:  Chris Thompson, 20, Florida, running back for Florida State University, suffered fractures of the T5 and T6 vertebrae while being tackled in a game and was hospitalized overnight. Thompson is walking and wearing a neck brace for 6-to-12 weeks, then starts rehab. He hopes to play football again, according to The Orlando Sentinel.

Online Reports, Survivors of Heatstroke and Related Illness, Football 2011

July 11:  Jordan Hawthorne, South Carolina, sophomore lineman for Greenville High School, was stricken during morning team workout as local temperature would later reach the mid-90s and about 100-degree index. Hawthorne, listed as 5-foot-10, 200-pound defensive lineman, reportedly passed out but regained consciousness before transport by ambulance to a local hospital, where at last report he spent the overnight in ICU. Source: WPSA-TV.

Aug. 1:  Ciani Davis, 17, Texas, offensive/defensive lineman for his 6-man team at Advantage Academy Charter School, collapsed of heatstroke in morning practice. Paramedics measured 108-degree body temperature for the teen, listed at 6-foot-4 and 350 pounds, and he was placed in medically induced coma for 48 hours. Davis was hospitalized for a week, mostly in ICU, and began outpatient rehabilitation. Sources: WFAA-TV and KDFW-TV.

Aug. 2:  Dustin Snow, 17, Ohio, offensive tackle for Wauseon High School, collapsed during team lunch break after practice. The 6-foot-1, 285-pound teen slipped off a chair, tried to stand up, then a teammate caught his fall. Emergency response resulted in helicopter life-flight to Cleveland, where Snow was hospitalized in critical condition before he began to recover. His father, Bob Snow, said, “It was a nightmare the first 24 hours.” Dustin Snow, a 4.0 student ranked No.1 in his senior class, was discharged from hospital after a week and soon spoke with reporter Bill Bray. “I barely remember [Aug. 2] practice,” Snow told Bray, of the hours leading to his collapse, continuing: “It was severe dehydration. … The first thing I remember I was waking up in the hospital with the [ventilator] tube in my mouth. … I was really freaking out. … I had so much lactic acid in my body that they had to put a room full of fluids in my body. They had seven IV bags hooked up to me at one time. My kidney function was very close to dead as was my liver function. That started to affect all my other organs and my stomach began having problems functioning as well. I couldn’t digest food and it was really bad.” Snow will no longer play football; in addition to his heat illness, he has learned of “an extra bone growth in the back of my head,” discovered during hospitalization, which doctors warn could damage his spinal cord on impact. Sources: Wauseon Reporter and Toledo Blade.

Aug. 10:  Clay Huskey, 14, Alabama, player for Buckhorn High School, collapsed of heatstroke during a water break at afternoon practice. Coaches applied ice to Huskey’s body while awaiting paramedics. The teen was hospitalized for three weeks, including 17 days in ICU, as chronicled on Facebook by a deep thread of relatives, friends and more followers. For about a week Huskey was basically comatose, wracked by high fever and body pain, then had to overcome a lung infection and surgery. Upon his hospital release at day 21, Huskey faced “a lot of physical therapy,” Denise Sisco Shockley reported online, “and he will be out of school another 4-6 weeks, but he is healing. Thank you, God, for answering our prayers!” Sources: Shockley on Facebook.com and WAFF-TV.

Sept. 2:  Clay Callahan, teenager, Ohio, junior lineman for Conneaut High School, was stricken as primarily 100-degree heat and humidity sent six players to local hospitals from a game between his school and Champion High. Callahan was unconscious in critical condition, hospitalized on ventilator for an overnight before discharge after about a week. Candy Oliveira, identifying herself as a relative of Callahan on Facebook, wrote on Sept. 7: “I have been to other high school football games and have seen large ice coolers with towels soaked… . My nephew showed multiple signs of HEAT STROKE prior to his unconsciousness.” Callahan, whom his aunt described as “very lucky,” returned to the Conneaut team for the Oct. 14 game, reports sportswriter Don McCormack. Sources: Ashtabula Star Beacon, WJW-TV, Oliveira on Facebook.com, InAshtabula.com, and Conneaut Area City Schools.

Online Reports, Survivors of Cardiac Arrest, Heart Attack, Football 2011

May 19:  Teddrick Lewis, 15, Louisiana, player for Breaux Bridge High School, collapsed on the sidelines during a spring football scrimmage. Coach Paul Broussard employed a portable automated external defibrillator, or AED—after having trained in a mock drill with his team and school personnel weeks earlier—to restart the heartbeat and save Lewis’ life. “Because we had a plan in place, we knew exactly what to do,” Broussard said. Lewis was hospitalized for a week and has since recovered for normal activity, but doctors advise he not return to contact sport. Sources: KATC-TV and ZOLL Medical Corporation.

Aug. 22:  Unnamed teenager, Missouri, eighth-grade player for Waynesville Middle School, collapsed of cardiac arrest during afternoon practice. Local fire and ambulance personnel restored the boy’s heartbeat. “The defibrillator devices were absolutely what saved him,” said Mike McCort, of the ambulance district. As of Aug. 26, the teen was hospitalized, according to The Pulaski County Daily News.

Aug. 30:  Ross Palmer, 17, Idaho, receiver/cornerback for American Falls High School, collapsed of apparent cardiac arrest while running wind sprints at practice. Two coaches began CPR while another fetched a portable defibrillator, then they correctly ignored a directive not to use the device, from responding paramedics, reports journalist Patty Henetz. “If [the stricken player] had not been shocked, no way would he have come out of that,” said cardiac surgeon Dr. Brian Crandall. Three days post-incident, surgeons implanted a self-activating stimulator in Palmer’s chest. Henetz reported “if Ross’ heart goes into ventricle fibrillation arrest—quivering instead of beating—the implantable cardiac defibrillator, or ICD, will shock his heart back into action.” Source: Salt Lake Tribune.

Sept. 2:  David Wilganowski, 17, Texas, touted lineman for Rudder High School, collapsed of cardiac arrest during a game. Rudder's certified athletic trainer, Jamie Woodell, revived the heartbeat with an AED and staff performed CPR, saving the teen. Wilganowski was hospitalized 10 days and surgery placed an ICD device in his chest. An honors student, aspiring engineer, Wilganowski is formerly a prized football recruit at 6-foot-5, 240 pounds and athletic. He will not play football again, but Rice University reportedly pledges to honor its scholarship offer. Sources: KBTX-TV, KCEN-TV and Bryan-College Station Eagle.

Sept. 9:  Brett Greenwood, 23, Iowa, former University of Iowa safety just released by the Pittsburgh Steelers of the NFL, suffered a reported heart attack during an individual workout at his alma mater high school in Bettendorf. Personnel of Pleasant Valley High were present and likely kept the athlete alive until paramedics arrived, media report. School athletic director Randy Treymer said, “The school nurse ran a defibrillator where our athletic trainer was working on Brett. … They kept pushing with the defibrillator and CPR. If they weren’t around, who knows what could have happened?” Doctors placed Greenwood in medically induced coma and on life support, and he was hospitalized in ICU for about two weeks. Greenwood was transferred to a specialized care facility where he remains, reportedly awake, talking and walking. Medical treatment continues and a likely lengthy recovery. Sources: Quad City Times and Daily Iowan.

Sept. 20:  Alex Templeton, 13, Texas, a linebacker for Azle Junior High School, went into cardiac arrest of contact during a game. Templeton chased down an opponent near the sideline, making the tackle from behind, and the opponent’s cleat jabbed his chest. The seventh-grader stood up, looked at the grandstands and collapsed. A coach performed CPR while a nurse who was a spectator administered a portable AED owned by the school; Templeton lay still until the defibrillator restored heartbeat, rousing him. “Seeing the boy spring back to life was an emotional experience for all those involved,” Edwin Newton reported. Templeton is recovering and hopes to play football again in about two years, when doctors might grant permission, but his dad, Matt Templeton, may not: “I don’t want him to play, but we will have to make the decision later,” the father said. Azle school officials, meanwhile, have ordered 11 additional defibrillators, intending to station one for every athletic activity of the district.  Sources: Azle News, WFFA-TV and DFWCBSLocal.com.

Oct. 1:  Ty Egan, 8, Illinois, youth-league player in LeRoy, was sprinting open for a touchdown when he slowed and collapsed, his heart having stopped. An ambulance was on site and medical personnel were watching as spectators, and they scrambled in response. But only oxygen was administered before the grade-schooler revived, resuming normal pulse and heartbeat. An electrophysiologist later told the parents their son was in cardiac arrest and a miracle saved him, not oxygen. Doctors are restricting the boy from all sports except golf in the future, reports Randy Kindred, The Bloomington Pantagraph.

Online Reports, Survivors of Blood Clot, American Football 2011

April:  Nermin Delic, 19, Kentucky, defensive lineman for the University of Kentucky, underwent emergency surgery for a blood clot. The life-threatening condition followed his operation to repair a torn groin muscle, an injury from spring football. “In the second week of April, I was walking to class and my arm was turning blue,” Delic told reporter Drew Brantley. “They told me I had a blood clot. I spent eight days in the hospital. I had some internal bleeding and a two-foot tube down my throat. It made me realize some things.” Soon after, Delic had surgery to remove a rib, and he chose to leave football and the university. In July, however, the 6-foot-5, 260-pound athlete announced he would return to UK and the football program in 2012. Sources: Dalton Daily Citizen, BleedBlueKentucky.com and Lexington Herald-Leader.

Aug. 27:  Jacy Dike-Pedersen, 16, California, fullback/linebacker for California School for the Deaf, experienced difficulty breathing in a scrimmage; two days later, an arm became swollen. Doctors found blood clots in his upper body and Dike-Pedersen entered ICU for drug treatments and then surgery to remove a rib. The 6-foot-3, 185-pound honors student now takes blood-thinning medicine, and he returned to school on Sept. 19, although finished with football this year. If the blood clots clear in the future, Dike-Pedersen might return to football, reports Phil Jensen, The Oakland Tribune.

Sept. 2:  Tyler Story, teenager, Texas, receiver/linebacker for Decatur High School, sustained a severe knee injury in a game; later a blood clot developed and the teen underwent emergency surgery lasting five hours. A family member reported damage to the artery and nerves, and Story stayed weeks in ICU. He was recently discharged from hospital, but surgery for the knee injury is pending. Sources: Wise County Messenger and Jeff Jones on Blogspot.com.

Oct. 8:  Andrew Gonnella, 21, Maryland, 6-foot-5, 290-pound offensive guard for the University of Maryland, suffered a dislocated knee in a game that included compound bone fracture, leading to surgery that night. Three days later, Gonnella had a blood clot and was hospitalized. Sources: Washington Times and Baltimore Sun.

Online Reports of Organ Rupture and Damage, American Football 2011

Sept. 23:  Taygen Schuelke, 17, South Dakota, running back for Newell High School, suffered a ruptured kidney during a game. He was hospitalized in ICU a few days then moved to a regular room to begin physical therapy. Schuelke was released after about a week and is home for a slow recovery. Two years ago, Schuelke fractured his C7 vertebrae in rodeo competition. Sources:  Rapid City Journal and Jan Swan Wood for TSLN.com.

Sept. 23:  Luke Bewley, 17, Montana, halfback/linebacker for Hellgate High School, suffered a lacerated kidney while blindsided in a reportedly “clean” but hard hit from a blocker. Bewley was hospitalized in critical condition and surgeons implanted a stint to redirect liquids away from the damaged kidney. He was discharged from hospital within a week and doctors expect a rapid recovery. Bewley aspires to play basketball in the coming season and also return to football next year, reports Jamie Kelly for The Missoulian.

Sept. 24:  Zach Sheffield, 18, Kansas, cornerback for Olathe South High School, sustained a destroyed kidney from contact during a game. This case is among many of 2011 demonstrating how quickly emergency can accelerate beyond anyone’s control at the common football setting—and typically mortal danger threatens a student player. For the Sheffield catastrophic injury, Kansas City Star sportswriter Tod Palmer provides a vivid account available online… Sheffield fell on the run, pursuing a ball-carrier during a Saturday road game, and his twisting body struck the opponent’s flexed knee in impact that damaged his left kidney irreparably. Sheffield trotted off the field, short of breath he later recounted, then collapsed in apparent distress. No one could readily diagnose the problem, including trainers and coaches, and no ambulance was immediately available, so the dying player was loaded into a family automobile. His dad, Bret Sheffield, sped off for an ER five miles away through metro traffic. The father “drove like a man possessed” to make it, Palmer wrote, continuing: “He recalls weaving across a median at one point then speeding down the shoulder on I-435 west, which was backed up because of weekend construction. … Zach described the pain as excruciating, ‘probably a 9 out of 10,’ he said. Doctors could barely move him off the gurney to the CT machine, because the pain was so intolerable. … All the hospital’s medical staff could do was stop the bleeding to the burst kidney, which now felt like an inflating balloon in his abdominal cavity, and wait for his other kidney to begin working double-time.” Surgery removed the destroyed kidney and Zach Sheffield remained hospitalized on Sept. 30, slowly recovering, as Palmer’s report was posted at www.kansascity.com.

Sept. 30:  Derek Wall, 13, Utah, student at Pleasant Grove Junior High School, suffered severe internal injuries from contact during intramural flag football, an after-school program on campus. The injured boy’s father, James Wall, said, “They had to do exploratory surgery on him—he’s got a 10-to-12 inch cut on his stomach now, perforated bowels, his pancreas is bruised, there’s some liquid in his lungs, they had to take out his gall bladder, his appendix. Everything was just kind of bruised up.” A week following the incident, Derek Wall was recovering although unable to eat or drink without help, and would remain hospitalized for weeks longer, reports Emiley Morgan, The Deseret News.

Online Reports of Femoral Artery Rupture, American Football 2011

Sept. 3: Jacob Rainey, teenager, Virginia, touted quarterback for Woodberry Forest School, projected as a top college recruit in 2013, suffered femoral artery burst of a leg during a preseason scrimmage, among contact injuries when he was tackled from behind. Doctors amputated the lower leg on Sept. 10. Sources: The Daily Progress, The Associated Press, and MaxPreps.com.

Matt Chaney is a writer, editor, teacher and restaurant worker living in Missouri, USA. For more information, including about his 2009 book, Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com.

Union memos reveal runaround by WADA and NFL

By Matt Chaney

Posted Friday, August 26, 2011

This story of skullduggery follows the classic theme of what looks like, walks like, talks like, often isn’t.

It features contemporary names and concepts in NFL news, of purported wisdom, science and integrity, and illusion, smoke and mirrors, when black is actually white, or the seeming good guys bad, and so forth.

This is about NFL management and players, which party is really to blame for the serious dispute over beleaguered, so-called Olympic testing for recombinant human growth hormone—a growing fight preventing full ratification of the new collective bargaining agreement celebrated as ending the lockout and restoring America’s beloved football season.

Long-short, the problem party of HGH testing is not the players and union, per the imagination of dumb sportswriters and politicians.

In reality the players are getting railroaded over HGH blood testing, or were, and they refuse to play along, as PA officials have clarified for months in private communication with the league, according to current union memos obtained by Chaney’s Blog.

Shady dealing begins with the quasi-governmental entities World Anti-Doping Agency and American arm USADA, which are funded by government and sport organs. WADA-USADA bureaucrats incessantly promote their closed “science” for dubious synthetic GH detection that’s ripped mercilessly by independent experts worldwide.

“WADA refused to provide scientific information justifying the reliability of their HGH test (validation studies, population studies, performance testing between labs, etc.),” states an union email circulated among members Wednesday afternoon, following a meeting of NFLPA representatives with anti-doping and league officials at WADA headquarters in Montreal.

“We leave here with more questions than answers,” the union memo continues. “The quality of player care is non-negotiable and we will continue to press for all the relevant data. We want to ensure that any testing meets the highest standards and has scientific consensus.”

Obfuscation is also game plan for NFL management, especially commissioner Roger Goodell and his frontman on the issue, attorney Adolpho Birch, senior vice president of law and labor policy. Goodell and Birch utter nonsense on HGH testing, for more than a year running, only to go unchallenged by sport reporters who parrot the misinformation.

League officials blatantly misled the union before Wednesday’s confab in Canada, promising to finally produce documentation on the controversial GH “isoform” test, validation studies withheld by WADA at least seven years, including from NFLPA experts who’ve filed specific requests since April.

Obviously the league promise proved phony in Montreal, where no missing data were forthcoming Wednesday, and longtime observers of WADA and its in-house isoform immunoassay would only expect as much.

Critics like preeminent testing engineer Dr. Don Catlin in Los Angeles, a former tester for Olympic and pro sports who operates the non-profit Anti-Doping Research laboratory.

Catlin has waited for scientific information on the GH-isoform test since before WADA deployment at the Athens Olympic Games in 2004. “You want to see the data,” Catlin told me in 2007. “A scientist says, ‘Fine, show me the data, show me the paper that’s been [peer] reviewed and published.’ ”

“You’ve got to have hard-core evidence…,” Catlin continued: “ ‘Here’s the study. Here’s what we did. Here’s what we found. Here’s the [rate of] false-positive. Here’s the false-negative.’ ”

“I never pay any attention to what they say [WADA officials],” Catlin dismissed. “I only pay attention to what’s published. And if there’s something published in peer-review literature on the [HGH] test, I’ll know all about it.”

What of the mysterious WADA studies, I wondered then, that supposedly establish test validity and reliability?

“Well, they’re always being conducted,” Catlin said. “I hear of them. But with so much I’ve heard over the years, I just go way back and believe only what I can touch and feel myself.”

“It’s in the interest of a sport organization to say they have a test, because they don’t look very good when they don’t have a test. I have a letter from WADA, two years old [circa 2004], saying a test for growth hormone will be released shortly,” Catlin noted. “You lose credibility when you speak before you’re sure.”

Epidemiologist Charles E. Yesalis of Penn State, an ScD and foremost expert on sport doping, discussed WADA defiance of scientific protocol for implementing faulty approaches in punitive anti-doping, with only athletes punished for the scattered positive results, among countless false-negatives.

“I’m just astounded,” Yesalis, avowedly conservative, told me in February 2010 as NFL and MLB officials started chirping favorably about WADA blood testing for growth hormone.

“I mean, if you’re going to ruin somebody’s life, and if you don’t have [vetted methodology] totally locked up, to me that is immoral and unethical,” Yesalis said. “I’d rather see five million cheaters compete than see scientists bastardizing themselves.”

I interviewed Catlin again about the isoform, with no essential change in play since we spoke three years previous—nothing substantially improved about testing method and instrument since their patenting by WADA prior to Athens.

And despite the first reported positive result on Feb. 22, 2010, for British rugby player Terry Newton, 31, who admitted HGH use uncontested and accepted a two-year suspension under WADA guidelines.

An informant had fingered Newton for no-notice testing, the typical way for detection through the isoform’s laughable window of but a few hours to perhaps a day.

“Well, if you know the guy’s going to shoot up this morning, and you arrive at noon, OK,” Catlin remarked, caustically. “Glad it works that way.”

“They can’t do much about the detection window,” Catlin said of the isoform’s great insurmountable limitation, if not debunking factor. “That’s the nature of the test.”

Scientific literature still lacked credible review on the WADA isoform, then six years in use with some 1,500 negative results until Newton, and Catlin wasn’t surprised.

Who would want to vouch for this lousy, unvalidated application? No credible scientist or other authority, anywhere on the planet.

“It is simply not a useful test, no matter how you cut it or spin it,” Catlin said.

*       *       *       *       *       *

For almost five months, the NFL Players Association has asked WADA and the league to provide simple validating information for the GH-isoform assay, a blood test used on athletes for punitive anti-doping since 2004, according to recent union documents obtained by this blog and an Aug. 9 letter to WADA quoted by Juliet Macur of The New York Times..

Union officials, in the final week leading to Wednesday’s face-to-face with WADA and the NFL, beseeched anti-dopers and league brass to come clean, produce any substantial research data on the isoform.

Apparently, the question arises whether WADA even has a formal article on its closet research. An Aug. 19 union letter to Birch at the NFL states: “we understand… that no technical document exists on the isoform test. If our understanding is incorrect, and a technical document exists either in final or draft form, we renew our request for those documents.”

That letter to Birch last Friday, written by NFLPA associate general counsel Heather M. McPhee, channels mounting union frustration with WADA and NFL management—and players’ skepticism and mistrust for alleged HGH testing.

McPhee informed Birch the union had “concerns” about management conduct and WADA cooperation. Birch’s agenda for the Montreal meeting did not provide for ample discussion of the scientific controversy, McPhee emphasized, particularly since union experts supposedly were to receive and review critical documents on spot.

McPhee noted recent materials the PA received from both the NFL and WADA were essentially useless, largely irrelevant to questions at hand, perhaps even “mistakenly included.”

“We emphasize that the vast majority of these items consist of papers or abstracts that involve a different [rHGH] test—the marker test—and not the isoform test the NFL is currently proposing.”

McPhee noted the August materials received “again [do not] include the [agency] validation studies, reference and population studies, and validation studies conducted by each WADA [accredited] laboratory that uses the isoform test.”

In closing, McPhee reiterated dire need for union experts to review literature prior to the discussion time Birch scheduled for the impending meeting, an hour in Montreal, absurdly short. “For this reason, again, we continue to strongly encourage you to provide the information,” McPhee implored of Birch in New York.

Birch apparently didn’t reply to McPhee in Washington for four days, until Tuesday, on eve of everyone’s gathering in Montreal—and of course without the necessary documents on WADA testing..

McPhee fired right back to Birch by email Tuesday, tactfully scolding on several points, including the reality that issue discussions would only have to continue.

“It is apparent that we will not receive the information that we requested from both WADA and the NFL prior to the meeting tomorrow,” McPhee wrote. “In light of that circumstance, it is impossible for the substantive issues regarding this matter to be resolved tomorrow, and we need to plan for additional meetings in the near future.”

In addition, McPhee corrected Birch for his public misstatements regarding what the union and players have agreed upon thus far: “your statement that the NFLPA made two testing proposals, most recently three weeks ago, is not accurate.”

“In early August, [the] NFLPA engaged in negotiations in response to the League’s proposal,” McPhee wrote, “but as you know, the NFLPA clearly stated that any agreement regarding HGH testing is contingent on the NFLPA’s satisfaction with rigorous independent analysis and assessment of the test that the NFL has proposed for use on players.”

By Wednesday north of the border, NFLPA representatives had literally chased WADA yaks and NFL sidekicks to Montreal, but for no avail. Once again, an earnest party hit wall in quest for WADA disclosure on its notorious HGH testing.

“WADA won’t show the numbers,” Catlin had already surmised, a year ago. “They recognize, rightfully, that as soon as they do show the numbers, there could be difficulty.”

*       *      *       *       *       *       *

The epitome of fluffy NFL rhetoric on blood testing, mostly inaccurate, has been statements by Adolpho Birch, league attorney assigned to the issue.

In dialogues with reporters, Birch portrays suspect HGH detection as “solution” for protecting NFL players and even impressionable youths, ensuring “clean competition and a level playing field.” He claims the league welcomes input from “all expertise,” but, he adds “the program we have designed will be effective and will meet any sort of scrutiny that will be put on it.”

Birch claims HGH testing “has been used by the top labs for years now and has withstood legal challenge upon appeal.”

Regarding ever-present expert rebuke and adverse evidence of GH-isoform test efficacy, Birch says: “From our perspective, there are no significant detractions to its effectiveness or reliability.”

“We believe, like every other test we have ever used, we will be able to improve that [detection] time. All tests evolve as the science and the technology evolves. We expect [the isoform] to be the same way. It is a far different thing than unreliability, which would be something that would promote a false-positive [result], something you absolutely cannot have in the context of drug testing.”

“There has been zero indication from anyone since sort of the dawn of this test that false-positives are an issue,” Birch says, wholly false.

In fact, many indie experts—including Catlin, Yesalis, University of Texas biostatistician Donald A. Berry, and former BALCO doping guru Victor Conte—argue that false-positives have yet to be ruled out, given insufficient information made public to date.

Anti-doping agencies even acknowledge the fact, with an NFLPA letter, quoted by The Times, inquiring about “WADA’s acceptance of a 1 in 10,000 false-positive rate” for the GH-isoform.

Meanwhile, contrary to Birch’s version, the WADA test has not faced challenge in a courtroom of law, democratic or otherwise, nowhere yet.

The appeal process that Estonia skier Andrus Veerpalu presently follows, as one of 5 known positive-result cases among some 4,000 HGH assays since the Athens Games, is confined to the kangaroo arbitration cells of elite amateur sport. Veerpalu, age 40, is the only athlete reported to formally contest the WADA test so far.

Newton, the unfortunate first known to test positive, committed suicide last year within months of the announced result, and Berry took exception from afar, hearing the news in America.

In 2008, Berry, the data expert, shredded anti-doping as generally bad science in a widely read review he authored for Nature journal. “If conventional doping testing were to be submitted to a regulatory agency such as the U.S. Food and Drug Administration to qualify as a diagnostic for a disease, it would be rejected,” Berry told science writer Brian Alexander, reporting for MSNBC.com.

Last year I notified Berry of Newton’s death, and the normally reserved scientist blasted circumstances of modern athletes, those clean or “cheating,” for entrapment perpetuated and driven by questionable or invalid anti-doping that somehow skirts law, ethics, fairness—wherever, whenever deemed necessary by an official few so powerful, of sport, media and government.

“Terry Newton’s plight should be a wake-up call to all,” Berry wrote to me and others, by email. “As a society we cannot take this issue lightly. What many regard to be a small penalty can be a death sentence.”

“Are we trying to save sport? High-level sport? At what cost? Is it worth it? Quite obviously we’re ruining people’s lives. Perhaps we should be exacting such extreme penalties to save sport so we can be entertained by athletes on what we like to think is a level playing field. But a few people should not be making this decision for the rest of us. And the entire process of labeling people with the stain of cheater should be defensible and not cloistered.”

“Are we trying to save the bodies of young people?” Berry continued. “If so, is the tack we’ve taken even remotely reasonable? And is the trade-off of bodies saved and lives ruined appropriate, even if our tack is eventually successful?”

“I don’t pretend to have the answers to these questions, but they must be debated much more broadly than presently, with the pros and cons of the various approaches clearly delineated and widely publicized.”

“And, oh yes, we must get the science right,” Berry affirmed in conclusion, “and we must appropriately and adequately fund research in this area so we have a chance of getting it right.”

Matt Chaney is a writer, editor, teacher and restaurant worker living in Missouri, USA. Email him at mattchaney@fourwallspublishing.com . For more information, including about his 2009 book, Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com .

By Matt Chaney

Posted Wednesday, June 29, 2011

This is Part 5 of an analysis series titled Brain Trauma Dictates Epic Football Reform, which will culminate with independent recommendations for steps imperative to the blood sport’s survival at public schools, colleges, and likely the professional level.

Believe what you’re seeing, parents, in tackle football. Use common sense and drop your sentiment for the game mythologized as pure, essential Americana.

Tackle football is simply blood sport, not the glorious rite of manhood and education you’re always led to believe.

No, collision football is not beneficial for kids overall, and it turns brutal at competitive levels that begin far below professional football, incidentally, on any field where aggressive competitors roam, predators of all ages—who become prey too at some point to the game’s perpetual maw, battering themselves down if not falling to peer attackers.

An American football player can only hope to leave the sport on his own volition, because forcible exit by injury is neither kind nor prideful, ranging from orthopedic maiming to rattled brain cells, to, yes, spinal paralysis or death for the most unfortunate.

“This crazy game will hurt you; this ain’t no party, this ain’t no disco,” said David Meggyesy, book author, former head-hunting NFL linebacker, and retired players union official, referencing the Talking Heads classic “Life During Wartime.”

Nothing, no one will ever change the extreme danger of tackle football—no rules, no education or “awareness,” no experts with their theories and snake-oil “testing” for preventing concussions, steroids or whatever risk.

Understand, parents, never can football be but fundamentally violent and terribly unsafe, whether staged in your town or on television, and whether it’s your own flesh and blood on that field or someone else’s.

If that doesn’t grab you, know this: Football costs the public foremost for its fun of destructing bodies by the thousands, human damages amounting to billions of dollars annually. The game and its profiteers don’t carry the carnage, just us, society at-large, paying already and forever for today’s mass of living football wounded, children to elderly.

Most importantly, reject football officials who always claim control of the latest health concern, like muscle doping in recent decades and brain injuries in the present. Every so-called prevention of football danger ends up a sham if not scam, and players suffer real consequences.

Last year, for example, football organs and their medical experts, from NFL commissioner Roger Goodell to his associate Dr. Robert Cantu, claimed a “culture change” and “awareness” toward "safer" football—reviving the sport’s antiquated response during injury crisis—but fatalities remained virtually unchanged.

At least 17 young Americans died of football during 2010, according to news reports and injury research, compared to the official 18 recorded for 2009.

Six of those players died of collisions in 2010, ranging in age from 11 to 21, three more than the previous year, proving no fundamental shift in football brutality.

Nothing could’ve saved Zach Shaver, an 18-year-old defensive tackle rendered comatose by a turf hit during a team scrimmage at Tarleton State University in Stephenville, Texas, March 27, 2010. The 6-foot-2, 280-pound freshman battled an opponent while the two fell over other players, slamming Shaver’s head to ground with the offensive lineman atop him.

“It looked like an ordinary football play,” said witness Brad Keith, local sports editor. “An assistant coach said that the offensive lineman said Shaver fell limp in his arms.”

Shaver was air-lifted to a hospital but didn't regain consciousness; he died of the head injury two days later, survived by his parents and a sister.

Six weeks later, during spring scrimmage at Eastern Oregon University in LaGrande, safety Dylan Steigers came off the field after making a tackle and told a coach he’d taken a headshot. Then he began vomiting and seizing.

Steigers was suffering a subdural hematoma, massive hemorrhaging of blood vessels in the brain. The 21-year-old was placed on life support and died the next day, leaving a 2-year-old daughter in his wake.

Steigers’ former high-school coach in Montana, Pete Joseph, said, “He played the game the way it should be played. He had excellent physical tools, he played the game hard, he played the game fast, and he loved football.”

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American football likely isn’t long for present form, pervasive and carried by the public in expenses from operations to healthcare. Not in this litigious, cash-poor country.

Too many health risks impact players and families, including drug abuse, cardiac disease, heatstroke, orthopedic disabilities and, of course, brain trauma and damage, says epidemiologist Charles E. Yesalis, professor emeritus at Penn State University.

“To me, it’s either a tsunami or perfect storm on the horizon with football,” said Yesalis, a foremost expert on muscle drugs in sport, during a telephone interview in December, when he surmised that head injuries had surpassed doping as an issue.

Yesalis noted boxing’s immense popularity of the past, when thousands of schools and colleges hosted pugilism and it commanded prime-time telecasts, until medical findings indelibly stamped the hazards in public conscience and turned-off too many people, especially parents.

“How many white middle-class parents today let their kids box?” emphasized Yesalis, whose father was a top amateur boxer. “How many boxing teams still remain at colleges? How many in high schools?”

“You have to view it in that milieu: What happened in boxing and our risk-adverse culture today. For me it’s a no-brainer: Parents today are dramatically more risk-adverse than were the parents of my generation or my dad’s generation.”

“Then there’s our litigious society today,” Yesalis continued, “and all the costs within the maelstrom regarding healthcare, how that plays into this [sport head injuries]. And the overall economy. When’s the last time your heard of a school district that was flush with money?”

“So the notion that the thousand-dollar helmets, for example, are going to save the day? Even those are not scientifically validated.”

Kids comprise the biggest annual body count for football, as the overwhelming majority of participants, with more than 1 million playing at 15,000 schools and 3 million in youth leagues. Children and adolescents far lead in casualties minor to severe, with medical facilities having treated about 920,000 for football injuries in 2007, according to a government report.

Research methods on injuries nationwide vary in construct, always subject to error for collection limitations, but the data clearly establish a long-standing public health menace in tackle football, especially for juveniles.

Researchers at Nationwide Children’s Hospital in Columbus, Ohio, recently concluded football-related injuries among youths increased 27 percent over an 18-year period from 1990.

In the study’s final year, 2007, hospital emergency rooms treated 346,772 injuries of players ages 6 to 17, including about 97,000 serious orthopedic cases such as bone fractures, joint dislocations and tendon tears. The ERs handled 8,631 diagnosed concussions, per the report.

“Adolescents aged 12 to 17 years old suffered a greater proportion of the injuries (78 percent),” a release states, “and were more likely to sustain a concussion or be injured at school when compared to younger players.”

Hospital ERs treated a daily average of almost 2,000 juvenile injuries during football season 2007, and investigators condemned the average of 57 concussions. “The potential long-term consequences of this type of injury make this an unacceptable rate,” said study co-author Lara McKenzie, professor of pediatrics at Ohio State University College of Medicine.

Annual concussions are incalculable in close terms, but an estimated 43,000 to 67,000 occur in high-school football, according to the National Athletic Trainers’ Association.

Catastrophic injuries involve the central nervous system, trauma to spinal cord, brain or both. Last year at least 7 American football players were paralyzed of spinal injuries without complete recovery, 5 at high schools and 2 at colleges, while at least 4 were brain-injured without full recovery, all at high schools, according tor the annual report by the National Center for Catastrophic Sport Injury Research at University of North Carolina.

The center is the American football’s official clearinghouse of worst-case reports, based at UNC since 1965, with famed neurosurgeon Dr. Cantu serving as medical director since 1987. The researchers’ inexact method is to gather news accounts of catastrophic football injuries, assisted by a national network of spotters such as coaches, trainers, doctors and organizers, with everyone utilizing electronic search and transmission for collection and reporting.

The center records 1,021 collision deaths in football over the last 80 years, along with 722 deaths of “indirect” game conditions such as heatstroke. More than 1,400 of those fatalities since 1931 were players for schools and community programs like youth leagues.

The data are profound but incomplete, for the Catastrophic Injury Center cannot account for every case across the vast realm of tackle football. Prior to Internet explosion of the 1990s, a portion of reports was assuredly overlooked in the old, limited process of locating and “clipping” from newspapers, magazines and journals.

Even with e-search, the Injury Center missed at least one collision fatality in football during 2010—Quadaar White, age 15—for its new annual report posted on the UNC site, listing only 5 such deaths for the year as of posting for this analysis.

White died on Aug. 31 in a Philadelphia hospital after suffering a neck injury in practice for a youth team comprised of boys 13 to 15, one of five squads in a community program of Upper Darby, Pa.

The smallish White shot low into a collision at practice, helmet out front for proper football leverage, and his head struck the knee of another boy. He lay motionless, not breathing by the time paramedics arrived, and he died seven days later, survived by parents and nine brothers and sisters.

Tony Jackson, a coach in the Wildcats program, said of White: “He was fast. He was aggressive. He knew how to tackle.”

A blog promoting lawsuit services addressed the White tragedy, stating “a Philadelphia personal injury attorney might argue that there was negligence in the incident, which can be grounds for a personal lawsuit.”

“Both amateur and professional athletes can be held civilly liable for the injuries they inflict on other athletes, even with contact sports like hockey and football,” the legal ad continued. “With recreational football teams, the sporting institutions or coaches can also be held liable for injuries or fatalities of athletes.”

Last season 2 football deaths involved rare “second-impact” brain trauma to the juvenile victims, cases demonstrating the hopelessness of alleged safety net known as concussion management.

An 11-year-old boy in Muskego, Wis., Evan Coubal, was apparently concussed during a youth-league scrimmage on Aug. 25. The injury wasn’t detected initially, and a week later Coubal struck his head on a contact sled for football during recess at his school. The second impact “exacerbated the earlier undiagnosed injury,” Jane Ford-Stewart reported for Community Newspapers, Inc., and the boy was rushed to a hospital, where he died on Sept. 5.

Nathan Stiles, 17, of Spring Hill, Kan., died of a subdural hematoma on Oct. 29 after returning to football from a diagnosed concussion he’d sustained four weeks previous. Although the brain hemorrhage killed the teen, Dr. Cantu confirms a re-bleed of the initial concussion also occurred, according to pathology results of his colleagues at Boston University.

Stiles had returned to football after his family doctor’s interpretation of concussion guidelines cleared the youth as asymptomatic, ready again for collisions, reports The Kansas City Star. The youth’s parents, Ron and Connie Stiles, did not respond to an interview request from this writer.

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Episodic concussion is only one concern of brain trauma for tackle football, attests a chorus of contemporary medical experts, along with decades of case studies of "dementia pujilistica" in pro boxers.

“We know, from the literature in boxing, the problem is not necessarily these major concussive events,” Yesalis said. “What can be of greater damage is the constant hitting short of concussion.”

“Every blow to the head is dangerous,” neuropathologist Dr. Bennet Omalu told Congress a year ago. “Repeated concussions and sub-concussions both have the capacity to cause permanent brain damage.”

A long-held assumption of medicine—holding that sub-concussive or mild repetitive head impacts of contact sport can cause neural degeneration—is jelling into expert indictment against tackle football, particularly upon milestone findings of imaging studies with prep players at Purdue University.

Purdue researchers employ advanced MRI to detect sub-concussive brain trauma in active football players, in real time, as the teens absorb collisions to become cognitively impaired while appearing asymptomatic.

Diffusion tensor imaging sees “functional” changes of brain regions caused by impacts milder than concussion, the disruptions and redirections of liquid through white-matter axon fibers that are stretched and sheared, thus altering chemical flow among neuron cells comprising the grey matter at cerebral surface.

The Purdue fMRI research and modern pathology of football brain damage are helping finally place repetitive head blows above concussion for medical priority in the sport. “What’s come to the fore is the risk of repetitive minor hit injuries,” said neurosurgeon H. Hunt Batjer, who co-chairs the NFL Head, Neck and Spine Committee.

Although many football fans are slow to grasp issue complexities—like most mainstream media and parents—many doctors aren’t waiting to propose epic remake of the game, beginning with dramatically reducing contact exposures.

“I don’t see that there’s any way of lowering the incidence of this without changing the way the game is played,” said neuropathologist Dr. Ann McKee. “I’m sure it’s going to be incredibly unpopular, but it’s going to have to be a game that maybe isn’t such a violent sport, that doesn’t have the thousands of sub-concussive hits that occur in every season.”

L. Syd M. Johnson, postdoctoral fellow in neuro-ethics at Dalhousie University, Nova Scotia, has researched brain trauma and policy in hockey and tackle football. "Preventing the kinds of chronic head impacts that are just part of the game would be impossible without radically altering the game of football,” Johnson stated in email

So do juvenile players accumulate enough hits for risk?

Does the football impacts of school and youth leagues cause brain damage?

Both McKee and Omalu have found early stages of chronic traumatic encephalopathy, or CTE, in the brain cells of deceased 18-year-olds, former prep football players dead of other causes, and the alert spreads to other youth sports like boxing. Experts agree the brain is most vulnerable in development, until the ages of 14 to 16.

“The real question we are going to have to ask is when is it that the body is too young in order to engage in contact activity,” said Dr. Byran Wasson, a physician for the U.S. Amateur Boxing Association.

Eric Nauman, engineering professor and co-head of the imaging and collision studies at Purdue, notes exposures of football contact for teens far exceed numbers for higher levels of the game. “In the NFL, players take, on average, 50 blows to the head per week,” Nauman said. “High-school players may, however, take upwards of 160 blows per week.”

Chris Nowinski, concussion author and co-founder of the Sports Legacy Institute [SLI], advocates reducing football contact. “I don’t think the jury’s out at all on whether high-school exposure’s enough for CTE,” he told Boston Magazine. "We’ve seen it in a kid who’s just 18. We just haven’t looked at a lot of 40- and 50-year-olds who just played high-school football. If it starts in your teen years and it just progresses, some percentage of kids are walking out of high-school football with CTE already in their brain. And probably the earlier they started, the higher their risk. If you played from 6 to 16, that’s probably just as bad as someone who plays in the NFL [and competes from ages] 14 to 24. Maybe worse, because the young brain is, again, more sensitive.”

College football is prime suspect for brain injury and long-term disease en masse, and the NFL certainly wants to research a possible distinction, proposing to study 100 to 150 of its retirees for comparison with “an age-matched and position-matched study of football player who played NCAA but not the pros,” Batjer said.

Harry Carson, Hall of Fame linebacker and retirees' advocate, has his gripes with the NFL and union about head injuries, but he believes lower levels of football are problematic too. Carson reports being “inundated” with contacts from former college and prep players experiencing permanent cognitive problems.

“Their emails bring me to a point of understanding that there are some major problems with concussions sustained in contact sports (but especially football) that have not been adequately addressed by anyone,” Carson wrote on his blog.

Nowinski, a former Harvard defensive tackle and WWE performer, criticizes the NCAA for inaction on brain injuries. “They’ve been completely absent from this conversation,” he said at a March symposium on legal questions for sports.

A total of 16,277 concussions were reported in NCAA football of 2009, according to The Daily Kansan, among programs in division classifications I, II and III. The NCAA is one of three collegiate federations for tackle football in the United States, with an estimated total of 75,000 players competing annually.

Chronic traumatic encephalopathy is confirmed in two cases involving NCAA football: Mike Borich, a former receiver and coach dead of a drug overdose, and 21-year-old defensive end Owen Thomas, who committed suicide last year at the University of Pennsylvania.

“Mike Borich played football in college, but did not play football professionally,” reported the research team of McKee at Boston University and the SLI. “He died at age 42 after exhibiting a pattern of erratic behavior throughout much of his adult life. His college playing career included stints with Snow College and Western Illinois University in the 1980s. He was known to have approximately 10 concussions during his college football career with no subsequent concussions or head injuries after college.”

“Mr. Borich’s brain revealed less pathology overall than many previous cases of confirmed CTE [from the NFL], but was consistent with CTE nonetheless.”

McKee group findings in the Thomas case were released to The New York Times, which broke the major story last September as brutal NFL hits and concussions were raising public scrutiny on head injuries in football. “A brain autopsy of a University of Pennsylvania football player who killed himself in April [2010] has revealed the same trauma-induced disease found in more than 20 deceased National Football League players, raising questions of how young football players may be at risk for the disease,” Alan Schwarz reported for The Times.

Neuropathologist Dr. Daniel Perl reviewed the BU results, remarking, “This is a call for a broader range of research into this problem that extends beyond the heavy duty NFL level of athletics.”

Thomas hanged himself in an off-campus apartment as spring football concluded and he was elected team captain at Penn. Six-foot-two and 240 pounds, Thomas was a highly aggressive football player, relishing head contact but without sustaining a diagnosed concussion in the sport he played since age 9.

“It really shows us that you don’t need to have had known or reported concussions to develop this brain disease,” BU neurologist Robert Stern told CNN. “It really shows us that those multiple, repetitive sub-concussive blows to the head that are experienced by so many athletes in many different sports can bring on the beginnings of this disease.”

Thomas “loved to hit people,’ his mother, the Rev. Kathy Brearley, told The Times. “He loved to intimidate,” she said. “It’s kind of sad. We all love football. We all love watching. We all love these great hits.”

What would be regarded a “proper” hit by promoters of “safer” football, without direct helmet-on-helmet contact, resulted in concussion and paralyzing injury on Nov. 20 for Jesse Reising, a Yale senior linebacker and honors student. Reising was set to become a Marine officer when he collided with Harvard running back Gino Gordon in the season finale for both teams.

“His helmet ended up hitting my shoulder pad, and my helmet hit his shoulder pad,” Reising told Jim Fuller of The New Haven Register. “That created a motion when my shoulder went downward; my head went to the side and stretched a lot of nerves in my neck, and that is what caused a lot of the damage.”

A few months later, Reising still had not regained feeling and motor function in his deltoid muscle, capping the right shoulder, with bicep and rotator-cuff muscles also affected. Thus the Marine Corps determined he was no longer needed.

“My low point when the reality of the situation really sunk in, how much of a turn my life is going to take, was probably the conversation I had with my recruiter [dropping] me from officer’s candidate school,” Reising said.

Reising graduated from Yale on May 23, majoring in economics and political science with a 3.75 grade-point-average. He recently underwent surgeries on the nerve damage and will work as a contractor in Afghanistan, still hopeful of recovering enough to someday serve in the Marines.

Elsewhere, Minnesota, doctors are perplexed in the case of a former college football player struck by degenerative syndrome. Scott Wierschem, 51, is a former offensive lineman at St. Cloud State, a NCAA Division II school, whose progressive condition has forced retirement from his 25-year career in corrections.

Doctors have yet to diagnose the ailment, described as a neuro-physical disorder, but Wierschem’s speech is slurred and he avoids hard food for fear of choking. His body core is particularly weakened, so he doesn’t stand upright long and walks with a cane.

No one knows if brain or spinal injuries are at root of the problem, and in the past Wierschem had no diagnosed trauma involving football. “I’d block low, at the knees,” Wierschem said of college football, speaking recently with The West Central Tribune. “I suppose my helmet took a lot of hits.”

In Canada, a 2009 brain study of former college football players who were concussed detected long-term problems, although all 19 subjects led productive, active lives. The former concussed players had a mean age of 60.

College football’s heavyweight conferences have taken heat from Congress for concussion mismanagement, as brain trauma became jock issue du jour in the news. Politicians have summoned officials, athletes and experts for well-publicized hearings of head injuries in multiple sports, and lawmakers ripped the NCAA.

Naturally, the NCAA responded with revised policy on so-called mild traumatic brain injury, new concussion guidelines for member institutions that include requiring removal of a symptomatic athlete from competition until evaluation and clearance by a specialist. In addition, all athletes must sign a pledge to self-report “their injuries and illnesses to the institutional medical staff, including signs and symptoms of concussion,” states an NCAA release.

The measures lack punitive teeth, since no association bylaw was enacted, and offer minimal protection to athletes—reflecting all policy and state law yet enacted for head injuries in sport.

And enforcing consistency of standards among universities, such as confirming a staffs of qualified medical personnel for brain injury and management, is virtually impossible on part of the NCAA.

Unsurprisingly, concussion controversy marked the collegiate year in men’s and women’s sports. At the University of Missouri, medical staff came under question for quickly returning head-injured basketball stars to action, male and female.

“Concussion management and assessment is not a perfect science by any means,” Dr. Chris Farmer, MU athletics physician, told The Columbia Daily Tribune. “It is a mix of subjective data, objective data and professional judgment.”

Authorities of brain trauma like Dr. Omalu and Dr. Lester Mayers, director of sports medicine at Pace University, recommend concussed athletes be minimally sidelined from one to three months, depending on age and diagnostic tools. They contend recovery of brain trauma should begin with strict isolation, meaning no physical or mental stimulation—including no “concussion testing”—for several days if not weeks.

About 85 percent of concussed football players of all ages currently return to contact within two weeks. Computerized testing like ImPACT, panned by independent reviewers as invalid for years, usually begins for the athlete within 48 hours of injury.

The NCAA recommends “the return-to-play progression should occur in a step-wise fashion,” but the association provides no time frame and points to expert disagreement over recovery, stating: “How quickly [an athlete] moves through this progression remains controversial.”

Matt Chaney is a writer, editor, teacher and restaurant worker living in Missouri, USA. Email him at mattchaney@fourwallspublishing.com. For more information, including about his 2009 book, Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com.

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Epidemiologic Study Nowhere in Sight for Afflicted Players

By Matt Chaney

Posted Thursday, June 23, 2011 

This is Part 4 of an analysis series titled Brain Trauma Dictates Epic Football Reform, which will culminate with independent recommendations for steps imperative to the blood sport’s survival at public schools, colleges, and likely the professional level.

These days the NFL talks good game about addressing and managing brain injury in players, for its official feeds to pliant popular press. Meanwhile, the league’s historical, ongoing actions and low-profile rhetoric tell the subtle, same old truth.

The NFL still doesn’t want to know much about brain trauma and lasting damage, especially among living players, in real time.

League and union officials claim 17 years of research into cerebral trauma and degeneration, but questions of longstanding urgency remain unaddressed, particularly for risk and outcome in living players.

Information leading to or confirming system culpability for brain damage in individuals is somehow avoided, as always.

By the 1990s, NFL management and union had heard reports of emotional duress and cognitive impairment among retirees, including the case of full-blown dementia in former linebacker Dale Meinert, confined to a nursing home in his 50s. But no scientific evidence yet linked brain damage to tackle football, even at pro level.

Professional boxing was identified as culprit though. Medical literature tied that blood sport to cognitive decline in athletes since 1928, for repetitive head impacts, and thus cast suspicion upon tackle football, the modern, head-ramming pro game—including in view of some NFL doctors.

“Think about boxing,” Bills team physician Richard Weiss said in 1992, as Jets All-Pro receiver Al Toon retired following his ninth diagnosed concussion in eight NFL seasons. “Suffering a large number of concussions over a period of years more than likely leaves some permanent residue.”

The NFL established a concussion committee and research arm in 1994, and soon the issue took spotlight through head injuries of marquee talents Troy Aikman and Steve Young, among star quarterbacks sidelined by shattering hits.

The boxing analogy came up again, conjured this time by Dr. Joseph Waeckerle, a Chiefs physician who served on the NFL concussion committee. Chronic brain trauma “becomes cumulative,” Waeckerle said. “A great example would be a boxer. That may occur to other professional athletes who suffer many concussive syndromes.”

Independent researchers followed the boxing trail of brain damage right to pro football, cases of NFL retirees.

Esteemed neurologist Dr. Barry Jordan, authority on boxing trauma, co-authored a 2000 study that observed a minimum “two different mechanisms may contribute to the development of chronic cognitive dysfunction in [tackle] football players,” episodic concussion and thousands of asymptomatic traumas of lesser impacts over time. The report, published in Neurosurgery, continued:

“First, cognitive impairment secondary to concussion may be cumulative. Football players occasionally experience concussive events through typical contact sport collisions, i.e., head-to-head, head-to-body, head-to-ground, and head-to-goal post collisions. Second, football players may experience sub-concussive events through these same collisions during play and practice/training sessions. For professional boxers, CTBI [chronic traumatic brain injury] has been associated more strongly with career length than with the number of knockouts and concussions, suggesting that sub-concussive blows are an important primary environmental mechanism of neurological dysfunction.”

Another student of brain trauma, neuropathologist Dr. Bennet Omalu, had consumed the extensive library of CTBI cases in pro boxers, prepping him for a milestone football discovery in 2002: pathological evidence of brain damage in a deceased NFL player.

Omalu, a then-unknown deputy medical examiner in Pittsburgh, anticipated and found brain disease of repetitive impacts at cellular level during full autopsy of Steelers legend Mike Webster, a Hall of Fame center dead of cardiac arrest at age 50. Omalu named the football condition chronic traumatic encephalopathy, or CTE.

Omalu’s research group followed with more confirmations of CTE in deceased NFL players, as did a separate team at Boston University, under direction of neuropathologist Dr. Ann McKee.

By 2010 CTE was confirmed in more than a dozen NFL players examined postmortem by the Omalu and McKee teams, for case studies endorsed throughout medicine. Yet NFL loyalist experts doggedly disputed the evidence, as they had since the Omalu report on Webster published five years before.

Dr. Waeckerle of the NFL, who today serves on brain-injury committees for both the league and union, has labeled the CTE cases “anecdotal” and “marginally good” science.

Waeckerle, a renowned authority in emergency trauma who endured harsh criticism as brain researcher for the NFL—as co-author of discredited league studies involving controversial doctors Joseph Maroon, Elliot Pellman and Ira Casson—basically dismisses pathology of neural disease the vast majority of experts accept as convincingly linked to collision football.

Waeckerle instead promotes highly speculative theory for CTE in NFL players, like abuse of anabolic steroids or street drugs. He says a dire research question is whether some athletes are genetically predisposed for having their brains bashed-in by football contact. And he doesn’t point to CTBI in boxing anymore, for comparison to the NFL problem.

Waeckerle even had Webster under watch during the final season of the player’s 17-year pro career, 1990 with the Chiefs, when the battered lineman may have already begun cognitive decline, according to family members, doctors and other witnesses.

In a November profile of Waeckerle published by The Pitch weekly of Kansas City, writer David Martin reported: “Waeckerle isn’t ready to say football is killing guys like Mike Webster. Maybe it’s genetics. Maybe it’s steroids. Maybe it’s a combination of things. ‘We don’t know if there’s a cause and effect yet,’ he says. ‘We’re studying it.’ ”

Regarding cerebral risk and injury outcome of pro football, Waeckerle has estimated conclusions of NFL research are still a decade away, some possibly long as 30 years.

*       *       *       *       *       *       *

Nate Jackson is an ex-pro football player, dashing and single at 32, a talented writer with his first book contract—and he detects no cognitive alarms, thank you, after playing seven seasons in the vicious NFL.

Jackson feels fine mentally and physically, happy and enthused for a new craft and future beyond football. But he does contemplate the possibility of brain damage, like practically every peer of the contemporary NFL, players past and present.

“I don’t think about it too much. I try not to worry much about it,” said Jackson, former wide receiver and tight end, during a telephone interview. “I don’t think there’s much I can do about it at this point. I don’t think I was a head-banger for long enough, you know…” He paused, added, “But I don’t know. I don’t know.”

Lasting and typically progressive cognitive impairment is obvious in many NFL retirees and documented in several, ailments that begin for some as young as Jackson and spread wider through the older generations.

The mildest cases can be undetectable to lay people, but the known worst include an extraordinary three retirees with deadly ALS that manifested in their 30s, along with early onset dementia in men like John Mackey, Hall of Fame tight end diagnosed at 60.

Sylvia Mackey believes her husband’s condition is because of football, and she has seen the signs in his NFL peers. “Every year, he would go back to the Hall of Fame ceremony, and, every year that I went back, I noticed that more and more players—and these were Hall of Fame guys—had dementia,” she said on PBS NewsHour in 2009. “And I thought, there’s something wrong with this picture. It’s just too much of a common thread right here in this small group.” Sylvia Mackey estimated “plenty” of retired players suffer dementia.

Critics of autopsy-based NFL research contend large-scale epidemiological study of living players is urgently needed, valid random clinical trial conducted by a multidisciplinary team of experts and preferably free from influence by the likely funding sources of football. Large control groups must be assembled and quickly, among challenges, say observers such as epidemiologist Charles E. Yesalis, ScD, professor emeritus of Penn State University.

“There are four or five epidemiologic methods to apply the study to any disease state, prospective or retrospective,” said Yesalis, a foremost researcher of drug use by athletes. “It would obviously be good to have a top epidemiologist involved, and I don’t think I’m saying that in a self-serving manner because I’m retired and I have no interest in doing any work.”

“Part of the problem for investigators, other than your clinical study of acute effects, is you get into money need and who’s going to fund it?”

No party among the NFL, the NFLPA and NCAA has yet to support such ambitious, costly research while the government has expressed no interest, and other potential sponsors aren’t forthcoming at moment.

Smaller studies are underway, nevertheless, and findings and expert opinion increasingly suggest epidemic parameters for cognitive impairment in players of pro football, if not those of collegiate, school and youth levels.

The NFL sphere includes at least 13,000 to 16,000 living retirees, and surveys since the 1980s show excessive rates of diagnosis for depression and Alzheimer’s disease in the population. Medical evaluation of individuals and small groups finds brain disorders, and anecdotal information accumulates as dozens of retirees disclose experiences and concerns in public, such as during news interviews and testimony at congressional hearings.

Neuropsychologist Robert Stern, co-director of the Center for the Study of Traumatic Encephalopathy at Boston University, recently discussed the condition with NFL retirees in California. “It’s a progressive neurodegenerative disease,” Stern told them. “It’s a disease that gets started early in life and gets worse with repeated blows to the head.”

Stern’s presentation sobered former NFL linebacker Charles Anthony. “This was a real awakening and educational meeting that some of my friends probably should have come to,” Anthony told The San Mateo County Times.

With the recent necropsy results of former safety Dave Duerson, dead at 50 as one of several NFL suicides in recent years, Boston researchers have found CTE in 14 of 15 players examined postmortem. More than a hundred living players have pledged donation to this “NFL brain bank” and are participating in longitudinal cognitive assessment until death, but the hopeful study will require many years of building to ever produce meaningful data on scope and consequences of problem.

No epidemiological observations can be made of case studies limited by participant numbers and biases, for constituting a representative sample of the NFL population or any in football.

The NFL-funded Sports Legacy Institute at BU and its research rival Brain Injury Research Institute, of West Virginia University, both solicit brain donors and families without random selection while the player parties typically have their agenda.

“There’s a tremendous selection bias, so you can’t make any conclusions about the incidence or prevalence of disease,” Dr. McKee of BU and the SLI recently told The New York Times, discussing pathology for CTE to date.

“A family is much more likely to donate the brain of a loved one if they have even the smallest suspicion that something was wrong,” McKee said. “If they were perfectly confident that the [player was] functioning 100 percent normally, they’re less likely to go through the process.”

Regardless of paltry attempt at assessing risk and outcome thus far, authoritative consensus around tackle football—or common sense—sees brain trauma as widespread in the collision sport and irremovable, leaving lasting damage in countless players of multiple levels. McKee’s team has found early-stage CTE in two players who were 18 and 21 at their deaths.

“I am scared that [CTE] can be more common than we thought,” Stern said of the NFL, where he expects “many more” cases to emerge.

Dr. Omalu detects impairment signs in virtually every NFL retiree he encounters. “But what happens is that these players are usually ashamed to acknowledge that they are having problems, but when you interact with them, when you engage them, you would find out there is something going on,” Omalu said.

Dr. Daniel Amen, the popular psychiatrist and CEO of Amen Clinics, Inc., says every person is at risk, any age, upon merely participating in organized football with helmets and pads. During a PBS telecast of his show, The Amen Solution, the doctor declared that “if you played football, you probably have some sort of brain damage.”

Amen’s independent research group recently found high rates of impairment in 100 NFL players both active and retired, for its study based on SPECT imaging.

While some experts question efficacy of SPECT for brain analysis, the Boston group likewise employs the imaging in research, and Amen makes believers of retirees he diagnoses with radiology and treats with his supplements.

Count Terry Bradshaw as a faithful patient, the Hall of Fame quarterback and TV-film personality who spent a week at the Amen Clinic and follows the doctor’s prescriptions for brain therapy, like online puzzles and supplements.

Bradshaw made headlines by revealing his deteriorating cognitive condition in April. While a former star quarterbacking peer of Bradshaw is rumored to suffer disorder privately, the Steelers great and NFL analyst discussed his brain damage in a first-person post on the Fox Sports Website.

“Why did I go public?” Bradshaw wrote in his conversational style. “Well, I thought it would be good for a lot of players for this to get out, for me to tell my story because 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.”

Bradshaw frankly admitted a “horrible concentration problem for a while now” that affects him at work. “Toward the end of last season on the Fox pregame show, maybe the last six weeks, I really started to forget things.” Estimating number of his own head injuries as a player, Bradshaw recalled “numerous” that included six diagnosed concussions.

Working now at 62, Bradshaw’s memory loss makes him “jittery at times,” he attested. “It was driving me crazy [last season] 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.”

Openness about personal brain issues is a modern trend among former players, and many NFL retirees wield it against owners and union in the terrible dispute over disability and pension.

But former star linebacker Harry Carson went public in the mid-1990s, a few years after his diagnosis for “post-concussion syndrome” and as a lone wolf attacking the football culture. Even fellow retirees were skeptical, for their ignorance and denial of brain trauma caused by the sport.

“One problem is that a lot of players who suffer from it have no clue what they’re dealing with,” Carson told Sports Illustrated in 2001. “I’ve talked to players I’ve played with and against. Once I went public with this concussion thing, they were looking at me as being sort of brain-damaged, drooling and all this stuff. But it is an injury just like one to your knee or hip.”

Carson said then he suffered of severe headaches, inattentiveness, short-term memory loss and vision problems. He figured he sustained a minimum 15 concussions over his 13 seasons in the NFL, all with the Giants.

The year following this SI interview, Carson, a successful businessman, attended the funeral of a former foe he admired, Webster, and he further considered the possible depths for cerebral destruction in a football player. Later, Carson followed progression of the landmark lawsuit by Webster family members, who won retroactive payments plus interest from the Bert Bert/Pete Rozelle Retirement and Disability Plan.

Then Carson used his platform as Hall of Fame inductee to speak out at Canton in 2006. Beginning his unprepared enshrinement speech, Carson graciously remarked he could not appreciate the honor “until I get one or two things off of my chest.” Pointedly addressing league and union officials, Carson said, “You got to look out for [retirees]. If we made the league what it is, you have to take better care of your own.”

Carson has continued to learn about brain injury in football, and speak, write on his blog. The public honesty about his own problems has encouraged hundreds of former players to contact him, from all levels of the game.

“Every player who ever played football understands the physical risk that they take when they play,” Carson, 57, recently told The Bergen Record. “Now if you asked me a long time ago, knowing what I know now, I probably would analyze the physical risks and [still have] played. Now if you told me [then] what the neurological risks were? I probably would have to give you a much different answer.”

“I can see those who played the game prior to me and the issues they’re going through. And those are serious neurological issues like dementia, Alzheimer’s, ALS. I’m probably headed in that same direction.”

Amyotrophic lateral sclerosis, ALS or “Lou Gehrig’s Disease,” is on the worry radar of NFL players young and old. A 2010 study headed by McKee linked CTE with the motor neuron disease in deceased retirees and a boxer, and recent news heightens concern, reports that two former NFL players have been diagnosed with ALS, totaling three known cases among living retirees.

The Boston group’s report defines ALS as “a fatal progressive degeneration of motor neurons in the brain and spinal cord,” and researchers generally agree the disease manifests through nature and nurture, “a complex interaction between multiple genetic and environmental risk factors.”

For many researchers, the prime suspected impetus is a subject’s history of impacts to the head and spine, such as blows sustained in contact sports like tackle football and soccer. On review of literature, McKee et al stated that “trauma to the [central nervous system] emerges as one of the strongest and most consistent contenders for initiating the molecular cascades that result in ALS, as well as other neurodegenerative processes, such as Alzheimer disease and Parkinson disease.”

McKee found and associated CTE with the diagnosed ALS that killed two former NFL linebackers, Wally Hilgenberg, who died at 66, and Eric Scoggins, dead at 49. Examining the brains and spinal cords, McKee identified diffuse toxic tauopathy in distinct patterns and abnormal concentrations of the DNA-binding protein known as TDP-43, which could result of chemical cascades caused by repetitive blows.

The study was published in Journal of Neuropathology and Experimental Neurology, and McKee proposed her group had discovered a new syndrome they named chronic traumatic encephalomyelopathy, or CTEM.

McKee said, “The significance of this finding is that not all ALS-like disease attacks out of the blue—sometimes it’s because of our choices in life.” The Boston researchers suggested Lou Gehrig might have died of CTEM generated by multiple concussions he sustained in tackle football, as a youth and college player, rather than of ALS, his namesake disease.

The study was highlighted in popular press while garnering lukewarm response from some medical experts. Critics cited the small number of cases in the study and the method of autopsy analysis that limited understanding for early stages of neural degeneration in the subjects.

“The researchers are drawing inferences that may not be true,” Dr. Carmel Armon, neurology professor at Tufts University, told Neurology Today. Armon noted both CTE and ALS typically involve accumulation of TDP-43, but he was unconvinced that meant one condition leads to the other.

A high incidence of ALS diagnosis among NFL retirees is hardly disputed, however, even if experts may not agree on exact rate. Since the 1980s, five former pro football players are known to have died following diagnosis, including the historic cluster of three victims from the 1964 San Francisco 49ers: quarterback Bob Waters, running back Gary Lewis, and linebacker Matt Hazeltine.

Today, three NFL retirees live with ALS diagnosis: former running backs Steve Smith and Kevin Turner, ages 46 and 41, respectively, and a 33-year-old whose identity remains undisclosed.

“Playing NFL football was a dream come true,” Turner said last year, as he volunteered for research in Boston. “I just never thought in 20 years I would be fighting for my life.”

An NFL player is eight times more likely for ALS diagnosis than the average American, Boston researchers calculate. The disease often begins with motor loss of shoulders and arms before spreading to other muscle groups. In the end, speaking, swallowing and voluntary breathing become laborious then lost; Smith, for example, was diagnosed in 2002 and remains alive through a ventilator.

“ALS or CTEM may be the most difficult diseases in existence to watch,” McKee said. “They are slow, agonizing deteriorations that are witnessed helplessly by loved ones.”

All told, cognitive misfire strikes many if not most NFL retirees, and maddening mysteries will endure as questions rise for more players and families.

But sound expert assumption gains traction on good evidence, like threat of sub-concussive blows in football. Medical experts of multiple specialties increasingly concur that repetitive head impacts are most harmful, not concussions, and rationale follows that risk of brain damage rises in commiserate with a player’s exposures over time, especially on the line.

The concept unnerves many college players past and present, and it can haunt pro players and retirees, but it does provide direction amid brain trauma’s plethora of uncertainty.

*       *       *       *       *       *       *

Nate Jackson doesn’t feel clouded by cerebral impairment, but the budding author wonders what’s ahead because of his NFL past and entire football career.

Jackson made the Denver game roster in 2003 as an undrafted free agent from Menlo College, where he dominated Division III competition as a 6-foot-3 wide receiver. Early on the Broncos moved Jackson to tight end and he beefed up a few pounds to 235, yet about 30 short of good heft for the position.

Jackson battled for five seasons in the NFL trenches, taking on gigantic D-linemen and linebackers, drilling everybody with his facemask, and getting blasted in return. That period in pro football was Jackson’s most violent on the gridiron, obviously.

“As soon as I became a tight end, my whole football experience changed,” Jackson said. “Then it was all about, for me, sticking my head in there and banging away at these guys. It was kind of a normal experience to have [trauma symptoms like] a little headache or be a little woozy. And it was just something I dealt with, part of my reality.”

Jackson believes he had one concussion in the NFL, undiagnosed, and none in college or high school. He sustained thousands of sub-concussive or recurring blows, from youth to manhood, but many other players of the league are longer for heavy combat.

“I’m sure there’s a lot of guys out there, who did it for 15 or 20 years, who are probably experiencing [impairment] symptoms,” Jackson said. “But I don’t know how to quantify it. We don’t know enough. We’re all just kind of guinea pigs, this generation of football that gets more and more intense every year, with bigger, faster and stronger players every year. And so these impacts are more intense every year.”

“We’re probably not going to really know for another 20, 30, 40 years. I hope that I’m going to be OK. I think I will. I feel like I have all my wits about me. I don’t feel demented and I don’t feel depressed or anything like that. So I think I escaped without those symptoms.”

“But…,” Jackson added, “you never know.”

Experts concur that answers won’t be available anytime soon for living players like Jackson.

“There’s so many things that you could study, and chances are virtually none of them has been done,” said epidemiologist Yesalis, during a recent telephone interview. “One thing you could do is a prospective study. You could take NFL retirees versus people who did not play college or professional football, and look at the difference in incidence of disease states that may be the result of multiple concussions, or multiple chronic brain traumas.”

A similar study frame reportedly is underway at University of North Carolina, funded by the NFL, but control groups are small.

Legit epidemiologic studies are pricey and complicated, noted Yesalis, who co-directed the first national research of steroid use among teens. “Who’s going to pay for that study of NFL players or former players? Number one, it’s unlikely the NFL will. It’s unlikely the NCAA will.”

Yesalis says government funding for vital research is possible. “But keep in mind how protracted the process is for them—meaning the feds, who are trying to cut back expenditures because of the horrible financial situation of the country—to identify [football brain trauma] as a problem, to getting proposals submitted, to funding them, to doing the research and publishing it.”

“You’ve got a five-year time span there, at least.” 

Matt Chaney is a writer, editor, teacher and restaurant worker living in Missouri, USA. Email him at mattchaney@fourwallspublishing.com. For more information, including about his 2009 book, Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com.

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By Matt Chaney

Posted Thursday, June 16, 2011

This is Part 3 of an analysis series titled Brain Trauma Dictates Epic Football Reform, which will culminate with independent recommendations for steps imperative to the blood sport’s survival at public schools, colleges, and likely the professional level.

Doctors and medical researchers have long agreed boxing can cause brain damage in athletes and lead to personality disorders and outbursts, through repetitive impacts both concussive and sub-concussive.

A 1973 study on postmortem evidence of 15 ex-pro boxers who suffered “punch-drunk syndrome” documented their “violent behavior and rage reaction” through interviews of relatives. Several of the boxers died in psychiatric wards.

Decades earlier, boxers who became demented and deranged were known as “slug nutty,” according to a 1928 report by Dr. Harrison Martland.

Meanwhile, yet today, the NFL and loyalist experts loathe admitting that tackle football even causes long-term impairment, much less off-field violence by players and chaos for families.

Neuropsychologist Mark R. Lovell, career NFL consultant with a PhD—and marketer of the critically rebuked ImPACT “concussion testing” pushed by the league’s media machine—helped author a 2011 review that concludes “adverse long-term neurocognitive effects of concussive injury have been demonstrated empirically in professional boxers only” [italics for emphasis].

The NFL’s stalling about brain damage in players is easy to lampoon, along with its PR measures such as arbitrary fines for helmet hits and lousy concussion assessments.

But there is legal logic for NFL absurdity in the issue, say astute observers, and especially the league’s acting innocent when an active player or retiree goes berserk.

“This shows that the NFL is frightened about getting sued,” Dr. Gabe Mirkin, sports medicine pioneer and erstwhile Redskins consultant, told Washington City Paper. “Mark my words: The NFL is going to be at the end of a lawsuit where a guy says they should be paying for this or that criminal behavior, because some guy got hit in the head too much playing football, and a jury will be convinced of that.”

“And that is a reasonable argument. The brain controls everything. And there’s accumulating evidence to show that getting hit in the head can cause anything to change—thought processes, mood, anything. The NFL has to act like it’s taking action.”

By 2009 the research team of breakthrough pathologist Dr. Bennet Omalu had found brain damage, chronic traumatic encephalopathy [CTE], in four of five deceased NFL players and one professional wrestler. Elsewhere, Boston University, pathologist Dr. Ann McKee and colleagues corroborated Omalu et al, finding CTE in deceased NFL players and more athletes of sports with repetitive head impacts.

Depression and erratic behavior had marked CTE subjects in latter life, and most studied died in their 30s and 40s. Several committed suicide, including an NCAA football player at 21, Owen Thomas, and NFL retirees Terry Long and Andre Waters. Another retiree, 36-year-old Justin Strzelczyk, drove straight into an oncoming tractor-trailer while fleeing police, dying in the fiery crash. Chris Benoit, 40, the WWE star whose brain matter was analyzed by Omalu, infamously killed his wife, son and then himself.

A 2010 report by the Omalu group, of the Brain Injury Research Institute at University of West Virginia, is titled “Chronic Traumatic Encephalopathy, Suicides and Parasuicides in Professional American Athletes: The Role of the Forensic Pathologist” and published by American Journal of Forensic Medicine and Pathology. In reviewing the cases of Long, Waters, Strzelczyk, Benoit and Mike Webster, an NFL lineman who had attempted taking his own life, the researchers concluded: “The key risk factors for suicides are depression and other mental disorders… CTE in our 5 cases may represent a common risk factor in our 5 cases.”

The NFL has bristled at Omalu findings for years, but now the league claims to advocate real research, and last year commissioner Roger Goodell committed funding to the McKee team, awarding $1 million to the BU non-profit Sports Legacy Institute founded by Chris Nowinski, celebrated speaker, brain-chaser and former Omalu associate who authored a book on concussion crisis in American football.

Recently the McKee team released findings of CTE in former NFL star Dave Duerson, who committed suicide on Feb. 17 at age 50, shooting himself in the chest to preserve the brain for analysis he requested in a final note.

“Dave Duerson had the classic pathology of [CTE] and severe involvement of all the [brain regions] that affect judgment, inhibition, impulse, mood control and memory,” McKee said.

America is grudgingly accepting that playing football may spur anti-social acts because of brain damage, not stale theory like “ ’roid rage” resulting of anabolic steroids, which the game always blames on individuals only, or of the silly assumption that former players cannot handle a simpler existence after glitter life as football star.

Anymore, very few people publicly question a link between tackle football, CTE and mental issues, and former NFL players are convinced that terror can ignite.

“Andre Waters and Duerson—these deaths aren’t just a coincidence,” said Eric Dickerson, 50, Hall of Fame running back. “That’s not something young black men do, stick a gun to our head and kill ourselves.”

*       *       *       *       *       *       *

American football traditionally managed to distance itself from players exhibiting behavioral or mental disorder, and a classic NFL case is Jim Tyrer, early cornerstone lineman for the Chiefs, one of the greatest offensive tackles in history. Today Tyrer remains shut out of the Pro Football Hall of Fame, more than 30 years since his tragic end, when the league and media suddenly wanted to forget him.

In autumn 1980 Tyrer was six years retired from the NFL, spiraling downward in business and health at age 41, when at dawn on a Monday morning he rousted his wife with a gunshot into her pillow. He killed Martha Tyrer on second aim then shot himself with the .38 pistol, completing the murder-suicide with three of their four children in the home near Kansas City.

The carnage was senseless, outrageous for family and friends. None could firmly grasp a motive for Tyrer, once a perennial All-Pro and most respected player in the league. “Something had to snap,” said Len Dawson, former Chiefs quarterback. “He was such a strong, stable guy. He was a great family man. Doing something like this is completely contrary to his character.”

Book author Michael Oriard, former teammate of Tyrer on the Chiefs, recounted the shock and mystery in a chapter of his The End of Autumn, an unheralded but riveting 1982 account of life in pro football.

The dignified Tyrer had worn suit and tie to work every day, an unfailing gentlemen toward everyone including unknown rookies and free agents, the clubhouse lower class from which Oriard emerged. Jim and Martha Tyrer, sweethearts since high school in Ohio, led player families as religious souls dedicated to their children and always willing to help others.

“Jim Tyrer was the unlikeliest suicide-murderer to those who knew him,” Oriard wrote. “Among all the Chiefs I played with, he seemed the most responsible, the most controlled, the most conscientious and stable. He struck his other associates in football the same way.”

Oriard continued: “In the days before the murder-suicide, Tyrer clearly seemed depressed to those who saw him. [Former teammate] Fred Arbanas had lined up an opportunity to sell national accounts for the Yellow Pages, but Tyrer never showed up to take the test. He was a college graduate, but had been out of school for twenty years. He told Arbanas that he always did poorly on those tests; he was competing with kids right out of school, barely older than his daughter. His minister and friend at the Presbyterian church he attended detected paranoia and arranged psychiatric counseling. [Former teammate] George Daney saw him on the Wednesday before the fateful Sunday. Jim was obviously down. He kept asking George how he looked; he was concerned about the forty pounds he had lost. They talked about football. Jim had continued his contact with the Chiefs’ organization, buying season tickets, attending Chiefs’ functions. That Sunday he took his eleven-year-old son, Jason, to the game in Arrowhead Stadium, won 17-16 by the Seattle Seahawks. Someone reported that Jim stayed afterward, wandering around the empty stadium before he went home. For the last time.”

‘No one knows what passed through Jim Tyrer’s mind between the end of the Chiefs’ game and five the next morning…”

The physical massiveness and brutality of Tyrer as feared lineman did not explain his final act for Oriard. “Jim Tyrer was not a violent man. And football violence is very different from murder and suicide,” Oriard wrote. “Jim Tyrer was human, not a character in a soap opera. How can we fully understand what drove him to do what he did?”

Today, some believe brain damage affected Tyrer, particularly for his 14 years as pro player that included 180 consecutive starts at offensive line for the Chiefs.

Standing 6-foot-6, weighing 280 pounds, Tyrer was a Sporting News AFL All-League tackle eight consecutive seasons, from 1962 to 1969, then a two-time AFC All-Pro following the NFL merger. He played in three Super Bowls and was named a first-teamer on the AFL All-Time Team.

But voters for the Pro Football Hall of Fame ignore great offensive tackles, anyway, having inducted only about a dozen from NFL history, and they’ve literally forgotten the decorated giant who killed his wife and himself three decades ago at Kansas City.

Tyrer was a finalist for Canton enshrinement in 1981, the Hall’s first election following his deadly rampage, but he wasn’t selected and hasn’t come close since.

The murder-suicide largely drives pro football’s snub of Tyrer, according to a family member and several former players interviewed last year by J.W. Nix, a Washington-based blogger.

“Dad belongs there [Hall of Fame], but I am unsure if the voters will ever put him in,” said Brad Tyrer, the eldest child.

“It is time to wipe the slate clean and induct [Tyrer],” said Ben Davidson, a Raiders defensive end from 1964 to 1972. “Life goes on. These types of events happen daily. We are turning him into a Pete Rose by excluding him, though everyone knows he should be in.”

“Tyrer was the pioneer of big offensive tackles,” said Elvin Bethea, Hall of Fame defensive end for the Houston Oilers from 1968 to 1983. “He was the preeminent left tackle in all of football. All other blockers in the NFL were mediocre compared to him.”

The possibility of brain damage was a prominent question in Nix’s many interviews about Tyrer, and the consensus was that he experienced depression.

Brad Tyrer said, “I felt my dad’s mental state at the end of his life must have been impaired and that very well could have been as a result of the trauma his brain experienced during his football career.”

Former Broncos defensive end Pete Duranko empathized with Tyrer, his old opponent, having battled depression himself while working with other retirees suffering emotional duress. “It creeps up on you,” Duranko said. “People, especially the [Hall] voters, do not understand mental illness. Jim was a strong man who did his best to hide his disease. He didn’t want people to know he was depressed and preferred to try to deal with it himself.”

Voices still speak up for Martha Tyrer, too, the certain victim of tragedy. Her brother, Al Lundstrom, grew up with Jim Tyrer and played football alongside him at Ohio State.

“Though he [Jim] was depressed about his financial situation, I am not convinced his depression was brought on by post-concussion syndrome,” Lundstrom told Nix.

The couple’s youngest child, Stephanie, was 11 at time of the murder-suicide. “I think about it ever day,” she recalled 24 years later, during an interview with Kansas City Star sportswriter Wright Thompson, who reported the four children grew up to lead productive and fulfilling lives.

As an adult, Stephanie Tyrer harbors complex emotions about her father and deep loss for her mother, who was beautiful, talented, endearing. “That hurts more than anything,” Stephanie said. “My dad is the focal point, and my mom is left behind. I miss my mother more, because there was an anger factor with my dad. My dad traveled a lot, was on the road a lot. My mom was the one who took us to all our practices and games. The person who made an important impact on my life was my mom.”

The author Oriard remembers Martha and Jim Tyrer and still wonders what happened. An English professor and former Chiefs lineman, Oriard follows contemporary reports on brain trauma and suicides of football players, and he considers whether ramming heads severely injured Tyrer, “but all I can do is wonder,” Oriard stated recently in email. “Jim was obviously going through personal and financial problems, but whether he was suffering from the consequences of too many hits, and that affected his reaction to his problems, we’ll never know…”

Dr. Omalu recently considered the story of Jim Tyrer and said, “He may have suffered from CTE.”

Permanent brain dysfunction of football cannot be investigated in the case of Tyrer, unfortunately, but modern research does connect CTE to the sport, so termed by Omalu during his landmark postmortem study of NFL retiree Webster in 2002 at Pittsburgh.

Omalu, then a medical examiner for the coroner’s office of Allegheny County, confirmed in autopsy the Steelers legend died of cardiac disease at age 50, and the brain of Webster appeared normal, free of damage. Then Omalu conducted microscopic pathology, examining brain cells of the Hall of Fame lineman who played 17 seasons in pro football and a quarter-century in the sport, accumulating tens of thousand hits to head.

“The heart attack cannot explain his life after football,” Omalu would remark to ABC Television. Most people around Pittsburgh knew of Webster’s personal downfall in NFL retirement, during his 40s, for media stories published local and national about his odd behavior, drug dependency, financial ruin, homelessness and estrangement from family. A teen-age son, Garrett Webster, told local media his father had suffered diagnosed “brain injuries from football.”

And so the Nigerian-born Omalu, specializing in neuropathology and working from medical literature on boxers with “dementia pugilistica,” found CTE in Webster, the brain damage he anticipated of an American football player.

Under microscope, brain slides of Webster displayed diseased “tauopathy,” brown splotching and tinting of cell tissue known as cerebral grey matter. The formerly clean blue hue of healthy brain cells was discolored as result of repeated impacts Webster sustained, replaced by a tone of dried blood with diffuse shapes—“neuritic” threads and “neurofibrillary tangles,” toxic buildups of tau protein. In Webster’s case, hardened “amyloid plaques” blocked axon fibers or white matter from transferring neuron impulses. The signs were much like Alzheimer’s Disease, although CTE produced distinct variances in tauopathy outlay.

The CTE resulted of untold metabolic cascades during brain traumas for Webster, volatile chemical reactions for the jellied organ’s attempts at healing, apparently foiled by relentless pounding of football, especially at line of scrimmage. Webster was never diagnosed for a concussion in his NFL career.

Three years later, Omalu’s research group published a report on the Webster case in Neurosurgery, titled “Chronic Traumatic Encephalopathy in a National Football League Player.”

The report, citing literature of traumatic head injury in boxing and elsewhere, stated, “Possible symptoms of CTE may include recurrent headaches, irritability, dizziness, lack of concentration, impaired memory, and mental slowing; mood disorders, explosive behavior, morbid jealously, and pathological intoxication and paranoia; tremor, dysarthria, and parkinsonian movement disorders.” The report continued: “Postmortem telephone interviews of close family members of [Webster]… indicated a long-standing mood disorder…”

The NFL objected strongly, allegedly having researched brain trauma itself since 1994 while managing no full autopsy of a deceased player, while never connecting its sport to dementia pugilistica in boxing and “post-concussion syndrome” in the military, and despite knowing of early onset impairments among league retirees for at least two decades.

The NFL, which Howard Cosell once described as more powerful than government, had even managed to alter medical lexicon over years, seeing that the term post-concussion syndrome was supplanted by the league’s new label, mild traumatic brain injury.

The NFL minions for shaping opinion got busy on the unknown Dr. Omalu during 2005 and years following, those “experts” and other league loyalists of research, medicine, media, PR and football. They campaigned ugly to discredit Omalu and his findings on Webster and other retirees, until CTE was found in enough deceased NFL players to finally shut them up.

“It is something shameful…,” Omalu recalled of the period during a telephone interview, “that the NFL, despite all the money they have, did not identify this disease. It was an ignominious outsider like me who makes the link. And even when I made it, they attacked me, they de-legitimatized me. They insinuated that I was a voodoo doctor from Africa and that I should not be trusted. They made some statements that had visceral undertones.”

Simultaneously, league and union officials fought family members of Webster in acrimonious lawsuit proceedings. A court judgment in favor of the Webster family withstood appeal in 2006, awarding the estate about $2 million in retroactive disability benefits, costs and interest.

*       *       *       *       *       *       *

Two years ago, Dr. McKee directed neuropathology of former defensive lineman Shane Dronett, who came close to rampaging like Jim Tyrer and the wrestler Benoit.

Dronett stood 6-foot-6, weighed 300 pounds for a 10-year career in the NFL, but he died young, violently, bereft of inner peace and terrorizing people who loved him, among eerily familiar signs.

Until beset with his declining mental state around age 35, the Dronett story seemed stuff of grid legend, Texas pride. He was the small-town boy who became All-American for the UT Longhorns, a top draft pick, and an established NFL player making big plays and appearing in a Super Bowl. At retirement from the Falcons in 2002, Dronett was by accounts a good man, an engaging personality and doting father motivated to succeed in business.

But Dronett’s family life began disintegrating a few years later, when deranged episodes overtook him. Paranoia and rage would manifest and the hulking man became capable of anything, beating loved ones and strangers, brandishing weapons, issuing death threats. His wife Chris and two daughters learned to flee their home in suburban Atlanta for extended stays in secret places.

Ultimately, in January 2009, a confrontation between husband and wife turned deadly at the home, thankfully with the children away. Chris recounted for media how an enraged Shane went outside to his truck, grabbed a 12-gauge shotgun and returned inside. Chris saw the gun and ran out as Shane shot himself to death in the kitchen. He was 38.

The McKee group found CTE in Dronett, a result recently disclosed, and everyone wonders of the effect for his alternate persona, disturbances and death. Dronett did have brain surgery in 2007 to remove a benign tumor, but case experts doubt it as prime factor, in their conclusions at the Center for the Study of Traumatic Encephalopathy at BU.

“There’s no way we would ever know what was specifically caused by the tumor or the surgery for the tumor or CTE,” Robert Stern, co-director of the center and BU professor of neurology, told CNN. “But more than likely at least some of his behavior and symptoms were associated with the worsening of the CTE.”

Matt Chaney is a writer, editor, teacher and restaurant worker living in Missouri, USA. Email him at mattchaney@fourwallspublishing.com. For more information, including about Chaney’s 2009 book, Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com.

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By Matt Chaney

Posted Saturday, April 23, 2011; revised Monday, April 25, 2011

This post is Part 1 of an analysis series titled Brain Trauma Dictates Epic Football Reform, which will culminate with independent recommendations for steps imperative to the blood sport’s survival at public schools, colleges, and likely the professional level.

Today’s official effort against gridiron brain trauma recycles the old “safer football” concept.

In the NFL and trickling down to colleges, schools and youth leagues, “behavior modification” of players involves teaching “proper contact,” or “form tackling” as known in 1976. Coaches tell football players to hit without using heads, as if hogs might be taught to fly.

Current purveyors of the theory, led by Chris Nowinski and Dr. Robert Cantu of the Sports Legacy Institute, and NFL commissioner Roger Goodell—who funds the Nowinski nonprofit with $1 million—propose action reminiscent of the plug-in electric football game, with plastic players bumping across the vibrating surface, hooking at shoulders in ring dances.

And that’s only the beginning of hocus-pocus remedy for rampant head injury in American football.

While mysteries are daunting for the problem, like positive diagnosis of concussion, mere clinical intuition guides the varied protocols of diagnosis and judgment for when players are fit to compete again. No random clinical trial of legitimacy has been attempted.

The growing national setup worries Dr. Lester Mayers, concussion researcher of Pace University athletics, who joins experts like Dr. Bennet Omalu in sounding alarm over football’s touting concussion testing as valid, which is parroted by most media.

These critics warn football conducts potentially dangerous “concussion management” based on incomplete research for assessing symptoms, and many brain-injured players are prematurely returning to contact, all ages, typically within days.

Indeed, radiology techniques are demonstrating holes in concussion testing, notably of studies at Purdue University, where functional MRI reveals that sub-concussive brain injury in prep players is missed by standard external assessments through computer.

At Purdue, teen football athletes displaying brain injury through diffusion tensor imaging, an fMRI technique, are registering normal state in intuitive-grounded baseline tests and monitoring systems of neuropsychology.

Last month in Washington, lawmakers heard a military concussion test fails badly, the Website www.nextgov.com reported. The test, Automated Neuropsychological Assessment Metrics, “is insensitive and nonspecific,” said Lt. Gen. Eric Schoomaker, surgeon general of the U.S. Army. “It misses about a quarter to a third of (soldiers) who are concussed and includes about 50 percent of (those) not concussed.”

Insurance companies inform military officials that the assessments lack scientific vetting for validity and reliability, and carriers have alerted schools in Washington state that concussion testing could raise liability stakes for personnel who administer the tests in error, The New York Times reported.

Meanwhile, concussion testing takes a thrashing in independent peer review.

Current Sports Medicine Reports recently published another scathing analysis by Christopher Randolph in Chicago, professor of neurology at Loyola University, who details glaring faults in “baseline” testing of hot-selling ImPACT software employed by youth leagues, schools, colleges and pro sports. “The use of baseline neuropsychological testing in the management of sport-related concussion has gained widespread acceptance, largely in the absence of any evidence suggesting that it modifies risk for athletes,” Randolph observes.

Since 2005, Randolph is among reviewers for several journals who find unacceptable rates of false-positive and false-negative results for ImPACT, among popular brain assessments developed and marketed by academics and doctors associated with the NFL and benefiting from the league’s pervasive publicity machine.

“It is a major conflict of interest, scientifically irresponsible,” Randolph told ESPN The Magazine in 2007. “We are trying to get to what the real risks are of sports-related concussion, and you have to wonder why they (NFL experts) are promoting testing. Do they have an agenda to sell more ImPACTS?”

The marketing succeeds, with sales to a thousand schools and hundreds of colleges thus far, and media only increase exposure of ImPACT in the furor over concussions, especially in football.

An overwhelming majority of journalists, politicians, educators and football experts ignore the accumulating evidence rebuking concussion testing as invalid and unreliable, choosing instead to endorse the quick-fix notion and push it for mandate by law.

“With the tools to properly manage concussions and implement safety precautions, parents, coaches and students can change the culture of school sports for the better and keep our students safe on the field and thriving in the classroom,” declared U.S. Rep. George Miller, of California.

Such rhetoric confounds Mayers. “The response is infantile,” he said. “The ImPACT people have taken over the idea that somehow they can tell you when it’s OK that the athlete goes back.”

The engineers and marketers of ImPACT, neuropsychologists Mark R. Lovell and Michael W. Collins in Pittsburgh, did not respond to questions about their product recently forwarded them. Lovell is the former NFL director of NP testing, and his consulting for the Steelers franchise spurred development of ImPACT software. Collins is on the Steelers medical staff and consults for other teams. A third partner in the product is Dr. Joseph Maroon, Steelers neurosurgeon who serves on the NFL committee overseeing concussion management.

“The topic of sport-related concussion has been highly visible in the media over the last few years… and the issue of concussion management in the NFL even has reached the point of Congressional hearings,” Randolph wrote in the January-February edition of Reports. “What consistently is missing from these debates, however, is a rational, empirically-based discussion of the true risks associated with sport-related concussion, the potential for any given management strategy to modify these risks, and the actual evidence that such risk modification can be achieved. In addition, there has been little attention paid to the clinical validity or psychometric characteristics of (computer) baseline tests, despite widespread use of these measures.”

Randolph, characterizing utility of the tool as “clinical guesswork in most cases,” concluded: “It is clear that, to date, the baseline tests used in sport-related concussion management programs lack sufficient clinical validity and reliability for their intended purpose.”

Mayers cites lack of specificity and sensitivity for NP tests on the market. “Basically, they’re all unsuitable for clinical work with concussions,” said Mayers, director of sports medicine for Pace University in New York. “They don’t have the reliability, the accuracy or the validity, the three technical terms for the use of neuro-psych work. They’ll miss 20 to 25 percent of athletes who have concussions, and this has been used by the NFL and the National Hockey League, and the NCAA is considering mandating this.”

Word is that the NCAA will soon require concussion testing of all member schools, with NFL officials and experts behind the push, and Mayers says these factors helped his department adopt computer assessment, posing a dilemma for him.

Mayers authored a 2008 review published by Archives of Neurology, concluding a concussed athlete should be sidelined at least four to six weeks, but he notes football’s current “standard of practice” for brain trauma includes NP testing and fast return to play, so he conformed at Pace. “I really believe four to six weeks (recovery time) is appropriate, but it’s not the standard of community,” he said. “So I could be sued by an athlete I held out for four weeks, if he chose to do so.”

A neurology journal has approved publication of a new Mayers review, which denounces computerized concussion assessment, he said.

More medical voices doubt concussion testing. Dr. Randall Benson, imaging expert and neurologist at Wayne State University, warned Congress last year “that neuropsychology is not an exact science,” a fact echoed by Dr. Jeffrey Kutcher, of Michigan Neurosport, testifying for the same committee. “Relying on protocols is, in my opinion, potentially dangerous, clinical protocols, as they assume that concussions are similar enough to each other to fit a predetermined paradigm,” said Kutcher, who serves on committees for the NFL and American Academy of Neurology.

Dr. Omalu, practitioner of science and law, says concussion testing amounts to “fraud” in the context of accurate, reliable diagnosis, and it can be harmful during initial days following trauma—when most injured athletes, suffering chemical disruption of brain cells, are subjected to mental strain of the programs. The online ImPACT test lasts 20 to 30 minutes and presents memory challenges involving colors, texts and forms.

“ImPACT testing is not a diagnosis tool,” said Omalu, chief medical examiner for San Joaquin County, California, and director of autopsy for the independent Brain Injury Research Institute. “It is a forensic follow-up to monitoring a patient, to evaluate the amount of damage. Using (computerized) testing in the acute phase of injury can actually make the symptoms worse.”

Doctors outside sports medicine would agree, Omalu added, and apparently many who work in athletics, given media reports of concussed youths prescribed isolation with total layoffs ranging from a month to two years.

Dustin Fink, a certified athletic trainer in Illinois, seconds Omalu. Fink discourages computerized testing until a concussed athlete is free of symptoms such as headaches, memory loss and unsteadiness. “I use the NP tests as a baseline to educate the athlete about what some signs and symptoms could become present and as a true baseline when they think that are ready to return,” said Fink, an injury authority whose popular Website, theconcussionblog.com, serves as information clearinghouse.

Fink believes “money grab” drives overuse of concussion testing, and he generally supports Omalu’s publicized stance that longer rest is needed for concussed athletes. At Shelbyville High School, where Fink works, “we are seeing recovery times on the average of 24 days,” he said. “More and more evidence suggests that a 28 to 42-day (layoff) period may be necessary.”

In previous reports on Chaney’s Blog, Omalu has proposed concussed juvenile football players be sidelined at least three months. Omalu says NFL players should rest one to three months with diagnosed concussion, depending on severity and technology for treatment, which he advocates to be functional MRI that isn’t approved by the league.

Only sports in civilian life will quickly return the brain-injured to activity, and a practice of general medicine calls for strict isolation lasting days and longer, involving no stress mentally and physically.

In the military, researcher Craig Bryan, a psychologist and professor at the University of Texas Health Science Center, recently concluded that three days of isolation, removed from sunlight, was optimum for beginning treatment of concussed soldiers.

A neural consultant for the New York Jets once discouraged use of NP testing on a football player until symptoms abated, based on a large NCAA study he’d co-authored, and quickly found himself out of the league.

During a 2004 conference in New York, neuropsychologist Bill Barr remarked that “the research indicated that the best time to do neuropsychological tests on players with concussions was after their symptoms had completely cleared, usually five to 10 days after the trauma,” Peter Keating reported for ESPN in 2006.

Jets physician Dr. Elliot Pellman confronted Barr after the conference, and the neuropsychologist ended up losing both his job with the team and his place in league research. “NFL teams, Barr understood, preferred testing players just one to two days after a concussion, allowing for quicker diagnoses and returns to play,” Keating reported.  

Barr, of the Comprehensive Epilepsy Center at NYU, did not respond to a recent interview request.

Matt Chaney is a journalist, editor, teacher and restaurant worker in Missouri, USA. For more information, including about his 2009 book, Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com.

 

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