The Effects of Head Trauma on Muhammed Ali and NFL Quarterbacks
The incidence of head trauma is quite alarming in combat contact sports like boxing and football. Head trauma arises from hard blow to the head and neck area that causes brain damage and has been referred to as traumatic brain injury (TBI). Its symptoms may be characterized by one or more of the following symptoms: pain, deterioration in cognition, motor dysfunctions, distorted sensory perceptions and behavioral disorders. The most common form of TBI is mild traumatic brain injury (MTBI) or also known as concussion. Recurrent MTBI has been associated with Parkinson and Alzheimer like symptoms in chronic traumatic encephalopathy (CTE) among professional contact sports athletes. Neurological degeneration of Muhammed Ali and numerous National Football League (NFL) quarterbacks has been attributed to CTE. Continuous research on etiology and risk factors to prevent the onset of CTE is recommended so that stricter precautionary safety policies can be implemented to protect the quality of life of our athletes while competing and more so upon retirement.
Keywords: Head trauma, traumatic brain injury (TBI), mild traumatic brain injury (MTBI), chronic traumatic encephalopathy (CTE)
According to an American Association of Neurological Surgeons (AANS, 2011), there were an estimated 446,788 sports-related head injuries treated at U.S. hospital emergency rooms in 2009. Head and neck trauma are considered among the most dangerous since it may lead to long term disability. Head injury arises from a hard stroke or blow that causes brain tissue damage. It is interchangeably referred to as Traumatic Brain Injury (TBI) (AANS, 2011). Concussion, the most common type, is also known as Mild Traumatic Brain Injury (MTBI), referred to as such because it involves temporary loss of consciousness or disrupted brain function (Johnson 2014). Common symptoms of MTBI are state of being dazed or confused, memory or concentration problems, headaches, loss of balance, nausea, vomiting, faulty sensory ability, mood swings, fatigue and sleeping disorders (Mayo Clinic 2014).
There are compelling reasons for further research on associated long-term effects of recurrent MTBI resulting in chronic traumatic encephalopathy (CTE) originally known as dementia pulligistica observed on selected professional boxers and American football players (Solomon et al 2011). Associated neurodegenerative changes results in progressive often irreversible pathological, memory, behavioral and personality disturbances. A full blown dementia has Parkinson’s like symptoms. Distinctive neuropathological profile of this disorder holds the key to its appropriate prognosis, prevention and cure.
In boxing, the dangers of CTE was clearly shown in the case of Muhammed Ali who was a very successful professional boxing career covering 21 years with a total of 61 bouts consisting of 56 wins and 5 losses. At the age 42, he was diagnosed with Parkinson’s Disease in 1984 whose symptoms are identical to stage 4 CTE (Gigney 2013). It was relatively young for him given that the majority of Parkinson’s sufferers develop the illness past the age of 60. He exhibited characteristic symptoms during his public appearance as part of the Olympic flag bearers for the opening ceremony of the 2012 Summer Olympic in London wherein he needed help to be able stand (Gye 2012). Aside from Muhammed Ali, some of the best known boxers which include Jake Sharkey, Mickey Walker, Beau Jack, Floyd Patterson, Joe Frazier, Sugar Ray Robinson, Billy Conn, Joe Louis, Jerry Quarry, Emile Griffith and Freddie Roach suffer from some forms of neurodegenerative disorder (Markus 2013). Alzheimer’s disease (AD) is one of the most common form of dementia for the elderly with similar mental decline symptoms in which head injury is one of the risk factors. There are recent findings that there is genetic predisposition for AD, known as early familial AD attributed to certain gene mutations. Other risk factors like health condition, medications and exposure to toxins in the environment if present may exacerbate AD (McCrory 2002).
In National Football League (NFL), several quarterbacks have complained of mental degeneration linked to years of recurrent sub lethal concussions. In 2012, Brett Favre the 44-year old quarterback legend has reported experiencing short term memory losses (Howard 2013). Similarly, Chicago Bears quarterback, Jim McMahon at 53 years old is suffering from early stage of dementia (Associated Press 2012). Some football players like Dave Duerson and Junior Seau committed suicide after a lengthy NFL career. Upon examination of their brains after their deaths, CTE was confirmed (Uribarri 2014).
Former Ravens and Broncos quarterback Cullen Finnerty was found dead of pneumonia and according to autopsy findings, he was also suffering from CTE (Katzowitz 2013). There are now more than 4,500 plaintiffs who have sued the NFL for allegedly withholding what it knew about the dangers of repeated head blows. The NFL wanted to settle and had agreed to pay out $765 million (Uribarri 2014).
Contact sports have long history of incidence of CTE among it players but these games are here to stay. In boxing, the main objective of athlete is to harm the opponent to win. It is documented that stricter safety measures spells the difference in amateur and professional boxing with respect to incidence of CTE. Furthermore, the number of professional bouts is a risk factor for boxers at an advanced age when they are more susceptible. Ring side physician, Pacheco claimed Muhammed Ali would not have suffered his injuries had he stopped fighting earlier than he did (Gigney 2013). In all contact sports, like boxing and football, education of the coaches and athletes about concussion and CTE should be mandatory and strict implementation of safety measures must be followed. Screening for genetic predisposition to AD should be included in recruitment of athletes since it has important bearing on healing from concussions and the onset of CTE. Continuous research efforts on understanding the compounding risk factors that affects diagnosis, prognosis, and treatment must be undertaken. Independent neurologist should be present during a game or bout to ensure appropriate MTBI assessment protocols and return to play guidelines are followed. Sufficient precautionary measures must be taken to protect the quality of life of our athletes while still competing and more so upon retirement.
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