Amid the increasing talk, a new documentary on head injuries and ways to address them arrives in Philadelphia this week, with a private screening at Penn on Thursday evening. Head Games, directed and coproduced by Steve James, who made the renowned basketball documentary Hoop Dreams, features several people with Philadelphia ties.
The filmmakers interviewed former Philadelphia Flyer Keith Primeau and the parents of Owen Thomas, the Penn football player who committed suicide in 2010 and was later found to have the same brain disease discovered in several other athletes who took their own lives, including former Eagles safety Andre Waters. Smith was also interviewed.
While much of the concussion debate centers on the NFL, the movie attempts to draw attention to the dangers of head injuries in youth sports, including football, hockey, and soccer.
"This is not a phenomenon that's restricted to just NFL football players. It goes through boys and girls of all ages," Smith, director of the Center for Brain Injury and Repair at Penn, said in an interview.
"[The movie] really asks the hard question of, 'Are we doing enough to protect our children?' " said Chris Nowinski, a former Harvard football player and professional wrestler who wrote the book that inspired the film.
Primeau, a Flyers center who retired in 2006 after 15 NHL seasons, is quoted in the movie's trailer, along with young hockey and soccer players. Concussions forced Primeau into retirement.
"I know that I've damaged my brain," Primeau said in the trailer. "I don't know where I am 10 years from now. I don't know where I am 20 years from now."
Owen Thomas came from a family with deep roots in football. His grandfather was a running back at Millersville State. His father, Tom, was an offensive lineman at Virginia, and his brother was a lineman at East Stroudsburg.
Owen was a defensive end. He was 21 when he hanged himself at Penn.
Later tests found that he had chronic traumatic encephalopathy (CTE), a brain condition that can lead to memory loss, aggression, depression, and impulse-control problems. It has been found in numerous athletes who have committed suicide or struggled with addiction.
One of the most worrying aspects of Thomas's case was that a concussion had never been diagnosed in him, leading to concern that less-severe hits accumulated over time can create damaging long-term consequences. Part of the film focuses on Thomas and his parents.
Tom Thomas, Owen's father, doesn't think CTE caused his son's suicide, but he does believe it was a "contributing factor." It may have added to Owen's struggles and frustration with his schoolwork, Thomas said.
"I want people to take it seriously, not only in football but also in other sports and just generally in life," said Thomas, a minister with a church in Schnecksville, Pa., near the family's Allentown-area home. "It's not just an injury, it's an injury with serious repercussions."
Concussions can lead to cognitive problems that last six months or longer in 15 to 20 percent of patients, Smith said.
"The other name for a concussion is mild traumatic brain injury ... there's nothing mild about it," he said, noting that doctors have been aware of the long-term consequences since early dementia was found in boxers in 1928.
What to do
The obvious question, and one the movie attempts to take on, is how coaches and parents should handle the increasing knowledge about the danger of concussions.
If he had to do it over, Thomas said, he would not pressure Owen to play football, but wouldn't stop him, either.
"He loved the game with passion and he loved the hitting of the game," he said in an interview. "He loved the controlled violence of the game, so it was important for him."
But he would encourage parents to be sensitive to head injuries and to treat them seriously.
"Make sure the child knows that this is not like a broken arm or a stubbed finger or even an ACL," Thomas said.
He plans to donate his own brain for study when he dies, and hopes other former athletes do, too, so more can be learned about CTE.
Penn's Smith doesn't want to alarm people - many people with concussions live full, healthy lives - but he also urges caution for parents, even when their children are striving to return to play. Parents often call his offices to ask for advice about returning to the field after concussions.
"My answer is always the same: It's just not worth it," he said.
One concussion makes a person more likely to suffer another, and no test can definitively say when someone is healed, Smith said.
"Look, it's their brain," Smith said. "Because you don't know, how else can you handle it? Be reckless, or be conservative?"
He also encouraged better education of coaches and training young athletes to be less aggressive. Teaching tackling without a helmet, for example, might help young players learn to play less dangerously.
"You don't use your head as a battering ram if there's no protection," Smith said.
He will moderate a discussion on head trauma after Thursday's screening, the third of three early showings. The film was shown in Chicago in May and will be screened in Boston on Wednesday.
Nowinski, the former wrestler, was forced to retire because of his own concussions. He wrote Head Games: Football's Concussion Crisis, and cofounded the Sports Legacy Institute, which aims to advance the treatment and study of brain trauma.
"People who think we have this problem under control are fooling themselves," he said in a telephone interview.
He hopes the movie increases vigilance among parents. They should make sure their kids' coaches understand concussions, he said, and sports' governing bodies should manage their rules and equipment to make games safer. As one example, he cited USA Hockey's decision to increase the age when checking is allowed.
"All sports can be reformed to a level that a rational person can be comfortable with," Nowinski said. "It's just a question of if that sport is willing to make the changes."
Contact staff writer Jonathan Tamari at 215-854-5214, firstname.lastname@example.org. Follow
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