When former Iowa Hawkeyes and New York Giants’ safety Tyler Sash was found dead at age 27 in September of what was determined to be an accidental overdose from mixing painkillers methadone and hydrocodone, it sparked further discussion of the NFL and painkillers, but it turns out that concussions may have played a significant role in Sash’s death as well. As Bill Pennington writes in The New York Times, the discovery that Sash had an advanced form of chronic traumatic encephalopathy (CTE) may explain a lot of the struggles he had after the Giants cut him in 2013:

Cut by the Giants in 2013 after what was at least his fifth concussion, Sash had returned to Iowa and increasingly displayed irregular behavior, family members said this week. He was arrested in his hometown of Oskaloosa for public intoxication after leading the police on a four-block chase with a motorized scooter, a pursuit that ended with Sash fleeing toward a wooded area.

Sash had bouts of confusion, memory loss and minor fits of temper. Although an Iowa sports celebrity, both as a Super Bowl-winning member of the Giants and a respected, popular star athlete at the University of Iowa, Sash was unable to seek meaningful employment because he had difficulty focusing long enough to finish a job.

Barnetta Sash, Tyler’s mother, blamed much of her son’s behavior on the powerful prescription drugs he was taking for a football-related shoulder injury that needed surgery. Nonetheless, after his death she donated his brain to be tested for chronic traumatic encephalopathy, or C.T.E., a degenerative brain disease caused by repeated trauma that has been found in dozens of former N.F.L. players.

Last week, representatives from Boston University and the Concussion Legacy Foundation notified the Sash family that C.T.E. had been diagnosed in Tyler’s brain and that the disease, which can be confirmed only posthumously, had advanced to a stage rarely seen in someone his age.

Dr. Ann McKee, chief of neuropathology at the V.A. Boston Healthcare System and a professor of neurology and pathology at the Boston University School of Medicine who conducted the examination, said Tuesday that the severity of the C.T.E. in Sash’s brain was about the same as found in the brain of the former N.F.L. star Junior Seau, who committed suicide in 2012 at the age of 43.

Doctors grade C.T.E. on a severity scale from 0 to 4; Sash was at stage 2. McKee, comparing the results to other athletes who died at a similar age, said she had seen one case, a 25-year-old former college player, with a similar amount of the disease.

Sash’s case is further proof that CTE isn’t just something that affects NFL players who played decades ago in eras where concussions weren’t a focus. The disease can strike young (as it did in 2010 with Penn captain Owen Thomas, who committed suicide at 21), and it can have major impacts on players in their 20s. As Sash’s mother Barnetta noted, CTE changed him:

“My son knew something was wrong but he couldn’t express it,” Barnetta Sash said Monday night. “He was such a good person, and it’s sad that he struggled so with this – not knowing where to go with it.”

She continued: “Now it makes sense. The part of the brain that controls impulses, decision-making and reasoning was damaged badly.”

A real warning sign for the future of football comes from the comments in that article from McKee, who’s been a key figure in the research into concussions and CTE. McKee said that Sash’s 16-year football career gave him “a high exposure“:

McKee said that “very classic lesions of C.T.E.” were found in the frontal and temporal lobes of the brain in the amygdala. The location of lesions has bearing on symptoms exhibited.

“It helps explain his inattention, his short fuse and his lack of focus,” McKee said.

McKee added: “Even though he was only 27, he played 16 years of football, and we’re finding over and over that it’s the duration of exposure to football that gives you a high risk for C.T.E. Certainly, 16 years is a high exposure.”

That may sound like a substantial amount of football at first, but consider that four years of high school, four years of college and four years in the NFL would be 12 years, and many players start football before high school and/or play in community leagues as well as high school ones. There are whole waves of players out there with similar levels of football exposure to what Sash had. Not all of them have suffered as many documented concussions and other injuries, and not all of them will wind up with the health issues he faced, but his story has to have many wondering about if football’s worth the risk. Tyler’s older brother Josh (who played in high school and considered college) told the Times it would be hard for him to recommend his kids play football, and Tyler’s mother Barnetta echoed those sentiments:

“I want other parents to realize they need to have a conversation with their kids and not just think it’s a harmless game — because it’s not.”

[The New York Times]

About Andrew Bucholtz

Andrew Bucholtz is a staff writer for Awful Announcing.