August 11, 2011
The long-term impacts of concussions have been a hotly-debated topic for years now, but on the CFL front, there hasn't been a lot of hard data. We've seen frightening stories about individual players like Matt Dunigan, Jay Roberts and Bobby Kuntz, but although efforts are being made to improve concussion protocols, there are still debates over how wide-ranging an issue they are. The forces lobbying for change received some significant ammunition this week, though, thanks to a study by The Hamilton Spectator that got 25 former Tiger-Cats' players to take the cognitive ImPACT test—and found that 24 out of the 25 scored below average in key brain function indictators. However, that study appears to have received some opposition from an unexpected source—the CFL Alumni Association.
This isn't a trifling result. Yes, it's not a huge sample size, and there are questions of selection bias (only 25 of the 50 former Tiger-Cats the Spectator contacted agreed to take the test, and it would seem likely that those experiencing mental problems would be more willing to investigate them than those who seem healthy), but that's still a stunning number of players. Their poor scores came in a variety of categories, too, including verbal memory, motor speed and reaction time, and several scored in the bottom 10th percentile of all men their age.
Moreover, the players involved reported a total of 46 concussions during their playing careers, but only missed a total of 12 games, and those who reported the most concussions had the lowest scores. As Drew Edwards and Jeff Green wrote in their story on the tests, those numbers caused some experts evaluating the data to take notice.
"There's definitely some people here that are having a lot of trouble," says Eric Nauman, a professor of biomedical engineering at Purdue University, who has done extensive research with ImPACT testing.
"It indicates that something unusual is happening."
...Nauman says the ImPACT results point to some interesting trends. He notes the players who had longer careers or reported having a higher number of concussions — one of the medical history questions included in the test — had some of the lowest scores.
"There are some people that just tanked and they are often associated with players that had a lot of concussions," Nauman said.
But concussions aren't the only indicator of trouble. Nauman's work with high school players showed that neurological changes could occur even without a diagnosed head injury, such as a concussion, and former Ticats showed a similar trend.
It's important to keep in mind that this isn't just some random test. The ImPACT test is the world's most widely-used concussion evaluation system, and it has a database of 2 million results that the CFL players' results were compared against. The Tiger-Cats taking the test scored below average as a group in every single category: verbal memory, visual memory, motor speed and reaction time. On the cognitive efficiency index, which combines accuracy and speed results to give an overall picture, the group scored just 0.15, well below the average of 0.34. Anything below 0.20 is considered poor, and 18 of the 25 players fell under that mark. Only one player scored above 0.34.
Moreover, these are not just abstract, theoretical results suggesting problems where there are none. The stories from the players Edwards and Green talked to demonstrate that many of these guys are dealing with real, severe mental health issues in their day-to-day lives. They didn't have to have long CFL careers to feel the effects, either. Take the case of Doug Redl, the Saskatchewan Huskies' offensive guard who played for the Tiger-Cats in 1980 and 1982 (and spent four years in total in the CFL with Hamilton and Toronto before his career ended at 26 thanks to a leg injury). Here's part of what Redl (seen above during his time with the Huskies) told The Spectator:
"If I don't write something on a sticky note and put it in my pocket, I won't recall it," says Redl. "I have a difficult time keeping both my two boys' phone numbers registered in my mind."
He alternates between reflection and remorse, mirroring the polarizing emotional states that led to the end of his marriage seven years ago.
"I still love the woman. Taking a look at it, the mood swings — I couldn't explain why I was going into sort of a tank. Such mood swings, from highs to lows, like when it was sunny, it was sunny. When it was dark, you could barely see your way out of the room," says Redl, who adds there's no history of mood swings in his family.
"I wondered 'What the hell is going on?'"
After hearing a call-in radio show about brain damage from football, his concern grew, and he has decided to donate his brain to research when he dies.
"We're all brain-damaged, we all are," says Redl.
Redl's situation is far from unique, as more and more stories like this keep coming out. What's notable is that they're getting closer and closer to the current day, though. It's easier to shrug off stories of people like Bobby Kuntz and Jay Roberts who played in the 1950s and 1960s as evidence of a more dangerous game from a different time, but it gets tougher when you're talking about guys like Redl who played in the 1980s, or guys like Matt Dunigan who played in the 1990s, or even guys like Etienne Boulay who are still playing.
Concussions haven't gone anywhere, and are still a major issue facing this league. It's great that the CFL's taking some action on the prevention and treatment fronts, but there's still a lot to be done; consider that many injuries that seem to involve concussion symptoms still aren't treated as such. Moreover, the reaction of the CFL Alumni Association to this data is quite troubling; Leo Ezerins, head of the association and a former Tiger-Cat himself, not only declined to take the test when contacted by The Spectator, but reportedly got involved with their attempts to interpret the data—and not in a particularly helpful way.
Ezerins, the official advocate for league alumni, admits he feels the urge to defend the sport and the league. That sentiment led Ezerins to raise concerns regarding The Spec's project as it was being conducted.
The Spectator used the ImPACT tests at the suggestion of experts at the David Braley Sport Medicine and Rehabilitation Centre at McMaster University, who were involved with the project since its inception and had agreed to interpret the results.
But in late May, just days after testing was completed, Ezerins and former Hamilton Tiger-Cats Alumni president, Dave Lane, met with representatives from McMaster and ImPACT. Five days later, McMaster informed The Spectator that it was no longer willing to interpret the test results.
"We're really protecting the sport and protecting the CFL," Ezerins said. "It's a very important issue and we want to make sure it doesn't reflect poorly on the game of football, that we have the proper perspective.
"There's a lot of fear."
You know, we've heard that rhetoric before from executives supposedly representing the interests of former football players, and it didn't go all that well. Still, Ezerins apparently is convinced that the stories of concussions and their long-term effects "do not represent the majority of former football players". If he's worried about anecdotal evidence, though, you think he'd support a study that looks at a larger group of players using a proven methodology rather than attempt to stop it.
That's the importance of this project. In and of itself, it's just one piece of evidence, but it's a pretty compelling one. Finding neurological issues on such a wide scale among former CFL players is a very notable result. When you add this to the growing mountain of evidence about the dangers of concussions and hits to the head, though, it takes on even more significance. There's still a lot we don't know about the brain and how it's affected by football injuries, but the more we learn, the more troubling it is.
The nationwide concussion protocols the CFL and the alumni association (amongst many other groups) were involved in creating are certainly a positive step, but they can't be the only step. More research needs to be done and more action needs to be taken. The momentum towards realizing the significance of concussions, finding ways to help those who suffer from them and working proactively to prevent future ones is building; hopefully research projects like The Spectator's will cause more people to jump on board.