HJAR Jul/Aug 2023

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2023 11 irregular pattern at the depths of the cor- tical sulci. What is the purpose of the Concus- sion Legacy Foundation? Our mission is to support athletes, vet- erans, and all affected by concussions and CTE; to promote smarter sports and safer athletes through education and innova- tion; and end CTE through prevention and research. CLF is a proud supporter of and collaborator with the Boston University CTE Center. Our vision is a world without CTE, and concussion safety without compromise. The science of CTE was in its infancy when you founded CLF. At what stage would you say the science of CTE is today? That’s a loaded term. In some ways, science is always in its infancy because we are always learning more. I’d rather use a football analogy. When I founded CLF, it was first down on our own 1-yard line. We are finally approaching midfield. One critical breakthrough is that the National Institutes of Health and CDC both now agree that CTE is caused by repeated traumatic brain injuries, both concussive and non- concussive hits. We are at the moment when science agreed smoking caused lung cancer, even though in both situ- ations, causation was declared before we knew exactly how or why the dis- eases formed. Today, let’s focus on the game that most affects the boys and young men in our area, tackle football. We have always known football as a violent game. The second loudest sound in the stadium other than a score is a hard hit. The education effort your group and others have instituted around CTE appears to be a game changer for many par- ents and players as they look at the long-term consequences we now know football can inflict decades after these men leave the playing field. Why do you think it took so long for CTE to be “discovered” in an American football player when we have been playing the game for so long? You can’t find what you don’t look for. The original CTE cases were found in boxers. I am still in shock people were surprised to find it in football players, too. Your brain doesn’t know if it’s being hit by a helmet or a gloved fist. You were a college football player; I am assuming you, like so many of your generation, were taught to “lead with your head” and to get back up when you got your “bell rung.” What can that do to a player from a concussive and a subcon- cussive perspective? And, because many of the former players I know don’t even know the current defini- tion of “concussion,” will you please explain the difference between those two terms? A concussion is a traumatic brain injury defined by the presence of signs or symp- toms associated with an acute change in brain function. In this use, a subconcussive injury is a traumatic brain injury that is sub- clinical, meaning it doesn’t cause any signs or symptoms, but still causes injury. A lot of rule changes have been implemented in the past decade to make the game “safer.” Do you think it is safer than when you played? Do you think the rules have gone far enough to protect players? Some changes have been made to try to make football safer, but it is unclear if those changes will reduce concussion or CTE rates. The rule changes are offset by players being bigger, stronger, and faster, causing more energy to travel to the brain than ever before. Do you think we, as a society, are a little nonchalant about the fact that even after all the steps we have taken to reduce con- cussions, they are still an inevi- table part of a “game” we let children play? It’s important for people to remem- ber that many sports we allow chil- dren to play were never originally intended for children. Organized sports in the United States began at the college level, and they kept mov- ing younger and younger as the finan- cial benefits of being good at a sport grew. I am surprised that we still play some youth sports by the same rules as professionals. We launched a campaign in 2022 to prevent concussions and CTE in youth sports called “Stop Hitting Kids in the Head.” No sport should tolerate an 11-year-old getting hit in the head hundreds of times a year when we know it causes brain injuries and can cause CTE. Do you think current high school baseline studies are effective? What are your thoughts on youth players