When Ken Stabler led the Oakland Raiders to the Super Bowl during the 70s, they called him The Snake because of his ability to wriggle away from defenders. And when he was inducted into the NFL’s Hall of Fame on Saturday, his grandson gave a warming homily about how much Stabler “loved football, and that was the life for him”.
So much for that nimbleness. So much for that love. So much for that life. As we discovered last week, Stabler had the degenerative brain disease chronic traumatic encephalopathy (CTE). His family suspected as much, what with the memory loss and confusion. Before he died last year, his headaches got so bad that when he gritted his teeth to kill the pain he broke a bridge in his mouth.
In the buildup to Super Bowl 50, the New York Times also reported another new case of CTE in a Super Bowl winning quarterback – Earl Morrall, the 1973 winner with Miami Dolphins who died in 2014. Meanwhile Joe Kapp, who was on the losing side for the Minnesota Vikings three years earlier, also came forward to announce he had Alzheimer’s disease – which can itself be a marker for CTE, although at the moment only a postmortem can confirm a diagnosis.
We should prepare ourselves for more such sombre tales. And not only in American football, but both codes of rugby, boxing and other contact sports too. But in the week when the Will Smith movie Concussion, which details how the NFL suppressed research on CTE, arrives in the UK, scientists appear to be slowly making inroads into such a devilish problem.
Back in 2012 researchers at UCLA developed an imaging tool which can identify a buildup of an abnormal protein called tau in the brain – which, in a distinct form, identifies CTE – in people still alive. But on Thursday Bennet Omalu, the doctor played by Smith in Concussion, went several steps further by announcing the first correlation between UCLA’s experimental testing and a posthumous examination in a recent autopsy on the former Minnesota Vikings linebacker Fred McNeill.
Dr Huw Morris, a professor of clinical neuroscience at UCL Institute of Neurology, called the news “revolutionary” on Friday. And he also gave preliminary details of UCL’s three-year study into concussion based on testing the Saracens rugby team. For the past year, players have worn an X2 bio-patch, containing an accelerometer which measures the force of impacts. But behind the scenes, Morris’s team have also been taking blood, urine and saliva samples as potential biomarkers for concussion.
The UCL team aim to monitor the destructive force of hits more closely – and, crucially, to use biomarkers to assess the severity of the damage to the brain following a concussion.
As Morris explained, the research is based on pioneering work by the Swedish scientist Henrik Zetterberg on concussion. Zetterberg monitored 288 players in the Swedish Ice Hockey League during the 2012-13 season, with all 35 who suffered a concussion during asked to submit repeated blood samples in the hours and days that followed. Zetterberg’s team found that by examining a post-concussion sample for tau protein levels an hour afterwards, they could determine the severity of the blow, if the player needed to rest longer, and if the injury posed risks for lifelong symptoms.
As Morris explained: “The idea is that because these tau proteins actually reflect damage to a nerve cells, the difference between damaging 100 or 1,000 or a million brain cells might be reflected in what you can measure in the blood.”
Of course there is still a long way to go. Scientists do not understand fully how short-term brain injuries, such as concussions, can affect the brain decades later, or why some people get CTE and others do not. The scale of the problem is also hard to gauge and monitor, especially given that multiple sub-concussive blows, which can tear nerve fibres and bruise the brain, are often undetected at the time.
Dr Julian Bailes, another pioneer in the battle to expose CTE in the NFL, believes that the former Pittsburgh Steelers centre Mike Webster took around 100,000 such hits when he played American football. How many proved to be too many?
Don’t hold out waiting for the NFL to answer. Reported concussions were up 58% this season but at its annual health and safety press conference last week it refused to admit a link between CTE and gridiron. Meanwhile all this new research may yet push fans of other contact sports down uncomfortable paths. Perhaps they will also have to start asking tougher questions about how to minimise the dangers.
For instance Dr Mike Loosemore, the lead consultant in sport and exercise medicine at the English Institute of Sport, warns that the rise of headguards and shoulder pads in kids’ rugby could have unintended consequences. In his view “they will put their head where it shouldn’t be more often, because they feel safer and it will actually increase the rate of concussion, not reduce it”.
Loosemore believes that one way of reducing serious brain injuries in both American football and rugby would be to take helmets and padding off, even if it makes the games less spectacular.
As he spoke I thought of Stabler’s response to being asked whether he planned to be a high school coach when he retired. “My lifestyle is too rough,” he replied. “Too much booze and babes and cigarettes.” The game he played, though, proved to be rougher still.