Brain injuries hit young, fit, strong, amateur and professional

Australian dementia specialists are seeing younger, fitter and stronger former sports people seeking full-time care as years of head trauma take their disturbing toll.

Brain Bank founder and former wrestler Chris Nowinski Picture: Getty Images

Australian dementia specialists are seeing younger, fitter and stronger former sports people seeking full-time care as years of head trauma take their disturbing toll.

The experts say the problem is only expected to increase as those who lived through an era of increasing professionalism and earlier recruitment begin to suffer the awful consequences of repeated head knocks. The sooner you start and the longer you play contact sports, the younger you find yourself in an institution.

Australian rules footballers Danny Frawley, Shane Tuck and Graham “Polly” Farmer along with rugby league’s Steve Folkes are the high-profile athletes whose tragic ends were in some way attributed to the cumulative toll of repeated brain injuries caused by CTE, or were found to have had it post-mortem.

However, in the community there are increasing reports of ­patients showing symptoms who played either amateur or professional sport.

It is not so much the level of sport that was played but how often it was played.

Angela Raguz, the general manager of the HammondCare Dementia Centre, says there is a clear pattern emerging of a younger demographic with sporting backgrounds needing full-time treatment.

For health care and families, the complexity of dealing with brain injuries in stronger patients can be traumatic. Raguz says these people do not always fit the gentle, confused stereotype of the elderly Alzheimers patient and violence is a common problem.

“It is incredibly traumatic for people when unprovoked aggression becomes part of a person’s story because they used to do it as a sport,” Raguz said.

“It is not that they are angry, it is the reaction that comes with that brain injury.”

She likens it to a muscle memory. A rising concern among the health experts is sporting codes treating concussion protocols as the magic wand to guard themselves against criticism or legal challenges when studies show it is not how hard people are being hit but how often.

Forget concussion. The more often you tackle, the more rounds of boxing you participate in, the more times you head the soccer ball … the more likely you are to suffer permanent brain damage and tragic decline.

Concussion, one expert says, is that cigar you smoke once a month. It’s big and it is bad for you, but it’s the pack of cigarettes every day that are the real worry.

In America, trauma expert Chris Nowinski and the foundation he is part of are examining the brain of his former college roommate Chris Eitzmann, a Harvard football captain who went on to share a house with Tom Brady when drafted to the Patriots in the NFL and then to graduate with an Ivy league degree when football didn’t work out.

In March this year, Eitzmann died of an alcohol-related disorder, leaving behind four children and a wife who donated the brain to the Boston University VTE Centre, which Nowinski established, to ascertain what had happened to her husband.

“It’s getting too close to home,” Nowinski told The Weekend Australian. He knows one day someone will be looking at his brain.

Also a Harvard graduate, Nowinski “found sitting at a desk for 80 hours a week selling your game to the highest bidder in the consulting world” boring. The strongly built athlete took up professional wrestling and made the WWE under the name Chris Harvard.

Nowinski, who was also a college footballer, was forced to quit wrestling after a series of concussions left him unable to continue and unwilling to do so if he could.

Alarmed by his own condition, he set out to discover all he could about head trauma and his 2006 book Head Games: Football’s Concussion Crisis sent “shockwaves through the National Football League”, according to Lancet.

He went on to earn a PhD in Behavioural Neuroscience and in 2007 he co-founded the Concussion Legacy Foundation.

  “I have been a guinea pig for some of our studies and unfortunately the more we learn the more it appears I have CTE, but we can’t confirm it while I’m alive.

“Recently one of the doctors looked at an MRI I had taken years ago and it had all the telltale signs we’ve learned are associated with CTE.”

Chronic Traumatic Encephalopathy (CTE) caused by head injuries can only be diagnosed after death.

It is getting too close to home for former Australian sporting stars and even those who never rose above the amateur ranks.

In February this year, the Australian Sport Brain Bank published a paper in the Medical Journal of Australia detailing what it had found in 21 completed donations since establishment in 2018.

“All 21 donors had participated in sports with risks of repetitive head injury, including 17 who had played in the football codes,” the authors wrote. “All but one donor exhibited some form of neurodegeneration.”

More than half were discovered to have been suffering CTE and half of those had died at their own hand.

Professor Michael Buckland, founder of the Australian Sports Brain Bank and RPA head of neuropathology, says concussion protocols may help those who are concussed, but they are not going to head off the growing prevalence of CTE in sports people.

“All the evidence to date says this is from a cumulative lifetime exposure to mild traumatic brain injury,” he said

“It is probable the concussions contribute a lot less than the sub concussive hits because you tend to get a lot less and you are quite often forced now to stop and rest with concussions but it is the repetitive hits.

“It’s a bit of a furphy and to be honest we knew this in 2017 and 2019 when the Concussion in Sport Group published their recommendations and when the Australian Institute of Sport updated their recommendations.

“We knew it wasn’t just concussions then, it was sub concussion, but it is almost ignored and it is like there’s a deliberate focus on concussions that lets the codes come back and say ‘we follow international best practice concussion protocols’.”

Nowinski, who helped set up the Australian brain bank, agrees.

“Now we know there is no correlation between how many concussions you have and your odds of developing CTE,” he said.

“It is much closer related to how many hits you’ve taken and how hard they were, and you ­usually have to be hit thousands of times to be at risk for CTE.”

The American expert is a key speaker at the International Dementia Conference run by HammondCare’s Dementia Centre in Sydney on September 8-9.

Nowinski says Raguz’s observations about younger patients presenting with severe dementia is another sign of the growing toll contact sports have on the brain.

“They are the canary in the coal mine,” he said. “They are the first ones who are going to see in greater numbers middle-aged or relatively young former athletes with dementia. Historically, this issue is hidden because there’s no reason to talk about when a person develops dementia at 60. You didn’t want to change their reputation and their legacy.

“Even in America the NFL used to say they weren’t aware of any former players with dementia but when they launched a fund for families with dementia, 200 families signed up within the first few months.”