Football's brain injury problem: There's more to it than just concussions

A new study by researchers at the Cleveland Clinic Lerner College of Medicine links long-term brain damage to subconcussive hits in football, meaning hits that don't even cause concussions. This is by no means a revelatory finding, but it is interesting in its method, and its potential implications.

The study examined 67 players during the 2011 season and found from blood tests that the 40 players who sustained the hardest hits had unusually high levels of an antibody that is connected to brain damage.

When they scanned the brains of those players, they found damage that was predicted by the antibody:

"This positive correlation could be an early indicator of a pathological process that, with time, could perturb players' brain health," says Nicola Marchi, a professor of molecular medicine at the Cleveland Clinic Lerner College of Medicine, who co-authored the study with Lerner colleague Damir Janigro and Rochester's Jeffrey Bazarian. "All football players have repeated subconcussive hits-throughout the game, the season, and their careers," he says, but without external symptoms of injury, the hits were hard to measure. The blood tests appear to offer an early warning system."

It seems like the real gains to be made here are at the amateur levels, where the training staffs and doctors don't possess the same level of expertise as those working for the NFL. Perhaps these blood tests can complement on-field concussion tests and other evaluations of brain trauma.

If these researchers have in fact found an early-warning system for brain damage in athletes, and football players especially, it's something that could save lives. It's also something that may further call into question the safety of football and threaten its long-term vitality. What we've learned in recent years is that there is essentially no way around head injuries for football players - big hits make headlines, but the subconcussive damage adds up, and no football player avoids those subconcussive hits.

The Big Ten and the Ivy League are working together on new head-trauma research, which involves an analysis of athletes before and after their college careers. This will provide a before-and-after perspective and a potential baseline for the interpretation of head injuries incurred in college. That baseline alone could be useful in understanding just what exactly repetitive hits do to the brain, and how quickly (or exponentially) damage is done.

The National Football League has done studies of its own, some of which have been plagued by a conflict of interest. And this is a part of a crucial side issue, which is that football makes a whole hell of a lot of money for the folks involved. It funds entire university athletic departments; it drives television contracts.

How does one handle a thriving game with an inescapable issue like this?

NFL commissioner Roger Goodell spoke recently about "taking the head out of the game," but that is a breezy summation of a complicated and fundamental problem. He's danced around the subject enough to make it apparent that he has no real answers.

Maybe this is a start, though. The blood test could be a truth serum, of sorts, that football desperately needs.

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