Why the NFL's admission over CTE could be momentous in the long-term

An NFL vice president admitting a link between football and the degenerative brain condition CTE is a big deal.

That this NFL vice president is in charge of health and safety for the league makes the admission an even bigger deal. Over the years the NFL has done many things to erase the line between the game and long-term effects on the brain not the least of which has been rolling out dubious experts who deny science. Suddenly saying that football might cause CTE is a huge change in the league’s message.

But there isn’t any great surprise in what Jeff Miller told the House committee on Energy and Commerce on Monday. Acknowledging that football can lead to CTE is much like big tobacco saying smoking causes cancer. He was simply stating what everyone else has accepted.

The real value of Miller’s testimony is what he said next: “I think the broader point, and the one that your question gets to, is what that necessarily means and where do we go from here with that information,” he said.

When it comes to understanding sports and their impact on head trauma we are at the tip of a very large iceberg. A link between football and CTE has been established. The brains of nearly 100 deceased football players have shown signs of the disease. It was only a matter of time before even the NFL had to shrug their shoulders and concede the obvious.

But a link is just a link. The study of CTE is a world about which science knows little, mainly because this isn’t an easy subject to research. Currently, the only way to test for CTE is to physically examine the brain. The only way to properly examine the brain is to cut it apart which means the subject being tested must be dead. Usually the only people likely to donate their deceased father or husband’s brains are those who had reason to believe something was wrong – meaning researchers still don’t have a great grasp on the depth of CTE.

Last fall’s Frontline report that 87 of 91 former NFL players had tested positive for CTE made for alarming headlines, but the numbers weren’t much of a shock. Many of the brains that were donated for study came from ex-players who either died of unnatural circumstances or had serious struggles like Junior Seau and Dave Duerson.

But there are many former players who seem to lead normal lives without the symptoms of dementia or early-onset Alzheimer’s seen in players who later test positive for CTE. What does this mean? What is the true percentage of players who develop CTE? And what are the causes? Are concussions solely to blame? Are the violent hits that everybody focuses on the real culprit? Or might CTE develop from the repeated bumping of helmets in the seemingly benign scrum of line play?

So much is unknown. So much study has yet to be done. Researchers need more brains to understand how widespread CTE really is and how it develops. Few families want to donate the brain of a loved one who died of natural causes. Some current and recently-retired players have promised their brains for study upon death but that might be decades from now. Tests to determine CTE in the living are still years away. In the meantime, more former players continue to die. And there are others who believe CTE and concussion are problems that extend across the sporting world.

If the NFL is truly ready to accept that football leads to CTE then they can also take a legitimate role in helping to understand CTE’s impacts and how to better protect their players.

The immediate impact of Miller’s words might be to change the league’s pending settlement with the families of thousands of former players who say they were impacted by football-induced brain trauma – currently the deal only covers players who were diagnosed with the disease between 2006 and April 2015 but that is under appeal. Certainly lawyers for players’ families believe Miller’s admission has given them grounds for further compensation claims. “The NFL’s statements make clear that the NFL now accepts what science already knows: a ‘direct link’ exists between traumatic brain injury and CTE,” said Steven Molo, a lawyer for the family and players. “Given that, the settlement’s failure to compensate present and future CTE is inexcusable.”

That’s the short term though, the long-term effect might be to open new lines of research. The NFL is going to have to stop thinking like a corporation run by attorneys and more like a leader in making football safe at all levels. Miller’s admission was a small but significant first step. Perhaps now the league will partner in the development of a CTE test for the living. Perhaps now it will encourage more former players to donate their brains for study.

For years, the NFL has hidden behind the absence of complete scientific proof in holding back from drawing a link to CTE. The lack of hundreds or thousands of confirmed cases of CTE has allowed the league to be dubious of a connection between football and CTE. But in seconds on Monday Jeff Miller tossed the league into a discussion it has long tried to avoid.

Maybe this was an accident. Maybe Miller strayed from his talking points under a congresswoman’s interrogation. Maybe it was a calculated statement – the NFL’s message that it is opening a new dialogue. Either way, the conversation has changed. It’s up to the NFL to see how far it will go to help everyone understand CTE and football’s role in causing it.

Powered by Guardian.co.ukThis article was written by Les Carpenter, for theguardian.com on Tuesday 15th March 2016 19.28 Europe/Londonguardian.co.uk © Guardian News and Media Limited 2010