Warren Sapp wants to bring awareness to brain injuries in football

A few months ago, NFL Hall of Famer Warren Sapp left his home in Florida to drive to the office of a close friend for lunch — a trip he’d made a thousand times. But this time, he pulled the car over to the side of the road, unable to remember how to get there.

“I went home, just turned around and went back home. I don’t know where I was going, or what I was doing, it must not have been worth it,” Mr. Sapp said in an interview with The Washington Times.

Today, he looks back on that day and laughs, bringing levity to a troubling topic: Repeated impacts imperil football players to chronic traumatic encephalopathy (CTE), a degenerative brain disorder that can cause memory loss, mood swings, depression and suicidal thoughts.

Mr. Sapp, 44, said he has learned to deal with memory loss by writing himself reminders in his cellphone about what he needs to do on any given day.

“Little things like that I used to take for granted. I had a memory like an elephant,” he said. “Nah, nah, the elephant has left the room.”

On Wednesday, Mr. Sapp will be a keynote speaker at the second annual Cohen Veterans Care Summit, a two-day conference in Washington, D.C., featuring leading researchers in the diagnosis and treatment of traumatic brain injuries and post-traumatic stress disorder.

A seven-time Pro Bowl defensive tackle, Mr. Sapp played for the Tampa Bay Buccaneers and the Oakland Raiders from 1995 to 2007, and won Super Bowl XXXVIII. He retired in March 2008.

In June, he announced that upon his death, he would donate his brain to Boston University’s CTE Center, which since 2008 has collected about 400 brains of people who have suffered multiple traumatic head injuries, including former pro football players.

CTE can only be diagnosed post-mortem via an examination of the brain. It occurs when a protein, called tau, builds up in the crevices of the brain and destroys neural pathways, which affects cognition.

The scientific community’s understanding of CTE and its link to football has evolved over the past decade or so — starting in 2005, when Dr. Bennet Omalu, a Nigerian pathologist working in Pittsburgh, published landmark findings of confirmed CTE in former pro football player Mike Webster.

Webster for years had suffered with severe behavioral and cognitive disfunction, and had attempted suicide before dying of a heart attack in 2002.

Mr. Sapp said his goal is to make football safer for future generations and to encourage people who may have symptoms of CTE to seek help.

“I just think back to Andre Waters, [Dave] Duersen and all those guys — if we had some knowledge, if they could seek some help instead of taking their lives,” he said, referring to two pro footballers who were confirmed to have CTE. “But now we have their brains and everything that comes with that, so now we’re working towards making it better for all the rest of us.”

Mr. Sapp said that when he first started noticing problems with his memory, he chalked it up to age.

“Nine times out of 10 after 40 it’s getting a little worse,” he said. “I hadn’t done any hitting in almost a decade. You don’t think about that part of it.”

As more research started to emerge linking multiple concussions to brain damage, it invalidated earlier findings that returning to play after a concussion doesn’t pose a significant health risk.

“We play the game and people didn’t tell us what exactly was going on — and wrote in medical journals that you can have back-to-back concussions and go back to work. Yeah, I was there when the rheumatologist wrote that. My 13 years, that was him — ’95 to 2008, those are my exact years,” he said referring to Dr. Elliot Pellman, the NFL’s chief medical adviser.

Dr. Pellman retired last year amid criticism for being underqualified for the position and not having experience in neuroresearch.

The NFL for years had avoided acknowledging a link between concussions and symptoms of traumatic brain injury. In 2015, thousands of NFL players settled a class-action lawsuit against the league, which agreed to a pay $5 million to each player who retired before July 2014 for medical costs associated with severe head trauma.

Last year, Jeff Miller, the NFL’s senior vice president for health and safety, became the first high-ranking league official to confirm a link between football and CTE, during a roundtable discussion with members of the U.S. House Committee on Energy and Commerce.

“You’d be a damn fool not to realize what you’re reading is about yourself. If you want to play the tough guy, ’nah, nah it can’t be’ — yeah, it is us, it’s us,” Mr. Sapp said.

He said that not enough changes have been made for safe play to avoid concussions and that no child under 14 should be playing tackle football.

“Nah, we don’t need that. We don’t need that at all. Let’s do some swimming, let’s do chess, let’s do tennis, let’s do golf, let’s expose them to something other than a Saturday afternoon of going out and hitting and playing football that no one gives a damn in 10 years about an 8-year-old championship or a 10-year-old championship,” he said, adding that he started playing football when he was 16.

“This is what I always tell people, if we baptize them in the Southern Baptist at 13, we bar mitzvah them at 13, 14 — now they’re ready to go!”

Last week, CTE Center researchers published an additional study evaluating long-term effects associated with playing football before or after the age of 12. The researchers were trying to determine if head trauma on the developing brain led to common CTE symptoms later in life, such as behavioral issues, depression, apathy, among others.

Robert Stern, the lead author of the study, told STAT News that the research has “tons of limitations” — such as study participants were volunteers SNF data relied on self-reporting — but that the findings appear to be consistent with other research linking repeated head trauma and CTE.

Of the participants, those who played football before the age of 12 had much higher instances of depression, apathy and other behavioral issues than those who started playing football later. Participants who had played high school, college and professional football had an even greater instances of poor mental health and depression.

Dr. Douglas Comeau, a specialist in concussions and director of Boston University’s Sports Medicine Services, said that rule changes among youth athletic leagues and collegiate programs to reduce the risk of concussions have taken place over the last 12 years with stricter enforcement taking hold in the past few years.

This includes Pop Warner, the youth football league for ages 5 to 14, instituting new rules that would help offset the chance of concussions, such as limited contact in practice and new blocking and tackling restrictions.

“Due to the change in contact rules with Pop Warner, we saw a dip in the amount of concussions that people would sustain. I think that in light of past — from 2013 to the present — more rule changes have happened,” Dr. Comeau said.

He added that the National College Athletic Association has eliminated two-a-day practices that include contact and that Major League Baseball changed their policy of suspending play from concussion from 14 days to seven, in the hope of spurring more athletes to admit when they’ve had an injury.

For his part, Mr. Sapp hopes to increase awareness not just for athletes but for veterans suffering the effects of traumatic brain injury.

“The message I want to get across is that we [are] working together to get us treatment, taking action, getting better treatment with the veterans, bioscience, research on traumatic brain injury, find better treatment and diagnosis, that’s all we can do,” he said. “Take a step every day that — we all on the same team, trying to get better because there are veterans out there, those are real heroes, the ones that go on road trips and not everyone come back. The Sunday guys that have a good time playing the kids’ game, we can all get together and help each other because this is something that is affecting way too many.”