April 20, 2014

Cribbs head injury seems to have scared everyone but Josh

Josh Cribbs shares with rookie receivers

Sometimes the things we love most about NFL players is also their worst and most self-destructive attribute. Josh Cribbs talked to the media yesterday and showed his patented toughness after taking a vicious head shot from an odd angle against the Ravens. The hit knocked him unconscious but Cribbs, as if transported from a different decade, wanted desperately to go back in the game.

“I don’t remember much about the hit, but after I came up, I was ready to play again, said Cribbs. “They had to take my helmet and everything for me not to play and had to keep tabs on me in the locker room so I wouldn’t run back out there. I was ready to play and I’m ready to play this week. I’m back ready.”

This is how NFL players came to be the darlings of sports fans in the United States, but it’s also why there is so much concern about the culture of the game that has historically influenced players to put their own physical safety and well-being second to their image as gladiators. Josh Cribbs is cut from that mold. It’s one of the reasons he is so beloved, but it should also be great cause for concern.

I’ve never read conclusive evidence linking former Browns running back Jerome Harrison’s brain tumor to his career as a football player, but it became fair game when Josh Cribbs brought it up yesterday. I thought about Jerome Harrison not too long ago, but there hasn’t been any sort of an update on him in the media. Cribbs has continued to stay in touch with his former teammate and his assessment was chilling.

“I still go over to his house every now and then and talk to him,” said Cribbs. “He’s doing pretty bad. He’s in and out of the hospital with seizures. They (Cribbs’ family) just don’t want the same thing to happen to me.”

From Mary Kay Cabot’s report, there is plenty of indication that Cribbs’ loved ones are all concerned for his health right now. It seems there are a lot of fans that are concerned too. The Browns had ten days off between games to heal up for the Giants, but we’ve all learned that these head injuries and concussions couldn’t be further from ankle sprains that benefit greatly from a few extra days. Head injuries are cumulative meaning that they leave something in the head forever different than it was before.1

Apparently the only one who isn’t scared is Josh Cribbs.2 In a lot of ways that makes sense. Playing football is what Josh Cribbs does. Take that away from him and he’s left like so many other retired players who can’t figure out exactly who they are when you put the word “former” in front of the thing – professional football player – that they’ve done better than anything else in their lives. So maybe fear of head injuries is more manageable than fear of not being a football player anymore. Take all that and combine it with the fact that this is a contract year and it makes a lot of sense as to why Josh Cribbs wants to play so badly this week (and every other week for that matter.)

For any fans who have been paying attention to player safety and health though, it is a scary-looking elixir that we’ve seen many players imbibe to their detriment in recent history. All you can do is hope that the doctors and Josh Cribbs aren’t deluding themselves into thinking he shouldn’t take a couple games off after that monster hit that stole his consciousness last Thursday night. It’s bad enough that head injuries are considered cumulative. It would be even worse if they turn out to be even more devastating when they occur closer together and somehow Josh Cribbs sustains another this weekend in New Jersey.

In the end, Cribbs said he didn’t really even remember the collision with Ellerbe last Thursday. “The doctor said my brain focused on the immediate trauma and shut down everything else. Some guys have brain swelling and don’t recover as fast. I’ve got someone looking out for me.”

It may be true that Cribbs has someone looking out for him. The biggest fear among Josh’s family and fans it seems, is that number 16 isn’t that someone.

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Footnotes:

  1. I’m wording this carefully because I’m not a scientist or a doctor, but all indications are that by “cumulative,” most doctors and scientists almost undoubtedly mean more fragile and damaged. []
  2. and the doctors that are seemingly going to let him play? []

  • humboldt

    Craig, as to your footnote, the simplest way to think about head injuries is in terms of cumulative stress across the lifespan. Every time the brain impacts the skull there is acute inflammation resulting from the brain recruiting immune cells to the damaged site. Multiple hits to the head, not to mention full concussions, can lead to chronic inflammation which damages brain tissue over time. Head injuries can also stretch and damage axons, the “connectors” of the brain that integrate various lobes.

    When neurons accumulate stress across a lifetime (not only from head injuries but also from things like unhealthy diets, lack of exercise, exposure to heavy metals, etc) it can lead to the compromise of their cellular structure over time. The microtubules that serve as a sort of structural support and enable the transport of nutrients throughout the cell break down (“phosphorylate” for the scientists among us) and get gummed up with the intracellular tau protein tangles commonly associated with “Alzheimer’s”. These tangles likely don’t ’cause’ neurons to die, but are rather downstream markers of diffuse damage and cumulative stress further upstream.

    People have heard the fancy term “chronic traumatic encephalopathy (CTE)” applied to many football players w/ early onset dementia, which is a fancy way of saying there was heavy tau pathology on their brains at autopsy. One would then conclude that the brains of these players have accumulated undue stress that led to the diffuse neuropathology and thus the progressive death of neurons.

    Whereas many people who are well educated and live healthy lives can perhaps withstand a higher burden of this pathology and still function normally, many athletes (esp NFL players) may a relatively weaker “cognitive reserve” and thus be at greater risk for dementia. This is likely why studies have shown NFL players are at 19 times greater risk for early onset dementia than the general population – as a group they just can’t withstand the cumulative stress and neuropathology that the general public can.

    As pertains to Cribbs, I love the guy – absolutely love him. But if I knew him I would be in his ear telling him to stop playing after this season. I’d tell him to find another career in which he can use his immense charisma and intelligence to still stay close to the game.

  • BenRM

    Wait, people are actually linking Harrison’s brain tumor to football? That’s the first I’ve heard of it.

  • http://www.waitingfornextyear.com Craig Lyndall

    I was very careful. Josh seemed to indicate that his family was scared about it…

  • BenRM

    I’m not a doctor so I don’t know how that works…just the first I’ve ever heard the connection made. Scary stuff.

  • Garry_Owen

    Excellent explanation. Thanks.

  • humboldt

    This is still debated in the field. Associations have been observed, but most large-scale population studies have not detected a significant association. It is likely that head injuries may aggravate one’s existing susceptibility to brain tumors, but the injuries don’t cause cancer outright.

    Nevertheless, you can understand why even the hint of an association could be frightening to the family of a recently-concussed NFL player.

  • Harv 21

    This is where the business of football makes me sick. Cribbs’s hit looked on a par with Colt’s last year, and Cribbs was out cold. I understand he’s undergone standard concussion tests and he’s a warrior and wants to play. But thee’s no common sense involved here. He’s in a contract year, and those currently in charge who might otherwise be more objective about his health in a non-playoff year rightly fear for their own jobs right now and would probably risk anything for an upset win this week.

    So Benjamin is hurt, so MoMass is hurt, so Little has the dropsies, so Gordon doesn’t yet have a clue. So what. If there’s obvious loss of consciousness he needs to have someone sit his ass down for at least a game. If Lerner was engaged at all he should order it. Haslam probably is prohibited from doing it even if he was s o inclined. But if he gets dinged in the head again this week people will rightly wonder why he’s out there already.

  • Garry_Owen

    Curious to know what you think – if you saw it – of Michigan State’s “treatment” of William Gholston last Saturday. He was obviously knocked out cold, though the “official” MSU statement was that he “had the wind knocked out of him.” I don’t know if Gholston threatened to rip the heads off of the medical staff or what, but in my mind there is no way that he should have come back into the game – and ESPN/ABC is complicit in advancing the false, reckless narrative that MSU fed them.

  • Garry_Owen

    I just asked Humboltd (hate to be redundant, all over again), but did you see what happened to William Gholston last week in the MSU/OSU game? I was having trouble watching the rest of the game for a while (and not because the Buckeyes looked so bad). I couldn’t believe that they explained his obvious KO as “getting the wind knocked out of him.” Given all that has happened in the last few years in the head injury department, it was sickening to see this 1950s response of “tape an aspirin to your head and get back in there – we can’t win without you!”

  • humboldt

    Gary, I was up in Schuylkill County with my med students during the game and missed all but the final series. Didn’t see or hear about the Gholston incident, but appreciate you bringing it up. Sickens me, and appears to be a totally anachronistic and unacceptable response by the MSU staff.

    I appreciate you implicating ESPN/ABC as well. From my vantage, the media have been largely complicit in continued ignorance about head injuries. For instance, I have zero respect for Mike Mayock of the NFL Network. When Colt McCoy was clearly concussed in the Steelers game last year no mention was made of it on the telecast (and they had the benefit of replay). And then, when Cribbs was viciously hit against the Ravens he went on a tangent about the legality of the play.

    Now I don’t expect announcers to “intervene” but they have a powerful platform to change fan perceptions/beliefs/values surrounding head injuries — or at least to observe them in a solemn and thoughtful manner when they occur — and many are failing in their responsibility (with obvious exceptions, don’t want to paint too broadly).

  • Harv 21

    Didn’t see that but not surprised.

    I get emotional and go a little overboard on this issue because our perspective has become so warped just because it’s football. Imagine the national hot dog eating contest where watching contestants withstand some gastrointestinal discomfort is part of the deal and maybe part of the fun. But you found out that one guy regurgitating violently and uncontrollably,or if contestants had to go for stomach pumping later, or if we found out that digestive systems were permanently damaged, wouldn’t that be enough to kick it down a notch? No way, the NFL is holy Americana, it’s different. But it’s not, it’s just a stupid sport.

    Now that we are getting more medical facts we should be rushing to implement very strict player safety polcies, because not to do so is just medieval. Ok, enough for me on this.

  • Garry_Owen

    Check it out: http://www.sbnation.com/college-football/2012/10/1/3439514/william-gholston-knocked-out-michigan-state-ohio-state
    Disgusting. (The sideline announcer later breathlessly exclaims that Gholston thankfully was not concussed, but had the wind knocked out.)
    [Funny to think that we might be two of only a small handful of people on this site who know that that word is pronounced "skookle."]

  • Garry_Owen
  • humboldt

    Agreed 100%. It’s positive progress that he wasn’t put back in the game (that is simply illegal in today’s NFL, although obviously still happening in NCAA as Gary points out below) but still a long way to go in protecting players’ long-term health.

    It is more than frustrating to watch scenarios like this as a fan/concerned observer. We need those in leadership positions to lead, but obviously there’s no chance of that happening in Berea right now.

  • saggy

    Oh i totally forgot about this!!!! I was laughing/screaming at my tv. I was laughing because of the obvious lie (wind knocked out?? come on!). I was screaming because the announcers didn’t even question it.