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Recently the bestselling author Malcolm Gladwell gave a key note address at The University of Pennsylvania on the subject of proof and more concisely how much proof is required before the need to act. The talk descended into controversy when he suggested that College (and High School) Football should be banned and that the students at Penn should boycott their games. Gladwell shot to fame with his book Outliers and his championing of The 10,000 Hour Rule which states that in order to become elite at any pursuit, you need to do 10,000 hours of meaningful practice. Gladwell has a huge reputation as an academic and when he speaks people listen. What he had to say at Penn was controversial and indeed very brave, considering Penns heritage as a college football power house. What Gladwell was speaking about was not new, but his consideration of the banning of football was what many had secretly feared as unlikely but maybe just possible. Chronic Traumatic Encephalopathy (C.T.E.) is the build up of a protein called tau which is found in the brain tissues of people who exhibit neurodegenerative disorders such as Alzheimers. Head injury is the cause of C.T.E. and is a progressive process caused by repeated head trauma such as concussion. Repeated concussions and injuries less serious than concussions ("sub-concussions") incurring during the play of contact sports over a long period can also result in C.T.E. The brain floats in fluid and is tethered at the bottom of the brain stem and spinal cord. During a collision the skull stops but the brain keeps moving to the point it snaps back stretching the nerve bundles or white matter in the brain. In American football the helmet is used as a battering ram resulting in at least a 1,000 sub- concussions a year for the average N.F.L.

player. This is quite apart from the traumatic big hits in the normal state of play. Add this to the hits taken in practice and it is no wonder that numerous footballers in recent time have taken their own lives as a result of depression caused by C.T.E. When analysed under autopsy, 40 year old brains of players who have taken their own life have resembled the brains of 85 year olds with Alzheimers. Players have taken their own lives such as drinking anti freeze, shooting themselves in the heart instead of the head (while leaving a note to his ex wife to make sure his brain is donated to the N.F.L. Brain Bank) and driving their car into a tanker truck. Skull injuries are not new in football. At the turn of the 20th Century, football had become so violent that in 1905, eighteen people had died on the field of play that year. It would take the intervention of President Teddy Roosevelt who summoned a number of coaches to the White House to discuss the future of the game and to turn the tide of public opinion which had become alarmed at the brutality of the sport. The forward pass was the result of these discussions which opened up the game and de-militarised it. This would eventually have repercussions for the modern game which has become faster and faster with bigger and bigger players making more bone crunching hits year after year. Of course there are those who say football is hazardous to your health just the same as cigarettes are hazardous to your health. And that taking violence out of football would be analogous to banning beer for Australians or guns for Americans. Of course the banning of football if it will happen is not going to happen anytime soon, but it may be a slow painful death. What is now known is that N.F.L players are five to nineteen times more likely than the general population to succumb to a dementia

related diagnosis, that the helmet manufacturers are overseen by a voluntary group funded mainly by helmet manufacturers and that Lou Gehrig didnt die by the disease that bears his name but by a concussion related trauma. One Chicago Bears champion relates that his memory is pretty much gone and often walks into a room without knowing why. Another player admitted Im always concussed; they just caught me this week. The figures are indeed alarming. Between 1982 and 2009, there were 295 fatalities directly or indirectly from high school football. From 1977 to 2009 in all levels of football there were 307 cervical cord injuries. And between 1984 and 2009 there were 133 occurrences of brain damage. And this was not slow related concussive damage but damage on impact. The N.F.Ls response to all of this has been interesting and predictable. They have shifted through the four states of reaction to any troubling issues that presents a threat to their existence: Active resistance to passive resistance followed by passive acceptance and finally active acceptance. While they have started to crack down on big hits with massive fines they have done themselves no favours by promoting breast cancer awareness every October especially when one considers an average of ten players in every week are concussed by bone crunching hits, all the while the victims and offenders are wearing pink gloves, chin straps and cleats to highlight the cause. Another embarrassing incident was making available for sale the photograph of a player flattening his victim on the NFL web site. The player in question had made the comment post game in the locker room that I try to hurt people. Maybe Harvey Norman and Bunnings should look at their sponsorship of Rugbys Big Hits that have been running on Australian television for a number of years.

Some teams such as the Pittsburgh Steelers have employed a neurosurgeon on the sidelines. The N.F.L. have instituted the Head, Neck and Spine committee which looks at such issues as Finite element modelling in determining concussion thresholds and Onfield testing of impact biomechanics. However the prospect of a concussion proof helmet is likely to never eventuate, at least any time soon. But what of other sports? Ice Hockey has a higher incidence of concussion than football. Even the sport of Soccer will in the future come under increased scrutiny because of the g-forces in the act of a header simulate that of a minor car crash. It is not beyond the realms of possibility that players in the future will be required to wear a soft form of headgear. The way this issue could play out is that the courts will decide the future of football, not just American football, but Rugby and Australian football. Already there is a class action of 4,000 players and wives who charge the N.F.L. as being negligent in deliberately covering up that repeated hard hits resulting in concussion can lead to long tern effects on the brain. They are being represented by the top plaintiff lawyer in the United States and who was involved in the class action against asbestos in the 1970s. It will be difficult for the N.F.L. to defend these accusations because as far back as 1994 they had set up a committee to study the effects of concussion on the brain. In the early years of the committee most of the effort was to deny the dangers of concussion rather than investigate it. However the consensus is that there will be a settlement in the billions that will be payed out over time while further research and ways to alleviate the problem are worked through. Of course players considering a career in football cannot be part of any future action as they now know the risks.

The question that remains is that now the risks are known what is the future of football and indeed other sports such as ice hockey, rugby and Australian Rules football? Will the alarming research result in fewer players wanting to play the game(s)? What influence will parents have in the childrens formative years? What ways can the rules be changed to make the game safer, or will that completely take the soul from the game? Is there a future for technology to make the game safer with better helmets and the like? Will the insurance premiums payed by high schools, colleges and N.F.L. teams become prohibitive? Will the public tire of the violence over time and the game become irrelevant much the same way as boxing has? My guess is that American football is so much part of the psyche of the country that much the same as guns are seen as part of their rights that to ban football will never happen. Indeed there are forces at work spearheaded by shock jocks such Rush Limbaugh that the banning of football would spiral into a racial debate. Three quarters of the NFL players are black and the majority of the teams are owned by rich white guys. Extreme right wing voices will turn this into a lefty plot which is pointing to the white owners using the black players to their own ends despite the risks. Whatever the outcomes for American football, the A.F.L. must be vigilant. Already they have changed rules which are designed to make the head sacrosanct. While the A.F.L. does not have the problem of sub-concussions hits through the use of the helmet as a battering ram, it does have the big hits that have reached a point of violence unseen in the past as the pace of the game becomes a dizzying spectacle that at times is breathtaking. Again the A.F.L. has attempted to slow the pace of the game but the big hits will always occur while players such as Jonathan Brown and Joel Selwood grace the field. Indeed the A.F.L. players vote on their peers for the most

courageous player in the League. In other words, the player who is most likely to risk skull fractures and more likely concussion and the eventual possibility of C.T.E. in later life. Malcolm Gladwells brave key note address at Penn University may have been a wakeup call to all football codes. This was probably the first person who had the gumption to actually call for the banning or at the very least the boycotting of an American institution. It must be remembered that the American college system relies on the receipts of their football teams where some stadiums regularly accommodate week after week more fans than the A.F.L grand final. While Gladwell didnt call for the banning of the N.F.L; as grown men should be allowed to decide their fate, the banning of high school and college football would surely kill N.F.L. as these institutions are the feeder apparatus to the N.F.L. This was a stark flaw to his argument. However his speech has certainly made an impact. What impact will be fascinating to watch over the years as to how the issue of C.T.E. will be handled by the N.F.L, the A.F.L. and other football codes around the world? The end of football? Somehow I doubt it!