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Wednesday, Nov 22, 2017
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Researchers take hard look at hidden risk of sports head injuries

TAMPA - Like most people, Andre Kirwan gets the occasional headache. And he says some theme park rides can make him a little dizzy. Most days, Kirwan, 38, shrugs it off as part of the aging process. But there are times the former star football player at Jesuit High and Stanford University, now working as an assistant coach at Berkeley Prep, asks himself if this is normal. Or are the 14 years of competing in a violent sport now taking their toll on his mind and body? In particular, he thinks of the three concussions he suffered during his eight years in the Canadian Football League, where he was carried off the field unconscious. "You don't want to attribute every little headache to it, but when you take all the years of pounding that I did, from high school all the way through to the pros, you start to wonder," Kirwan said. "I've talked to other guys who I played with who have had concussions, and they say they've noticed it as well." Kirwan's personal experience is one reason he is pleased to see a study being conducted right on his field at Berkeley Prep, as well as Wharton High.
Gianluca Del Rossi, who holds a doctorate in athletic training and sports medicine and heads the University of South Florida Concussion Center, is spearheading the research. He and his fellow researchers are trying to learn about the cumulative effects of the numerous sub-concussive hits football players take throughout a season, not the obvious impacts that result in concussions. Researchers across the country are discovering chronic traumatic encephalopathy — progressive damage to the brain associated with repeated blows to the head — in athletes at younger and younger ages. An autopsy conducted in 2010 on the brain of Owen Thomas, a 21-year-old junior defensive end at the University of Pennsylvania who committed suicide by hanging himself, showed early stages of CTE. Even more startling is the recent Boston University study that revealed evidence of CTE in an 18-year-old who suffered multiple concussions playing high school football. Analysis of his brain, donated by his parents following his death, revealed the earliest evidence of CTE ever recorded. In July, former Middleton High and Fort Hays State star wide receiver O.J. Murdock died from a gunshot wound to the head in an apparent suicide. Murdock's family recently agreed to donate his brain tissue to the same Boston University researchers. Murdock, who was about to start training camp with the Tennessee Titans when he died, received only one known concussion but had played football since he was a child. Del Rossi and other researchers are focusing their attention on the acute, short-term effects of repeated sub-concussive blows to the head in high school football players. He says there already is clear evidence of the dangers of repeated concussions. What he wants to know is what happens to athletes who endure repeated hits that may not cause a concussion but are still a serious health risk. "We're not looking to learn much about concussions because there's already been a lot of research done there," Del Rossi said. "What we're hoping to discover is how the accumulation of sub-concussive impacts affects brain function. That's an area we don't know much about, but one that is potentially just as dangerous." Each day of football practice at Berkley Prep and Wharton, data is recorded from a group of five to six players at each school who volunteered for the study. Within each player's helmet are six accelerometers that are part of the protective cushioning. The accelerometers track the impact of the hits they receive through a normal day of a contact practice. The impact is measured in G-force, or the force of acceleration on the player's head after the impact. Berkeley Prep athletic trainer Eddie Bunton said concussions to most football players occur with hits of about 96 Gs or more. In the data he has collected during the past three seasons, Bunton said he has recorded hits to Berkeley players that measure as much as 150 Gs. This fall, Berkeley junior linebacker Clint Gasque is the Berkeley study's record-holder for highest Gs during an impact. In one game, Gasque registered an impact of 136 Gs when he collided with the ball carrier helmet to helmet. The result of that collision: Gasque said his vision was momentarily blurred, but it quickly returned to normal. After the collision, Gasque sat out one play and returned to action. Gasque said he was never concerned that he had hurt himself and wasn't worried he had suffered a concussion. Big hits are part of football. It's what makes football exciting. But are all of the hits — from the little knocks to the big blows, from the time a player is an 8-year-old competing in youth leagues until he's a senior in high school and beyond — having cumulative, detrimental effects on the brain? In one game alone, a Berkeley player's helmet recorded 80 hits of 10 Gs or more. And then there are the hits players receive to the head in practice. Not every day is a contact day, but a recent study of a high school team in Lafayette, Ind., conducted by Purdue University showed more than 50 hits per player per week of practice. Combined with games, one high school player in that study recorded 1,600 hits to the head during just one season. These and other studies have trainers such as Bunton thinking that it's not just the big blows that result in problems later in life, but also the accumulation of the other helmet hits — from pee wee to the pros — that are dangerous. "I've got two small kids and a lot of times I will get asked, 'Would you allow your kids to play football?' And my answer has always been, 'Yes, without a doubt,' " Bunton said. "Now, I think I would say I believe they should be a little older before they start playing. I don't think there's any reason to participate in contact football until sixth grade." Bunton didn't know the impact Gasque had received to his head was well above the typical concussive level until the data was downloaded from the helmet after the game. But at Wharton, the data can be tracked by Del Rossi and his research team in real time by a computer program called the Sideline Response System. The SRS uses an antenna to receive and record the information being transmitted by the players' helmets. If a Wildcats player receives a serious blow, athletic trainer Tim Kocher can see it register immediately on a computer receiving the data in real time. If the hit records a high amount of Gs, Kocher can immediately remove the player from practice — whether the player has been knocked out or not. Del Rossi says the helmet used by most high school players today is doing what it was designed to do: absorb most of the impact of the hit to the head. What Del Rossi looks at are the forces at work on the brain after the helmet absorbs that impact. In other words, even after the helmet does its primary function of preventing the blunt trauma to the head that can cause skull fractures, the brain is still in motion within the skull and experiencing the effects of the G forces. While Del Rossi's group is still in the process of gathering data for its study, the research by Purdue revealed that brain activity changed in players as they accumulated sub-concussive hits. Essentially, the study showed that as impacts increased, brain functionality decreased. So while performance might not have noticeably changed, brain activity did, the Purdue researchers found. More importantly, the researchers showed the more hits a player took and the more brain activity change there was, the more likely that player would one day receive a concussion. As one of the researchers, Kevin Nauman, said, "The one hit that brought on the concussion is arguably the straw that broke the camel's back."

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