Pankhudi Narayan
Blogpost 3
Mike Webster is an intriguing case study for the link between playing professional football, brain injury and the long term consequences of repeated instances of brain injury. He was a retired NFL player who had passed away after suffering from a heart attack at only the age of 50. The devastating consequences that followed his injuries works to serve as a cautionary tale along with the several other similar trajectories followed by several other retired NFL players. Through this blogpost, I highlight vulnerabilities and risk factors Webster had that could have provided him with a greater disadvantage by presenting relevant research to substantiate my arguments. Instances of his life have been taken from The Frontline’s covering of the case in the documentary titled ‘League of Denial: The NFL's concussion crisis’ (Kirk et al., 2013).
Mike Webster played American football which is a contact sport that is one of the kinds of sports known to increase the risk of athletes encountering concussions and brain injuries (Lincoln et al., 2011). Football has been found to be the greatest risk factor for men in developing neurodegenerative disorders and symptoms (2011). Webster, not only played professionally at the level of the NFL, but he also played competitively during his schooling days. This may have aided to his later condition as schooling ages from 10-12 have been identified as a critical period where the brain develops and the importance of avoiding tackle football until this age is passed has been emphasised (stamm et al., 2015). Webster’s early engagement with football therefore may have predisposed him to cognitive impairment later in life. This has also been substantiated by research that has found that individuals who play football before the age of 12 are two times more and three times more likely to report cognitive concerns and depression respectively when compared to those who began to play after 12 years of age (Alosco et al., 2017).
As a professional athlete at the NFL, Webster played the position of centre (Kirk et al., 2013) that required speed and in the course of his career, he took several impacts. His position may have made him more liable to getting a concussion as research based on positions players occupy has revealed that significantly more concussions are experienced by players playing speed positions compared to non speed positions (Lehman et al., 2012).
After Webster retired, his family noticed marked behavioural changes as he was seen getting angry very quickly and becoming impatient that was uncharacteristic of his previous behaviour (Kirk et al., 2013). As reported by his wife, he even slashed all his football pictures using a knife in a fit of rage (2013). Research has found that changes in personality can be observed as an outcome of brain injury as the individual may become emotionally dysregulated, become more irritable and in some cases, show apathy (Max et al., 2015). Webster’s family laid emphasis on him not resembling the person he once was (Kirk et al., 2013). In adults with severe traumatic brain injury, research outcomes have shown that significant others of the individual suffering report drastic personality changes in approximately 59% of instances (Norup & Mortensen, 2015).
Webster’s declining cognition was becoming evident as he would become confused, would not be able to finish his line of thought that was muddled and was known to have memory related problems in an instance where he forgot the way to the grocery store (Kirk et al., 2013). The memory related problems and irritability have been found to be commonly experienced symptoms of traumatic brain injury (Cerejeira et al., 2012). He also suffered from a lack of sleep to an extent that he would request people around him to tase him using a stun gun so he would be able to sleep (Kirk et al., 2013). Studies have found that disturbances in sleep were observed in about 50% of individuals after suffering traumatic brain injuries at much higher rates when contrasted with the general population (Mathias & Alvaro, 2012).
After retirement, Webster also engaged with substance abuse - he was specifically caught forging prescriptions for Ritalin on which he had become dependent on (Kirk et al., 2013). For individuals suffering from head injuries, research has found an elevated risk of developing substance abuse disorders amongst other psychiatric disorders for several years after the onset of the head injury (Koponen et al., 2002). This alludes to the head trauma faced by Webster being a potential risk factor in the development of his substance dependence and abuse.
Mike Webster was a promising athlete and loved member of his family. His change in behaviour and the onset of his cognitive problems, substance abuse and derailment from his previously known normal can be linked to the injuries he endured during his career as a professional football player in the NFL. While he received some compensation for his disabilities, the time of recognition of the problem was too late and not much could have been done to cure his condition. His quality of life deteriorated and he passed away only at the age of 50 years old. The risks of playing football and getting repeated injuries to the head need to be emphasised with players taking the informed decision of laying and injuries should be given enough healing time to ensure that long term consequences do not prove to be devastating.
References
Alosco, M. L., Kasimis, A. B., Stamm, J. M., Chua, J. S., Baugh, C. M., Daneshvar, D. H., Robbins, C. A., Mariani, M., Hayden, H., Conneely, S., Au, R., Torres, A., McClean, M. D., McKee, A. C., Cantu, R. C., Mez, J., Nowinski, C. J., Martin, B. M., Chaisson, C. E., … Stern, R. A. (2017). Age of first exposure to American football and long-term neuropsychiatric and cognitive outcomes. translational psychiatry, 7(1236). https://doi.org/10.1038/tp.2017.197
Cerejeira, J., Lagarto, L., & Mukaetova-Ladinska, E. B. (2012). Behavioral and psychological symptoms of dementia. Ageing. https://doi.org/10.3389/fneur.2012.00073
Kirk, M., Wiser, M., Fainaru, S., Fainaru-Wada, M., Gilmore, J., Lyman, W., In Audette, S., McCoy, B., Low, JE. PBS Distribution (Documentary Movie),. (2013). League of denial: The NFL's concussion crisis.
Koponen, S., Taiminen, T., Portin, R., Himanen, L., Isoniemi, H., Heinonen, H., Hinkka, S., & Tenovuo, O. (2002). Axis I and II psychiatric disorders after traumatic brain injury: a 30-year follow-up study. Am J Psychiatry, 159(8), 1315–1321. https://doi.org/10.1176/appi.ajp.159.8.1315
Lehman, E. J., Hein, M. J., Baron, S. L., & Gersic, C. M. (2012). Neurodegenerative causes of death among retired National Football League players. Neurology, 79(19), 1970–1974. https://dx.doi.org/10.1212%2FWNL.0b013e31826daf50
Lincoln, A. E., Caswell, S. V., Almquist, J. L., Dunn, R. E., Norris, J. B., & Hinton, R. Y. (2011). Trends in concussion incidence in high school sports: a prospective 11-year study. Am J Sports Med, 39(5), 958-963. https://doi.org/10.1177/0363546510392326
Mathias, J. M., & Alvaro, P. K. (2012). Prevalence of sleep disturbances, disorders, and problems following traumatic brain injury: A meta-analysis. Sleep Medicine, 13(7), 898-905. https://doi.org/10.1016/j.sleep.2012.04.006
Max, J. E., Wilde, E. A., Bigler, E. D., Hanten, G., Dennis, M., Schachar, R. J., Saunders, A. E., Ewing-Cobbs, L., Chapman, S. B., Thompson, W. K., Yang, T. T., & Levin, H. S. (2015). Personality Change Due to Traumatic Brain Injury in Children and Adolescents: Neurocognitive Correlates. Journal of Neuropsychiatry and Clinical Neurosciences, 27(4), 272-279. https://doi.org/10.1176/appi.neuropsych.15030073
Norup, A., & Mortensen, E. L. (2015). Prevalence and Predictors of Personality Change After Severe Brain Injury. Archives of Physical Medicine and Rehabilitation, 96(1), 56-62. https://doi.org/10.1016/j.apmr.2014.08.009
Stamm, J. M., Bourlas, A. P., Baugh, C. M., Fritts, N. G., Daneshvar, D. H., Martin, B. M., McClean, M. D., Tripodis, Y., & Stern, R. A. (2015). Age of first exposure to football and later-life cognitive impairment in former NFL players. Neurology, 84(11), 1114-20. doi: 10.1212/WNL.0000000000001358
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