Note: I have never seen an issue in sports as polarizing as concussions and CTE in football. On one hand, I hear so many sports fans talk about how the media is inciting fear. They often say that they played football and suffered concussions and had no long-term problems. On the other hand, I hear from parents (often when I examine their children in my practice) who are truly worried about the risk of brain damage in the sport. The media’s coverage of suicides in several former NFL players has definitely brought attention to the issue. I decided to discuss it in my latest Football game (1)newspaper column.

Former Pittsburgh Steelers offensive lineman Terry Long committed suicide by drinking a gallon of antifreeze. Dave Duerson and Junior Seau shot themselves in the chest. Kansas City Chiefs linebacker Jovan Belcher murdered his girlfriend and then drove to the Chiefs practice facility, where he shot himself in the head.

The latest former NFL player to commit suicide was Adrian Robinson, who died by hanging. Robinson, like the others above, was found to have chronic traumatic encephalopathy (CTE).

Is suicide common among former NFL players?

Given the shocking nature of these highly publicized deaths, many football players and parents of kids who play football might wonder if suicide is common after playing the sport.

A study performed at the CDCs National Institute for Occupational Safety and Health compared the mortality by suicide of former NFL players to that of the general population. The findings were published this month in the American Journal of Sports Medicine.

Also read:
Suicide and mental health concerns exist after concussions in young athletes
The link between football and CTE and the questions we must answer now

The risk of suicide in professional and college football players

From a database of 3439 NFL players who played at least five seasons in the league between 1959 and 1988, only 12 suicide deaths were found. The researchers estimated that there would be 25.6 suicide deaths among people of the same age, race and sex in the general population. When looking specifically at “speed” positions – quarterbacks, running backs, wide receivers, tight ends, defensive backs and linebackers – the risk of suicide was significantly less than the US population.

These findings corroborate those from a study published last year on suicides among college athletes. While football players did have a suicide risk more than twice as high as college athletes playing sports other than football, the suicide rate was still lower than that of male college students in general.

The authors of the CDC study cautioned that the lower risk of suicide among former NFL players who played at least five seasons might not apply to other levels of football, like high school athletes.

Questions raised about suicide and NFL players

The findings here are somewhat comforting, but they raise questions as well. First of all, why would the suicide risk be lower than for the rest of us? Is there a benefit to the years of physical activity? The researchers did note that there were fewer deaths from cancer and heart disease in these former players than in the general population.

Does the financial security from playing the most popular sport in America help? Maybe NFL players have more access to doctors and have a better support system to maintain their mental health.Youth football linemen copy

We can add these questions to the growing list of questions about CTE and football.

Also read:
How common are suicides in college athletes?
Sports medicine stats: Suicide in NCAA athletes

Questions about CTE, concussions and football

The data from Boston University’s Center for the Study of Chronic Traumatic Encephalopathy, which has discovered the most cases of CTE in former athletes, paints a frightening picture. In a congressional hearing earlier this year, Dr. Ann Mckee reported that they have found evidence of CTE in the brains of 90 of the 94 former NFL players they have examined. The researchers admit that these findings do not mean that 95% of all football players will develop CTE one day. Just how likely is CTE for a current NFL player? What about a high school athlete?

We also don’t know why some players develop this brain degeneration and so many others don’t. Genetics likely play some role, but there are probably other important risk factors too. Plus, we are just starting to collect data on athletes’ concussions and repetitive subconcussive blows. Those could become valuable pieces of information as we try to explain brain damage that seems to develop after long playing careers.

A complicated puzzle

This study is one piece of a complicated puzzle. We need a lot more research in both deceased athletes as well as living ones. That data will come, but it will take a long time to put the pieces of the puzzle together. Only then will we understand the real risks of brain trauma for our young athletes.

Also read:
Chronic traumatic encephalopathy: What is CTE, and should athletes and parents be concerned?
Common questions about CTE and traumatic brain injuries in sports

Are you surprised by this suicide data? Does the possibility of CTE developing in football players worry you? Please share your thoughts below!

Note: A modified version of this article appears as my sports medicine column in the May 25, 2016 issue of The Post and Courier.

Lehman EJ, Hein MJ, Gersic CM. Suicide Mortality Among Retired National Football League Players Who Played 5 or More Seasons. Am J Sports Med. 2016 May 5. Epub ahead of print.

Rao AL, Asif IM, Drezner JA, Toresdahl BG, Harmon KG. Suicide in National Collegiate Athletic Association (NCAA) Athletes: A 9-Year Analysis of the NCAA Resolutions Database. Sports Health. 2015 Sep-Oct;7(5):452-7.