In many ways, it had been an exemplary few days for the NCAA and its signature basketball tournament—a weekend that put the madness back in March.
On Friday, Michigan and star guard Trey Burke completed an epic comeback over Kansas. On Saturday, Cinderella team Wichita State crashed the Final Four.
But for many people watching the Louisville-Duke game unfold, a disturbing injury to Louisville guard Kevin Ware illustrated a different sort of madness: the continued lack of compensation for the players who make the tournament so special.
“Pray for [Ware],” columnist Dave Zirin tweeted. “There is no safety-net for the injured NCAA athlete.”
Injury worst seen on TV
Ware’s broken leg—”about the most gruesome injury I’ve seen in a basketball game,” bemoaned analyst Seth Davis—came on a routine play, as he landed awkwardly after trying to block a shot by Duke’s Tyler Thornton.
“Would I let my son play football?”
It’s a question that more and more parents are asking themselves these days. There are some people out there who say, “No way!”
Football is way too violent and should be abolished as a sport. Even some NFL players admit that they would not let their own sons play football. Then there are others, fierce advocates who think football is a wonderful game with tremendous benefits to its participants and think all of the media hype about injuries are just overrated scare tactics and headline grabbers.
But the majority of us are probably somewhere in the middle and aren’t quite sure what to think. So why don’t we spend a little time sifting through all the facts and emotions and see if we can make some logical decisions about the subject. I have an interesting perspective in that I am a sports medicine physician who is a true fan of the game, has played the game, has sustained injuries and has a son of my own.
Thus I can see the argument from all sides. Let’s start with the physician side. My job is taking care of injured athletes. I see patients with fractures, sprains, strains, overuse injuries, head injuries, concussions, trauma, you name it. During the months of August, September, October and November, I probably see more patients than I do for the entire remainder of the year. Why? Football season.
Like many in neuroscience, I’ve been thinking about the consequences of traumatic brain injury in football. In thinking about this, I think I’ve figured out how American-style football will end. I’m putting the over/under at about 10 years.
The simple explanation of football is this: football is the optimal activity to put the maximum explosive energy a human can develop and deliver it to another human, pause, catch your breath, and do it again. Football is a game of inches, and so the ball is carried by huge, weight-lifting sprinters who hurl their 200+ pound frames at a line of huge, weight-lifting thugs who try to stop them cold. I am not anti-football: I played a little football in high school, I played full-pads, full contact intramural football while an undergraduate (an insurance company’s nightmare), and was a rugby player and coach as a graduate student. My own athletic skill was thuggery.
The problem with this is that repetitive shocks to the brain seem to create pathology in the brain of the protein tau. Athletes who engage in contact sports have a tendency to suffer from chronic traumatic encephalopathy (CTE), which is identified pathologically by finding dense tangles of tau. Dense tangles of tau have been found in boxers, football players, professional wrestlers, and soldiers. There is concern in hockey players and soccer players who head the ball. One researcher found tau tangles in 8 of 9 donated brains from former NFL players. This kind of accumulation of tau is associated with young-onset dementia, cognitive change, and mood disorders.
If you are reading this then you are already well aware of the current concussion crisis in the NFL. No matter where on the spectrum your opinions lie regarding this topic, there is one question that still remains: How did we get here? Surely if something has gone wrong then there must be someone to blame for it. Was it the league’s fault? The coaches? The players? The doctors? Maybe it is the injury itself that’s to blame? Perhaps it was just the perfect storm of a number of factors that put us in this situation? To truly get to the bottom of this, it is important to have a better understanding of the doctor-patient relationship. Not just in general, but specifically as it applies to concussed athletes in the NFL. Ultimately we may not find blame here, but we should at least shed some light on the realities of the situation.
As a sports medicine physician, I have taken care of thousands of concussed athletes at all levels. Eight year old hockey players, high school soccer players, collegiate football players, professional moto-cross racers and skaters, you name it. For all of them, the doctor-patient dynamic is similar. However, for the NFL players, that dynamic is entirely different. Let’s begin by looking at the usual non-NFL doctor-patient relationship.