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Brain Injury in Sport

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I posted this on my FB page a couple of days ago. It is a subject that I am very interested in not because I believe that sport should be stopped if it proves to cause injury or death, but because the sports where deaths are reported, need to look at their laws and codes of conduct.


Charlie Chat

8 February at 17:35 · 

Brain Disease and Brain Trauma

Have we any idea what the pain of this suffering has caused Joost van der Westhuizen and his close ones? Some believe that we the public have a right to know more about this disease “Motor Neuron Disease” and its causes. It seems that the medical fraternity address symptoms and pay too little attention to cause. That is why the suffering of such a public figure should be in the public domain despite all of the pleas for privacy.

Perhaps this posting will get push-back from medical professionals, but as lay people, should we not be concerned as to the cause of this wasting disease and others which appear to be related? We currently have been made aware of the symptoms by the afflictions to public figures like Joost who was a hero of the Springboks during their winning Rugby World Cup 1995 campaign and subsequently. Andre Venter another Springbok great is also afflicted but he suffers Transverse myelitis which is a disease of the spinal cord that can result in paralysis. It involves the breakdown of the myelin sheath, the insulation layer around the spinal cord and other parts of the nervous system.

The protest against the Oscar awards last year drew my attention to the two movies which garnered most of the public interest.

Leonardo di Caprio won the Oscar: “Best Performance by an Actor in a Leading Role ‘The Revenant’” (2015). The actor, who was supported by many in opposition to the Revenant, was Will Smith for his NFL head trauma drama ‘Concussion’. His portrayal was of the doctor who first brought the dangers of repeated blows to the head to the awareness of professional football in America.

This was a docufilm based on the experiences of Dr. Bennett Omalu who, in his capacity of Forensic Pathologist in the Coroner’s Office of Allegheny County, performed the autopsy on former NFL player Mike Webster. Webster had played for the Pittsburgh Steelers and was nicknamed Iron Mike. Dr. Omalu discovered neurological deterioration in the brain of Webster and traces of Tau Protein similar to that found in punch-drunk boxers. The deterioration, similar to the effects of Alzheimer’s disease was named as “Chronic Traumatic Encephalopathy – (CTE)”. Webster had died at the age of 50 after experiencing dementia, depression and sleep loss.

Smith played the part of the Nigerian born Dr Omalu and other cast members included Will Smith, Alec Baldwin, Gugu Mbatha-Raw, Arliss Howard, Paul Reiser, Luke Wilson, Adewale Akinnuoye-Agbaje ,David Morse and Albert Brooks.

There was a hue and cry caused by the omission of this film from the list of nominees. Many climbed on the “race bandwagon” and it was because of this that the significance of the film was lost.

Smith said this on a British talk show hosted by Graham Norton:
“I am a member of the Academy and the thing that’s most important for me is that the spirit of the awards has to be maintained. The media creates the ‘us’ and ‘them’ but for me there is no ‘us’ and ‘them,’ it’s ‘we’. I feel very strongly that there is a regression in America toward separatism and racial and religious exclusion, so for me, it’s about putting my hand up and reminding my community, the Hollywood community, that we have to lead.”

At the time I was led to believe that this was indeed about race and voiced an opinion. I then decided that I would say nothing more until I had seen both films. This I have now done.

I have come to the conclusion that whilst di Caprio played his part with great skill, for me the storyline was a bit far-fetched. The character played by di Caprio was attacked by a full grown female bear and whilst one may be able to survive, his recovery time added to his ability to travel and survive further ordeals was just not believable.

The film Concussion was also an excellent performance by Will Smith backed by a very fine cast. The storyline is based on the exposé "Game Brain" by Jeanne Marie Laskas, published in 2009 by GQ Magazine.

It is my humble opinion that this film did not pass muster simply because it was very controversial and would perhaps have damaged America’s favourite winter sport – Gridiron.

There are a number of articles which support the theory postulated by Dr Omalu, just as there are several which offer counter argument. The statistics relative to known cases of deaths due to sport injuries are not alarming; however one has to ask how many deaths of sportsmen have been examined by pathologists suspecting the same findings as discovered by Dr Omalu? In fact Webster’s death was stated to have been caused by a heart attack at age 50.

The film has gained very little attention and up until August 2016 has earned just $48.6 million at the box-office. If the National Football League had any hand in keeping the film from the public acclaim, which in my opinion it deserved, it would not surprise me too much.

Recent injuries in Rugby Union to high profile players such as Patrick Lambie of the Natal Sharks and Springboks as well as Charlie Ngatai of the Chiefs and All Blacks, have created an awareness and concern for such injury. A head knock that put an end to what promised to be a breakout All Blacks season, is still troubling Charlie Ngatai.

The Laws of Rugby Union have been overhauled with regard to dangerous play and contact with the head and neck areas. That is a good thing, but we still do not have a proper understanding of the extent of injury caused to players who have been subjected to continued concussion.

The passing of Muhammad Ali was, in some senses, similar in nature to that of Joost van der Westhuizen. 
“In February 2013, Ali's brother Rahman Ali said Muhammad could no longer speak and could be dead within days. Ali's daughter May May Ali responded to the rumors, stating that she had talked to him on the phone the morning of February 3 and he was fine.

On December 20, 2014, Ali was hospitalized for a mild case of pneumonia. Ali was once again hospitalized on January 15, 2015, for a urinary tract infection after being found unresponsive at a guest house in Scottsdale, Arizona. He was released the next day.

Ali was hospitalized in Scottsdale on June 2, 2016, with a respiratory illness. Though his condition was initially described as "fair", it worsened and he died the following day, at the age of 74, from septic shock.”

While we South Africans mourn the passing of arguably one of the World’s greatest scrumhalves, his passing should surely be a reminder to the authorities and Lawmakers in Rugby Union and other contact sports that brain damage is likely to be caused by repeated concussion.

The public deserves to know more about the dangers and parents need to be able to advise or protect their children with much more knowledge. We need to know more, even though more transparent examination may be invasive to those who suffer or die from the effects of brain trauma.

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