Why Sports Don't Need Concussions To Destroy Players' Brains

CTE. Scourge of the human brain. Recent cause célèbre that confirms that, no, evolution didn't design our heads to be beaten in repeatedly for 15 years. It's coming for our athletes one by one, whether or not they put themselves in harm's way.

It was announced that Rick Martin, famously of the Sabres' French Connection line, was living with chronic traumatic encephalopathy (CTE) when he died earlier this year. The news came, as all CTE news does these days, from the Boston University researchers and VA "Brain Bank" that's stockpiling the brains of deceased athletes and studying them for signs of trauma. As would be expected from men whose jobs of choice necessarily involve head traumas, seemingly every month a new athlete is confirmed to have had the disease. The frequency and quantity of new names doesn't make it any less sad, but it does run the risk of losing potency.

Ever-media savvy (BU's pointman is Chris Nowinski, accessible and charismatic former football player and professional wrestler), they sent out the release announcing Martin's CTE yesterday afternoon at 3, embargoed until 9. This gave outlets plenty of time to report and write the story, and have it ready to go for prime time news and this morning's papers. The hook, for a public numbed to new cases, is that Martin is the first hockey player diagnosed with CTE who wasn't an enforcer.

"Rick Martin's case shows us that even hockey players who don't engage in fighting are at risk for CTE, likely because of the repetitive brain trauma players receive throughout their career," said BU CSTE Co-Director and SLI Co-founder and CEO Chris Nowinski.

Yet it's almost inaccurate to say that Martin "suffered" from CTE, because he didn't suffer at all. The BU news release states that Martin was in stage 2 (out of 4) of the disease, "a stage unlikely to significantly affect his cognitive abilities or behavior." He died of a heart attack, without ever being affected by the typical dementia and motor-neuron symptoms found in more severe CTE patients. That's because Martin never received the most severe blows to the head that we associated with CTE. Despite not wearing a helmet, he only received one concussion in his career. A horrible one to be sure—his head struck the ice and he went into immediate convulsions—but a one-off deal, nothing like Bob Probert and Reggie Fleming whose CTE diagnoses came from thousands of fists to the head in their playing days.

The BU release barely mentions concussions, a necessary but interesting tack. For now, CTE is untreatable (and undiagnosable while alive), so concussions naturally take the fore. We can do something about concussions. Player safety mandates are the safe sex education to CTE's HIV. But beyond helmet as prophylactic, there's little that could have been done to spare Rick Martin's brain, and that's what makes this case so telling and depressing.

CTE is a degenerative disease, a slow breakdown rather than a sudden-onset trauma. It's characterized by progressive disintegration of brian tissue, and a buildup of a certain protein—two results caused only by repeated head traumas. Were you to be struck by an anvil tomorrow, you wouldn't develop CTE. But were you to play hockey for a decade, or football, or boxing, or even a no-contact sport like baseball, you'd be at risk. Even if you never had one concussion.

Dr. Bennet Omalu is a forensic pathologist at the Brain Injury Research Institute, working separately from Nowinski and Ann McKee in Boston. He points not to concussions, but to the undetected and insidious litany of so-called sub-concussions: blows not severe enough to register at the time. Trauma doesn't have to be traumatic.

"For every documented concussion there are hundreds of impacts to the head called sub-concussions," said Omalu. "Players wouldn't have immediate functional impairment with sub-concussions."

Omalu calls these blows "unavoidable," and there's the rub. The very natures of our sports make them impossible to prevent. Safer helmets, fines for headhunting, all these things are wonderful. But unless pass rushes are reduced to counting to three-Mississippi, or body checks are outlawed, there's little we can do. Put it this way: Sidney Crosby's concussion that's left him unable to play these past nine months actually saved him the constant barrage of minor hits that his healthy teammates have accumulated. It's not beyond the pale to believe that Crosby's concussion has extended his life span.

So there's nothing we can do, despite the calls for safety brought down by successive Brain Bank findings. It sounds hopeless. It's not. CTE has only been named and studied for a decade or so, and we still know very little about the disease. The name of the game right now is identification and research, but someday it will be about looking for a cure. Professional sports aren't going to fundamentally change the way they're played, so we're going to have to accept that some-to-most of our athletes are going to have rotting brains (even if the effects are minor, like with Rick Martin). Thanks to doctors like Omalu and McKee, there's hope that we'll be able to do something for the athletes after they play and before it's too late.