Steve McMichael Inducted into the Football Hall of Fame As Family and Friends Visit with Him, Now with ALS
ALS is Four Times More Prevalent in Football Players than in the General Population of Men
Being Inducted into the Hall of Fame
Now with ALS or Amylotrophic Lateral Sclerosis or Lou Gherig’s Disease, Steve is seen ⬆️ surrounded by family and friends.
The Past
The Present
ALS
Is ALS More Common in Football Players?
According to the ALS Foundation, no. But they're continuing to look at it.
Because it seems rather obvious to me that football players get it more often than other sports players.
This week, former San Francisco 49ers receiver Dwight Clark announced he has ALS. He joins other NFL football greats including Steve Gleason, Tim Shaw, Kevin Turner, O.J. Brigance, and others, who have been diagnosed with ALS following their pro football careers. These announcements have brought much attention to the connection between football and traumatic brain injury (TBI) and the question of whether such injuries from football can lead to ALS or chronic traumatic encephalopathy (CTE). Here, we highlight some research behind the possible connection.
Traumatic brain injury can be defined as “an alteration in brain function and consciousness which results in impaired cognitive and physical functioning caused by external force.” Traumatic brain injury is not a rare event and can be caused by multiple types of impact to the brain. It is important to note that not all TBI leads to neurodegenerative disease. That said, TBI involves a complex physiological process with both short and long-term outcomes, including increased risk of people developing neurodegenerative diseases such as Alzheimer’s disease, CTE and ALS.
Sometimes there is confusion of whether a person has ALS or CTE, but they present differently. ALS is caused by death of motor neurons (i.e. a type of cell of the central nervous system that coordinates movement). When motor neurons die, they can no longer connect and communicate with muscle, leading to muscle atrophy, weakness and eventually paralysis. Some cases of ALS are also connected to reduced cognitive function due to overlap with Frontotemporal Dementia (FTD). On the other hand, CTE primarily manifests with signs of dementia and cognitive defects. Symptoms can include aggression, depression, impulsivity, irritability, short-term memory loss and heightened occurrences of suicide.
Diagnosis for both ALS and CTE is difficult. On average, it takes one year for an ALS diagnosis, due to the complexity of the disease and possible overlap with similar neurodegenerative disorders. Currently, CTE is only definitively diagnosed after death, by studying brain tissue during autopsy. There is also debate of whether repetitive trauma or even a single TBI is sufficient to cause ALS and CTE. In addition, little is known regarding what type of head trauma causes ALS and CTE. Reports of injury during soccer, football and boxing are the most well reported cases. There is also the possibility that other parts of players’ athletic training experience, not just head trauma, are a risk factor for developing ALS.
Research behind TBI supporting a connection between ALS and CTE is still unclear. A recent study in animal models demonstrated that repeated, mild TBI induced long-lasting defects in motor function and brain pathology. In contrast, a recent study in people with ALS, with and without head injury, showed that “head injury was not associated with faster ALS disease progression” and did not result in a specific pathology in the brain.
Due to the high complexity of both diseases, more long term studies are needed for a full understanding of this connection. Specific TBI biomarkers will be necessary to improve the accuracy of the differential diagnosis between ALS and CTE.
The ALS Association is committed to unlocking these questions to provide these important answers and to providing the best care available to people living with ALS. We also encourage football leagues, from young divisions to the NFL, to continue efforts to make playing football safer to help prevent TBI from occurring in the first place. We will update the ALS community with future studies along these lines.
References:
Traumatic brain injury: a risk factor for neurodegenerative diseases.
Gupta R, Sen N.
Rev Neurosci. 2016 Jan;27(1):93-100. doi: 10.1515/revneuro-2015-0017. Review.
PMID: 26352199A model of recurrent concussion that leads to long-term motor deficits, CTE-like tauopathy and exacerbation of an ALS phenotype.
Thomsen GM, Ma AM, Ko A, Harada MY, Wyss L, Haro PS, Vit JP, Shelest O, Rhee P, Svendsen CN, Ley EJ.
J Trauma Acute Care Surg. 2016 Dec;81(6):1070-1079.
PMID: 27602892Head injury does not alter disease progression or neuropathologic outcomes in ALS.
Fournier CN, Gearing M, Upadhyayula SR, Klein M, Glass JD.
Neurology. 2015 Apr 28;84(17):1788-95. doi: 10.1212/WNL.0000000000001522.
PMID: 25832660A blow to the head trauma – ALS hypothesis.
Armon C, Albert SM.
Neurology. 2015 Apr 28;84(17):1728-9. doi: 10.1212/WNL.0000000000001528. No abstract available.
PMID: 25832659Source: https://www.als.org/blog/can-football-cause-als-look-research
… And Then There's This Study, which Wasn't Mentioned
Professional football players in the NFL are four times more likely to develop and die from ALS than the adult male population, according to new research.
Scientists at Boston University's CTE Center, who conducted the study released Wednesday, said they couldn't determine exactly why the rate was higher for those athletes but suggested that repetitive head impacts and traumatic brain injuries may play a role.
Amyotrophic lateral sclerosis, also known as Lou Gehrig's disease, is a fatal neurodegenerative disease with no known cure. ALS has been linked to chronic traumatic encephalopathy, or CTE, another degenerative brain disease found in many former football players.
Researchers examined all 19,423 NFL players who took the field for at least one game from 1960 to 2019 in what the scientists said was the largest study of ALS risk in professional football players. Previous, smaller studies have also found links between league play and the disease.
The latest study found that 38 players had received an ALS diagnosis during the study period and 28 had died, a four-fold increase over the rates for the overall U.S. male population adjusted for age and race.
NFL players who developed ALS had significantly longer careers than those who didn't get the disease, but researchers said other factors like a player's position, body mass index and race didn't show any differences.
Other factors such as smoking, strenuous physical exertion and exposure to environmental toxins such as pesticides may also increase the risk of ALS for NFL players, the study said.
The NFL did not immediately respond to NPR's request for comment.
Source: https://www.npr.org/2021/12/16/1064850108/nfl-players-als-study
WHAT I REALLY THINK
What do you think of this video from McMichael’s bedroom?
Was it in poor taste? Did it bother you, or is it a good thing that it was televised?
My personal opinion is that they did a good thing but it would have been nice to prepare us for it in some way, perhaps with an explanation or introduction of ALS.
You can see that although he is on a ventilator, the wife or significant other is quite supportive and close to McMichaels; that is good to see.
It appears that he's not in a hospital but lives on a ventilator at home. You can tell by the ceiling’s A-frame, typical of a house. And it looks like he is very well taken care of.
I have 1 friend with ALS and she had 2 traumatic brain injuries from being thrown from her horse.
Lou Gehrig had this disease