Brain Injuries in Sports: Is it worth the price of admission?

Posted on December 11,2013 by aliatmspp

In light of the recent incident between Shawn Thornton of the Bruins and the Penguins’ Brooks Orpik (despite being taken off the ice on a stretcher, Orpik was evaluated and deemed well enough to travel home with the team, thankfully), I was thinking about the physical and psychological impact that these contact sports could have on an individual.

In hockey, the “enforcer” is a teammate, typically of a larger stature, whose primary responsibility is to protect other teammates while simultaneously motivating them. This is often achieved by fighting players on the opposing team. The enforcers are not usually known for their skating, passing or shooting prowess; instead, they are revered for their fighting skills. Often their roster slots are precariously defended, literally with their fists, and their names draw crowds of cheering fans who wait for the dropping of the gloves.

However, it is becoming alarmingly clear that there is often a disconnect between these players’ internal experience and the external expectations for them to perform. Former NHL player Derek Boogaard took his own life following a lifetime of filling the “enforcer” role. His father, Len Boogaard, explained the dichotomy of Derek’s professional persona with his true personality by saying, “On the ice, he had this persona which he basically, you know, scared all the players on the other team. But his persona off the ice was the complete opposite; he was very meek, he was very mild, very quiet, very laidback” (NY Times, 2011). To further complicate the life of an enforcer, studies conducted posthumously indicate that fighters’ brains match the profile for chronic traumatic encephalopathy (CTE), a degenerative disease that is often caused by repetitive trauma to the brain.

It is not difficult to connect the dots between athletes who are exposed to chronic pain, in particular NFL and NHL players, and substance use. A player like Boogaard who was involved in bareknuckle exchanges regularly, would amass a laundry list of injuries, often untreated and instead masked by pain killers. The comorbidity of substance abuse and depression in individuals who have sustained a traumatic brain injury (TBI) is one that is still being researched. In the case of Boogaard, comorbid conditions of depression and substance abuse ultimately led to a fatal overdose. In a few of the classes at MSPP that I have taken already, we have discussed the impact that TBI can have on an individual’s functioning, specifically in terms of memory recall, processing time, and depressive symptoms.

Yet even with the dissemination of this knowledge, jerseys with names like Thornton and Boogaard are still in high demand. Often, what makes the highlight reel on SportsCenter will be a hockey brawl or a massive hit is delivered on an NFL field, thereby reinforcing the value of these incidents. The physicality is glorified in the media and at times, explicitly through coaching. When discussing the prospect of a friend’s young child starting to play sports, one parent reported to me that he hoped his son wouldn’t want to play hockey or football based on the information about the impact of head injuries on youth. So, my question is, what do you think? Knowing some of the positive psychological and social effects of participating in sports (increased communication skills, cooperation and teamwork, a rise in self-esteem and self-advocacy, etc.), I find it a tricky question to negotiate. There is a potential cost-benefit analysis to be had here (cost of potential injury vs. benefit of experience playing on a team and simply loving the game), and I’m curious to hear your responses!

Below are some links that I found of interest when considering this issue.

Boston University’s Center for the Study of Traumatic Encephalopathy:

Gladwell, M. (2009). Offensive Play. New Yorker Magazine. Retrieved from

Guskiewicz, K. M., Marshall, S. W., Bailes, J., McCrea, M., Harding, H. P., Matthews, A., Mihalik, J. R., & Cantu, R. C. (2007). Recurrent Concussion and Risk of Depression in Retired Professional Football Players. Med. Sci. Sports Exerc., Vol. 39,No. 6, pp. 903-909, 2007. Found at:

“Punched Out,” NY Times video journalism project about Boogaard:

Wilson, K. (2011). On Enforcers, Depression, and Risk Factors. Retrieved from