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Photographs taken Sept 18 2012 during senior football practice at St. Michael's College School in Toronto. The school performs baseline tests on all athletes taking part in extracurricular sports. If there's any suspicion of concussions, they take another baseline test to see if there is indeed any brain injury. (Fred Lum/The Globe and Mail)
Photographs taken Sept 18 2012 during senior football practice at St. Michael's College School in Toronto. The school performs baseline tests on all athletes taking part in extracurricular sports. If there's any suspicion of concussions, they take another baseline test to see if there is indeed any brain injury. (Fred Lum/The Globe and Mail)

Head injuries provide for an unsettling year in sports Add to ...

The document will also likely include the third iteration of a step-by-step tool used by medical professionals to assess concussions incurred on the playing field. The current version, called SCAT2, uses a questionnaire-based format applicable to any sport for athletes ages 10 and older. Researchers say it can be improved by adapting questions to specific sports, such as hockey.

2. Chronic traumatic encephalopathy (CTE) and the long-term consequences of repetitive head injuries

In recent years, researchers have gained critical new insights into how concussions affect athletes’ brains in the days and weeks after a hit. Next is to assess whether and how repetitive hits to the head affect athletes long after their retirement.

A team of researchers at Boston University has dominated the news on this subject, most recently with a blockbuster study published in early December that showed that of the 85 brains of dead athletes in their study, 68 were found to have chronic traumatic encephalopathy, a disease brought on by repetitive hits to the head and linked to depression, memory loss, aggression and dementia. Half of those 68 were former professional football players; 16 more played football as their primary sport.

While Boston University claims 600 athletes have already pledged their brains to research after they die, other researchers have thrown their hats into the ring. The brain of Junior Seau, NFL linebacker who died of suicide in 2012, will be studied at the National Institutes of Health. In Canada, a team led by Dr. Charles Tator is also collecting brains. It has already studied the brains of six former CFL players, and the results should be published in the next year.

Currently, the data sample is wildly skewed toward finding the disease. That’s because CTE can only be diagnosed after an athlete dies, and families often donate the brain of a loved one who is already showing symptoms. That means scientists are still working to answer one very basic question – how common is CTE? – as well as a number of other questions, such as how many hits, at what severity over what period of time, are required to trigger the disease? Some clues suggest there may be a genetic or environmental component that stops the advance of the disease in some people, suggesting there may be hope for a cure.

3. Legal action

If it is true that violent contact sports have lifelong, debilitating consequences for athletes, should sports organizations be on the hook for damages?

That issue will continue to play out in the courts this year, as the NFL stares down a monster lawsuit brought by thousands of retired football players touched by head injuries during their careers. At the heart of the players’ claims is the charge that the league hid what it knew about the link between hits to the head and long-term brain damage. As The New York Times reported in December 2012, another new frontier could emerge if insurance companies balk at paying for the league’s mounting legal bill and the hundreds of millions of dollars in potential damages that might stem from the cases brought by the retired players.

The NFL’s legal woes are sure to be watched by other professional sports leagues, specifically the NHL. But it also has the potential to affect sports at the lower level. Because as information about the link between head trauma and long-term injuries grows, coaches, athletic directors and others will have a harder time claiming that they were unaware of the dangers.

As a result, colleges, high schools and club teams may be forced to consider severe measures in the face of liability issues, like raising fees to offset higher premiums, and requiring players to sign away their right to sue coaches and schools. Some experts are projecting even more severe measures: that schools and leagues may even shut down teams because the expense and legal risks are too high.

4. Unravelling possible gender effects

For years, scientists have noted that girls seemed to be suffering concussions at rates higher than boys. But they have yet to determine why that is.

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