Tyler Sash (Giants safety) - dead; CTE at age 27

[dave mcbride]

 

This is one of those cases that has me say "there must be more to this CTE thing".

 

This kid was relatively low mileage as a football player. He had serious injuries, and was apparently medicating heavily with pain-killers and self-medicating for the pain. He couldn't sleep.

 

There are plenty of guys who have much longer careers, play in more games, also sustain injuries, and if they do develop problems, only much much later in life.

 

I had the pleasure of seeing Bo Eason's 1 man show "Runt of the Litter" a couple years ago (funny! and moving). This would be a guy who had a similar career to Tyler Sash - started playing football young, played his a** off as the brother of a star and from a football family, played in college, played 4 years (36 games) in the NFL, suffered multiple serious knee injuries that finally ended his career. In his day he was noted for being a hard hitter (kind of dirty guy) and I don't believe spearing was illegal then (?84-87) so I'm guessing he went helmet-first into a lot of guys.

 

He's 54 now and making a living as an actor, playwright, and speaker. Nothing wrong with his focus, speaking ability, and so on.

 

Is it some combination of playing years, playing style, specific medication, medication interactions, lifestyle?

 

Certainly if I was a family member of a former player with symptoms like inability to focus, personality change, inability to sleep, I would want him worked up for CTE.

Well, he was a hard hitting safety throughout his career, and that position seems to be over-represented in the stats (Duerson and others). He also appears to have been absolutely clobbered in one of those concussions. 16 years of doing that sort of thing adds up.

[DC Tom]

 

This is one of those cases that has me say "there must be more to this CTE thing".

 

This kid was relatively low mileage as a football player. He had serious injuries, and was apparently medicating heavily with pain-killers and self-medicating for them. He couldn't sleep.

There are plenty of guys who have much longer careers, play in more games, also sustain injuries, and if they do develop problems, only much much later in life. I had the pleasure of seeing Bo Eason's 1 man show "Runt of the Litter" a couple years ago (funny! and moving). This would be a guy who had a similar career to Tyler Sash - started playing football young, played in college, played 4 years (36 games) in the NFL, suffered multiple serious knee injuries that finally ended his career. In his day he was noted for being a hard hitter and I don't believe spearing was illegal then (?84-87) so I'm guessing he went helmet-first into a lot of guys.

 

He's 54 now and making a living as an actor, playwright, and speaker. Nothing wrong with his focus, speaking ability, and so on.

 

Is it some combination of playing years, playing style, specific medication, medication interactions, lifestyle?

 

Certainly if I was a family member of a former player with symptoms like inability to focus, personality change, inability to sleep, I would want him worked up for CTE.

 

A lot of it probably comes down to individual variation. Sash probably had some sort of genetic or biochemical makeup that we don't know about that made him susceptible to CTE. Maybe the subarachnoid space in his skull was just slightly smaller than normal, leading to greater susceptibility to sub-concussive trauma. Hell, for all we know, he just read one too many Bucky Gleason editorials.

 

There's simply a hell of a lot we don't know - we really don't know how CTE occurs, just that it correlates with repeated sub-concussive and concussive trauma.

[eball]

Relegating everything to pay per view was instrumental in transforming boxing from a mass sport into a cult sport.

 

 

MMA is more popular than boxing

 

 

This ^ Boxing certainly didn't decrease in popularity due to health concerns such as CTE. MMA has basically taken over the role boxing once had. The popularity of the MMA definitely proves that safety had nothing to do with the fall of boxing.

 

I was just about to post something similar, DriveFor1Outta5, but you beat me to the punch -- no pun intended.

 

I'll be surprised to see any significant drop in football participation in this country in our lifetimes.

[GG]

 

A lot of it probably comes down to individual variation. Sash probably had some sort of genetic or biochemical makeup that we don't know about that made him susceptible to CTE. Maybe the subarachnoid space in his skull was just slightly smaller than normal, leading to greater susceptibility to sub-concussive trauma. Hell, for all we know, he just read one too many Bucky Gleason editorials.

 

There's simply a hell of a lot we don't know - we really don't know how CTE occurs, just that it correlates with repeated sub-concussive and concussive trauma.

 

There's not a lot of talk about contributing factors outside of repeated head hits.

 

It's unusual to me that a large number of players being diagnosed came into the league from late '70 through now. A time series analysis of players of different decades is necessary to distinguish if other factors are involved. Football has been around for over a century, and if repeated head hits were the primary factors, there would be a lot more football suicides in each succeeding decade after a player's retirement. But I don't think that's been the case. Maybe our resident football historian can shed some light on this.

 

I'm going purely on guilt by association, but I think that the increased steroid & other hormone use by players starting in the '70s is the missing link between a violent contact sport and CTE.

[yungmack]

Outside of the South and Texas, I strongly believe that this is already happening.

Texas is experiencing a significant decline in Pop Warner and interscholastic participation. I heard it on a radio program so I can't give you a link but I'm sure the stats are available online.

[K D]

I don't think football will lose athletes to other sports. What are the alternatives? There can only be so many basketball players and the ones that make it are usually 6'6" and taller so if you aren't born into it then you have a better shot at winning the lottery. Baseball is no longer the National past time with the majority of the players coming from other countries. Hockey is too expensive to get into so that cuts out almost all of the inner city athletes. Soccer is boring. Tennis and golf are for old men.

 

Football is still their best shot at a scholarship and maybe more. It's the most popular sport in America and it's a way of life down south where there are not any other sporting events in town. CTE or not, football will continue to be the #1 sport so our best hope is to figure out how to make it safer (better helmets!)

Texas is experiencing a significant decline in Pop Warner and interscholastic participation. I heard it on a radio program so I can't give you a link but I'm sure the stats are available online.

 

I would argue that all sports are seeing a decline. Kids these days would rather play video games than go outside. But for true athletes, I think they will still be drawn to football

[Mango]

The NFL defender an effort by BU to figure out a way for CTE to be diagnosed in live patients. However the league wanted control of the results, which BU wouldn't provide.

 

Why?

 

Because diagnosing CTE is a huge risk for football. Imagine diagnosing a couple of kids at your local HS in anywhere USA. That team and school district caries insurance in order to have that team. Given a diagnosis of head injury across players on the roster would make it nearly impossible to continue to afford having that team. Colleges outside of the big time football programs, like SUNY, will no longer be able to afford having a a football team for the same reasons. The NFL will lose it's pool of athletes over time and will eventually be less viable.

[BobbyC81]

Who has seen the movie Concussion?

[dave mcbride]

I don't think football will lose athletes to other sports. What are the alternatives? There can only be so many basketball players and the ones that make it are usually 6'6" and taller so if you aren't born into it then you have a better shot at winning the lottery. Baseball is no longer the National past time with the majority of the players coming from other countries. Hockey is too expensive to get into so that cuts out almost all of the inner city athletes. Soccer is boring. Tennis and golf are for old men.

 

Football is still their best shot at a scholarship and maybe more. It's the most popular sport in America and it's a way of life down south where there are not any other sporting events in town. CTE or not, football will continue to be the #1 sport so our best hope is to figure out how to make it safer (better helmets!)

I would argue that all sports are seeing a decline. Kids these days would rather play video games than go outside. But for true athletes, I think they will still be drawn to football

Well, youth football participation rates are declining - the numbers are inarguable: http://www.aspeninstitute.org/about/blog/7-charts-that-show-the-state-of-youth-sports-in-the-us-and-why-it-matters. But they're happening across all sports because of one-sport specialization and kids simply participating less. Football participation is declining at a higher rate, though, and interestingly it is the poorest sport in terms of household income average. As for soccer being boring, youth soccer participation absolutely dwarfs football.

[DC Tom]

 

There's not a lot of talk about contributing factors outside of repeated head hits.

 

It's unusual to me that a large number of players being diagnosed came into the league from late '70 through now. A time series analysis of players of different decades is necessary to distinguish if other factors are involved. Football has been around for over a century, and if repeated head hits were the primary factors, there would be a lot more football suicides in each succeeding decade after a player's retirement. But I don't think that's been the case. Maybe our resident football historian can shed some light on this.

 

I'm going purely on guilt by association, but I think that the increased steroid & other hormone use by players starting in the '70s is the missing link between a violent contact sport and CTE.

 

Except the defining criteria isn't suicide, it's dementia. And going back, it's increasingly difficult to measure increased CTE-related dementia in older players, because 1) records just weren't kept as well, 2) those living, you'd have to distinguish it from geriatric dementia, and 3) those already dead, you'd have to exhume the body and autopsy the brain, which isn't practical for a complete study. In other words, part of the reason you see CTE start to spike with players playing from the late 70's onwards is because they're the first group of retired players who could actually be studied for this.

 

But that wouldn't discount PEDs...which could easily have an indirect causal relationship in making players bigger and faster, and hits that much harder, causing an increase in CTE. Or maybe they have a direct causal relationship (which could be tested by comparing the population to non-football or non-athlete populations using steroids (how many juicing baseball players get CTE, for example?)

 

But that all gets back to my point: we really don't know what causes it. We only know what correlates with it.

[bobobonators]

 

This is one of those cases that has me say "there must be more to this CTE thing".

 

This kid was relatively low mileage as a football player. He had serious injuries, and was apparently medicating heavily with pain-killers and self-medicating for the pain. He couldn't sleep.

 

There are plenty of guys who have much longer careers, play in more games, also sustain injuries, and if they do develop problems, only much much later in life or not at all.

 

I had the pleasure of seeing Bo Eason's 1 man show "Runt of the Litter" a couple years ago (funny! and moving - if you ever get the chance, GO even if you hate theatre). This would be a guy who had a similar career to Tyler Sash - started playing football young, played his a** off as a kid, played in college, played 4 years (36 games) in the NFL, suffered multiple serious knee injuries that finally ended his career. In his day he was noted for being a hard hitter (and kinda dirty) so I'm guessing he went helmet-first into a lot of guys.

 

He's 54 now and making a living as an actor, playwright, and speaker. Nothing wrong with his focus, speaking ability, and so on.

 

Is it some combination of playing years, playing style, specific medication, medication interactions, lifestyle? Sleep is important. Is inability to sleep a symptom or part of the cause?

 

Certainly if I was a family member of a former player with symptoms like inability to focus, personality change, inability to sleep, I would want him worked up for CTE.

 

I would like to see a very broad retrospective study of players and former players, gathering data about their football careers, their injuries, lifestyles, medications, administering cognitive tests, PET or MRI scans (whatever shows best). How prevalent is it? How many players and former players show early symptoms of cognitive awareness? Establish baselines, like the concussion baselines but more comprehensive. What helps? What mitigates? Study it. Figure it out.

 

What we have now is just Gollygoshing and Aintitawful, because yes it's a problem, but how prevalent is it? Are there secondary factors and what are they? We just don't know.

Exactly. Well said.

 

Everyone is pointing the finger at football. We don't know the cause yet. There may be an association but not a direct causation.

[GG]

 

Except the defining criteria isn't suicide, it's dementia. And going back, it's increasingly difficult to measure increased CTE-related dementia in older players, because 1) records just weren't kept as well, 2) those living, you'd have to distinguish it from geriatric dementia, and 3) those already dead, you'd have to exhume the body and autopsy the brain, which isn't practical for a complete study. In other words, part of the reason you see CTE start to spike with players playing from the late 70's onwards is because they're the first group of retired players who could actually be studied for this.

 

But that wouldn't discount PEDs...which could easily have an indirect causal relationship in making players bigger and faster, and hits that much harder, causing an increase in CTE. Or maybe they have a direct causal relationship (which could be tested by comparing the population to non-football or non-athlete populations using steroids (how many juicing baseball players get CTE, for example?)

 

But that all gets back to my point: we really don't know what causes it. We only know what correlates with it.

 

I'm not going to argue the procedure for the study, that's for you Dexter.

 

All I'm saying that even if you're looking to diagnose CTE-related dementia in the players, the manifestation of the disease in the more recent era has lead to more violent/suicidal tendencies than in the past eras. Whether that correlation is statistically valid is an open question, but it certainly appears to be on the surface.

[Mr. WEO]

My 16 year old son is a good athlete (6'2"; throws in the low 80s; has played high-level travel baseball for 8 years) and loves the NFL. Neither he nor any of his many sports-oriented friends even contemplate playing football. He literally doesn't know anyone who plays anything beyond the local NFL sponsored flag league (which he plays in). Granted, we're in the NYC area, but I hear this from people in other parts of the country that are not the South too. I don't know any parents who would let their kid play either, and the concussion issue is central. It's a different world from when I was growing up. The decline in Pop Warner and HS participation in areas that are not the South is real. This is one among many stories: http://highschoolsports.oregonlive.com/news/article/-5368247292851455294/high-school-football-at-crossroads-as-participaton-continues-to-decline/ .

 

Will the NFL decline? Perhaps not. There are plenty of great players and programs in the South, and anyway what makes the game interesting is the game itself, not whether it has the best athletes of all outside of athletes who weigh 275-plus pound category (the NFL has a monopoly on those). Elite athletes who have options are not choosing football (again, outside of the South). I can guarantee you that.

 

If your kids grew up outside of the city, like up in Rochester, they would know every kid on the varsity football team and would probably be at all the games. It's still a big deal--even up here in the football dead NE. For the South/SE and panhandle states, football will always be king. There is still an endless stream of kids trying to get recruited to the best NCAA programs and even Div 2 and 3 teams. Everyone knows about CTE/concussions, etc. Yet they will play anyway.

 

I just don't think there are enough MLB roster spots available to make that a goal for the vast majority of these elite kids.

 

[DriveFor1Outta5]

Well, youth football participation rates are declining - the numbers are inarguable: http://www.aspeninstitute.org/about/blog/7-charts-that-show-the-state-of-youth-sports-in-the-us-and-why-it-matters. But they're happening across all sports because of one-sport specialization and kids simply participating less. Football participation is declining at a higher rate, though, and interestingly it is the poorest sport in terms of household income average. As for soccer being boring, youth soccer participation absolutely dwarfs football.

Youth soccer numbers have been growing in this country since we hosted the 94 World Cup. Although it certainly hasn't caused many American's to actually watch the game. It also hasn't really increased the quality of the game in this country either. It's become the sport of choice for northeastern upper class suburbanites in particular. A lot of people want to see their kids exercise as opposed to being online all day. I think this has really pushed the soccer numbers up. I think many kids are forced into just because being a "soccer mom" is the thing to do. I could make the argument that those upper class suburbanites were never the center of the football universe anyway. Traditionally football players came from either cities or football crazed areas of rural America. Areas like Long Island or suburban Boston were never known as football hotbeds.

Even suburban areas up here in WNY aren't exactly known for producing NFL players in mass quantities. Also keep in mind the number of girls that play soccer. That makes a big difference when it comes to stats. My point is that I believe football players will continue to be produced by the same areas of this country that have been doing so for years. In other areas were football isn't everything, participation will likely drop. Ultimately I don't see this impacting the pros much if West Texas and Florida keep producing players.

Edited January 27, 2016 by DriveFor1Outta5

[Buffalo Barbarian]

Football will likely go the way of boxing. Its hard to believe now but from the Jack Dempsey era up until the Ali-Frazier battles, championship boxing bouts were as big as the super bowl is now. Muhammed Ali was considered the most recognizable man on earth. Now most posters don't even know who the heavy weight champion is. It is painful to watch high school football now when you personally know the individual students, knowing the risks their brains are at. It is not as fun as it used to be.

 

Because MMA is WAY better

[dave mcbride]

Youth soccer numbers have been growing in this country since we hosted the 94 World Cup. Although it certainly hasn't caused many American's to actually watch the game. It also hasn't really increased the quality of the game in this country either. It's become the sport of choice for northeastern upper class suburbanites in particular. A lot of people want to see their kids exercise as opposed to being online all day. I think this has really pushed the soccer numbers up. I think many kids are forced into just because being a "soccer mom" is the thing to do. I could make the argument that those upper class suburbanites were never the center of the football universe anyway. Traditionally football players came from either cities or football crazed areas of rural America. Areas like Long Island or suburban Boston were never known as football hotbeds.

Even suburban areas up here in WNY aren't exactly known for producing NFL players in mass quantities. Also keep in mind the number of girls that play soccer. That makes a big difference when it comes to stats. My point is that I believe football players will continue to be produced by the same areas of this country that have been doing so for years. In other areas were football isn't everything, participation will likely drop. Ultimately I don't see this impacting the pros much if West Texas and Florida keep producing players.

Soccer is huge in NYC (the city) and in California/Oregon/Washington at the HS level. Whether it ever takes off at the pro level in the US I don't know. Americans don't root for it, I think, because a city-based team league never formed in the heyday of sports league formation (late 19th/first half of the 20th century). If it had, the fans would be there. That's where loyalties come from -- not really from the sport itself. I think soccer is boring partly because I have no loyalty to anyone and no US teams are historically rooted in flesh and blood cities. However, I have a lot of British friends whose loyalty and fanaticism are Bills-like -- and it stems almost completely from a combination of town/city loyalty and long histories (usually of frustration). I find soccer to be no more intrinsically boring than hockey, basketball, or baseball (although I prefer baseball to the other two) but I have team loyalties in the latter sports that have been hardwired into me. And team loyalties are usually place-based and history-inflected loyalties for most Americans.

 

Regardless, the NFL isn't going have a shortage of players, and it'll continue. One important point about HS football participation -- as one reporter said, it's the one team sport you can't get cut from.

[GG]

Soccer is huge in NYC (the city) and in California/Oregon/Washington at the HS level. Whether it ever takes off at the pro level in the US I don't know. Americans don't root for it, I think, because a city-based team league never formed in the heyday of sports league formation (late 19th/first half of the 20th century). If it had, the fans would be there. That's where loyalties come from -- not really from the sport itself. I think soccer is boring partly because I have no loyalty to anyone and no US teams are historically rooted in flesh and blood cities. However, I have a lot of British friends whose loyalty and fanaticism are Bills-like -- and it stems almost completely from a combination of town/city loyalty and long histories (usually of frustration). I find soccer to be no more intrinsically boring than hockey, basketball, or baseball (although I prefer baseball to the other two) but I have team loyalties in the latter sports that have been hardwired into me. And team loyalties are usually place-based and history-inflected loyalties for most Americans.

 

Regardless, the NFL isn't going have a shortage of players, and it'll continue. One important point about HS football participation -- as one reporter said, it's the one team sport you can't get cut from.

 

 

If you subscribe to the street vendor theory of what's the next sport to boom, bet on soccer. In years past, NYC street vendors stocked plenty of MLB hats for the tourists to scoop up. This year, the inventory is largely hats scarves of the Euro football clubs. Only a few MLB hats in the back row.

[metzelaars_lives]

Ya got me. WHO is the current Heavyweight Champ? I used to follow boxing avidly and once could recite all the Champions of the previous century. Still a fan of Ali. I haven't watched or followed it for years now..

Tyson Fury is pretty much the unified champ. Believe me when I tell you he is no Muhammad Ali.

[boyst]

 

There's not a lot of talk about contributing factors outside of repeated head hits.

 

It's unusual to me that a large number of players being diagnosed came into the league from late '70 through now. A time series analysis of players of different decades is necessary to distinguish if other factors are involved. Football has been around for over a century, and if repeated head hits were the primary factors, there would be a lot more football suicides in each succeeding decade after a player's retirement. But I don't think that's been the case. Maybe our resident football historian can shed some light on this.

 

I'm going purely on guilt by association, but I think that the increased steroid & other hormone use by players starting in the '70s is the missing link between a violent contact sport and CTE.

That could very well be, and as Tom makes several other suggestions there could be other issues at play. Perhaps the culture has had something to do with it, the lifestyle. If you're a celebrity 24/7 walking around town and everyone knows you and parades are held in your honor. By the time you reach the NFL you've been rewarded and awarded so much in life that by the time you no longer live that life you no longer want to live life.

 

Add in some head banging, drug use, and a wild lifestyle and eventually you end up with a potent cocktail of life. Depression isn't always a result of head trauma. You can have both, or just depression. There have been countless studies done studying the brain of depressed individuals. It has major effects over time. 5-10 years of depression can cause havoc on a brain.

 

 

Exactly. Well said.

 

Everyone is pointing the finger at football. We don't know the cause yet. There may be an association but not a direct causation.

Yet, if you do not think it is football related, if you do not think there is enough evidence - you'll be called out on it. I've been called out on it several times here saying I do not buy the subject being sold. The Concussion movie was great.

 

 

Except the defining criteria isn't suicide, it's dementia. And going back, it's increasingly difficult to measure increased CTE-related dementia in older players, because 1) records just weren't kept as well, 2) those living, you'd have to distinguish it from geriatric dementia, and 3) those already dead, you'd have to exhume the body and autopsy the brain, which isn't practical for a complete study. In other words, part of the reason you see CTE start to spike with players playing from the late 70's onwards is because they're the first group of retired players who could actually be studied for this.

 

But that wouldn't discount PEDs...which could easily have an indirect causal relationship in making players bigger and faster, and hits that much harder, causing an increase in CTE. Or maybe they have a direct causal relationship (which could be tested by comparing the population to non-football or non-athlete populations using steroids (how many juicing baseball players get CTE, for example?)

 

But that all gets back to my point: we really don't know what causes it. We only know what correlates with it.

I have been looking for causes of death for the 70's for about 10 minutes to give me any type of indication on % of suicides to compare to today. No luck yet.

 

 

I'm not going to argue the procedure for the study, that's for you Dexter.

 

All I'm saying that even if you're looking to diagnose CTE-related dementia in the players, the manifestation of the disease in the more recent era has lead to more violent/suicidal tendencies than in the past eras. Whether that correlation is statistically valid is an open question, but it certainly appears to be on the surface.

Partially based upon media coverage there is also a rise in violent and suicidal tendencies among the public.

 

 

If your kids grew up outside of the city, like up in Rochester, they would know every kid on the varsity football team and would probably be at all the games. It's still a big deal--even up here in the football dead NE. For the South/SE and panhandle states, football will always be king. There is still an endless stream of kids trying to get recruited to the best NCAA programs and even Div 2 and 3 teams. Everyone knows about CTE/concussions, etc. Yet they will play anyway.

 

I just don't think there are enough MLB roster spots available to make that a goal for the vast majority of these elite kids.

 

Except, my brother and sister in law in Texas are not letting their son play football, and they're not alone. My nephew is on a few travel baseball teams and only two kids play football and overall a handful of kids he knows are playing football. Granted they are only 2nd graders, but in their area (Plano/Dallas) there is not the numbers there for kids playing football like you'd think. At least among the middle and upper class folks.

 

Even here in NC, there are fewer kids playing.

[metzelaars_lives]

And of course there are a few people questioning the validity of studies and arguing that we can't know for sure that there is a direct causal correlation between bashing heads together for 25 years of one's life and CTE. Why would I expect anything different? I guess we don't know for sure that smoking causes lung cancer; we only know there is a correlation between smoking and lung cancer.

 

When it comes to suicide and depression though, I would contend that being out of the spotlight, not being able to play football anymore and standing there at age 30 not knowing what to do with yourself is probably a huge contributing factor as well.

Edited January 27, 2016 by metzelaars_lives