http://highline.huffingtonpost.com/articles/en/nfl-football-...

In football, as in boxing, the original investigation began because head trauma is obvious, but as the study broadened some of the worst cases of CTE were actually offensive linesmen. These are generally not the players who dish or receive hard hits, and many had never had a suspected concussion in their career. That led to the dominant theory that it isn't concussions -- the big hits -- that are the main cause of CTE, but instead many small traumas (in that case the o-line engaging with the d-line) that add up to CTE.

There is every reason to suspect that many other sports yield these sorts of recurring sub trauma, and aggressive skiing seems a probable candidate [edit - note that it does not require that you hit your head, have an accident, etc. If enough of a high-G event is transmitted to the brain, that can be a subconcussion]. It just isn't terribly common to do an intensive brain study of people after death to find these correlations.

I think there's a fair distinction to be drawn between sports that might cause head trauma if you make a mistake, and sports in which head trauma is practically the defining characteristic (see also: boxing). I am three weeks away from having a son, and while I've got some years, I'll eventually have to make some decisions about what activities I want to encourage and discourage. It at least seems possible to learn to ski without repeatedly bashing your head. Not so for football.

I ski and snowboard and I'm not planning on stopping, I think the benefits outweigh the risks. I'd say that about most sports but I'm not about to let either of my kids play football or box.

We need to study this stuff a lot more.

Again, someone studied football players because the impact is obvious. As it reaches out, players in even relatively low-g sports like soccer are being found with CTE.

And the part of soccer that seems to cause concern is heading the ball, not the running around part.

Comparing helmet to helmet impacts to skiing over rough terrain feels like a real stretch here.

But we don't know what the concern is in soccer. Heading is immediately looked at because it's an impact, but the actual cause may be something altogether different.

I mentioned the g forces measured in skiing elsewhere. They are absolutely in the range of subconcussion.

We evolved to walk with a limited brain suspension that just wasn't adapted for 100kph wax shoe runs.

If you're skiing at the level I'm talking about, falls are probably not that frequent, though.

In my earlier comment I was talking more about the explosive vertical compression-expansion cycle that characterizes skiing really hard with very tight turns on short radius skis. Those are much less violent than hitting a lineman though.

Where are you skiing that results in you receiving repeated blows to your head?

The comparison doesn't hold up at all, and OP's original point still stands against yours.

When you have a number of HN commenters correcting you, it's not them it's you.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995699/

[2] http://www.uwhealth.org/sports-medicine/clinic/concussion/11...

Take a moment and review the HN Guidelines please: https://news.ycombinator.com/newsguidelines.html

> Be civil. Don't say things you wouldn't say in a face-to-face conversation. Avoid gratuitous negativity.

Guidelines are exactly that, guidelines. If you can't follow them here on HN please avoid commenting.

I will engage no further with a user like yourself who cannot comment in a civil matter.

He's had a charmed life. Lots of great experiences, like a real-life Tom Sawyer or Huck Finn, and the stories to go along with them.

Now's he battling (and losing) with the late-stage effects of dozens of concussions, which is manifesting itself as severe short-term memory loss, increasingly poor long-term recall, and eventually the inevitable situation where he doesn't recognize his own children, only grandchild, and only great grandchild. My father also played football most of his life (but not at the same level), and I'm concerned the same thing will eventually happen to him.

I'm very thankful to have had my grandfather in my life for so long (I'm now 37), and I have so many really wonderful memories and experiences that I can attribute to him (sitting in the cockpit of a 727 as a toddler, flying in the family little Piper Cub, countless lovely tailgate parties, a huge loving extended family of his long-time friends, etc), and I want to make sure that in the short window that's left where he's able to be at-least present in the moment that myself and my young son spend ample time with him.

It's difficult to watch the decline, but I can't imagine how difficult it must be for him to be living it.

The point being, from what I've seen on the subject, there's no way to diagnose CTE until the patient has passed away and you can slice open their brain. It's possible that your grandfather's symptoms are related to his concussions, but it's also very possible that it would have happened anyways. CTE usually manifests 8-10 years after these brain injuries and has a lot of symptoms beyond the dementia you list, so it could be garden-variety Alzheimers.

Regardless, you have my sympathies. Alzheimers-type dementia is truly a terrible way to lose a loved one. The anti-climactic nature of it makes it really difficult to get closure in the way that you do when someone's death is more abrupt. Instead, they slowly fade away in the "boiled frog" fashion and you're left at whatever funeral you end up having realizing that they died a long time before their body expired and you never got to grieve. Be sure that you're intentional in remembering the person he used to be and don't let the empty shell of a person that exists now replace that in your memory. I didn't do that enough and it made grieving for my grandmother very difficult.

If there's a silver lining to my story, my mother is now past the age when her mother was diagnosed with Alzheimers and is, thus far, not showing signs of the disease. Given some of the research that's tying Alzheimers to particulate air pollution, I'm hopeful that the strides made by the EPA and others in reducing our air pollution will mean that she won't have to go through that ordeal and I won't have to lose her the way I lost my grandmother. If your dad is more than a decade past his football-playing days and symptoms haven't shown up, there's a good chance that he won't either.

Senile dementia, Alzheimers, brain cancers, and TBI frighten me even more than being flung 100m across the pavement in an automobile accident, or getting dragged into the gap by a commuter train. With those, you know you're dead, and so does everyone else. When you slowly lose your mind, no one can ever really be sure when you stopped being you, not even yourself.

The article implies a selection bias -- that the actual number of football players with CTE could be as low as 9%. It also notes cases where CTE effects really become "horrible" much later in life, for men who are older than the guys you list.

Guys who self-select to be television personalities also might have a lower incidence of CTE. There's also a chance that some odd behavior on TV will be interpreted as "quirky" or "goofy" and not "experiencing brain damage."

At any rate... Of course the answer is: No, not everyone with CTE dies "horribly." But it's seeming increasingly likely that CTE can have major unexpected consequences on the later lives of football players. And the worst case scenario of CTE (Junior Seau, Jovan Belcher) is exceptionally horrible and exceptionally tragic.

Which is still disgustingly high.

This study showed that 110 of 111 players tested had CTE. But many of their families consented because they suspected CTE already, so it's not a random sample and therefore you can't generalize that to the rest of the population. 110 is 9% of the population of 1300 deceased players for the given time period. CTE is normally extremely rare.

I don't think that it's fair to look at these former players that go into broadcasting and "diagnose" them in anyway. We don't see inside the private lives of these guys and we don't know what struggles they may or may not live with everyday.

What I don't understand is what that means exactly. Are there degrees of CTE? Might some of these players have CTE but hardly ever show much of a symptom in their lives? Or is everyone, as the people who I was responding to suggested, doomed to some sort of dementia where they forget who they are their families are? And if that's the case, shouldn't we see this more often among ex-players who are still in the public? Or are the former players who take these jobs all in the 10% that don't get CTE? Just trying to make sense of the conflicting data here.

Of course the problem is that you can go half a life time doing this thing, and then it sneaks up on you and there's no reversing the damage. The danger isn't presented as clear or present as with anti-smoking messaging, or with something like solo free climbing which needs no warning.

Maybe you'd rather your kid play football or learn boxing than lay on the couch. If the risk is 10x that of baseball, and 50x that of track and field, however, you might steer them to different activities.

That's interesting because the accidental insurance (that I took out during the football years) had separate premiums for skiers and snowboarders. The most serious concussion that I ever got was from snowboarding.

> There's a difference between "you might die right in the middle of this very fun activity" and "you might die slowly and horribly years from now when you're retired and in the midst of raising a family."

It's kinda arbitrary to draw these lines of "my dangerous sport is superior to your dangerous sport." It's all risks and benefits. Skiing/snowboarding is pretty dangerous for catastrophic accidents AND it still has a high concussion rate.

0.37 = American football concussion rate per 1,000 athletic exposures

0.2 = Skiing/snowboarding closed head injury rate per 1,000 mountain visits

You're not incredibly far behind football in terms of risk, my friend.

what if you were paid millions of dollars to do it and treated as a living god? i think a lot of people would still take that deal even knowing the risks.

Good clean fun that has erased quite a bit of usable life from your knees. Better than a brain injury, but not great.

brain injuries and knee injuries are not really comparable.