Do Big Hits Mean Big Trouble?

By Brian Roach

For years, the National Football League and National Hockey League have popularized and glamorized "big hits" in professional sports. Now, after five years of research, and some startling discoveries regarding the frequency and long-term effects of concussions, the NFL and NHL -- as well as the governing bodies at all levels of sport -- are starting to re-consider their policies on such punishing blows.

"The game has changed -- players play at a higher speed and faster pace than they've ever played before," Scott Bertoli, Interim Athletic Director and head coach of the Princeton Day School varsity boys ice hockey team, said. "[Athletes' bodies] are evolving as 'off-the-field' conditioning becomes more intense. As athletes get bigger, stronger and faster, hits and collisions get bigger -- these factors lead to more injuries and concussions...it's clear that we need to protect these athletes at every level, in every way possible," the former East Coast Hockey League All-Star added.



(Scott Bertoli, whose number 19 was retired by the Trenton Titans (ECHL) in 2009, now serves as the Interim Athletic Director and head coach of the varsity boys ice hockey team at Princeton Day School. Photo courtesy of ECHL Online.)

Among the leaders in research designed to educate and protect those involved in athletics (and the military) are the Sports Legacy Institute -- founded in 2007 "to advance the study, treatment and prevention of the effects of brain trauma in athletes and other at risk groups" -- and the Boston University School of Medicine's Center for the Study of Traumatic Encephalopathy -- founded as a collaborative venture between the Sports Legacy Institute and the Boston University School of Medicine in 2008.



(Together with the Sports Legacy Institute, the Boston University School of Medicine helped create the Center for the Study of Traumatic Encephalopathy in 2008. Photo courtesy of the Sports Legacy Institute.)

Although both the Boston University School of Medicine and the Sports Legacy Institute declined to comment on the state of their current concussion studies, a review of the Sports Legacy Institute's most recent Form 990 (filed with the IRS in 2008) revealed that the non-profit spent $25,316 that year to help fund the Boston University Center for the Study of Traumatic Encephalopathy and secure the post-mortem donation of 107 brain, hosted a "coaches concussion clinic" in an attempt to educate 120 New Hampshire Pop Warner coaches on the diagnosis and management of concussions, and spent $29,724 to "raise awareness of the dangers of concussion[s]" (through pieces featured on CNN, ESPN, the New York Times and the Boston Globe).

A catalyst for the flurry of research being done at institutions across the nation appears to be an article by Dr. Bennet Omalu in the July 2005 issue of Neurosurgery, Dr. Steven DeKosky reported in the New England Journal of Medicine. Dr. Omalu's article, "Chronic Traumatic Encephalopathy in a National Football League Player," represented the first autopsy report of a professional football player with distinct symptoms of cognitive and neurological decline (Chronic Traumatic Encephalopathy).

According to the Boston University Center for the Study of Traumatic Encephalopathy's website, Chronic Traumatic Encephalopathy (CTE) is caused by repetitive blows (or trauma) to the brain. Early symptoms of CTE -- which causes impaired function, and eventual death, of brain cells -- include memory impairment, emotional instability, erratic behavior, depression and problems with impulse control. In some cases, the website said, "CTE may eventually progress to full-blown dementia."



(In Neurosurgery, volume 57, Dr. Bennet Omalu's autopsy of a retired professional football player definitively revealed the degenerative effects of "repeated mild traumatic brain injury" (i.e., concussions). Photo courtesy of Neurosurgery).

In the wake of Dr. Omalu's breakthrough article, numerous studies dealing with the effects of brain trauma in sport have been published in medical journals -- including Dr. DeKosky's "Traumatic Brain Injury -- Football, Warfare, and Long-Term Effects", and Dr. Kevin Guskiewicz's Journal of the American Medical Association article "Cumulative Effects Associated with Recurrent Concussion in Collegiate Football Players." In his article, Dr. Guskiewicz asserts that, "approximately 300,000 sport-related concussions occur annually in the United States." His review of the data also revealed that players with a history of concussions are more likely to suffer repeated instances of concussions (possibly in the same season -- 6.5 percent of the sample studied suffered two or more concussions in the same season).

Such findings have left the governing bodies at all levels of sport, and the manufacturers of protective sporting equipment, searching for solutions to this growing neurological crisis.

The New Jersey State Interscholastic Athletic Association, made up of 433 "accredited public, private and parochial high schools in the state," implemented a formal policy mandating that coaches remove any players suspected of suffering a head injury or concussion. Coaches are to closely observe the player over the next "several hours," and cannot allow the athlete to return to action until he or she has been evaluated (and cleared to play) by a medical professional.



(The New Jersey State Interscholastic Athletic Association has put regulations in place to protect athletes affected by head injuries and concussions. Photo courtesy of the New Jersey State Interscholastic Athletic Association.)

Policies in collegiate and professional sports -- where teams often have athletic trainer(s) on staff -- are not so cut-and-dried, Luke Hensel, head athletic trainer for the Princeton Day School, said. And, while some head coaches may rush their "star players" back into action before their head injuries have sufficiently healed, Princeton University head football coach Bob Surace said that his priority has been -- and will continue to be -- the long-term well being of his players.

"It is so important to protect the player's safety," Surace, who also served as an assistant with the Cincinnati Bengals for eight years, said. "Sometimes, these players try to be 'macho' -- it's important to make sure that the right decisions are being made regarding their health. I will never sacrifice a player's health -- I will do anything to make this game [football] safer...If studies show that there are better ways to [treat players], then we will do what needs to be done to make things better."



(Bob Surace, who spent eight years as an assistant in the NFL before coming to Princeton University last year, said that he agrees with NFL legislation aimed at reducing helmet-to-helmet collisions. Photo courtesy of PressOfAtlanticCity.com).

Helmet companies, like Easton-Bell Sports, Inc. (parent company of Riddell, Inc.), are also trying to stay ahead of the game by patenting new technologies to protect players against concussions (a review of Easton-Bell Sports, Inc.'s latest 8-K filing with the Securities and Exchange Commission reveals that the company experienced a 14% growth in sales of football equipment).



(According to researchers at the University of Pittsburgh Medical Center, the Riddell Revolution helmet significantly reduces the incidence of concussions -- wearers were 31 percent less likely to suffer a concussion (when compared to wearers of "traditional" football helmets). Photo courtesy of Riddell.com.)

Helmet manufacturers and medical experts agree, however, that even the most technologically advanced helmet will not prevent concussions and head injuries 100 percent of the time.

"I think that [helmet companies] really are trying to make a difference with new designs...but, no helmet can ever guarantee that it will prevent brain traumas," Hensel said in an e-mail. "Helmets certainly protect [you] from soft tissue and skull damage, but a concussion occurs when [the] brain strikes the insides of [the skull], which can be caused by whiplash, or other types of indirect contact -- things that a helmet cannot protect against," he added, noting that new helmet designs will only be helpful if professional (and non-professional) athletes are willing to adopt them.

While Hensel acknowledged that helmet technology and clinical research have continued to move forward, he's also noticed a startlingly negative trend that he would like to see reversed as soon as possible.

According to Hensel, many doctors who review athletes' post-injury CT scans (CT scans visualize the brain, checking for blockages and other severe problems in the blood vessels) and find no abnormalities suggest that these athletes rest and return to action when they feel most ready. But, Hensel noted, CT scans do not tell the whole story. In order to effectively diagnose, and treat, concussions in the long-term, doctors must also learn to utilize such resources as baseline testing results (baseline tests compare current -- often post-concussive -- brain functioning to the individual's "normal" brain functioning).

Research and regulations aside, Hensel admitted, injury is -- and always has been -- a part of every sport.

"Every sport carries an inherent risk of some level of injury," Hensel said in an e-mail. "And, while we try to make them as safe as possible, if you make [things] too safe, you're taking away from the game itself. Some people in my profession, or in the medical community, might call me crazy, but I think that you need to realize that if you [over-regulate], athletes and fans are not going to find it fun anymore...I think that prevention is certainly key, but we can also have a positive effect by managing injuries better when they occur, so that athletes make full recoveries before returning to play."



(Luke Hensel, head athletic trainer at Princeton Day School, treats approximately 20-50 concussions per year. Here, he discusses his experience with concussions, treatment of head injuries and what lies ahead for the treatment and prevention of concussions. Video courtesy of Brian Roach.)

Stephen Kurkjian: "A Legend in the Newsroom"

BOSTON -- Stephen Kurkjian – a former member of the Boston Globe’s “Spotlight Investigative Team” – has been a part of three Pulitzer Prize winning projects, has been awarded more than 20 regional and national journalism awards, and is, in the words of current Spotlight Team member Matt Carroll, “a legend in the newsroom.”

(Photo courtesy of the Armenian Mirror-Spectator: Stephen Kurkjian, one of three original members of theBoston Globe’s “Spotlight Investigative Team,” worked as a reporter and editor at the Globe for more than 35 years).

“He [Kurkjian] has been at the top of this game for the past three or four decades,” Carroll, who worked with Kurkjian for more than a year on a 2003 Pulitzer Prize winning series on sexual abuse in the Roman Catholic Church, said. “Steve is one of the best reporters I’ve ever worked with – he is so good at digging, he’s tenacious…and he, like any good reporter, is excellent at ‘sniffing’ out stories.”

(Photo courtesy of TIME Magazine online: Kurkjian’s work with the Boston Globe’s “Spotlight Investigative Team on sexual abuse in the Roman Catholic church earned him his third Pulitzer in 2003.Kurkjian was also awarded Pulitzers in 1972 – for exposing corruption in Somerville – and 1980 – for his investigative work on the Massachusetts Bay Transportation Authority.)

And, although the Armenian Mirror-Spectator reports that he accepted a buyout from the Boston Globe in 2007, Kurkjian remains active – serving as a reporter for the Dorchester Reporter, researching a picture from the 1915 Armenian genocide, and investigating the 1990 art heist at the Isabella Stewart Gardner Museum in Boston’s Fenway-Kenmore neighborhood.

(Photo courtesy of the Isabella Stewart Gardner Museum: On March 18, 1990, 13 pieces of art were stolen from the Isabella Stewart Gardner Museum, including these two Rembrandts: A Lady and Gentleman in Black and The Storm on the Sea of Galilee. The perpetrators have not yet been identified. Kurkjian – who, after an estimated 200 personal interviews, said he has a “pretty good” idea of who is responsible for the heist – hopes to publish a book on the crime once he has compiled definitive evidence.)

The theft, which Kurkjian said has been described as the “greatest art heist in world history,” occurred during the early morning hours of March 18, 1990. Thieves – disguised as police officers – subdued the guard on duty, Kurkjian said, before stealing 13 works of art valued at nearly $300 million. Twenty years later, Kurkjian added, the government has not located a single painting.

The FBI’s failure to locate the paintings – or the perpetrators – however, will not deter Kurkjian from opening up an investigation of his own. In fact, according to Carroll, such stories are right up this award-winning journalist’s alley.

“[Steve] is an extremely…empathetic and trustworthy person – he can sit with pretty much anyone and get [them] to talk,” Carroll said of his former colleague. “And, he is a terrific researcher/reporter – he will dig and dig and dig until he finds out just what is going on.”

It is this ability to see “the story” and “piece things together” that has rocketed Kurkjian to a position of local and national prominence. In a talk conducted by John Ellement at Boston University’s College of Communication, Kurkjian cautioned that no one (including himself) could out-report every other news outlet every time. What they can do, however, is “out-smart” and “out-work” other reporters by looking for stories everywhere, looking at stories from a different angle, and tapping every available resource for information.

And, even though the game has changed since his 1969 Boston Globe article on the Woodstock music festival, the principles of good reporting have remained the same – preparation, curiosity, an ability to write clearly and concisely, and a willingness to ask questions.

“The skill set you learn here, in class, is practical – it will be put to use when you leave the classroom and deal with the outside world,” Kurkjian told the class of aspiring BU reporters, noting that while the future may seem unclear, journalism is certainly not dead – people will always be on the lookout for factual information reported clearly, truthfully, and concisely.

Born in Dorchester, MA – what he described as a “lower middle class-working neighborhood” – Kurkjian attended Boston Public Schools as a youngster before enrolling at Boston University in 1962. After he graduated with a Bachelor of Arts in English in 1966, Kurkjian began work in the newspaper business (he also attended law school at the request of his mother. Kurkjian graduated from Suffolk University Law School in 1970, and is a non-practicing member of the Massachusetts Bar Association).

(Photo courtesy of Boston University: Kurkjian attended Boston University as an undergraduate. He also graduated with his Juris Doctor degree from Suffolk University Law School in 1970.)

Kurkjian began his work with the Boston Globe in 1968, and during his tenure with the paper has served as reporter and editor for the “Spotlight Investigative Team,” Bureau Chief for the paper’s Washington Bureau, and senior assistant metropolitan editor.

For more than 35 years, Kurkjian tirelessly investigated and reported story after story for the Globe. Now, after three years of “retirement” from one of the giants in the Boston newspaper business, Kurkjian continues investigating, reporting, and writing (once a week in the Boston Public Library’s Bates Hall Public Reading Room – “the second-best room in Boston [behind the Globe’s newsroom],” Kurkjian said). It is because of this hard work and talent, Carroll and Ellement said, that he remains one of the best reporters in the journalistic world.

“[Steve] is inspirational…tenacious, and, he’s a phenomenal resource,” Carroll said. “He’s had a hand in probably every major scandal in this state [for quite some time]…and, again, he’s won three Pulitzers – there may be only two or three other people who can say that.”

“I am not full of myself,” Kurkjian told BU students. “But, I am full of being a journalist…I’d like to think my DNA is in the Globe’s newsroom.”

(Photo courtesy of the Boston Public Library: Kurkjian still visits the Bates Public Reading Room in the Boston Public Library’s main Copley branch once a week to do his writing.)

Steve Kurkjian: "A Legend in the Newsroom"

BOSTON -- Stephen Kurkjian – a former member of the Boston Globe’s “Spotlight Investigative Team” – has been a part of three Pulitzer Prize winning projects, has been awarded more than 20 regional and national journalism awards, and is, in the words of current Spotlight Team member Matt Carroll, “a legend in the newsroom.”

(Photo courtesy of the Armenian Mirror-Spectator: Stephen Kurkjian, one of three original members of theBoston Globe’s “Spotlight Investigative Team,” worked as a reporter and editor at the Globe for more than 35 years).

“He [Kurkjian] has been at the top of this game for the past three or four decades,” Carroll, who worked with Kurkjian for more than a year on a 2003 Pulitzer Prize winning series on sexual abuse in the Roman Catholic Church, said. “Steve is one of the best reporters I’ve ever worked with – he is so good at digging, he’s tenacious…and he, like any good reporter, is excellent at ‘sniffing’ out stories.”

(Photo courtesy of TIME Magazine online: Kurkjian’s work with the Boston Globe’s “Spotlight Investigative Team on sexual abuse in the Roman Catholic church earned him his third Pulitzer in 2003.Kurkjian was also awarded Pulitzers in 1972 – for exposing corruption in Somerville – and 1980 – for his investigative work on the Massachusetts Bay Transportation Authority.)

And, although the Armenian Mirror-Spectator reports that he accepted a buyout from the Boston Globe in 2007, Kurkjian remains active – serving as a reporter for the Dorchester Reporter, researching a picture from the 1915 Armenian genocide, and investigating the 1990 art heist at the Isabella Stewart Gardner Museum in Boston’s Fenway-Kenmore neighborhood.

(Photo courtesy of the Isabella Stewart Gardner Museum: On March 18, 1990, 13 pieces of art were stolen from the Isabella Stewart Gardner Museum, including these two Rembrandts: A Lady and Gentleman in Black and The Storm on the Sea of Galilee. The perpetrators have not yet been identified. Kurkjian – who, after an estimated 200 personal interviews, said he has a “pretty good” idea of who is responsible for the heist – hopes to publish a book on the crime once he has compiled definitive evidence.)

The theft, which Kurkjian said has been described as the “greatest art heist in world history,” occurred during the early morning hours of March 18, 1990. Thieves – disguised as police officers – subdued the guard on duty, Kurkjian said, before stealing 13 works of art valued at nearly $300 million. Twenty years later, Kurkjian added, the government has not located a single painting.

The FBI’s failure to locate the paintings – or the perpetrators – however, will not deter Kurkjian from opening up an investigation of his own. In fact, according to Carroll, such stories are right up this award-winning journalist’s alley.

“[Steve] is an extremely…empathetic and trustworthy person – he can sit with pretty much anyone and get [them] to talk,” Carroll said of his former colleague. “And, he is a terrific researcher/reporter – he will dig and dig and dig until he finds out just what is going on.”

It is this ability to see “the story” and “piece things together” that has rocketed Kurkjian to a position of local and national prominence. In a talk conducted by John Ellement at Boston University’s College of Communication, Kurkjian cautioned that no one (including himself) could out-report every other news outlet every time. What they can do, however, is “out-smart” and “out-work” other reporters by looking for stories everywhere, looking at stories from a different angle, and tapping every available resource for information.

And, even though the game has changed since his 1969 Boston Globe article on the Woodstock music festival, the principles of good reporting have remained the same – preparation, curiosity, an ability to write clearly and concisely, and a willingness to ask questions.

“The skill set you learn here, in class, is practical – it will be put to use when you leave the classroom and deal with the outside world,” Kurkjian told the class of aspiring BU reporters, noting that while the future may seem unclear, journalism is certainly not dead – people will always be on the lookout for factual information reported clearly, truthfully, and concisely.

Born in Dorchester, MA – what he described as a “lower middle class-working neighborhood” – Kurkjian attended Boston Public Schools as a youngster before enrolling at Boston University in 1962. After he graduated with a Bachelor of Arts in English in 1966, Kurkjian began work in the newspaper business (he also attended law school at the request of his mother. Kurkjian graduated from Suffolk University Law School in 1970, and is a non-practicing member of the Massachusetts Bar Association).

(Photo courtesy of Boston University: Kurkjian attended Boston University as an undergraduate. He also graduated with his Juris Doctor degree from Suffolk University Law School in 1970.)

Kurkjian began his work with the Boston Globe in 1968, and during his tenure with the paper has served as reporter and editor for the “Spotlight Investigative Team,” Bureau Chief for the paper’s Washington Bureau, and senior assistant metropolitan editor.

For more than 35 years, Kurkjian tirelessly investigated and reported story after story for the Globe. Now, after three years of “retirement” from one of the giants in the Boston newspaper business, Kurkjian continues investigating, reporting, and writing (once a week in the Boston Public Library’s Bates Hall Public Reading Room – “the second-best room in Boston [behind the Globe’s newsroom],” Kurkjian said).It is because of this hard work and talent, Carroll and Ellement said, that he remains one of the best reporters in the journalistic world.

“[Steve] is inspirational…tenacious, and, he’s a phenomenal resource,” Carroll said. “He’s had a hand in probably every major scandal in this state [for quite some time]…and, again, he’s won three Pulitzers – there may be only two or three other people who can say that.”

“I am not full of myself,” Kurkjian told BU students. “But, I am full of being a journalist…I’d like to think my DNA is in the Globe’s newsroom.”

- Brian Roach