Covering sports concussions: Some takeaways from the #AHCJ16 panel

Tara Haelle

About Tara Haelle

Tara Haelle (@TaraHaelle) is AHCJ's medical studies core topic leader, guiding journalists through the jargon-filled shorthand of science and research and enabling them to translate the evidence into accurate information.

Photo: Tara Haelle/AHCJNFL free agent Josh Cribbs captivated attendees with his own experiences, talking about the lengths that players would go to conceal possible concussions and game the tests.

Photo: Tara Haelle/AHCJNFL free agent Josh Cribbs captivated attendees with his own experiences, talking about the lengths that players would go to conceal possible concussions and game the tests.

Conversations about concussions, traumatic brain injury and chronic traumatic encephalopathy (CTE) have become more common in recent years as many military veterans return with disabling head injuries and the impact of football injuries on the brain gets more scrutiny in medical research.

The recent movie “Concussion,” starring Will Smith, raised even more awareness of the sports side of the issue. The higher profile in the media about sports head injuries, specifically in football, was the focus of a well-attended panel, “Covering the Concussion Crisis: Research and Real Life,” at the Health Journalism 2016 conference last month.

Although an NFL official representative declined to participate, the panel did include a current NFL player and a former player. Free agent wide receiver Josh Cribbs and former Cleveland Browns wide receiver Steve Sanders (now the founder and executive director of Training Camp for Life), joined ESPN senior producer Dwayne Bray and Dr. Charles Bernick, medical director of the Cleveland Clinic Lou Ruvo Center for Brain Health, for an eye-opening and incredibly frank discussion.

Here are some key takeaways from that discussion in terms of what we do and don’t know, and some stories journalists might want to pursue. I also include some of the very powerful personal testimony that Cribbs gave about his experiences. It’s worth reading the Storify below that to get a sense of how remarkable the session was — no doubt a favorite at the conference.

Knowledge about long-term effects of concussion and severe head injuries is still very limited. Since not everyone who gets hit will get CTE, what else contributes? Is it genetic? Environmental? Here are some story ideas:

  • What researchers are exploring genetic or environmental causes?
  • Can any of these improve prevention?

We don’t yet know for sure the history, prevalence, risk factors or diagnostic criteria for CTE. We do know the symptoms: depression, hopelessness, suicidality, impulsivity, explosively, aggression, cognitive difficulties. One story idea:

  • What have been the barriers to learning this information?

Pay attention to trends in youth football, where a 10 percent drop in participation has been attributed to increased awareness of the issue. In reality, we still don’t know enough about the effect of hard hits – including subconscussive hits – on young brains. And there’s not enough data to say for certain whether high school football is dangerous, said Bernick noting that data on retired players suggests that those who started playing before age 12 were more vulnerable to developing problems later in life. Consider these story ideas:

  • How does football compare to other high school sports in terms of participation?
  • How have participation rates at schools in your area moved up or down?
  • Have changes been seen in participation rates for other sports?

Cautionary American Academy of Pediatrics (AAP) policy statements have discouraged some kids from playing football. Meanwhile, an estimated 3.8 million kids per year still suffer concussions, about 60 percent of which go undiagnosed, according to Sanders. Some things to look at:

  • Have any schools in your area gone “tackle-free”?
  • How many concussions occur in other sports?
  • Between boys and girls?

Teens die every year on the field in high school football, which almost never happens in NFL or college football, yet only 37 percent of high schools have certified athletic trainers. Many also lack the funding for high-quality safety equipment for the players. Some story ideas to localize:

  • What type of equipment and trainers do schools in your area have?
  • Are there differences among different high schools?
  • Are parents aware of what’s needed?
Photo: Pia Christensen/AHCJESPN senior producer Dwayne Bray reminded journalists that the NFL pressured a journal to retract Bennett Omalu’s study on the late Pittsburgh Steeler player Mike Webster’s CTE.

Photo: Pia Christensen/AHCJESPN senior producer Dwayne Bray reminded journalists that the NFL pressured a journal to retract Bennett Omalu’s study on the late Pittsburgh Steeler player Mike Webster’s CTE.

Issues highlighted in “Concussion” are considered the tip of the iceberg on the extent to which the NFL is believed to have attempted to suppress information about it, the panelists said. When Bennett Omalu’s study on the late Pittsburgh Steeler center Mike Webster’s CTE was published, the NFL pressured the journal to retract it, Bray noted.

Football continues to be popular and rake in the dough, despite the increasing awareness about head injuries. Why? Football brings Americans together as a community; it’s part of our culture, Bray said. New regulations limiting tackles during practice now being seen at some Ivy League schools should help, the panelists said. One story idea:

  • Have any of your local high schools followed suit?

Cribbs captivated the attendees with his own experiences, talking about the lengths that players go to in attempts to conceal possible concussions and game the tests. He also discussed how conflicted he feels about whether his young son should play football. A recent MRI led his doctor to conclude that the 32-year-old Cribbs had a healthy brain — for someone in their 50s. Here are some particularly poignant comments from him at the panel:

  • “Football is a gladiator sport that’s only getting more violent. There’s a lot we didn’t know going in.”
  • Cribbs likened playing to smoking: “Not everyone will get sick from it, but there’s a connection that will dissuade some.” CTE scares the business because of the media, he said. The NFL is “brutal and entertaining,” so they won’t fund research or awareness unless they have to.
  • “Football is 100 percent injury. It’s not if you’re going to get hurt — it’s when.”
  • “The NFL says, ‘You’re going to make a lot of money!’ But they don’t tell you that you’ll die at age 52. I’m 32 years old and I can’t sleep at night. (The insomnia might be from all the medications he takes, he added.)
  • “I feel like I was diagnosed with cancer, so I’m going to smoke anyway.”
  • “Football is a great sport. I love it. I’d die for it — and I am.”

More highlights from the panel

Cribbs talks about being “an investment” instead of a person:

Sanders talks about kids’ misconceptions about playing for the NFL and the need to change their perception:

Cribbs talks about trying to cheat on his baseline concussion tests:

Tweets from the panel:

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