Despite rising concerns over concussions, this doctor prescribes football

Before the start of the 2015 season, Breck football coach Jon Martin held his usual meeting with parents of his players, giving them the lowdown on how he runs the program and trying to soothe fears stoked by media-fueled horror stories about head injuries.

"I got on my soapbox and talked about all of the reasons football is the greatest game and its benefits, like teamwork, camaraderie and discipline," he said. "Everything I believe in."

Afterward, the mother of a freshman player new to the school walked up to Martin and introduced herself. She was Dr. Uzma Samadani, an associate professor in the department of neurosurgery at the University of Minnesota and attending neurosurgeon at Hennepin County Medical Center.

"I thought, 'Oh boy, here it comes,' " Martin said, expecting to hear all about the dangers of football to the brain. "Instead, she shook my hand and said, 'I agree with everything you said.'

"To have someone with letters behind her name agree really validates the things I and other coaches have been preaching. Football is not the enemy. Head injury is the enemy."

Martin's thoughts reflect an overriding feeling among high school football coaches that their sport has become a whipping post for concussion-related hysteria. Frequent news reports trumpet football's connection to long-term brain injuries. A recent movie, "Concussion," instilled fears that playing football will inevitably lead to poor brain health. Doctors across the country have issued a number of high-profile statements calling for a ban on football at high school and youth levels.

Enter Samadani, who is one of the nation's leading brain-injury researchers, holding the Rockswold Kaplan Endowed Chair for brain injury research at HCMC.

A mom in her early 40s with a passion for studying and preventing brain injuries, she emerged as an unlikely voice of reason for football coaches. She has given presentations on her research to peer groups and coaches associations, including in football hotbed Texas. She served on a panel for the Independent Metro Athletic Conference that replaced tackle football with modified flag football for seventh- and eighth-graders.

"I think, if your child wants to play football, you should let them play," she said. "It's a risk/benefit situation, and the risks are far lower than the benefits."

Samadani never intended to become a leading supporter of the advantages of playing football. Her interests are focused on all types of brain injuries, with an emphasis on improving recognition and developing proper treatment. But her son Alexander, now a sophomore at Breck, wanted to play football, so she felt it necessary to educate herself about the sport.

"My kid wanted to play, so I had to check it out," she said. "Anybody would do that for their kid."

While doing so, she was troubled by the science behind the research linking chronic traumatic encephalopathy (CTE), a degenerative brain disease similar to Alzheimer's, to football, particularly since most current research was based on studies conducted on NFL players who already had experienced repeated big hits.

"I'm not pro-football and I'm not anti-football. I'm pro-brain health," she said. "Everything you do in life has risks and benefits. What people have done very, very well is look at the risks of brain injury. But they've equated those to the risks of football. They're not the same thing."

Basing recommendations on high-risk subjects such as NFL players, she said, is irresponsible.

"Professional teams and high school teams are on completely different levels," she said. "A pro player will sacrifice himself to reach certain goals. High school players, most of them don't want to get hurt. They're very reasonable."

Bottom line? Alexander is about to begin his second season as a kicker/wide receiver. Mom could not be prouder.

Some in the medical profession staunchly disagree with allowing kids to play football. Last year two University of Minnesota physicians — Dr. Steven Miles and Dr. Shailendra Prasad — published an editorial in the American Journal of Bioethics that received national attention by calling for the removal of football from schools. Dr. Bennet Omalu, the researcher who first linked football to CTE, does likewise.

Despite the opposition, Samadani believes most medical professionals concur with her conclusions.

"There's risk in every sport," she said. "It's not just me. Most other neurosurgeons I know feel the same way."

"Football has become the poster child for CTE and sports-related concussions," said Dr. Ramu Tummala, a neurosurgeon at the University of Minnesota. "While there's a growing amount of evidence that supports the dangers of CTE, the vilification of football is a big leap. Rather than banning it, we should be looking at preventive measures and making it the safest it can be."

The American Academy of Pediatrics decided not to endorse a ban on football, instead issuing recommendations that mirror Samadani's. Among them: changing tackling style to a rugby-style wrap-and-roll technique, limiting or banning contact in practices, and enforcing strict protocols for not allowing players to return to a game if a brain injury is suspected.

"Coaches are the first line of defense against brain injury," Samadani said. "There needs to be open lines of communication so that the player will be honest if he's injured. That's where a brain injury can be identified and treated. There's a myth that brain injuries can't be treated. That's not true. It's a matter of getting the right and appropriate care."

In fact, while the cause and effect of brain injuries still are largely a mystery, treatment has greatly improved.

"It's never been safer to have a concussion than it is now," said Dr. Aimee Custer, a neuropsychologist and part of TRIA Orthopedic's sports concussion management team. "It's about getting good information out and having good preventitive measures."

Like most high school coaches, Stillwater's Beau Labore was worried about football's image. A former player at St. John's University, he didn't feel that those denouncing the sport saw the whole picture.

He had attended Samadani's presentation to the Minnesota Football Coaches Association in February and finally felt as if the pendulum was swinging back.

"It was encouraging and inspiring," Labore said.

He scheduled her to speak at Stillwater Junior High in June and came away even more convinced that her message was just what football coaches needed to hear.

"I went up and shook her hand. I kind of wanted to give her a hug," he said." I wanted her to know that I appreciated someone with the courage to tell the other side."

Not that the calls to ban football have been without benefits, Labore said. High school coaches are more knowledgeable and have a greater understanding of the risks involved.

"Coaches are better prepared, and so are parents and kids," he said. "The game has been made safer, and that's made us better."

That, Samadani said, is the key to keeping football viable.

"I'm not saying football isn't dangerous. Of course it's dangerous," she said. "But many of the activities children engage in are as dangerous or more dangerous. Good brain health is not just about preventing brain injury. It's about exercise and so many other things you can get from playing football."

Jim Paulsen • 612-673-7737