January 30th is National CTE Awareness Day. CTE (Chronic Traumatic Encephalopathy) is a progressive disease of the brain which occurs in individuals with a history of repeated brain trauma, like concussion. Although it isn’t always necessarily associated with sports, we do see CTE in athletes who have played sports where head injury can occur, such as football or hockey – or winter sports like skiing and skating. And as media focus will be on the upcoming Super Bowl (February 13) and the Winter Olympics (February 4 – 20), we think it’s important to help spread awareness about the disease, its symptoms, and warning signs.
We’ve talked in the past about what happens to the brain in a concussion. Essentially, when a head injury occurs as a result of a bump, blow, jolt, or a collision with an object (the ground, the ice, a tree, another person’s head, etc.), the brain moves rapidly back and forth inside the skull causing tissue damage. In addition, when one part of the brain moves faster or slower than another part during impact, stretching or straining between the brain’s regions occurs, resulting in further damage.
Medical professionals may describe concussions as a ‘mild’ traumatic brain injury (mTBI) because they are usually not life-threatening, but their effects on day-to-day life can be serious, and include short- and long-term:
The CDC estimates that between 1 and 3 million sports concussions happen each year to children and adults, in both professional and recreational sports. And for some individuals, even despite the use of helmets, over time they suffer repeated blows to the head. (And as we mentioned above, CTE is not always associated with sports; it can also be associated with the military or other situations where repeated head trauma has occurred.)
Recent research has uncovered a troubling link between repeated head hits and dementia-like symptoms, which scientists have termed Chronic Traumatic Encephalopathy. What they have found is that in the brains of people with CTE, a naturally occurring protein, known as tau, builds up over time. The clumps of tau strangle brain cells, diminishing their ability to function. CTE often affects part of the frontal cortex, an area of the brain critical to thinking and executive function, including working memory, planning, and abstract reasoning.
Research on CTE causes, symptoms, and risk factors is still ongoing, but medical professionals do agree, according to the Alzheimer’s Association, that CTE has been associated with dementia-like symptoms, including:
And unfortunately, people may not experience these potential signs of CTE until years or even decades after head injuries occur, so they don’t know how much their repeated injuries may be causing long-term damage.
It’s impossible to quantify how many people might have CTE because the potential pool is large: it could include anyone who has ever played a contact sport and/or suffered multiple head injuries. What we do know is that CTE has been confirmed posthumously in boxers, wrestlers, football players, hockey players, skiers, and skaters, as well as in military veterans who have a history of repeated brain trauma. And CTE is not limited to professional athletes; it has also been found in athletes who did not play sports after high school or college.
The short answer is no. To date, no helmet or protective gear has been found which can prevent the brain trauma that can cause CTE over time. What we can do is to continue to raise awareness about CTE, to keep up on brain injury research in the scientific community, to carefully consider the risks when thinking about playing contact sports, to wear all the protective gear that is required if participating in contact sports, and to take any head injury seriously – which means getting checked by a medical professional even if there seem to be no symptoms present at the time of the injury.