Despite successful ACL repair surgery and rehabilitation, some patients with ACL-repaired knees continue to experience so-called 'pivot shift', or episodes where the knee 'gives way' during activity. For the last four years, orthopaedic surgeons Dr Steven Claes and Professor Dr Johan Bellemans have been conducting research into serious ACL injuries in an effort to find out why. Their starting point: an 1879 article by a French surgeon that postulated the existence of an additional ligament located on the anterior of the human knee.
That postulation turned out to be correct: the Belgian doctors are the first to identify the previously unknown ligament after a broad cadaver study using macroscopic dissection techniques. Their research shows that the ligament, which was given the name anterolateral ligament (ALL), is present in 97 per cent of all human knees. Subsequent research shows that pivot shift, the giving way of the knee in patients with an ACL tear, is caused by an injury in the ALL ligament.
Last year David Epstein looked at the influence of a variety of effects on elite athletes in his book The Sports Gene (recommended btw). RadioLab has a segment on the subject focusing on the Kalenjin in East Africa.
There have been discrepancies in studies looking at long term mental impairment in football players who have received repeated head injuries. Now a study in Science Reports looked at a small sample of retired NFL players looking at both performance on a standard cognitive test and fMRI scans of their brains in action. Major changes were seen in how their brains function that may explain the discrepancy. A summary appears in Ars and the very readable paper in online
Hypoconnectivity and Hyperfrontality in Retired American Football Players
Recent research has raised concerns about the long-term neurological consequences of repetitive concussive and sub-concussive injuries in professional players of American Football. Despite this interest, the neural and psychological status of retired players remains unknown. Here, we evaluated the performances and brain activation patterns of retired National Football League players (NFL alumni) relative to controls using an fMRI-optimised neuropsychological test of executive function. Behaviourally, the NFL alumni showed only modest performance deficits on the executive task. By contrast, they showed pronounced hyperactivation and hypoconnectivity of the dorsolateral frontal and frontopolar cortices. Critically, abnormal frontal-lobe function was correlated with the number of times that NFL alumni reported having been removed from play after head injury and was evident in individual players. These results support the hypothesis that NFL alumni have a heightened probability of developing executive dysfunction and suggest that fMRI provides the most sensitive biomarker of the underlying neural abnormality.
Things first began to change in the 19th century, with the start of the mandatory-schooling movement. Massachusetts made schooling compulsory in 1852, though it wasn’t until 1917 that the final state, Mississippi, passed a similar law. With the institution of mandatory schooling, children experienced a profound shift in the structure of their daily lives, especially in the social organization of their time. Compulsory education brought leisure time into focus; since “school time” was delineated as obligatory, “free time” could now be identified as well.
What to do with this free time? The question was on the minds of parents, social workers, and “experts” who doled out advice on child-rearing. The answer lay partly in competitive sports leagues, which started to evolve to hold the interest of children. Urban reformers were particularly preoccupied with poor immigrant boys who, because of overcrowding in tenements, were often on the streets. Initial efforts focused on the establishment of parks and playgrounds, and powerful, organized playground movements developed in New York City and Boston. But because adults didn’t trust boys to play unsupervised, attention soon shifted to organized sports.
Sports were seen as important in teaching the “American” values of cooperation, hard work, and respect for authority. According to historian Robert Halpern, progressive reformers thought athletic activities could prepare children for the “new industrial society that was emerging,” which would require them to be physical laborers. Organized youth groups took on the responsibility of providing children with sports activities.
In Texas, where high school football is something of a religion, a change was made at one school
Last year in Texas, whose small towns are the spiritual home of high-school football and the inspiration for Friday Night Lights, the superintendent brought in to rescue one tiny rural school district did something insanely rational. In the spring of 2012, after the state threatened to shut down Premont Independent School District for financial mismanagement and academic failure, Ernest Singleton suspended all sports—including football.
To cut costs, the district had already laid off eight employees and closed the middle-school campus, moving its classes to the high-school building; the elementary school hadn’t employed an art or a music teacher in years; and the high school had sealed off the science labs, which were infested with mold. Yet the high school still turned out football, basketball, volleyball, track, tennis, cheerleading, and baseball teams each year.
Football at Premont cost about $1,300 a player. Math, by contrast, cost just $618 a student. For the price of one football season, the district could have hired a full-time elementary-school music teacher for an entire year. But, despite the fact that Premont’s football team had won just one game the previous season and hadn’t been to the playoffs in roughly a decade, this option never occurred to anyone.
“I’ve been in hundreds of classrooms,” says Singleton, who has spent 15 years as a principal and helped turn around other struggling schools. “This was the worst I’ve seen in my career. The kids were in control. The language was filthy. The teachers were not prepared.” By suspending sports, Singleton realized, he could save $150,000 in one year. A third of this amount was being paid to teachers as coaching stipends, on top of the smaller costs: $27,000 for athletic supplies, $15,000 for insurance, $13,000 for referees, $12,000 for bus drivers. “There are so many things people don’t think about when they think of sports,” Singleton told me. Still, he steeled himself for the town’s reaction. “I knew the minute I announced it, it was going to be like the world had caved in on us.”
With the exception of a few schools, college sports are a big money loser. Students are forced to pay fees that are nothing more than a money drain. One wonders how sustainable this is - particularly if liability for football head injury becomes a larger issue.. There is undoubtedly a middle ground. A few colleges have established wellness programs for all students and require a year or two of physical eduation. Sports can be part of this is the students like, but usually these are scaled back and inexpenisve Division III offerings.