Chronic Traumatic Encephalopathy

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    Does Soccer Still Need Headers?

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    New rules, new science and new tactics are already beginning to push heading out of the game. But doing so could have unintended consequences.It would be futile to predict when, precisely, it will come. It is not possible, from the vantage point of now, of here, to identify a specific point, or an exact date, or even a broad time frame. All that can be said is that it will come, sooner or later. The days of heading in soccer are numbered.The ball, after all, is rolling. England’s Football Association has received permission from the IFAB, the arcane and faintly mysterious body that defines the Laws of the Game — capital L, capital G, always — to run a trial in which players under the age of 12 will not be allowed to head the ball in training. If it is successful, the change could become permanent within the next two years.This is not an attempt to introduce an absolute prohibition of heading, of course. It is simply an application to banish deliberate heading — presumably as opposed to accidental heading — from children’s soccer.Once players hit their teens, heading would still be gradually introduced to their repertoire of skills, albeit in a limited way: Since 2020, the F.A.’s guidelines have recommended that all players, including professionals, should be exposed to a maximum of 10 high-force headers a week in training. Heading would not be abolished, not officially.And yet that would, inevitably, be the effect. Young players nurtured without any exposure to or expertise in heading would be unlikely to place much emphasis on it, overnight, once it was permitted. They would have learned the game without it; there would be no real incentive to favor it. The skill would gradually fall into obsolescence, and then drift inexorably toward extinction.From a health perspective, that would not be a bad thing. In public, the F.A.’s line is that it wants to impose the moratorium while further research is done into links between heading and both Chronic Traumatic Encephalopathy (C.T.E.) and dementia. In private, it must surely recognize that it is not difficult to discern the general direction of travel.Major League Soccer recently learned of its first confirmed case of C.T.E. in a former player.Albert Cesare/The Cincinnati Enquirer, via Associated PressThe connection between heading and both conditions has been soccer’s tacit shame for at least two decades, if not longer. Jeff Astle, the former England striker, was ruled by a coroner to have died from an industrial disease, linked to the repeated heading of a soccer ball, as far back as 2002. He was posthumously found to have been suffering from C.T.E.In the years since, five members of England’s 1966 World Cup-winning side have confirmed they are suffering from dementia, drawing focus on to the issue. Only one of them, Bobby Charlton, remains alive.One study, in 2019, found that soccer players — with the exception of goalkeepers — are three and a half times more likely to suffer from neurodegenerative disease than the general population. Two years later, a similar piece of research found that defenders, in particular, have an even greater risk of developing dementia or a similar condition later in life. The more the subject is examined, the more likely it seems that minimizing how often players head the ball is in their long-term interests.Head Injuries and C.T.E. in SportsThe permanent damage caused by brain injuries to athletes can have devastating effects.C.T.E., Explained: The degenerative brain disease has come to be most often associated with N.F.L. players, but it has also been found in other athletes. Here’s what to know.Soccer: Scott Vermillion, who died in 2020, became the first U.S. professional soccer player with a public case of C.T.E., as concussion fears rise in the sport.Sledding: Brain injuries in sliding sports — often called “sledhead” — might be connected to a rash of suicides among bobsledders.Football: Demaryius Thomas had C.T.E. when he died in December at 33, but that diagnosis alone does not capture the role football had in the N.F.L. star’s quick decline.In a sporting sense, too, it is easy to believe that heading’s demise would be no great loss. The game appears, after all, to be moving beyond it organically. The percentage of headed goals is falling, thanks to the simultaneous rise in analytics — which, speaking extremely broadly, discourages (aerial) crossing as a low-probability action — and the stylistic hegemony of the school of Pep Guardiola.Sophisticated teams, now, do their best not to cross the ball; they most certainly do not heave it forward at any given opportunity. They dominate possession or they launch precise, surgical counterattacks, and they prefer to do the vast majority of it on the ground. The sport as a whole has followed in their wake, hewing ever more closely to Brian Clough’s rather gnarled maxim that if God had intended soccer to be played in the clouds, there would be substantially more grass up there.Top clubs, like Pep Guardiola’s Manchester City, already do most of their best work on the ground.Logan Riely/Getty ImagesCertainly, it is more than possible to watch an elite game — in Spain, in particular, but in the Champions League or the Premier League or the Women’s Super League or wherever — and believe that the spectacle would not be diminished, or even notably altered, if heading was not only strictly forbidden, but had not, in fact, been invented.But that is to ignore the fact that soccer is defined not only by what happens, but by what might have happened, and by what did not happen. It is determined not only by presence but by absence. That is true of all sports, of course, but it is particularly true of soccer, the great game of scarcity.For much the same reasons that crossing has fallen from favor, so too has the idea of shooting from distance. Progressive coaches — either for aesthetic or for algorithmic reasons — encourage their players to wait until they have a heightened chance of scoring before actually shooting; as with headed goals, the number scored from outside the box is falling starkly, too.That, though, has had an unintended consequence. A team that knows its opponent really does not want to shoot from distance has no incentive to break its defensive line. There is no pressing need to close down the midfielder with the ball at their feet 25 yards from goal. They are not going to shoot, because the odds of scoring are low.And yet, by not shooting, the odds of finding the high-percentage chance are reduced, too. The defensive line does not break, so the gap — the slight misstep, the channel that briefly opens in the moment of transition from one state to another — does not come. Instead, the defense can dig into its trench, challenging the attack to score the perfect goal. It is not just the act of scoring from range that has diminished, it is the threat of it, too.The aerial game is one of threats, and possibility. Eliminating it would inherently change the game.Rob Carr/Getty ImagesThe same would be true of a soccer devoid of heading. It is not just that the way corners and free kicks are defended would be changed beyond recognition — no more crowding as many bodies as possible in or near the box — but the way that fullbacks deal with wide players, the positions that defensive lines take on the field, the whole structure of the game.Those changes, in the sense of soccer as a sporting spectacle, are unlikely to be positive. Players may not head the ball as much as they used to, now, but they know they might have to head the ball just as much as their predecessors from a less civilized era. They cannot discount it, so they have to behave in such a way as to counteract it. The threat itself has value. Soccer is defined, still, by all the crosses that do not come.Removing that — either by edict or by lost habit — would have the effect of removing possibility from the game. It would reduce the theoretical options available to an attacking team, and in doing so it would make the sport more predictable, more one-dimensional. It would tilt the balance in favor of those who seeks to destroy, rather than those who try to create. Clough did not quite have it right. Soccer has always been a sport of air, just as much as earth.If heading is found — as seems likely — to endanger the long-term health of the players, of course, then that will have to change, and it would only be right to do so. No spectacle is worth such a terrible cost to those who provide it. The gains would outweigh the losses, a millionfold. But that is not the same as saying that nothing would be lost.The Great UnknownSpain led England with 10 minutes remaining on Wednesday and was out of the Euros within an hour.Glyn Kirk/Agence France-Presse — Getty ImagesThe end, for Spain, will always lead back to the start. It was only a couple of weeks before the start of the European Championship when Jennifer Hermoso, the country’s most reliable source of cutting edge, was ruled out of the tournament with a knee injury. It was only a couple of days before everything began that Spain lost Alexia Putellas, the game’s finest player, too.Those are the mitigating circumstances in which Spain’s campaign at Euro 2022 will — and should — be judged, making its quarterfinal exit to the host, England, on Wednesday night somewhere in the region of a par finish for a nation stripped of two of its best players. Regret at what might have been should outweigh disappointment at what came to pass.The reward for succeeding in this tournament, as well as the garlands and the trophy and all of that business, will, most likely, take the shape of considerable pressure at next year’s World Cup; the country that triumphs in the next week will be expected to meet, and perhaps overcome, the challenge posed by the United States and Canada, the game’s reigning powers.Spain will be spared that, at least. And yet it should not be discounted: Despite its reduced horizons, it came within six minutes of dislodging England from a tournament it is hosting, after all. Should Hermoso be fit this time next year — or Amaiur Sarriegi have blossomed sufficiently that Hermoso’s presence is not missed — and Putellas, in particular, have recovered in time, it is not especially difficult to imagine a world in which this week was not an end at all.The emergence of players like Amaiur Sarriegi, 21, will give Spain hope ahead of next year’s World Cup.Bernadett Szabo/ReutersThe Expanding MiddleIn the space of, by a conservative estimate, 30 seconds, the Netherlands might have gone out of the European Championship three times. Had Daphne van Domselaar, the Dutch goalkeeper, reacted infinitesimally more slowly; had Ramona Bachmann of Switzerland made a slightly different choice; had the ball rolled this way and not that, the Netherlands, the reigning champion, might have fallen.The temptation, within any major tournament, is to examine the likely contenders in search of some broader theme, some sweeping narrative. As a rule, it is just below the surface that the tides and the currents are most apparent.So it is with Euro 2022. One of the game’s established powers will win it — England or France or Sweden or Germany — and claim primacy among the continent’s elite, for the time being at least. More significant, though, may be what is happening below them. Belgium and Austria, denizens of the second tier, both made the quarterfinals. Though it ended ultimately in collapse, there was a moment when it appeared a genuine possibility that Switzerland might join them.The Netherlands and Switzerland were closer than expected.Franck Fife/Agence France-Presse — Getty ImagesThat feels like the calling card of this tournament, more than anything else. That the level of the finest teams in Europe, the ones with abundant investment and industrialized development programs, is screaming skyward has been well telegraphed and amply documented.That the continent’s middle class is expanding is easier to overlook, but it is no less important. Women’s soccer — like men’s soccer — should not just be the preserve of populous and wealthy nations. Strength in these matters always comes from depth. It is not just how high the elite can soar that makes games entertaining and tournaments compelling, but how broad the challenges they face along the way.CorrespondenceAn oldie but a goodie from Alfons Sola this week. “Have you ever thought about just calling it football and stop pretending like it’s soccer?” he wrote, despite (or possibly because of) spending five years living in New Jersey. “We all know calling it soccer is some kind of strange situation that exists in the United States, right?”Well, yes and no, Alfons. In England, for example, there is a venerable magazine called World Soccer. Many people start their Saturdays watching a show called Soccer A.M. If they choose to do so, they can then follow all of the day’s action on a program called Soccer Saturday.I often wonder whether their presenters are told quite as often as I am that the term soccer is an American abomination. Or, for that matter, whether someone like Matt Busby, the legendary manager of Manchester United, was met with sound and fury when he had the nerve to call his autobiography ‘Soccer At The Top’.Forgive me if we are traipsing down a familiar path, but as far as I know, “football” and “soccer” were largely interchangeable in England until some vague point in the 1970s, 1980s or 1990s. Quite what changed to make people quite so angry about the very sight of one of those words, I’m not sure, but I’m going to guess it had something to do with increased American attention on the sport.Regardless, the furor over it has always struck me as odd (especially when we should be far more aggravated by the fact that the word is not, as America believes, “furor” but “furore”). Did you know the Italians call it calcio, like the thing you get in milk? That doesn’t even make any sense. More

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      Scott Vermillion, Former American Soccer Pro, Had C.T.E.

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      Scott Vermillion’s family members still struggle to articulate the jumble of emotions they felt last November when they received the phone call from the doctors.Vermillion, a former M.L.S. player, had died almost a year earlier, on Christmas Day in 2020, at age 44. The direct cause was acute alcohol and prescription drug poisoning, his family said, a dour coda to a troubled life: A high school and college all-American who played four seasons in M.L.S., Vermillion had spent the last decade of his life withdrawing from his family as he struggled with substance abuse and progressively erratic behavior.Late last year, doctors at Boston University offered another explanation: After examining Vermillion’s brain, the B.U. experts told his family that he had chronic traumatic encephalopathy, or C.T.E., a degenerative brain disease linked to symptoms like memory loss, depression and aggressive or impulsive behavior.The diagnosis gave Vermillion the grave distinction of being the first American professional soccer player with a public case of C.T.E. It was a solemn milestone, too, for M.L.S., a league that has, even in its young history, seen the consequences of the type of brain injuries more commonly associated with collision sports like football, boxing and hockey.For soccer as a whole, the finding will add another note to a small but growing chorus of concern about the health risks of playing the world’s most popular game.“Soccer is clearly a risk for C.T.E. — not as much as football, but clearly a risk,” said Dr. Ann McKee, the director of the C.T.E. Center at Boston University.A neuropathologist, McKee has found the disease in hundreds of athletes, including Vermillion.For Vermillion’s family, the diagnosis brought a sense of clarity, however small, to a life littered with questions. It did not answer everything — it simply could not, given that C.T.E. can be diagnosed only posthumously. It triggered feelings of doubt, guilt, anger, relief. But it was, at long last, something.David Vermillion at his home in The Villages, Fla., with one of his son’s jerseys.David Lawrence for The New York TimesThe specter of C.T.E. began hovering over the N.F.L. almost two decades ago, when the first cases of the disease were found in the brains of former professional football players. Since then, C.T.E., which is associated with repeated blows to the head, has been discovered in the brains of more than 300 former N.F.L. players.In soccer, though, the research and public conversation around C.T.E. and head injuries are still emerging, even as the confirmed cases mount. An English striker. A Brazilian World Cup winner. An American amateur.The former M.L.S. players Alecko Eskandarian and Taylor Twellman have been vocal about how concussions ended their careers and affected their personal lives. Brandi Chastain, a two-time Women’s World Cup winner, publicly pledged in 2016 to donate her brain for C.T.E. research.“We have to understand the gravity of the situation,” Chastain said. “Talking about concussions in soccer is not just a hot-button topic. It’s a real thing. It needs real attention.”Vermillion signing autographs after a game with the Colorado Rapids in 2000. An ankle injury forced his early retirement after the 2001 season.Rodolfo Ganzales/Allsport, via Getty ImagesLast year, leagues and tournaments around the world, including M.L.S., began experimenting with so-called concussion substitutes, which grant teams additional substitutions to deal with players with potential brain injuries. M.L.S. has joined some other sports leagues in implementing a variety of other protocols, including the use of independent specialists and spotters to assess potential concussions during games.“M.L.S. has comprehensive policies to educate players, coaches, officials and medical staffs about the importance of head injury identification, early reporting, and treatment,” Dr. Margot Putukian, the league’s chief medical officer, said in a statement. “There is always more progress to be made, and M.L.S. is staunchly committed to this important work.”The focus, though, is not only on treating concussions. In a growing effort to prevent head impacts of all kinds, players at every level are seeing more guidelines aimed at limiting headers.Head Injuries and C.T.E. in SportsThe permanent damage caused by brain injuries to athletes can have devastating effects.C.T.E., Explained: What to know about the degenerative brain disease associated with repeated blows to the head.The Dangers of Sledding: Brain injuries in sliding sports — often called “sledhead” — might be connected to a rash of suicides among bobsledders.Warning Signs of C.T.E.: An ex-N.F.L. player was found dead after his former team won the Super Bowl. His widow recounted his decline.A Study of N.F.L. Brains: In 2017, a neuropathologist examined the brains of 111 N.F.L. players. She found C.T.E. in 110.A study in 2019 by researchers in Glasgow showed former professional soccer players were three and a half times more likely than members of the general population to die from neurodegenerative disease (and less likely to die of heart disease and some cancers). Vermillion’s story, then, becomes the latest in a recent string of cautionary tales.“C.T.E. had never even crossed our minds,” said Cami Jones, who was married to Vermillion from 1999 to 2004.Vermillion started playing soccer in Olathe, Kan., when he was 5 years old. He loved the incessant movement of the game, the swashbuckling action, family members said. His coaches in elementary school, in the interest of sportsmanship, often kept him on the bench for long stretches because he would score too many goals, said his father, David Vermillion.His talent eventually earned him places on elite regional club teams and U.S. youth national teams as a teenager. It took him to the University of Virginia, where he was a third-team all-American in his junior year. It carried him to M.L.S., where he joined his local club, the Kansas City Wizards, now known as Sporting Kansas City, in 1998 at age 21.Vermillion was a high school player of the year and a college all-American.Doug Pensinger/Allsport, via Getty ImagesHis talent as a defender earned him places on several U.S. youth national teams.David Lawrence for The New York TimesBut Vermillion, a scrappy defender, never fully blossomed as a pro. He moved on to two other clubs before a nagging ankle injury forced his early retirement after the 2001 season. His career earnings in the fledgling league were meager; his father recalled his son’s salary being around $40,000 a year when he left the game.“It was a big blow,” David Vermillion said. “He spent all of his life climbing that hill, moving up, making himself a good player, and to abruptly have it end was tough.”Scott Vermillion tried to find some footing in his life after soccer. He managed a family store. He coached local youth teams. He pursued a nursing degree. But his relationships were slowly unraveling.Though Vermillion’s behavior would grow most concerning in the decade before his death, Jones said she noticed changes in him even before his career was over: He was often lethargic, which struck her as odd for a professional athlete, and frequently complained of headaches.“When I met Scott, he was a vibrant, outgoing pro athlete, super fun, a jokester,” said Jones, who divorced Vermillion in 2004, three years after his career ended, when their children were 1 and 3. “I watched him change really rapidly, and it was scary.”Over the next decade, Vermillion continued to withdraw from his family. His drinking became extreme and his behavior more erratic, family members said. He married a second time, but that union lasted only about a year. In 2018, he was arrested, accused of aggravated domestic battery after an incident with a girlfriend. He went in and out of rehabilitation programs for alcohol and prescription drugs, emerging only to insist to his family that the programs did not help him, that he was incapable of being helped.His daughter, Ava-Grace, got accustomed to him missing her dance recitals. His son, Braeden, now 22, was devastated when he missed his high school graduation.Vermillion with his children, Ava-Grace and Braeden..David Lawrence for The New York Times“He would promise a lot of things and basically just make excuses and not show up for us,” said Ava-Grace Vermillion, 20.Dr. Stephanie Alessi-LaRosa, a sports neurologist in Hartford, Conn., cautioned against drawing causal links between posthumous C.T.E. diagnoses and patterns of behavior in a person’s lifetime. She said research on the subject was still in its early stages, and that doctors were still trying to understand why some athletes got C.T.E. while others did not.“I have patients who are hesitant to get psychiatric treatment because they think they have C.T.E. and are doomed,” she said. “I think it’s important for patients to get the help they need, and if their family is concerned, get them to a sports neurologist.”Alessi-LaRossa said she thought the benefits of sports outweighed the risks, but echoed the increasingly widespread idea that heading in soccer should be restricted for youth players.In 2015, U.S. Soccer — resolving a lawsuit — announced a ban on heading in games and practices by players under 10 and created guidelines for restricting heading in practice for older players. And last year, English soccer officials released guidelines for heading, recommending professional players limit so-called “higher force headers” to 10 per week in training. (How, exactly, this should be enforced has been less clear.)Vermillion’s mother, Phyllis Lamers, contacted the Boston laboratory about having her son’s brain examined after his death. C.T.E. has four stages, the final stage associated with dementia; Scott Vermillion was found to have Stage 2 C.T.E.Vermillion’s family members said they hoped coming forward with his story could help inform families about the hidden risks of soccer.David Lawrence for The New York TimesHis family said they hoped coming forward with his story, however painful it might be to relive, could help inform families about the hidden risks of soccer. They said they regretted how hard they were on him, how they cut him off at times when his behavior became too difficult to handle. They agonized wondering if they could have done more.Ava-Grace Vermillion recalled texting her father on Dec. 23, 2020, his 44th birthday. She had not seen him in close to a year, she said, and as she prepared to head off to college in California to study dance, she said she felt compelled to break the ice.“I remember the day so specifically,” she said. “I was at work and just thought it was time I reach out to him. I hadn’t talked to him in a while. I sent him a text saying, ‘Hope you’re doing well.’ He called me back, and I didn’t get to answer. And he died two days later.”Ken Belson More

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      C.T.E. May Not Fully Explain Phillip Adams's Shooting Spree

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      A finding of C.T.E. can help explain violence and erratic behavior by former football players, but it will not give a clear picture of why Phillip Adams fatally shot seven people, including himself.It has become a grim but familiar pattern: Soon after an N.F.L. player dies, his family must decide whether to donate his brain to be tested for signs of chronic traumatic encephalopathy, the degenerative brain disease associated with repeated hits to the head.That was the choice facing the relatives of Phillip Adams, who fatally shot six people and then himself in his hometown, Rock Hill, S.C., this month. The family asked that his brain be sent to the C.T.E. Center at Boston University, the leading site for research on the disease, which has been found in hundreds of football players and other athletes but can be diagnosed only after death.If investigators request an expedited diagnosis — and thus far they have not — the researchers at Boston University would still need about four months to produce a definitive answer.While it has become common for N.F.L. families to question whether, and how deeply, C.T.E. affected a player, the sudden and atypical nature of Adams’s violent outburst, plus the pressures in the football-mad community where he lived, figures to cloud the answers that brain testing might provide.“Having the disease can make it more likely for you to be depressed and even kill someone or yourself, but we’ll never know if it was the only or the main cause of this tragic outcome,” said Adam M. Finkel, a quantitative risk assessor at the University of Michigan School of Public Health. “But the inability to prove that the disease caused any particular outcome should not be used to cast doubt on the broader point, that exposure to repeated head hits is strongly associated with a disease that increases various bad outcomes.”Even if Adams, whose six-year N.F.L. career ended after the 2015 season, is found to have had C.T.E., that may provide only one clue as to why he killed himself and six others. The disease has been linked to a host of symptoms, including aggressive, impulsive behavior and even suicidal thoughts. In many cases, families and friends of players found to have had C.T.E. say that the symptoms were uncharacteristic of the person they knew and that they became more pronounced over time.In this case, Adams’s sister, Lauren Adams, told USA Today that her brother, who was 32, had recently become unusually aggressive.“His mental health degraded fast and terribly bad,” she said. “There was unusual behavior.” The disease has also been tied to memory lapses, loss of focus and problems following directions and handling everyday chores. But researchers have found only associations, not causal links, between the disease and the many apparent symptoms.It remains difficult and perhaps impossible to determine a motive after a suicide because so many factors can play a role, including persistent mental distress and drug use. Adams does not appear to have left a note that tried to explain his motives, and such messages are often considered unreliable.While aggression is common in players who are ultimately found to have had C.T.E., rarely have they resorted to murder or suicide. Junior Seau and Dave Duerson are perhaps the best-known football players who killed themselves and were found to have had C.T.E. A far smaller group — including Jovan Belcher, a Kansas City Chiefs linebacker — has killed others before dying by suicide. Still, C.T.E. has grown in prominence as more former players are found to have had the disease, leading to vociferous debate about its role in their deaths.Much is still publicly unknown about what kind of medical treatment Adams may have received, or what relationship Adams had with Dr. Robert Lesslie, one of the six people who were murdered. Lesslie was a prominent local physician who specialized in emergency and occupational medicine.Representative Ralph Norman, Republican of South Carolina, told WBTV in Charlotte, N.C., last week that he had learned from law enforcement officials that Dr. Lesslie had seen Adams as a patient. The Sheriff’s Office for York County, S.C., has not confirmed the relationship.In 2017, Adams tried to apply for so-called line-of-duty benefits for injuries he obtained while in the N.F.L., but he had some trouble getting the necessary paperwork from his former teams, according to a disability adviser who worked with Adams. It is unclear how many of Adams’s six former teams provided injury records.A member of the York County Sheriff’s Office guarded the entrance to the home in Rock Hill, S.C., where Dr. Robert Lesslie; his wife, Barbara Lesslie; their two grandchildren; and two other men were fatally shot by Adams before he killed himself.Sam Wolfe/ReutersThose closest to Adams described him as not having come to terms with the end of his N.F.L. career and as someone who had a caretaker role in his family. He was very close to his mother, Phyllis Adams, and had been spending more time in his childhood home with her in recent months, neighbors said. His former agent, Scott Casterline, said Adams had turned down a job offer from him because he did not want to relocate to Texas, where he would be separated from his young son.Adams grew up in Rock Hill, which has given rise to so many N.F.L. players that it is known as Football City U.S.A.Casterline and some of Adams’s friends said Adams held himself to a high standard and never quite got over how his professional career had fizzled because of injuries and other factors.Like some other players, Adams focused so much of his early years honing his craft to get to the N.F.L. that he may have been at a loss over what to do next.“It always starts and ends with expectations,” said Seth Abrutyn, a sociologist at the University of British Columbia who studies the intersection of youth suicide and mental health. “If you are the main caretaker, or at least believe you are, the expectations you face can intensify. They are invisible pressures that exert real force on us.”Adams’s access to guns could have also been a factor in the tragedy. States with higher suicide rates tend to have higher gun ownership rates, research has shown. The average gun ownership rate in South Carolina was 43 percent in 2016, according to a recent Rand Corporation study, well above the average of 32 percent for all states.Police said Adams used two guns in the shootings last week, a .45-caliber and a 9 mm. He was arrested in 2016 in North Carolina and charged with carrying a concealed weapon, a misdemeanor.“What drives the overall suicide rate in the U.S. is gun ownership in the home,” said Matthew Miller, a professor of health sciences and epidemiology at Northeastern University, who has studied the intersection of guns and suicide. “It’s much easier to die when you can reach for a gun than when you can’t.”This and other factors may have fueled Adams’s fatal actions, Abrutyn said. Untangling them to find a clear pattern of behavior may never be possible.“It’s easy to have a monocausal explanation because it allows us to sleep better at night,” he said. “When we look our own lives, we know that that’s not true.” More

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      What Led Phillip Adams, Former N.F.L. Player, to a Shooting Spree?

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      A small city that bills itself as Football City U.S.A. is grappling with the shooting deaths of members of a prominent local family by Phillip Adams who, many say, had been adrift after his N.F.L. career ended.He struggled to find work. His last-ditch chance to make an N.F.L. team fizzled. He had a child to support and little apparent direction in a life freighted with high expectations. His behavior was increasingly erratic. Then on Wednesday, for reasons no one yet knows for sure, Phillip Adams, a former N.F.L. cornerback, went to the Rock Hill, S.C., home of a prominent doctor and shot everybody he saw before fatally turning the gun on himself.Now, the football-loving community of 65,000 that bills itself as Football City U.S.A. is struggling to contend with Adams’s suddenly violent turn and its aftermath.Before he killed five people, including two children, and critically wounded a sixth person, Adams, 32, who shot and killed himself several hours after his rampage, had seemed adrift since he last played N.F.L. football almost six years ago, friends and associates said. He remained close to home, caring for his mother, Phyllis, a former high school teacher who became a paraplegic after a car accident a decade ago.But for all the pressures on Adams — and family members are openly questioning whether football damaged his brain — the many people who rooted for him throughout his career are grappling with the loss of Dr. Robert Lesslie and his family at the hands of a local son.“He was the role model that all coaches hoped they could coach,” said Jim Montgomery, who coached Adams in football at Rock Hill High School, the alma mater of numerous N.F.L. players. Montgomery said he spent most of Thursday answering phone calls through tears.The authorities said that Adams fatally shot Dr. Lesslie; his wife, Barbara; and two of their grandchildren, Adah Lesslie, 9, and Noah Lesslie, 5. James Lewis, 38, had been working on their home when he was killed, and a sixth victim, Robert Shook, is in critical condition.The police have yet to explain why Adams, who was described by friends as “chill” and almost reclusive, singled out the doctor, or whether the two men had any relationship.But Representative Ralph Norman, Republican of South Carolina, told Charlotte’s WBTV Thursday that he had learned from law enforcement officials that Dr. Lesslie had seen Adams as a patient. Sheriff officials would not confirm the relationship.“He was treating him and stopped giving him medicine and that’s what triggered the killings from what I understand,” said Norman, whose district encompasses Rock Hill.Members of the Adams family have their own theories. They wonder whether football may have damaged his brain in the same way that has led other players to turn violent and, in a few cases, take their own lives.On Thursday, Alonzo Adams, Phillip’s father, told WCNC, a Charlotte television station, “I think the football messed him up.” His sister, Lauren Adams, told USA Today that he had recently become uncharacteristically aggressive.“His mental health degraded fast and terribly bad,” she said. “There was unusual behavior.”Adams’s brain will be studied to determine whether he had chronic traumatic encephalopathy, or C.T.E., a degenerative brain disease associated with repeated hits to the head, according to Sabrina Gast, the coroner in York County. It can take months to receive a diagnosis for the disease, which has been linked to mood disorders, memory problems, impulsive behavior and other issues, and has been found in hundreds of former football players.Former coaches, colleagues, neighbors and associates who knew Adams described him in interviews as a hard-working athlete who never advanced beyond journeyman status in the N.F.L., but who remained a quiet, helpful presence in town.“In 43 years, if you would’ve told me that this would have happened with Phillip Adams, I would’ve put him in the last five of the thousands of kids I coached,” Montgomery said on Thursday. “It’s just a sad day.”Duane Belue, a longtime friend and neighbor of the Adams family, said Phillip was close to his mother. Though Phillip had bought a new truck, he did not appear to overspend, and he stayed with his parents for extended periods. Within the last year, the Belues said they noticed that Phillip’s behavior had changed. He was less approachable and would pace outside aimlessly.“We noticed in the yard, he was out walking, kind of sad,” Anne Belue said. “You can’t judge somebody that far away, but he was always real friendly before then.”A star player in high school and in college at South Carolina State, Adams was picked by the San Francisco 49ers in the seventh round of the 2010 N.F.L. draft. He sustained a severe ankle injury his rookie season that may have derailed his career.“The bone went through the skin,” said Scott Casterline, Adams’s former agent. “Luckily, he had a good surgeon who helped him. But when a team sees a devastating injury like that, they move on.”After the 49ers released him, Adams bounced around the league with stops in New England, Seattle, Oakland (where he sustained two concussions), the Jets and Atlanta.He had one more shot at landing a roster spot, according to Casterline. During training camp in 2016, the Colts called and asked Adams to get to Indianapolis to participate in practice the following day. Casterline urged his client to jump on the next flight, but Adams — who was always gung ho for football — was suddenly hesitant.“He made it to the Charlotte airport, but the flight had left already,” Casterline said. “I could tell his head was not in it. He’d given up on it.”Casterline described Adams as a loner, not one to go to clubs or drink alcohol. He also hinted at financial troubles. Adams earned $3.6 million during his career and, at one point, wanted to invest in a smoothie shop. Casterline, who said he thought of Adams as a son, told his client it was a mistake because many retail businesses fail.Last fall, Adams called his former agent and asked for help finding employment. Casterline said he tried to persuade him to relocate to Dallas and work at one of his companies.“I said to just come out here to Texas,” Casterline said. “He just wouldn’t do it. He had a son. He was a good father and it was difficult with the baby’s mother.”On Wednesday, the day of the shootings, Adams’s father, Alonzo, called Casterline and said he wanted to talk about his son. Casterline did not find the message unusual. Occasionally, Adams’s parents called if they were unable to find Phillip.“I called Alonzo back and left a message, not realizing it had already happened,” Casterline said.In a news conference on Thursday, York County Sheriff Kevin Tolson said evidence recovered from the home of the Lesslies led them to suspect Adams of the killings. The authorities said they evacuated the Adamses’ home and tried to persuade Phillip to surrender. They found him inside, dead of a self-inflicted gunshot.A mourner adjusted items at a memorial outside of Riverview Family Medicine and Urgent Care, where Dr. Robert Lesslie practiced medicine.Sean Rayford/Getty ImagesIt is often difficult to assign motive to cases where a gunman has not left a note or spoken specifically of his or her intent, even more so in cases that end with the gunman’s death.But some of Adams’s friends said he never got over how his N.F.L. career ended. Rather than catching on with one team and landing a big contract worth tens of millions of dollars, he bounced from team to team, often playing for the league minimum salary. The calls for his services stopped coming, a common fate in the N.F.L., because colleges produce dozens of cheaper, healthier replacement players every year.The disappointment of washing out was particularly acute for Adams, friends said, because he came from Rock Hill, which has given rise to so many N.F.L. players that it is known as Football City U.S.A.To Adams, even a six-year career — twice as long as the average — may have been a letdown when compared to those of other local players like Jadeveon Clowney, who was picked first over all in the 2014 draft and is a three-time Pro Bowl selection; tight end Benjamin Watson, who played 13 seasons with the Patriots, Saints and other teams; and Stephon Gilmore, a defensive leader on the Patriots.“We have a saying around here: You could pay $6 on Friday night or you can wait a few years and pay $600 to see the kids around here play,” said Gene Knight, a broadcaster who has covered the city’s sports for decades.Charcandrick West, who played with the Kansas City Chiefs from 2014 to 2018 and shared an agent with Adams, said he and Adams worked out together during a couple of off-seasons. West said Adams was reserved and proud of his Rock Hill roots.“I never saw him get mad at anyone,” West said. “He was all about his business, washing and folding his clothes, real neat.”West added: “I feel like every athlete tries to keep high expectations. When you’re from Rock Hill, such a great football town, he didn’t want to be known as the guy who bounced around.”Neighbors noticed that Adams’s behavior had changed in the past year. He was less friendly and would pace outside his Rock Hill, S.C., home. “We noticed in the yard, he was out walking, kind of sad,” Anne Belue, a neighbor, said.Sam Wolfe/ReutersCasterline, who has worked as an N.F.L. agent for decades, also said Adams had trouble grasping why he didn’t catch on with a team.“Sometimes, these decisions are political,” Casterline said of teams’ cutting players. “Someone who’s drafted in the first round is going to get the most opportunities. That weighed on him a lot. The Patriots cut him three times in one season. They needed him, they didn’t, they’d cut him and re-sign him. It’s good for the paycheck, but not for the psyche.”Knight, the local sports broadcaster, remembered Adams as “a fierce competitor on the field, but he was a gentleman off the field all the times I encountered him.”Knight had also been treated once by Dr. Lesslie, a popular and well-known physician in Rock Hill, when he struggled with food poisoning. He said Dr. Lesslie worked on him at 2 a.m., easing his symptoms with intravenous therapy.“It’s not two people whose paths I thought would cross in this manner,” he said. “And I think that’s what a lot of people are wrestling with in the whole craziness of this situation.”John Jeter More

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      Vincent Jackson’s Brain Will Be Donated to C.T.E. Study

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      AdvertisementContinue reading the main storySupported byContinue reading the main storyVincent Jackson’s Brain Will Be Donated to C.T.E. StudyJackson, 38, a retired N.F.L. wide receiver, was found dead in a Florida hotel room on Monday.Vincent Jackson’s family donated his brain to researchers at Boston University to determine if he had C.T.E., the degenerative brain disease linked to repeated head trauma. “It’s something his family wanted to do to get answers to some of their questions,” a spokesperson for the family said.Credit…Cliff Mcbride/Getty ImagesFeb. 18, 2021, 5:06 p.m. ETThe family of Vincent Jackson, the retired three-time Pro Bowl N.F.L. wide receiver who was found dead in a Florida hotel room on Monday, donated his brain to researchers at Boston University to determine if he had chromic traumatic encephalopathy, or C.T.E., the degenerative brain disease linked to repeated head trauma.“Vincent being who he was would have wanted to help as many people as possible,” said Allison Gorrell, a spokeswoman for the Jackson family, in a phone interview Wednesday. “It’s something his family wanted to do to get answers to some of their questions.”Many unanswered questions, including his cause of death, remain about Jackson’s demise. While it could take weeks to finish an autopsy, Hillsborough County Sheriff Chad Chronister said in a radio interview on Wednesday that Jackson, 38, had health problems associated with alcoholism, which Chronister said were cited in the unreleased autopsy report. He also said the Jackson family told him that they believed that concussions may have been a factor in his behavior.Gorrell said the sheriff did not speak for the family. C.T.E. can only be diagnosed posthumously and researchers at Boston University, which houses the world’s largest brain bank devoted to cases involving the disease, said that determination can take months. The severity of a player’s C.T.E. is related to the number of years that he played football and the number of hits he endured, researchers have found.The brain bank has received a growing number of donations harvested from players who were 34 years old or younger at the time of death. More than half of those athletes had C.T.E.A married father of four, Jackson was widely admired in and out of the N.F.L. for his community service and business acumen. A 12-year N.F.L. veteran who played with the San Diego Chargers and the Tampa Bay Buccaneers, Jackson was voted Tampa Bay’s nominee for the Walter Payton Man of the Year Award, which recognizes community service, four years running during his five seasons there. He was a union representative in the N.F.L. Players Association and one of the named plaintiffs when the union sued the league’s owners during the 2011 lockout.After retiring from the N.F.L. in 2018 at 35, he continued to help military families through the Jackson in Action 83 Foundation. He had not played since the 2016 season. Jackson’s father served in the United States Army and Jackson and his wife, Lindsey, wrote a series of children’s books about growing up in military families. He won the Distinguished Community Advocate Award in 2018 from the Tampa Bay Sports Commission.He had been cited for his smooth transition from the N.F.L. into real estate development.According to the Hillsborough County Sheriff’s Office, Jackson was found at the Homewood Suites in Brandon, Fla., just a few miles east of Tampa, where hotel staff said he had been staying since Jan. 11. Jackson’s family reported that Jackson was missing on Feb. 10. Two days later, sheriffs found him at the hotel and “after assessing Jackson’s well-being,” canceled the missing persons case.A housekeeper found Jackson dead on Monday morning.Jackson was a straight-A student in high school and majored in business at Northern Colorado University, where he graduated as the school’s career leading receiver. He was also a starter on the Bears’ basketball team for two seasons, leading the team in scoring both years.The Chargers drafted Jackson in the second round in 2005, and after an injury-filled rookie year, he quickly became a mainstay of the team’s pass-first offense. He was named to the Pro Bowl in 2009, 2011, and again in 2012, his first season with the Buccaneers. He still holds the Buccaneers’ record for most receiving yards in a game, 216.During his N.F.L. career, he caught 57 touchdowns and had six seasons with more than 1,000 receiving yards.According to NFL.com, Jackson was arrested twice, in 2006 and again in 2009, for driving under the influence. After the second arrest, he was sentenced to four days in jail and five years of probation and was suspended by the league for three games.James Lofton, the Hall of Fame wide receiver, coached Jackson in San Diego and remembered Jackson as exceptionally bright and motivated. He recalled, too, when Jackson called him at 4:15 a.m. to apologize for his 2006 arrest.“We are part of society, and the same ills that get people in society get us, too,” Lofton said of N.F.L. players. “He just didn’t seem like the person who would have met a tragic death.”Greg Camarillo, a former N.F.L. receiver, was roommates with Jackson at the Chargers’ training camp in 2005 and now has a student support role in the University of San Diego athletics department. Camarillo said he was shaken by Jackson’s death and posted to Twitter several messages Monday about professional football players’ struggles in retirement.Many players, Camarillo said, have difficulty coping after they leave the N.F.L. because lose their identity and find it difficult to forge a new path without it.“It could happen to me or any former player,” Camarillo said in a phone interview Thursday. “Vince is not drastically different than anyone else, including me.”Gillian R. Brassil contributed reporting.AdvertisementContinue reading the main story More