NFL shooting highlights battle to reduce brain injury in sport
A New York Police Department (NYPD) officer at the scene of a shooting at 345 Park Ave. in New York. Picture: Victor J. Blue/Bloomberg via Getty Images
I am a doctor who researches the links between rugby and brain injury so I was ghoulishly interested in the shootings targeted at the Manhattan headquarters of the National Football League recently. The shooter, Shane Tamura, did not play professional sport but he did play American football in high school and he was carrying a note that appeared to blame the NFL for a degenerative brain disease he said he had.
We will possibly never know whether there was a link between Tamura’s mental illness and the sport he played but we do know that the NFL has paid out an estimated $1bn to settle concussion-related lawsuits with thousands of retired players after the deaths of several high-profile players.
But even since that payout recent data has shown that minor rule changes have done little to change the rates of concussion in NFL. As for rugby, three failed Head Injury Aseessments and one knockout in Sydney last weekend should tell you all you need to know about what’s happening in the gentleman’s sport.
Fifteen years ago, a college footballer from Pennsylvania State University called Owen Thomas died by his own hand at the age of just 23. In a remarkably brave gesture, his parents gave permission for his brain to be examined by a neuropathologist who was able to formally diagnose the young man with Chronic Traumatic Encephalopathy (CTE). Owen had been a star footballer but within a year of joining the college team both his friends and family noticed a change in his behaviour: he was explosively irritable and often depressed and angry. As the season continued his condition deteriorated until the end came by his own hand.
There are examples closer to home of similar tragedies. Those deaths have not been proven to be due to CTE but all the evidence points towards it. Siobhan Cattigan, a young Scottish female international rugby player, died by her own hand four years ago after an inexplicable deterioration in mental health. More recently, Boston University published a series of brain autopsy results in 130 dead athletes under 30. The most common cause of death was suicide and as many as three in five showed evidence of CTE.
I can already hear the chorus of contact sport supporters accusing me of wishing to ban contact sports or failing to see the important mental and physical benefits of taking part in sport. Nothing could be further from the truth.
This is patently ridiculous and yet the driving analogy is a very useful one. In the mid-1970s, the average number of road deaths in Ireland was about 650 a year. Think of that; 650 families grieving over lost lives nearly every year of that decade. Last year, that figure was 174 road deaths despite a population increase of 2 million.
This decrease was due to a mixture of reasons. Car manufacturers used advances in technology to make cars safer while the State enforced drink driving laws, redesigned roads, insisted on seat belts and introduced penalty points of speeding.
By comparison, the State sees no role for itself in brain injury but encourages sporting bodies to do all they can to make the games safer. That’s like the State asking the car manufacturers to take all the responsibility to make driving safer back in the 1970s. It’s not good enough. We all have a role to play in making contact sports safer.
It is now well past time for a broad public health response to the brain injury crisis. The toxicity of the ‘intense physicality’ agenda needs to be balanced with a series of fresh initiatives to make the game safer. That starts with a proper, independently-funded research programme on risk.
Other measures might include mandating all coaches at all levels to undergo training in concussion awareness and tougher sanctions for clubs and countries that violate rest rules. Mandatory brain health and risk screening for all players should also begin immediately. This should all be directed by a new and independent agency like the one we have for road safety.
Garry Ringrose was rightly praised a few days ago when he withdrew from the British and Irish Lions squad after experiencing concussion symptoms. The move was described by many observers as selfless but the reality is that it was common sense. Sports such as rugby, Gaelic Football and hurling won’t be safe until Ringrose’s decision is the rule rather than the exception.
