Sports organizations must acknowledge that head impacts cause CTE to protect children

(Boston) – A new analysis by leading international experts on chronic traumatic encephalopathy (CTE) found conclusive evidence that repetitive head impacts (RHI) cause the degenerative brain disease CTE.

The researchers from Harvard University, Boston University, University of Sydney (Australia), University of Auckland (New Zealand), University of Michigan, University of California-San Francisco, University of Sao Paulo (Brazil), University of Melbourne (Australia), Oxford Brookes University (UK) and the Concussion Legacy Foundation are issuing a global call to action to sports organizations, government officials, and parents to immediately implement CTE prevention and mitigation efforts, especially for children.

The researchers analyzed the data through the “Bradford Hill criteria”, a trusted set of nine benchmarks developed by one of the pioneers of smoking and lung cancer research to gauge the confidence science can place in a causal relationship between an environmental exposure and an adverse health outcome.

Among the revelations in the analysis, the authors discovered that the brain banks of the US Department of Defense, Boston University-US Department of Veterans Affairs, and Mayo Clinic have all published independent studies on distinct populations showing contact sport athletes were at least 68 times more likely to develop CTE than those who did not play contact sports. This incredible strength of association, combined with robust evidence in all nine benchmarks, is conclusive evidence of causation.

“This innovative analysis gives us the highest scientific confidence that repeated head impacts cause CTE,” said study lead author Dr. Chris Nowinski, Concussion Legacy Foundation CEO. “Sport governing bodies should acknowledge that head impacts cause CTE and they should not mislead the public on CTE causation while athletes die, and families are destroyed, by this terrible disease.”

The most studied causes of CTE are contact and collision sports, which include soccer, rugby, boxing, American football, Canadian football, and Australian rules football. The study authors are concerned parents and coaches, who have the most control over whether children are exposed to repetitive head impacts, are not getting the facts from global sports organizations, and are exposing their children to preventable cases of CTE.

While both the United States Centers for Disease Control and Prevention (CDC) and the National Football League (NFL) acknowledge a causal relationship between repetitive head impacts and CTE, global sporting organizations including Fédération Internationale de Football Association (FIFA), World Rugby, International Olympic Committee (IOC), National Hockey League (NHL), Canadian Football League (CFL), National Collegiate Athletic Association (NCAA), Australian Football League (AFL), National Rugby League (NRL) and New Zealand Rugby thus far have refused to publicly acknowledge a causal relationship.

Researchers say it is the duty of these organizations to inform athletes and their families and take appropriate steps toward CTE prevention and mitigation. Many of the organizations, including the NFL, spend millions of dollars a year recruiting athletes, including children, without disclosing the risk of CTE.

“This analysis shows it is time to include repetitive head impacts and CTE among child protection efforts like exposure to lead, mercury, smoking, and sunburns,” said Dr. Adam Finkel, Clinical Professor of Environmental Health Sciences at the University of Michigan School of Public Health and a former Director of Health Standards, US Occupational Safety and Health Administration (OSHA). “Repetitive head impacts and CTE deserve recognition in the global public health discussion of preventable disorders caused by childhood exposures.”

CTE can only be definitively diagnosed through a post-mortem examination of the brain. Scientists don’t yet know how many athletes, military Veterans, and others exposed to head impacts have CTE, but knowing the prevalence of a disease is not required to enact disease prevention efforts, especially as the global scientific community closes in on 1,000 CTE cases diagnosed worldwide in the last decade.

“Even we were surprised by how strong the causal relationship between repetitive head impacts and CTE becomes when the data are analyzed within the appropriate framework and in an unbiased manner,” said study co-senior author Dr. Robert Cantu Concussion Legacy Foundation medical director. “Scientists and policymakers must retire the word association and begin using causation in all forums in an urgent effort to educate the public.”

The authors urge governments to support CTE research and prevention efforts since CTE is associated with developing dementia, which comes with extraordinary healthcare costs.

The research paper, Applying the Bradford Hill Criteria for Causation to Repetitive Head Impacts and Chronic Traumatic Encephalopathy, is published in Frontiers in Neurology, and can be viewed online.

Dr. Nowinski and Dr. Finkel answered some of the most frequently asked questions about CTE causation, read their blog here.

Hall of Famer calls for increased support for former players, heading ban until age 14

(BOSTON) – National Soccer Hall of Famer Bruce Murray, 56, revealed today to CBS News he is struggling with cognitive impairment and behavior changes consistent with what is seen in individuals diagnosed with chronic traumatic encephalopathy (CTE) after death. He and his wife Lynn Murray are going public with their struggles to help others suffering know they are not alone, and to raise awareness about the dangers of repetitive heading in soccer.

Murray was the all-time leading scorer in U.S. Men’s National Team (USMNT) history when a concussion forced him to retire in 1995. He was a key member of the 1988 U.S. Men’s Olympic Team and the 1990 U.S. World Cup Team and is known for his spectacular ability to score off headers. He has been experiencing progressive neurological symptoms for the last decade.

“My symptoms started with what I thought was normal forgetfulness but have gotten to the point where I’ve left my car running with the keys inside several times in one day,” Murray said. “I’m fearful there’s now a very real chance I’ll leave my children in the backseat and forget them too.”

Murray is speaking out just one week after the family of former USMNT and MLS player Scott Vermillion announced his stage 2 CTE diagnosis by Dr. Ann McKee at the Boston University CTE Center. Vermillion is the first former MLS player diagnosed with the disease.

“We appreciate Bruce and Lynn Murray’s courage in sharing their diagnosis and encourage the many other former players we know are struggling to reach out to the Concussion Legacy Foundation HelpLine for support,” said Dr. Chris Nowinski, CLF co-founder and CEO. “Thanks to the Murray and Vermillion families, we can learn from the mistakes of the past to change the future for the millions of children still heading soccer balls with no idea that it could lead to CTE.”

A dementia crisis tied to repetitive heading has been discovered among professional soccer players in the United Kingdom, as dozens of former players and families have revealed debilitating symptoms in the last few years. A 2019 University of Glasgow study found former professional Scottish soccer players were 3.5 times more likely to die from neurodegenerative diseases than the general population. A follow-up study in 2021 found the only position that didn’t have an increased risk of brain diseases was goalie, isolating repetitive heading as the most likely cause.

Bruce Murray supports CLF’s Safer Soccer campaign, which launched in 2014 alongside USWNT legends Brandi Chastain, Cindy Parlow Cone, and Taylor Twellman, to educate parents, coaches, and soccer stakeholders on the benefits of delaying headers in youth soccer until high school. Murray is now reigniting the call on U.S. Soccer to raise the ban on heading in the youth game until at least age 14 and accelerate efforts to minimize lifelong exposure to headers in older players.

“There is absolutely no reason for these kids to be heading the ball hundreds of times in a season,” said Murray, a former Harvard University men’s soccer coach. “I feel a responsibility to speak up and make sure nobody else has to go through what I’m experiencing.”

Former players and their families battling concussion or suspected CTE symptoms can reach out to The Concussion Legacy Foundation HelpLine at CLFHelpline.org.

To accelerate research on CTE diagnosis and treatment, CLF encourages former soccer players over the age of 40, who played at any level, to enroll in the online Head Impact & Trauma Surveillance Study (HITSS) at HITSS.org. The study is open to both men and women and led by researchers at Boston University and the University of California San Francisco.

About Bruce Murray

Bruce Murray was an essential part of U.S. Men’s National Team from 1985 to 1993. When he retired, he was the all-time leading scorer for the U.S. Men’s National Team. Murray was a member of the 1988 U.S. Men’s Olympic Team and the 1990 U.S. World Cup Team, where he was the only American to score and assist a goal. Murray played professionally for nine years, including two seasons in the English Premier League for Millwall. Murray won two National Championships at Clemson University and earned the Hermann Trophy, awarded to college soccer’s top player. Murray was inducted into the Clemson Hall of Fame in 1993 and elected to The National Soccer Hall of Fame in 2011.

Press Release

(Boston) – The family of Demaryius Thomas is announcing today that Boston University CTE Center researchers diagnosed the former NFL wide receiver with stage 2 (of 4) chronic traumatic encephalopathy (CTE). Thomas died in December 2021 at the age of 33. His family is releasing the findings of his brain study through the Concussion Legacy Foundation (CLF), which arranged the brain donation, to help raise awareness of CTE and encourage the football community to support research.

“Once I became aware of CTE and began to familiarize myself with the symptoms, I noticed that Demaryius was isolating himself and I saw other changes in him,” said Katina Smith, Demaryius’ mother. “He was just so young, and it was horrible to see him struggle. His father and I hope all families learn the risks of playing football. We don’t want other parents to have to lose their children like we did.”

Stage 2 CTE is associated with progressive behavior, cognitive and mood abnormalities. In the years before he died, Thomas developed depression, anxiety, panic attacks, and trouble with his memory. Stage 4 is the most severe stage of CTE and is usually associated with dementia.

“Like so many that have gone before, we found stage 2 CTE in the brain of Demaryius Thomas. The question I keep asking myself is ‘When will enough be enough?’ When will athletes, parents and the public at large stop ignoring the risks of American football and insist that the game be changed to reduce subconcussive hits and that the athletes be comprehensively evaluated at the beginning and end of every season?” said Dr. Ann McKee, chief of neuropathology for the VA Boston Healthcare System and director of the BU CTE Center and VA-BU-CLF/UNITE Brain Bank.

Concussion Legacy Foundation CEO and co-founder Dr. Chris Nowinski reached out to the Thomas family to propose the CTE study. Bobby Thomas, Demaryius’ father, alongside Katina Smith graciously agreed to make the donation to learn more about why their son changed, and to help others.

“The football community would have no idea why so many former players struggle with neurological disorders after their career without the families who say yes to brain donation, so I want to thank Bobby Thomas and Katina Smith – and all families – for their trust in Dr. McKee and this team,” said Dr. Nowinski, a former football player at Harvard University. “I hope this is a wake-up call to high profile current and former NFL players that CTE is rampant among them, and they need to get involved in creating real solutions. CTE should be their number one off-the-field issue.”

Thomas played 10 seasons in the NFL for the Denver Broncos, New York Jets, and Houston Texans, making four Pro Bowl rosters, and winning Super Bowl 50 with the Denver Broncos. Thomas was the 22nd pick in the first round of the 2010 draft out of Georgia Tech, and in all played 16 years of tackle football before announcing his retirement at age 33 in 2021, six months before his death. His cause of death has not yet been reported.

There has been speculation his death may be related to an epileptic seizure. Although late-stage CTE can be associated with epilepsy, it is far more likely that he developed post-traumatic epilepsy after a motor vehicle accident and fall he experienced several years before his death.

Thomas is one of more than 300 former NFL players who have been diagnosed with CTE by Dr. McKee and the BU CTE Center research team.

Former and current NFL players and their families worried about possible CTE symptoms can reach out to the Concussion Legacy Foundation HelpLine for support at CLFHelpline.org. The HelpLine staff provides personalized resources and recommendations for treatment.

BU CTE Center researchers found Scott Vermillion had stage 2 CTE when he died at age 44

(Boston) – The family of Scott Vermillion, a former professional Major League Soccer (MLS) player, is announcing today that Boston University CTE Center researchers diagnosed him with stage 2 (of 4) chronic traumatic encephalopathy (CTE). Vermillion died by an accidental overdose in December 2020 at the age of 44. His family is releasing the findings of his brain study through the Concussion Legacy Foundation (CLF) to help raise awareness of CTE in soccer.

“This disease destroys families, and not just football families,” said Dave Vermillion, Scott’s father. “We want others to realize this can happen to anyone who is exposed to repetitive head trauma because we didn’t even consider CTE when my son was struggling. He started withdrawing from his friends and family and we knew there was something going on, but we didn’t know what. We hope this will be a wakeup call to the soccer community to support former players and get them the help they need, so some good can come from this tragedy.”

While in his late 20s, Vermillion developed impulse control issues, aggression, depression, and anxiety which slowly worsened. He later developed apathy, substance abuse, social withdrawal, and memory loss.

“We learn more about CTE and the dangers of repetitive head trauma with every brain that is donated to our center,” said Dr. Ann McKee, chief of neuropathology for the VA Boston Healthcare System and director of the BU CTE Center and VA-BU-CLF/UNITE Brain Bank. “Mr. Vermillion has shown us that soccer players are at risk for CTE. We need to make every effort to identify players who are suffering and provide them compassionate care and appropriate medical support.”

Vermillion started his professional career in 1998 with the Kansas City Wizards after being called up from the Project 40 team. That same year, Vermillion was also a defender for the U.S. Men’s National Team. He went on to play four seasons in the MLS, taking the field for D.C. United and the Colorado Rapids, along with Kansas City. He retired after suffering a serious ankle injury during a game. In all, Vermillion played 22 years of soccer, beginning at age 5.

“It is time for the global soccer community to have a real conversation about heading, especially in the youth game,” said Dr. Chris Nowinski, CLF co-founder and CEO. “A dementia crisis tied to repetitive heading has been discovered among professional soccer players in the United Kingdom, and the same revelation may not be far behind in the United States. We urgently need to investigate how far this crisis extends into amateur soccer and immediately put in place reforms to prevent CTE in the next generation.”

Scott Vermillion is the first former MLS player diagnosed with CTE. Dozens of other soccer players at various levels have also been studied at the Brain Bank, including semi-professional player Patrick Grange, the first American soccer player diagnosed with the disease in 2014, and former high school player Curtis Baushke.

The Vermillion family wants former players who may be struggling with suspected CTE symptoms to know help is available. The Concussion Legacy Foundation HelpLine provides free, personalized support to patients and families battling concussion or suspected CTE symptoms. Anyone who needs assistance can reach out at CLFHelpline.org.

Over 100 sign open letter calling for action to protect athlete’s brains ahead of IFAB’s AGM

(Oxford, UK) – The football community is banding together to advocate for player safety, sending a letter to the International Football Association Board (IFAB) on Monday demanding they introduce temporary concussion substitutes to protect athlete’s brains and allow medical professionals to conduct proper evaluations.

“The current protocols for concussion in football are not working. Therefore, we need to do everything we can to support medical professionals to make the best decisions for player safety, that means allowing them the time and space to conduct robust clinical assessments away from the field of play.” said Dr. Adam J. White, Executive Director of the Concussion Legacy Foundation UK. “Temporary concussion subs are the only way that can happen”.

“Put simply, the current rules by IFAB are not working and players are being put at risk. This is completely unacceptable. Too often we are seeing players assessed for a complex brain injury on the field of play, with the noise and intensity of a football stadium and continuing the game only for them to be replaced later on.” said Dawn Astle, Founder of the Jeff Astle Foundation. “This demonstrates that the current guidelines are failing to prioritize player safety. Change is long overdue”.

PFA Chief Executive Maheta Molango: “The current rules set by IFAB are simply not working. Players are being put at serious risk. When determining the laws of the game, player safety and welfare have to be the top priorities.

“Medical teams are being given an impossible task. Within the pressurised environment of elite football, we have seen frequent incidents of players returning to play with a potential brain injury, only to be removed shortly afterwards once symptoms visibly worsen.

“As the representative voice of professional players in England, we have been clear that we want to see the immediate introduction of temporary concussion substitutes.”

Over 100 representatives from the PFA, players, the world’s top concussion and CTE researchers, and leaders of brain injury nonprofits have all signed the letter.

“It is vital that we better protect footballers from the dangers of continuing to play after sustaining a concussion – particularly those playing at grass roots level,” said Peter McCabe, CEO of brain injury charity Headway. “The introduction of temporary concussion substitutes should have happened years ago, and any further delays are simply unacceptable.”

Currently, medical professionals are forced to evaluate athletes on the field in as few as three minutes, making a comprehensive clinical evaluation impossible. These rules put athlete’s lives at risk. Returning to play with a concussion can and has led to sudden death from second impact syndrome.

Open Letter: Call for IFAB to introduce temporary concussion substitutions in association football

Concussion in association football (soccer) is of increasing concern to athletes, their families, and the public, along with researchers, physicians, and other medical and healthcare professionals.

A concussion is a brain injury. The global medical community agrees that when an athlete has a concussion, they should be immediately withdrawn from participation to prevent further harm.

The global medical community also agrees that an athlete suspected of having a concussion should also be removed immediately and, if a healthcare professional is available, clinically evaluated for concussion – without compromise.

Evaluating a concussion during competition is difficult. Few concussions cause immediate and unambiguous signs like loss of consciousness. In situations where a concussion diagnosis is not certain, current best practice is for an athlete to go through a multimodal assessment with a healthcare professional off the field, and for the athlete to be held out from competition if a brain injury cannot be ruled out.

In football today, healthcare professionals are forced to evaluate athletes on the field, and they face strict time limits, often as few as three minutes, that prevent the healthcare professional from conducting a comprehensive clinical evaluation. These arbitrary rules put the athlete’s life at risk. Returning to play with a concussion can and has led to sudden death through second impact syndrome.

Permitting a temporary concussion substitution in football would allow healthcare professionals to conduct more comprehensive assessments, and send an important signal to every person in the game to treat head injuries with the necessary care. If temporary concussion substitutions were allowed, these concussion evaluations would not be time-pressured and could be conducted off the field in a quiet and controlled environment, which would allow healthcare professionals to use their training to make the best decision for the athlete. More accurate concussion diagnoses are in the best interest of a player’s long-term brain health.

We need to be giving healthcare professionals the time, space, and resources to do their jobs and protect the brains, and lives, of athletes.

Therefore, we call upon IFAB to immediately implement temporary concussion substitutions in the laws of the game for association football for leagues whereby suitable medical and healthcare coverage and oversight allows concussion assessments to be administered.

Kind Regards,

Dr Adam J White

Executive Director, Concussion Legacy Foundation UK

Senior Lecturer, Oxford Brookes University

Dr Robert Cantu

Co-Founder & Medical Director, Concussion Legacy Foundation

Medical Director & Director of Clinical Research, Emerson Hospital

Clinical Professor of Neurology, Boston University School of Medicine

Dr Christopher Nowinski

Co-Founder and CEO, Concussion Legacy Foundation

Tim Fleiszer

Executive Director, Concussion Legacy Foundation Canada

Nathan Howarth

Director of Development and Operations, Concussion Legacy Foundation UK

Jonas Baer-Hoffmann

General Secretary, FIFPRO

Laraine Astle

Widow of Jeff Astle, Former Professional Football Player

Dawn Astle

Co-Founder, The Jeff Astle Foundation

Daughter of Jeff Astle, Former Professional Football Player

Dorice Mottram

Daughter of Jeff Astle, Former Professional Football Player

Claire Astle

Daughter of Jeff Astle, Former Professional Football Player

Rachel Walden

Trustee, The Jeff Astle Foundation

Daughter of Rod Taylor, Former Professional Football Player

Chris Byrant MP

Member of Parliament for Rhondda

John Mousinho

Chairman, Professional Footballers Association

Professional Football Player, Oxford United

Maheta Molango

Chief Executive, Professional Footballers Association

Professional Football Player

Gordon Stringer

Parent of Rowan Stringer

Advocate & Director, Concussion Legacy Foundation Canada

Professor Allyson Pollock

Professor, Newcastle University

Dr Ken Quarrie

Scientist

Dr Alan Pearce

Associate Professor, La Trobe University

Director, Australia Sports Brain Bank

James Drake

Founder, The Drake Foundation

Dr Hilda Hayo

Chief Executive & Chief Admiral Nurse, Dementia UK

Dr Catherine M Suter

Associate Professor

Chief Scientist, Australian Sports Brain Bank

Distinguished Professor Sir Richard Faull KNZM, FRSNZNZ

Director, Centre for Brain Research, University of Auckland, NZ

Dr Michael J Grey

Reader, University of East Anglia

Trustee, United Kingdom Acquired Brain Injury Forum

Chloe Hayward

Executive Director, United Kingdom Acquired Brain Injury Forum

Peter McCabe

CEO, Headway

Dr Thor Stein MD, PhD

Associate Professor of Pathology, Boston University CTE Centre

Professor Robert A. Stern, Ph.D.

Director of Clinical Research & Professor of Neurology, Neurosurgery, and Anatomy & Neurobiology, Boston University

Professor Adam M. Finkel, Sc.D., CIH

Professor

Dr Michael L Alosco, PhD

Associate Professor & Lead Scientist, Boston University CTE Center

Professor Helen Dawes

Professor, University of Exeter

Professor Hana Burianová

Professor of Neuroscience, Bournemouth University

Professor Willie Stewart

Consultant Neuropathologist, Glasgow

Peter Robinson

Father of Benjamin Robinson

Campaigner and Advocate

Nicholas Civetta

Chairman, United States Rugby Players Association

Dr Rory Magrath

Associate Professor, Solent University

Dr Chris Szedlak

Lecturer, Hartpury University

Dr Elisabeth Williams

Senior Lecturer, ​​Swansea University

Professor Gabriele De Luca

Associate Professor & Director of Clinical Neuroscience, University of Oxford

Consultant Neurologist, Oxford University Health Care Trust

Dr Melanie Lang

Reader of Safeguarding and Child Protection in Sport, Edge Hill University

Dr Howard Thomas Hurst

Senior Lecturer in Sport and Nutritional Sciences, University of Central Lancashire

Dr Jonathan Attwood

Academic Clinical Fellow in Neurology, University of Oxford

Dr Jack Hardwicke

Lecturer, University of Northampton

Dr Karen Hind

Associate Professor, Durham University

Andy Ellis

Professional Rugby Union Player

Dr John Batten

Senior Fellow, University of Winchester

Professor Eric Anderson MA, MA, PhD, CPsychol, FAcSS

Professor Sport, Health and Wellbeing, University of Winchester

Stephen Blain Elliotts

Former Professional Football Player

Eamonn Rogers

Former Professional Football Player

Andy Tysoe

Chair, Dementia Transformation Board and PFA Coordinator

Dr Joe Piggin

Senior Lecturer, Loughborough University

Keith R McIntosh

Sporting Memories

Dr Keith Parry

Deputy Head of Department, Bournemouth University

Director of Education Programmes, Concussion Legacy Foundation UK

Christine Gilliver

Wife of Former Professional Football Player

Dr Michelle Miller

Reader, University of Warwick

Dr Jo Batey

University of Winchester

Dr Kathleen Bachynski, PhD, MPH

Assistant Professor of Public Health, Muhlenberg College

Dr Katie Liston

Senior Lecturer, Ulster University

Hana Walker-Brown

Author & Creative Director, Broccoli Productions

Mrs Jean Hague

Wife & Full-time Carer for Former Professional Football Player

Dr Alex Fenton

Head of Centre for Professional and Economic Development, University of Chester

Penny Watson

Campaigner & Independent Consultant

Wife to Former Professional Football Player

Dr Stephen T. Casper PhD

Medical Historian

Joanne Claypole

Daughter-in-law of Former Professional Football Player

Paul Brown

Secretary, United Kingdom Acquired Brain Injury Forum

Partner, Burnetts Solicitors LLP

Professor Lea T. Grinberg

Professor, University of California San Francisco

Professor Martin Roderick

Head of Sport & Exercise Sciences, Durham University

John Stiles

Former Professional Football Player

Son of Nobby Stiles, Former Professional Football Player

Dr Lisa Ryan, BSc PhD RNutr

Head of Department of Sport, Exercise and Nutrition, Atlantic Technological University

Tom Ross

Sports Broadcaster

Dr Izzy Moore

Associate Professor in Human Movement & Sports Medicine, Cardiff Metropolitan University

Dr Chris M. Hanna

Sports Physician, Axis Sports Medicine Specialists

Jonathan Greening

Football Coach

Ben Purkiss

Former Professional Football Player & Former Chairman, Professional Footballers Association

Dr Stuart Whigham

Senior Lecturer, Oxford Brookes University

Steve Jamieson

Chief Executive & General Secretary, Royal College of Podiatry

Trustee, Dementia UK

Dr Simon Phelan

Senior Lecturer, Oxford Brookes University

Kim Worthington

Daughter of Frank Worthington, Former England International Football Player

Adrienne Fearis

Daughter of Tommy Carroll, Republic of Ireland International Football Player

Sarah Moss

Daughter of Ernie Moss, Former Professional Football Player

Gary Whitham

Son of Terry Whitham, Former Professional Football Player

Bonnie Kinnear

Wife of Joe Kinnear, Former Republic of Ireland International Football Player

Chris Gibson

Son of Colin Gibson, Former Professional Football Player

Dickie Davis

Reporter, Sky Sports Soccer Saturday

Kay Bonetti

Widow of former England international Peter Bonetti

Joe Mayo

Former Professional Football Player

Mickey Fudge

Former Professional Football Player

Dennis Clarke

Former Professional Football Player

Paul Peschisolido

Former Canadian International Football Player

Jonathan Greening

Former Professional Football Player and England Under 21 player

Victoria Bailey

Daughter of Mike Bailey, Former Professional Football Player and England International

Andrew Bailey

Son of Mike Bailey, Former Professional Football Player and England International

Chris Sutton

Former Professional Football Player

Pundit & Commentator, BT Sport

Caroline O’Loughlin

Daughter of Frank Wignall, Former Professional Football Player and England International

Dr Samantha Bureau

Assistant Executive Director, Concussion Legacy Foundation Canada

Director of Programmes, Concussion Legacy Foundation

Mrs Maureen Phoenix

Widow of Peter Phoenix, Former Professional Football Player

Mark Phoenix

Son of Peter Phoenix, Former Professional Football Player

David Ali

Chief Executive, Manchester United Family Group

Dr Virginia Newcombe

Emergency Physician, Cambridge

Dr Mae Mansoubi

Research Fellow, University of Exeter

Dana Saul

Daughter of Peter Simpson, Former Professional Football Player

Ann Simpson

Wife of Peter Simpson, Former Professional Football Player

Dr Jeff Brooks

Director of Operations, Concussion Legacy Foundation Canada

Mark Saggers

Presenter, Talk TV

David Serella

Former Professional Football Player

Pat Serella

Wife of David Serella, Former Professional Football Player

Val Mackay

Daughter of Dave Mackay, Former Professional Football Player and Scotland International

Alan Shearer

Former Professional Football Player

Dr Helen Murray

Research Fellow, The University of Auckland

Dr Michael E. Buckland

Director, Australian Sports Brain Bank

Dr Thomas McCabe

Consultant Old Age Psychiatrist, Renfrewshire

University of Glasgow, Honorary Clinical Lecturer

Royal College of Psychiatrists Sport and Exercise Psychiatry

Peter Hutchinson

Professor of Neurosurgery, University of Cambridge

Director of Clinical Research, Royal College of Surgeons of England

Kieran Gill

Journalist

Brian Deane

Former Professional Football Player and England International

Kevin Keegan

Former Professional Football Player

John Hartson

Former Professional Football Player

Tom Watt

Actor

(Oxford, UK) – BT Sport hosted the Concussion Legacy Foundation (CLF)’s Concussion Reporting Workshop PRO in late March, becoming the first sports media outlet in the world to offer the training. The Workshop is part of the CLF Media Project, the first and only concussion education program designed specifically for sports media members.

“Improving our understanding and research into concussion in sport is a subject that I am hugely passionate about, and whilst it is extremely important that we understand the impact in training, in the game and on our bodies, we the sports media can also play our part in ensuring that we report and describe concussion and head impacts correctly, so that our viewers understand what they are seeing on the field and the correct response,” said Ben Kay, Rugby Analyst for BT Sport. “The presentation taught us how to cover the injury while still dealing in facts, something which I would encourage all sports broadcasters to invest their time in learning about.”

CLF presented two Workshop sessions, one to cricket and boxing staff and another for football and rugby personnel. BT Sport producers, reporters, and presenters had the opportunity to ask CLF co-founders Dr. Robert Cantu and Dr. Chris Nowinski questions as they learned the basics of concussion, the dos and don’ts of reporting on concussion, and the importance of concussion reporting to educate hard-to-reach coaches, parents, and athletes.

“The UK is many years behind the US in terms of understanding and dealing with concussion in sport,” said Dr Adam J. White, Executive Director of CLF UK. “It is great that an organisation as influential as BT Sport is taking this step to educate their team on the proper standards for concussion coverage and shows tremendous leadership on responsible reporting. Every concussion on TV is an opportunity to educate, so when a commentator highlights the importance of concussion, it reinforces to every spectator, athlete, kid, and parent why we should be taking concussions seriously.”

CLF launched the Media Project, which includes three parts: a Concussion Reporting Certification for sports media professionals, a Concussion Reporting Workshop for sports journalism students, and the Concussion Reporting Workshop PRO for sports media outlets, in 2018. Sports media veterans J.A. Adande, Bob Costas, Andrea Kremer, and Olivia Stomski helped CLF create the curriculum for the Media Project and serve as advisors for the program. More than 140 sports media professionals are now Concussion Reporting Certified, and the Concussion Reporting Workshop has been taught in 54 classes at 24 schools in the US and UK including St. Mary’s University Twickenham and Bournemouth University.

Sports media outlets interested in offering a Concussion Reporting Workshop PRO to their staffs can learn more here and contact CLF Education Programs Manager Brandon Boyd at [email protected]. Sports media professional interested in becoming Concussion Reporting Certified can take the certification quiz here.
Press Release

Houston Tumlin died by suicide in 2021 at age 28, suffered from PTSD

(Boston) – The family of Houston Tumlin, a decorated U.S. Army Veteran and former child actor, is announcing today that Veterans Affairs-Boston University-Concussion Legacy Foundation (VA-BU-CLF) Brain Bank researchers diagnosed the Talladega Nights star with stage 1 chronic traumatic encephalopathy (CTE). Tumlin died by suicide in March 2021 at the age of 28. Tumlin’s family is releasing the findings of his brain study to help raise awareness of CTE in the military community and encourage Veterans to support CLF’s Project Enlist by signing up to donate their brain to research.

“My son was always confident and talented, but the last year of his life he lost his spark and drive,” said Michelle Tumlin, Houston’s mother. “My heart stopped when I realized he had all the symptoms of CTE, and now I’m determined to keep his memory alive by educating the world about the brain injuries our Veterans are suffering with and I will never stop trying to find ways to support them.”

Houston Tumlin, a former child actor and model, is remembered for his humor in the role of Walker Bobby, the oldest son of Will Ferrell’s character in Talladega Nights: The Ballad of Ricky Bobby.

Tumlin began playing tackle football when he was six years old. He suffered several concussions throughout his middle and high school playing days in Pell City, AL which led to lifelong headaches. In 2014, Tumlin enlisted in the U.S. Army where he served in the 101st Airborne Division at Fort Campbell. Tumlin was most proud of serving his country and earning his Air Assault Badge. He was awarded the Army Achievement Medal and the Army Commendation Medal, before leaving the military in 2019. When he returned home, Michelle Tumlin says her son was depressed, struggled with mood swings, anger issues, and night terrors.

“Although we continue to find CTE in the brains of young amateur athletes and military servicemembers, we will never get used to it,” said Dr. Ann McKee, chief of neuropathology for the VA Boston Healthcare System and director of the BU CTE Center and VA-BU-CLF Brain Bank. “We will never stop our efforts to find ways to prevent this preventable disease and to diagnose and treat CTE during life. Our thoughts and prayers remain with Houston’s family.”

The Department of Defense has reported more than 430,000 traumatic brain injuries among servicemembers in the last 20 years. Veterans who have suffered a concussion have double the risk of suicide.

CLF’s Project Enlist is working to accelerate finding answers to CTE and prevent suicide by encouraging Veterans and their families to donate the brains of deceased servicemembers to the VA-BU-CLF Brain Bank.

The VA-BU-CLF Brain Bank has studied more than 700 football players, and the majority of them have been diagnosed with CTE. Many Veterans, like Tumlin, are former contact sport athletes. Researchers are concerned former contact sport athletes who may already have CTE or increased CTE risk who go on to serve in the military, receive additional head impact exposure, and develop PTSD, may have a heightened risk for worse clinical outcomes.

“We are grateful to the Tumlin family for speaking publicly about Houston’s diagnosis and struggles,” said Dr. Chris Nowinski, CLF co-founder and CEO. “Houston is one of now multiple former football players who went on to serve in the military and receive a clinical diagnosis of PTSD before dying by suicide. We need better answers for Veterans and their families and brain bank research is an essential step in understanding the perfect storm of TBI, CTE and PTSD so we can protect and support the heroes who courageously fight for our nation.”

The Tumlin family has created a chartable organization, Houston Project, Inc. in Houston’s name to deliver hope to hurting Veterans.

The Concussion Legacy Foundation encourages all active servicemembers and Veterans to pledge to donate their brain to Project Enlist to advance research at ProjectEnlist.org.

Poll: Americans are worried about CTE, want NFL to stop recruiting children to tackle football

71% of Americans believe it is inappropriate for the NFL to recruit children to tackle football

(Boston) – A new national poll conducted by the Samford University Center for Sports Analytics in collaboration with the Concussion Legacy Foundation (CLF) found that because of CTE concerns, 71% of the 1,311 Americans polled believe it is inappropriate for the NFL to recruit children to tackle football.

According to official funding announcements, the NFL has spent more than $100 million to recruit children to youth tackle football since 2000, and the Super Bowl often features advertisements focused on recruiting children and their parents through brands like NFL Play Football.

“When he started playing tackle football in fourth grade his dream was the NFL,” said Greg Tuerk, father of former NFL and USC offensive lineman Max Tuerk, who died in 2020 at age 26 after struggling with severe mental health challenges. “He was so proud to achieve that dream, but we believe it cost him his mental health.”

After his death, researchers at the Veterans Affairs-Boston University-Concussion Legacy Foundation (VA-BU-CLF) Brain Bank diagnosed Tuerk with stage 1 CTE.

“To all my former colleagues at the NFL: please stop recruiting young children to play tackle football,” said Pro Football Hall of Fame member Mike Haynes, also a former NFL Vice President of Player and Employee Development. “If children wait until age 15 to play tackle football like I did, future football players will have a dramatically lower risk of CTE and will lose nothing in terms of developing the skills that could one day provide them a career playing professional football. It’s the right thing to do.”

The poll also revealed that 69% of former tackle football players, and 77% of Americans overall, support state governments banning tackle football for children before age 12. Since 2018, bills have been introduced in Illinois, New York, New Jersey, Maryland, Massachusetts, and California to ban youth tackle football, but none have yet succeeded.

A 2019 study of 266 deceased former football players from the VA-BU-CLF Brain Bank found the more years one plays football, the greater their odds of developing CTE. Odds increase by 30% per year played, meaning they double every 2.5 years. As of 2021, sixteen of the first 65 high school football players studied at the Brain Bank have been diagnosed with CTE.

More Americans than ever are now worried about CTE in football. 93% of those surveyed believe CTE is “certainly or probably” a serious public health issue. That number has increased from 87% in a prior poll conducted in 2016.

Other findings include:

• 72% of Americans believe tackle football should not be introduced until at least age 14.
• Respondents were concerned about informed consent for children. 77% of respondents believed NFL players are “well-educated on the long-term risks associated with repeated head trauma, such as CTE.” However, that number drops to 41% for high-school football players and 27% of youth football players.

Those surveyed agreed it is primarily the responsibility of parents to ensure children are protected from CTE, yet only 31% agree that parents are well-educated on the risk of CTE. The family of Max Tuerk wants to make educating parents across the country a priority.

“Now that the risks are well documented and we know the potential consequences, we need to educate parents about the risks associated with playing tackle football before high school,” said Greg Tuerk.

The poll of 1,311 American adults was conducted by the Center for Sports Analytics at Samford University. The Concussion Legacy Foundation assisted in developing the questions and provided funding support. Participants for the study were selected by conducting a random and demographically balanced sample of adults in the United States. Qualtrics was used to develop and administer the poll. Data collection began in September 2020 and continued for one year. More information on the poll methodology and polling data are available here.

About The Center for Sports Analytics at Samford University:

The Center for Sports Analytics at Samford University promotes the ethically centered, rational inquiry into issues at the burgeoning intersection of big data, analytics, and sports. It seeks to be an international thought leader in the emerging field of sports analytics by providing a forum for industry professionals and students to learn about the increasing role of analytics in the global sports industry. The center’s mission encompasses all areas where analytics impacts sports, including fan engagement, sponsorship, player tracking, sports medicine, sports media and operations.

(Boston) – The family of Vincent Jackson is announcing today that VA-BU-CLF Brain Bank researchers diagnosed the former NFL wide receiver with stage 2 chronic traumatic encephalopathy (CTE). Jackson passed away in February 2021 at age 38. Jackson’s family is releasing the findings of his brain study to help raise awareness for CTE and its risks.

“Vincent dedicated so much of his life to helping others. Even in his passing, I know he would want to continue that same legacy,” said Lindsey Jackson, Vincent’s widow. “By donating his brain to the VA-BU-CLF Brain Bank, we hope to continue to see advancements in CTE research, enabling physicians to diagnose the disease in the living and ultimately find treatment options in the future. There is still a lot to be understood about CTE, and education is the key to prevention. The conversation around this topic needs to be more prevalent, and our family hopes that others will feel comfortable and supported when talking about CTE moving forward.”

Lindsey Jackson supports prevention efforts like CLF’s Flag Football Under 14 program, which urges parents to wait to enroll their children in tackle football until age 14. According to a Boston University study, a football player’s odds of developing CTE may increase by as much as 30% per year played. Jackson played 23 years of tackle football, beginning at age 12. He retired in 2018 after 12 seasons in the NFL where he reached three Pro Bowls with the San Diego Chargers and the Tampa Bay Buccaneers.

CTE is a progressive degenerative brain disease caused by repetitive head trauma. Stage 2 CTE is associated with behavioral symptoms like aggression, impulsivity, depression, anxiety, paranoia, substance abuse, and suicidal ideation, along with progressive cognitive symptoms. Stage 4 is the most severe stage and is usually associated with dementia.

“Vincent Jackson was a brilliant, disciplined, gentle giant whose life began to change in his mid-30s. He became depressed, with progressive memory loss, problem solving difficulties, paranoia, and eventually extreme social isolation,” said Dr. Ann McKee, chief of neuropathology for the VA Boston Healthcare System and director of the BU CTE Center and VA-BU-CLF Brain Bank. “That his brain showed stage 2 CTE should no longer surprise us; these results have become commonplace. What is surprising is that so many football players have died with CTE and so little is being done to make football, at all levels, safer by limiting the number of repetitive subconcussive hits. CTE will not disappear by ignoring it, we need to actively address the risk that football poses to brain health and to support the players who are struggling.”

Jackson was known for his kindness and generosity. He was the Buccaneers’ nominee for the Walter Payton Man of the Year award four of the five years he was there.

“We thank the Jackson family for supporting CTE research after such a terrible tragedy,” said Chris Nowinski, PhD, CLF CEO and co-founder and a former football player at Harvard. “More than 300 NFL players have been diagnosed with CTE. I hope current and former NFL players of Mr. Jackson’s generation see this as a wake-up call and get off the sideline in the fight against CTE. If a four-time Walter Payton Man of the Year nominee who never had a diagnosed concussion can lose his fight against CTE at just 38, it can happen to anyone.”

Asking for privacy, the Jackson family will have no further comment and will not be speaking with media under any circumstances.

Former and current NFL players and their families worried about possible CTE symptoms can reach out to the CLF HelpLine for support. The HelpLine staff provides personalized resources and recommendations for treatment.

Adams, 32, died by suicide during a standoff with police in Rock Hill, South Carolina

(Boston) – Neuropathologists at the Boston University CTE Center have found that former NFL player Phillip Adams had stage 2 chronic traumatic encephalopathy (CTE). Adams died by suicide at age 32 in April 2021 after fatally shooting six people in Rock Hill, SC.

York County, SC, coroner Sabrina Gast facilitated the brain donation to the VA-BU-CLF Brain Bank and BU CTE researchers conducted a post-mortem study of his brain. CLF is releasing the findings upon request from the Adams family, who hope going public with the diagnosis will prevent other families from experiencing similar tragedies.

“As we process these results, we are deeply saddened by the events that occurred on April 7 and we continue to pray for the families of the victims,” the family of Phillip Adams said in a statement. “We are pleased to have a better understanding of the mental turmoil that Phillip was dealing with during the last moments of his life. We cannot say that we are surprised by these results, however it is shocking to hear how severe his condition was.”

CTE is a progressive degenerative brain disease caused by repetitive head trauma, and CTE stage is most closely associated with age of death. Most football players diagnosed with CTE in their 30s have stage 2 CTE. Stage 4 is the most severe stage and is usually associated with dementia.

CTE has been associated with behavioral symptoms like aggression, impulsivity, explosivity, depression, anxiety, paranoia, and suicidal ideation, along with progressive cognitive symptoms.

“Phillip Adams had an extraordinary amount of CTE pathology in the frontal lobe, the area of the brain behind the forehead. Frontal lobe damage is associated with violent, impulsive or explosive behavior, a “short fuse,” and lack of self-control,” said Dr. Ann McKee, chief of neuropathology for the VA Boston Healthcare System and director of the BU CTE Center and VA-BU-CLF Brain Bank. “His CTE pathology might have contributed to his abnormal behaviors, in addition to other physical, psychiatric and psychosocial factors. His predominantly frontal lobe CTE pathology, which resulted in atrophy, or shrinkage, of the brain, was similar in severity to Aaron Hernandez.”

According to a previous study of CTE in football players by the same research team, a football player’s odds of developing CTE may increase by as much as 30% per year played. Adams played 21 years of tackle football, beginning at age 7. He retired in 2016 after six seasons in the NFL.

“All behavior originates in the brain, and the discovery of the brain disease CTE in Phillip Adams should serve as an urgent call to action to better understand this historically neglected disease,” said Chris Nowinski, PhD, CLF CEO and co-founder. “The idea that playing a sport Adams first enrolled in at seven years old could be the inciting factor leading to six innocent people dying, along with Adams, is a hypothesis we need to explore as we try to prevent these senseless tragedies in the future.”

Full statement from the family of Phillip Adams:

As we process these results, we are deeply saddened by the events that occurred on April 7 and we continue to pray for the families of the victims. We are pleased to have a better understanding of the mental turmoil that Phillip was dealing with during the last moments of his life. We cannot say that we are surprised by these results, however it is shocking to hear how severe his condition was. After going through medical records from his football career, we do know that he was desperately seeking help from the NFL but was denied all claims due to his inability to remember things and to handle seemingly simple tasks such as traveling hours away to see doctors and going through extensive evaluations. We now know that these deficits were most likely caused by the disease. By participating in the research process, we hope to bring awareness to this condition so that players young and old can understand the risks. We will continue to advocate for any research that can prevent any other families from having to endure this type of tragedy. We want people to understand that this could happen to anyone. Phillip is not the first to battle with this disease and he will not be the last. Thank you so much to Boston University, the Concussion Legacy Foundation, the VA, and all of the folks that have helped us and many other families to get these much-needed answers.

Asking for privacy, the Adams family will have no further comment and will not be speaking with media about Phillip’s CTE diagnosis.

Former and current NFL players and their families worried about possible CTE symptoms can reach out to the CLF HelpLine for support. The HelpLine staff provides personalized resources and recommendations for treatment.