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Football safety takes a hit from new data

TAMPA

Berkeley Prep's Robert Klein, fast, tough and committed, took the handoff and raced toward the end zone. Crack! He spun off the first tackle and darted to the left and accelerated over the goal line. Crack!

Touchdown.

Klein's father, who played football in high school and college and is now a cardiologist, stood with a video camera on the top row of the bleachers.

Under those bleachers, in the athletic trainer's room, a computer recorded the same play in a totally different way. On the screen were statistics and color-coded lines on a graph tracking information received in real time from six sensors embedded in the padding of Klein's helmet.

The collected data are part of an ongoing University of South Florida study involving Klein and six other high school players at Berkeley Prep. The study is measuring the number of hits and their severity and the effects they're having on the players' brain function.

Talk of head trauma in America's most popular sport has spiked this fall. That's happened in large part because of a spate of exceptionally violent tackles in the National Football League and also the plight of a young man from New Jersey's Rutgers University who last month went from defensive lineman to quadriplegic.

But some of the latest research is focusing not on the occasional concussion or catastrophic injury, but rather on the smaller, subconcussive hits to the head that are more unavoidable and intrinsic to the game. Early findings suggest it doesn't necessarily have to be the visibly hard blows that have the most serious long-term ramifications. It is perhaps something even scarier. It could be every hit.

Klein's mother is a nurse. She's curious about what the study will show.

"I'm nervous," Pam Klein said, "because every day we're hearing more and more about the consequences of the trauma to the head. We're hearing about football players killing themselves."

So much of this research — being done at Boston University, Purdue University, the University of Pittsburgh, the University of North Carolina, USF — is still so new. But we know more information than we did a year ago. And we will know more information a year from now.

What are we going to do with it?

• • •

All this started not even a decade ago with the autopsy of a former Pittsburgh Steeler who was a Hall of Famer. After 17 seasons and countless concussions, "Iron Mike" Webster's head hurt so bad he Tasered himself to try to ease the pain, inhaled ammonia vapors in search of some kind of calm and often got so disoriented he'd have to call friends for directions back to his own home.

"All I see is trees," he would tell them.

Webster died, at 50, of a heart attack, and a neuropathologist's analysis of his brain showed extreme early-onset dementia.

Then the same doctor found the condition in the brain of a second dead former NFL player. Then a third. Chronic traumatic encephalopathy, or CTE, is football's version of boxing's "punch-drunk syndrome."

In April of this year, Owen Thomas, a 21-year-old football player at the University of Pennsylvania, committed suicide. Analysis of his brain showed the same condition. There were two major differences with his situation, though: Thomas had never played in the pros, and he'd never had a concussion.

Then, just this fall, a group of researchers from Purdue published a study in the Journal of Neurotrauma that documented decreased brain function in high school football players in Indiana who also had not had concussions. The longer the season went, the more they got hit, the more poorly they did on cognitive exams.

The unsettling conclusion?

"Just because someone hasn't shown any symptoms," Purdue professor Tom Talavage said last week, "doesn't mean everything is fine."

USF's study at Berkeley Prep is similar. The seven players took "baseline" electroencephalography tests before the season. The sensors in their helmets are measuring the head hits they take in every practice and every game. If a player takes a hit that reaches a certain severity, he is asked to go to USF for another test, providing a comparison between the baseline score and the new score.

The players are interested in what the study is going to show. But their decision to participate also sounds almost altruistic. They owe it to the game, they seem to say, after what the game has given them. The friendships forged, the lessons learned — they say they're worth the risk of injury.

Klein has torn knee ligaments twice. His fraternal twin, Richard, has dislocated his right shoulder four times.

But the brain is different.

"You can manage with a bum knee," said Gianluca Del Rossi, the lead researcher on the USF study. "But how do you manage with a bum brain? You don't. Once your brain is damaged, it's damaged. That's the difference."

Your brain isn't your arm or leg or ankle or elbow. Your brain isn't attached to you. Your brain is you. It controls your intelligence, emotion, memory, mood, personality, ability to move, ability to talk. Everything.

Trauma to the brain happens when it pushes against the ridges of bone on the inside of the skull or when its tissue stretches or tears. Cells die. Other cells can compensate. Too many dead cells, though, and those other cells can no longer make up all that work. That's how some football players in their 40s and 50s end up having the brains of demented octogenarians.

The still-developing brains of children and adolescents are the most susceptible to trauma.

The USF researchers ask the Berkeley players to come in on weekends for a new cognitive test if they receive a hit that registers 98 g's. One "g" is the force of gravity at sea level. Concussions average 98 g's but not all hits at that force cause concussions. For a point of reference, 120 g's is like being in a severe car wreck.

The specifics of the severity of the hits at Berkeley — like the ones Robert Klein took on his touchdown run — are off limits because of privacy laws.

Pam Klein, though, says this fall she's been to USF "almost every weekend."

• • •

"This is what the game is," a Philadelphia Eagle said earlier this season.

"A gladiator sport," an Arizona Cardinal said.

The quarterback for the Steelers said he'd rather have a concussion than an injured knee.

The kids are watching. The kids are listening.

In South Tampa, at Plant High, shirts worn at a recent practice said PREPARE FOR COMBAT. The offensive linemen and the defensive linemen gathered in a corner of the field and an assistant coach called out two at a time and those two worked on springing out of their stances and ramming into each other. The biggest impacts were the ones that elicited the loudest cheers from those who matter the most in a moment like that. The players' peers.

At Plant City High, the head coach is Wayne Ward. He suffered three concussions playing special teams in college at Virginia Tech. The first one was a helmet-to-helmet hit his freshman year. The second one he blacked out. The third one he stumbled to the wrong sideline and vomited. Doctors told him he couldn't play football anymore, but he came back anyway after being cleared following 3 1/2 months of neurological testing.

Now he sometimes forgets mid-sentence what he's telling his players.

He was asked recently if he'd do anything differently knowing what he knows now. Yes, he said.

"I'd go back and hit harder."

And over at Berkeley, Klein said before a practice, "I'd like to think most of my hits are given, not taken."

According to a UNC survey of thousands of former NFL players, players who suffer three concussions in their lifetimes, like Plant City's coach, have more than three times the rate of depression and five times the rate of cognitive impairment.

In this country, at the high school level, roughly one in eight boys plays football. "It's entirely possible," Chris Nowinski writes in his book Head Games, "that a whole generation of children will soon suffer the behavioral, emotional and cognitive problems caused by the game." It's also possible, he points out, that the risk isn't as great as many of the early studies indicate.

"I think you're going to hear more stories of younger and younger people with these brain changes," Del Rossi said. "I think it's just a matter of time."

Researchers urge a reduction in the number of hits to the head in practices and games at every level, but especially at youth and high school levels. For the most part, though, they don't want to get into a social and cultural debate. They just want to learn more and disseminate what they find.

What we do with the information is up to us.

"The idea that a human body can take X amount of hits over the years? That's kind of tough to measure and judge and quantify," Plant coach Rob Weiner said. "The alternative, I guess, would be to say, 'Okay, I guess we're going to stop the sport.' I don't know if society at some point will have to make that decision."

The nomenclature of the game traditionally has drawn a distinction between the words hurt and injured. Hurt, you have pain; injured, you can't play.

The mounting research on head hits, though, has introduced a third word.

Damaged.

At Berkeley, the crowd cheers, the video camera records and so does the computer, and Pam Klein thinks about her sons and waits to see if or how much.

Berkeley Prep linebacker Justin Maughon works on his tackling skills during a recent practice. Seven players on the team are part of a study by USF that tracks hits to the head and measures any changes in cognitive ability because of them.

EDMUND D. FOUNTAIN | Times

Berkeley Prep linebacker Justin Maughon works on his tackling skills during a recent practice. Seven players on the team are part of a study by USF that tracks hits to the head and measures any changes in cognitive ability because of them.

Football safety takes a hit from new data 11/18/10 [Last modified: Friday, November 19, 2010 3:05am]

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