Doug MacIver had CTE, which is further evidence CFL needs to be proactive on concussions

The passing of former CFL defensive lineman Doug MacIver in January at age 58 from a heart attack has taken on new implications thanks to this week's revelation that he had "moderately advanced" chronic traumatic encephalopathy (CTE). CTE's the degenerative brain disease that's played such a crucial role in discussions about football players' safety and life expectancy, and the discovery earlier this year that former CFL players Bobby Kuntz and Jay Roberts had CTE, and the news that former CFL and AFL player Cookie Gilchrist did as well, firmly brought that discussion north of the border. Now, the news about MacIver (which comes from Boston University's Center for the Study of Traumatic Encephalopathy) is further proof the CFL needs to take concussions seriously. As Allan Maki writes in The Globe and Mail, the findings weren't entirely surprising to the MacIver family, particularly to son Doug Jr.:

MacIver had told his family he'd once been hospitalized after suffering a concussion playing football for the University of Manitoba. In total, he had been knocked unconscious three times and on other occasions was left "seeing stars."

Even though MacIver Jr. had been concussed playing in the OHL, and knew the aftereffects, the son was startled by his father's erratic behaviour.

"When I came to work with my dad [at a Winnipeg auto dealership], he was all over the place. We were in his office — this was months before he died — and he was rambling. I said to him: 'I have no idea what you're talking about.' He broke down."

There was another telling incident.

"His problems affected his mood swings and, we were told, an area of the brain that regulates body temperature. I remembered he was always cold or hot. We were in Las Vegas and it was 127 degrees [F] in June and my dad was so cold in the casinos we had lunch on a rooftop. The rest of us were all dying in the heat."

What's crucially important about the MacIver case is it's further evidence concussions don't only affect players long after their careers, and they're not only a relic of the CFL's early days. Kuntz died at 79 and Roberts at 67, and Roberts' last CFL season came in 1970. By contrast, MacIver played until 1984 with the Toronto Argonauts, Saskatchewan Roughriders and Winnipeg Blue Bombers, winning a Grey Cup with Winnipeg in his final season. Of course, many who played even more recently and died young have already been found to have CTE, including Owen Thomas and Dave Duerson. (See this Guardian piece on Duerson for some details on how the Boston University centre goes about their examinations.) MacIver's the most recent player north of the border with confirmed CTE, though, and cases like his are extremely important for keeping pressure on both the CFL and its players' and alumni associations to take firm steps to address concussions.

The steps that have been taken so far, including the development of a national framework for dealing with concussions, are certainly positive, but much more can be done. One key remaining troublesome area is where players take a hit to the head and don't even appear to be evaluated before being sent back into the game. That's happened several times this CFL season, and although broadcasters are making an effort to mention it, it sometimes goes without even that acknowledgement. The concussion framework addresses this, but it doesn't always seem to be properly implemented. Moreover, there are still very few concussions listed in injury reports; whether that's thanks to few happening or them being listed as other injuries to avoid scrutiny is a matter of debate.

Concussions are clearly taking their toll on CFL players, though. Beyond Roberts, Kuntz and MacIver, many living CFL alumni (including TSN's Matt Dunigan and a wide range of former Hamilton Tiger-Cats) have candidly spoken about their struggles with the effects of concussions. Although some believe the differences in the CFL game may help to reduce concussions, they're clearly still a major issue affecting this league. The CFL has taken positive steps, including some rule changes, but more can be done.

It's also not just about protecting current players. The CFL, the players' association and the alumni association need to figure out expanded ways to help former players struggling with the effects of concussions. For all the problems with how the NFL has handled head injuries, its 88 Plan initiative has been tremendously positive, and the benefits for former players were expanded substantially in the league's 2011 collective bargaining agreement. The NFL's also donated $1 million to the Boston University group, while a similar Canadian group (the Canadian Sports Concussion Project, which has examined the brains of Roberts, Kuntz and others) hasn't received CFL funding.

CFL resources are obviously extremely limited compared to what the NFL has, but taking firm action to reduce future concussions, better manage the ones that are sustained and help former players suffering from concussions' aftereffects must still be a priority. The league's taken some promising steps on concussion issues, and that probably plays an important role in why former players are largely working with the CFL instead of suing the league so far. To maintain that, though, the CFL needs to keep pressing forward. There's currently no "Mission Accomplished" on concussions, and there likely will never be. It's an ongoing battle, and one leagues have to continue fighting if they want to survive.