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Padding and helmets may not be enough to protect football players from suffering injuries. A new study reports that consistent hits to the head that do not have to result in a concussion do significant damage to the brain post games and seasons. The study, headed by Damir Janigro, PhD with Cleveland Clinic and published in PLoS ONE, found that consecutive hits to the head could lead to the thinning of the brain-blood barrier, which contributes to neurodegenerative diseases.

Janigro recruited 67 football players from three colleges. The players were divided into three groups, those that were benched during the entire game, those who played but were never hit in the head, and those with frequent head collisions. None of the participants experienced an actual concussion. Janigro measured the S100B levels in each athlete. S100B is an antigenic protein that leaks from the brain to the bloodstream when the barrier is weakened. The researchers found that only the athletes that suffered head tackles had S100B leakage, which distinctly singled out head collisions as a contributing factor in brain damage. Playing football and avoiding head tackles do not pose a threat to brain function.

The athletes were given a questionnaire after the game that asked them to record the number of collisions they had and if there were any symptoms that they felt after these collisions. The numbers were verified by a tape recording of the game. The athletes also underwent pre and post game imaging tests. The researchers then followed up on the athletes six months after the game with MRIs and found that the brains of athletes who had head collisions looked very similar to brains that have actually suffered concussions.  The researchers also noted an elevated concentration of autoantibodies responsible for fighting leakages in these athletes' brains. The researchers concluded that consecutive sub-concussive hits to the head should be considered to be as dangerous as hits that cause concussions.

Leakage between the brain-blood barrier has been linked to several brain diseases. People who suffer from leakage have an increased chance of getting seizures, strokes, Alzheimer' disease, and several other traumatic brain injuries. Due to the severity behind head collisions, more research needs to be done in order to figure out the real damage done to these brains. Several football players have already or have vouched to donate their brains to research.

Some of the players that donated their brains to research are Mike Webster, Dave Duerson, Terry Long, and Andre Waters. Several of these players suffered from depression and had brains that were comparable to the brain of an Alzheimer's patient. With more players agreeing to donate their brains, the dangers behind head collisions can be observed more consistently.