The newly installed president of the ACA’s sports council, Dr. Shane Espinoza (yes, our Dr. Espinoza, who owns an amazing HS clinic in Oregon), sent me some information on CTE (chronic traumatic encephalopathy) that you should be made aware of. Unless you live under a rock, you’ve heard a lot about CTE because it's almost constantly in the news. The stories of retired NFL or college players committing suicide because of the massive side effects from CTE are growing weekly. A good friend of mine, whose son just suffered a nasty concussion in a high school football game last week called me in a panic, not knowing what to do or where to turn for help. We chiropractors MUST know about CTE. We must be current. Our patients will be increasingly asking for guidance and information. We need to be that source of information.
My nephew was a very highly recruited offensive guard, playing on a back to back D1 high school football state championship team ranked 6th in the country in the toughest division. He could have played collegiate football at almost any college in the country and he had dozens and dozens of offers from MIT to Stanford. Instead, he chose a full academic scholarship to Notre Dame. This means he’s done playing football. Why did he make this choice? He said to my brother, “Dad, I can play football for maybe another 8-10 years. I have the rest of my life to live. It’s not worth the risk.” CTE is real and it’s scaring the heck out of people. Fortunately, my nephew had the option of a full academic ride. Most athletes don’t have that option, so they must play ball. Many of your patients and their children will suffer concussions playing sports like football and soccer or even from accidents. Concussions can lead to CTE. Here’s valuable information.
Tau is a plaque that forms on and in the brain of people that will develop CTE. It also forms in the brains of Alzheimer’s victims. Tau is formed as a misfiled protein that is part of the skeletal structure of the axon of the nerve cell. CTE causes micro trauma or miniature strokes that in turn create inflammation and an accumulation of waste products in the nerve cells. This inflammation and waste product then causes misfiling of skeletal proteins which leads to TAU deposits, axon loss and cell death. Next come the behavior changes we associate with CTE. It could prove helpful to test treatments if we knew if someone has CTE that will progress to a serious problem. Now we can know that before the behavior changes. Up until now, the only conclusive diagnosis could be made after the victim dies and an autopsy is performed.
There is a new tracer substance that when used with a PET scan, can detect TAU deposits when they first form, years before any behavior changes. This is the first major breakthrough in treating CTE. If we know a person has the beginning of CTE forming, we can now get them treatment. And that’s another story. New treatments are being explored since we can now detect CTE very early. I expect some really interesting ‘alternative’ treatments will eventually take center stage, and I hope the chiropractic profession plays a great role.
For prevention, at least as far as football is concerned, much better helmets (about $1,500) are being designed and tested. There is also a new product called a HITT-SHIELD that fits into a helmet and significantly reduces concussive forces to the head from a direct hit. However, Dr. Shane tells me that most sport caused concussions result from rotational trauma, so we need much more innovation on this front.
There’s your primer on the new development in the detection of CTE. Share with your patients when you feel it’s appropriate. At the very least, you are now armed with additional information, and that’s a good thing!
Have an outstanding weekend as you all cheer on the Cleveland Indians this weekend!
Dr. Chris Tomshack