Every fall, over a million young Americans play high school soccer wearing helmets and padded shoulder pads. However, questions have been reinforced about the risks youth athletes face from repeated head injuries after a gunman who played football in Southern California claimed he was suffering from degenerative brain disease this year.
After killing four people and taking her own life, Shane Tamura, a former varsity player at two Los Angeles Regional High Schools, left a three-page suicide note, claiming she was suffering from chronic traumatic encephalopathy.
“Soccer gave me CTE,” Tamura reportedly wrote. “Study your brain.”
The disease can be clearly diagnosed through brain dissection, so it remains unclear whether the 27-year-old actually suffers from CTE. However, this claim comes at a time when concerns are growing over health risks in high school contact sports, particularly soccer.
CTE is caused by repeated head injuries, including concussions and non-active effects, so CTE tends to be diagnosed primarily in people who have been playing soccer for more than a decade. But four years of high school soccer could expose players to CTE, said Chris Nowinski, co-founder of the Concussion Legacy Foundation, a nonprofit organization that supports CTE and athletes affected by concussions.
“The probability of having a CTE is most correlated with the number of seasons played,” Nowinski said. “The best window we have is that we studied 45 former high school athletes who died before the age of 30, with 31% having CTE.”
Chronic brain injury and youth soccer issues are warming in Southern California.
Faced with political pressure last year, Gov. Gavin Newsom vowed to reject laws that sought to ban the state’s youth tackle football. Citing parents’ freedom to decide which sports children can participate in, Newsom said he will work with legislators to enhance the safety of the sport.
Currently, California maintains protocols for student-athletes who experience concussions or head injuries during the game. These measures include assessments from licensed healthcare professionals that have been removed from student play.
The California Youth Football Act limits the full contact practices of youth soccer teams within two days a week to 30 minutes a day. Full contact practices for youth football teams are also prohibited during the offseason.
Such laws try to limit the risk of injuries, but experts say they cannot completely eliminate the threat.
“What really matters is the amount of time you play, how much hit you have in the head during that time, and the strength of the head hits you experience. Those are the ones that play the biggest role in someone else’s risk.”
“So can a high school player get that? Yes,” Daneshver said.
Officials said Tamura appeared to blame the NFL for his condition, but he never played football beyond high school.
Experts say players such as Tamura, who are listed as playing offensive and defensive roles in their online player profiles, are particularly at risk of CTE.
“In his online huddle profile, he says he’s also a defensive back, clearly a very good running back and twice as much exposure,” Nowinski said.
It could take two to six months for scientists to determine if a gunman is actually suffering from CTE, experts say. However, such examinations require permission from the family.
High school athletes who play soccer guarantee greater learning and treatment, Daneshver said.
“Of the 3.9 million football players in this country, there are under 4% of those who play in college and professionals, so we’re talking about how they play more than 96% at the youth and high school levels,” Daneshver said.
“They are likely at lower risk based on the fact that they are more likely to have played fewer years than people who play at Collegiate Pro level, but their numbers are large.”
One of the most famous cases of young footballers who developed severe CTE is Aaron Hernandez. This is the National Football League tight end who played three seasons with the New England Patriots until his 2013 arrest for the murder of fellow football player Odin Lloyd.
When Hernandez was convicted in 2015 and died at the age of 27, researchers at Boston University studied his brain and diagnosed him with CTE stage 3, which resulted in repeated head injuries.
“When you see someone with stage 1 and some microscopic lesions, it’s difficult to interpret how it affects their behavior,” Nowinsky said. But using a Stage 3 person like Hernandez, he said, “I can be sure he’s 27 years old and not the same person as 15 years old. Everyone in Stage 3 has some degree of symptoms and disability.”
The disease begins with small lesions that develop along the stem of the brain in the prefrontal cortex, causing a chain reaction that slowly kills brain cells. According to Nowinski, this reaction can continue to spread for a long time after repeated impact stops.
If scientists determine that Tamura has CTE, Nowinsky stressed that brain disease does not mean that he or she committed a crime.
“It’s very clear that most people who developed CTE are not murderers, and most people don’t have the extraordinary psychiatric symptoms they are involved in for unwilling psychiatric retention,” Nowinsky said.
However, other forms of brain damage may have influenced his behavior.
“CTE is not the whole story,” Nowinski said, noting that experts have identified at least 15 different changes to the brain associated with traumatic and repetitive traumatic brain damage. “Even if CTE is not present, it doesn’t mean that brain damage cannot promote this. I think that in many cases, non-CTE changes are deeper than early CTE changes in younger, altered people.”
Diagnosing CTE is a complex process and involves studying more than 20 areas of the brain, Nowinski said.
First, the brain is stored in formalin for two weeks. Once it is drawn out, it is examined for atrophy or older contusion patterns. The brain is then sliced, and very thin sections are placed on glass slides, stained with antibodies that help to make abnormal proteins visible.
Currently, there is no treatment for CTE, but Daneshvar said it should not be seen as deadly.
“We have a lot of patients who are experiencing symptoms that may be related to CTE pathology. They can identify and treat symptoms and get better,” he said. “If someone has severe depression, there are medications and interventions you can do to manage your depression.”
As football season approaches for another high school, California lawmakers are proposing assembly bill 708. Such devices are currently prohibited.
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