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Essay "Chronic Traumatic Encephalopathy and the Improved Safety in Football"

ste2131604 1 / -  
Feb 13, 2020   #1
This lesson will provide a true external review, meaning that you will use a resource from outside of class to review your work. This could be a peer or a tutor. Your assessment for this lesson will be based on the review of your work and related self-reflection.

Step 1: Complete a rough draft of your research paper.
Step 2: Submit the Rough Draft for peer review.

The three areas in which my writing has shown weakness in the past.

Area 1)In-text citations
The first area where my writing has shown weakness in the past was is in my in-text citations. I was missing the author's name and date of publication. On my citation page, I was also missing the access date. This was causing me to lose points.

Area 2)Detail
Another area where my writing has shown weakness in the past was not providing enough detail for each argument. I made corrections by finding supporting statistics from reputable sources. Try to make an argument as to why football is safer and why it's now okay for parents to allow their kids to play. I initially struggled to locate statistics as to why this is true.

Area 3)Flow
The third area where my writing has shown weakness in the past is in my flow. My essay was not written in chronological order of events. Before the sentence outline, my information did not flow very well. Now, I tried to organize my writing by providing a history of concussions and how it led to the concussion study. The concussion study led to the NFL lawsuit which led to the rule changes making the game easier. I think the flow is a lot better now.


CTE-Football Link

Chronic Traumatic Encephalopathy and the Improved Safety in Football

CTE is a degenerative disease of the brain found in people that have a history of getting hit in the head. In the late 90's concussion occurrences drastically increased in all sports. Primarily the increase was most noticeable in the National Football League, but it was also noticeable in Soccer, Rugby, Baseball, Boxing, and other professional sports. I think that football got the most attention, because of the aggressive nature of the sport that it is and because of the money that was being generated by both the players and the league. The perception is that Football is a man's game and only real men can handle the sport. This perception caused a lot of players to downplay concussions or lie to the trainers about receiving a concussion or that they suffered from the symptoms. These cover-ups and side effects are what eventually led to the heightened attention concussions received. The great thing that came from all of this is was the awareness that was created and there were great improvements made to the safety in sports and mainly football. I hope to show that head injuries are serious, but football is still a great sport for the youth to play. My thesis will support that although head injuries are a major concern, with proper education football is still safer than it's ever been before and has drastically improved it's safety and can still be enjoyed by our youth.

"Another profession that created a lot of awareness towards concussions was the military. From 2000-2015 there were 270,000 concussions reported in the military" (Thomas Budinger, 2016). "An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States" (Gessel et al. 2007). These increased numbers brought a lot of attention to concussions. Another thing that had a major impact on how concussions were viewed and treated was that during the 2000 years a lot of former NFL players started speaking up about their memory loss, headaches, depression, and suicidal thoughts. Shortly after 2010, there were a few former NFL players that committed suicide and it was later determined that they suffered from CTE. A new study conducted by Boston University. The study concluded that CTE is caused by impact to the head not strictly concussions. They studied teenagers and mice. Both showed the same pathology after getting hit to the head. This is why 20% of athletes with CTE never suffered a diagnosed concussion. Monica Akhtar from the Washington Post provides a video stating that CTE is mostly common in boxers. Currently, CTE can only be diagnosed post-mortem. Texas Christian University is experimenting with a biomarker called Neurofilament Light. Neurofilament light can change the way that CTE is diagnosed. If it's successful CTE will be diagnosed by drawing blood while the patient is still alive (Cindy Boren, 2018).

The NFL suffered a lot of scrutiny from Congress from 2009 to 2012. Congress was placing a lot of the responsibility on the NFL to improve their concussion protocols and to fix their data and reporting. First, the NFL had a huge procedure problem. There were no mandatory procedures in place that forced NFL teams to disclose concussions or report on them. For example, in 2010 the Bengals reported 0 concussions and in 2009 the Dolphins reported 0 (Steve Fainaru, 2012). The teams had a fear that disclosing this information and making this information public would place a target on the players back. Teams also feared that this type of information would also undermine the team's strategy, because opponents would be able to prepare a game plan knowing that specific players would not participate. Another issue was that reporting was not standardized in the NFL. The team was allowed to classify a concussion under a variety of categories, concussion, head injury, upper extremity, headaches, loss of vision, fatigue, loss of hearing. Teams were listing the symptom rather than the root cause.

In 2014 a study was conducted to research the link between Chronic Traumatic Encephalopathy (Daniella Emanual, 2017) and the National Football League. CTE is a progressive degenerative disease of the brain found in people with a history of repetitive brain trauma (Robert Stern, 2020). The study concluded that 110 out of 111 former NFL players showed signs of pathology (Jesse Mez, 2017). The study brought a lot of attention to head injuries and athletic activities involving concussions. Baseball, hockey, and football leagues sprang into action and implemented protocols to identify and manage concussions. Improvements were made to all protective headgear. The NFL knew that admission would almost certainly lead to a class-action lawsuit. Jeff Miller, the NFL's Sr. Vice President of Health and Safety Policy said, "I think certainly, based on Dr. McKee's research, there's a link, because she's found CTE in a number of retired football players," Miller said. "I think the broader point ... is what that necessarily means and where do we go from here with that information." The NFL eventually agreed that there may be a link between playing football and CTE (Emmanuel Daniella, 2017).

Stat News opposes this argument and claims that the test was flawed because the candidates tested showed signs of CTE prior to being tested and that's why they were selected for the study instead of gathering a random sample, thus invalidating the data. Munro agrees that an athlete who participates in high impact sports and mainly sports where an athlete is susceptible to getting hit in the head is more likely to develop CTE in the long-term but disagrees with the statistics provided and argues that the statistics are flawed and would like to see a study performed with a control (Munro Cullum, 2019). The UT Southwestern Medical Center is asking for a control group. Currently, studies are not being conducted on ex healthy NFL players. Studies only ask for the brains of ex unhealthy NFL players. Another factor is that people manage concussions differently. Some people may have a concussion and not show any symptoms. Others may have a concussion and show immediate symptoms that go away within a few hours if not minutes. While other players may have a concussion and show symptoms for days if not weeks. CTE studies should be performed on regular healthy individuals that have never played a sport or have ever shown signs or symptoms. This would provide additional data and allow a comparison.

Head coach, Larry Fedora from the University of North Carolina wanted to make sure that we don't jump to conclusions. He said that football and concussions can certainly cause brain injuries, but so can a lot of other things. Dr. Peter Cummings a forensic pathologist and neuropathologist, said: "Association is not causation." A major issue is that CTE is not identifiable while a person is alive. CTE can only be identified after a person passes away and the proper test is conducted on the brain. Todd Ewen was a retired hockey player who worried about CTE. He suffered from memory loss and depression. He didn't want to face what the future might hold and he didn't want to be an inconvenience to his family. He took his own life in his basement to spare his family. The neuropathologist convinced his family to donate his brain for study. It was determined that he did not suffer from CTE. He may have suffered from depression and memory loss, the CTE was not the root cause. Munro Cullum, PH.D. said, "You shouldn't be telling somebody that they have CTE, because we don't have diagnostic criteria for it during life," he says. "There are some very serious ramifications."

In May 2012 Junior Seau committed suicide. His brain was examined after his death and it was determined that he suffered from CTE. This incident led to a class-action lawsuit against the NFL. This was a huge development that stemmed from the CTE study. For years the NFL denied that any link existed. Normally the NFL would avoid answering questions related to CTE. Their normal response would be that they were holding off and waiting for additional information before they were able to provide perspective. In June 2015 a federal judge approved a $5 million settlement between the NFL and former players.

The NCAA committed $30 million to fund the largest concussion study in education. They will study 37,000 student-athletes which includes both male and female. The NFL has implemented 47 rule changes since 2002 (Dr. Mckee, 2017). They changed the amount of time a player can practice per day and per week. They also implemented changes to the practice structure. Teams are limited to the number of days and the amount of impact they are able to allow in each practice. This helps reduce the risk to each player, by limiting the impact a player takes. The kick offline was moved up, and improvements were made to the helmets. The number of medical professionals on the sideline was increased to 29.

The majority of rule changes have trickled down to the college, high school, and youth levels making the game a lot safer for all. Football can be played year-round, but parents can help reduce their child's exposure by only allowing their child to play one season per year instead of all four. They can monitor their child's behavior, and by being more informed, parents can monitor their kid's behavior on the field and take them out of the game if necessary. Parents can also choose flag football over tackle football at a young age to introduce their kids to the game of football but not subject them to the hits. If the child waits till they are older, the child will be more self-aware and cognizant of their own mental health. The child is more likely to understand the tackling technique if they are older, high school age perhaps.

Three ways the game of football is much safer than it used to be. In 2010 a new bylaw was put in place. Bylaw number 313. The bylaw states that if a student-athlete is suspected of sustaining a concussion in practice and games they should be removed from competition for the rest of the day. Any athlete that has been removed from the competition cannot return until they have been evaluated by a licensed physician. The physician must be trained in the management and evaluation of concussions. The athlete cannot return until the physician provides a written clearance allowing the athlete to return. Prior to having this bylaw in place, the athlete would be allowed to return to practice or return to games as soon as they said that they felt fine. This new bylaw limits the repetitive hits that an athlete takes on the same day, where before the athlete would be allowed to return to practice or games after showing concussion symptoms. Second, the amount of education that a football coach has to go through has changed. The coach must be certified and get recertified every two years and concussions. In California not only is the certification required it's the law. Prior to this rule, coaches received zero concussion training. Coaches did not understand the short and long-term effects of a concussion. In addition to coaches getting training parents and players are also receiving concussion training as well. There is a concussion information sheet that both player and parent must read prior to beginning the activity. Third, football helmets have been engineered with technology that measures impact. Helmets have a chip installed that detects the number of hits the helmet has taken and it measures the impact of those hits. At some point hopefully these helmets used by all schools and professional teams who participate in tackle football (Chris Fore, 2017).

Parents are more educated about concussions today than ever before. There's a long list of literature and website sources they can use. For example, "Concussion Education Best Practices: A Parent's Checklist" by Brooke De Lench provides a list of symptoms that stem from concussions. It also describes the importance of athlete honesty. It's very important for the athlete to be honest and self disclose when a concussion occurs. In football, there is a misconception that as a player you cannot appear weak or acknowledge that you're hurt because then you'll let your team down. The athlete needs to feel like it's safe to speak up and like they won't get judged for being hurt. The site provides insight on how to manage a concussion and the dangers of continuing to play with a concussion (Brook De Lench, 2018). Another resource for parents is Chock Children's. They suggest that parents should understand their state concussion laws and to make sure your child is being taught "heads up" tackling techniques. Something that is not as common but very helpful is the neurocognitive test. This test should be taken by the athlete prior to the start of the season. This test measures the athlete's verbal, visual, and memory reaction time. This test would be performed again midseason and at the end of the season to ensure that nothing has changed (Linda Hepler, 2019).

As a father of a son who played Youth Pop Warner Football, I hoped to educate myself and get further informed, because I have another child who I will allow to play football and I want to make sure that I'm making the correct decision. "Concussion rates dropped 81% from 10.93 down to 2.04 per 1,000 plays simply by moving kickoffs up by 5 yards to the 40 yard line in 2016 (Judy George, 2018). I hope that parents will become more informed and aware of concussions and how to spot the signs. I also hope that parents understand that there are other options than taking football away from their kids. The game itself is safer because of the new rules. Contact is limited in practice. Helmet to helmet contact is no longer allowed. Equipment is replaced more frequently to ensure that it provides adequate protection. Physicals are now mandatory and part of the registration process. Parents can reduce the number of seasons played in a year by only allowing their child to participate once a year instead of four. Parents can pay attention to the signs and become more familiar with concussion symptoms. This will allow the parent to intervene when it's appropriate and pull their child out of the game for safety concerns. The game of football is the safest that it has been in a very long time.


Emanuel, Daniella. "CTE Found in 99% of Studied Brains from Deceased NFL Players." CNN, Cable News Network, 26 July 2017

Mez, Jesse. "Evaluation of Chronic Traumatic Encephalopathy in Football Players." JAMA, American Medical Association, 25 July 2017

Cullum, Munro, et al. "Research on Concussions Can't Say If Football Is Bad for the Brain." STAT, 27 Sept. 2019

Goldman, Tom. "Study: CTE Found In Nearly All Donated NFL Player Brains." NPR, NPR, 25 July 2017

Chuck, Elizabeth. "Despite Evidence, Skeptics Try to Cast Doubt on CTE-Football Link." NBCNews.com, NBCUniversal News Group, 30 Aug. 2018

Stern, Robert. "Frequently Asked Questions about CTE." Frequently Asked Questions about CTE | CTE Center, 2020

"The Concussion Myth: Brain: UT Southwestern Medical Center." Brain | UT Southwestern Medical Center, UT Southwestern Medical Center, 9 Nov. 2018

Mckee, Dr. "NFL Issues Response to CTE Research Report." NFL.com, National Football League, 26 July 2017

Gessel, Luke M, et al. "Concussions among United States High School and Collegiate Athletes." Journal of Athletic Training, National Athletic Trainers Association, 2007

Budinger, Thomas F. "An Overview of Concussion History and Needed Research." NAE Website, 12 Apr. 2016

Fainaru, Steve. "NFL's Progress On Concussions Blurred By Inconsistencies." PBS, Public Broadcasting Service

Fore, Chris. "3 Ways Football Is More Safe Now Than 15 Years Ago." Coachfore.org, 13 Oct. 2017

Lench, Brooke de. "Concussion Education Best Practices: A Parent's Checklist." MomsTeam, 2018

Hepler, Linda. "Football & Concussion: Worth the Risk?" CHOC Children's, 11 Aug. 2019

Boren, Cindy. "A New Study Shows That Hits to the Head, Not Concussions, Cause CTE." The Washington Post, WP Company, 18 Jan. 2018

George, Judy. "Fewer Concussions After Football Rule Change." Medical News and Free CME Online, MedpageToday, 1 Oct. 2018
Holt  Educational Consultant - / 10,377 3370  
Feb 13, 2020   #2
Regarding the way that you wrote the essay, it is important that you focus the information on a singular field of interest. the singular field will help strengthen your overall essay because you will have a uniform essay presentation. For the history part, you aren't really being clear about the history of concussions. You have to focus not on the history of concussion in spots, but the history of concussion in Football.

At this point I will have to stop and ask you to choose one between two fields that have a high rate of concussion. Now, I feel that concussion in sports have been reviewed to the point of tiresomeness. All the information regarding concussion in sports and football have been extensively studied. However, it has not been adequately covered in relation to military injuries, which are often more serious and fatal than sports concussions. By choosing the less reviewed subject, you will be getting new, interesting, and sometimes, unexpected information that can help inform the reader in a new manner.

Your citations are well referenced in the essay but the paraphrase or quotes are missing. If the quotes are there, then you did not format it properly because as I read the paper, it appeared that you were constantly doing paraphrases in the essay. However, it is hard to figure out which is the paraphrase and which is the self-reflection. You may want to revise the presentation to be clearer about that.

In reference to your self-reflection, I don't really get a sense of you having a personal interest in the research. You are mostly just restating or quoting information in paragraph after paragraph. There are no personal opinions. Personal analysis, objections to the information, and similar information that can prove a self-reflective stance on the topic.

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