Amyotrophic lateral sclerosis (ALS) has returned to the headlines recently on a national level, with MLB celebrating its first Lou Gehrig Day earlier this month, and locally, with the news that former Bears great Steve McMichael is now afflicted.
ALS is better known as Lou Gehrig’s disease because the former Yankees first basemen was the affliction’s best known victim when he was diagnosed in 1939. June 2 was chosen as the date for what will be an annual commemoration because it was the date Gehrig first entered the Yankees lineup in 1925 and also the day he died in 1941.
Gehrig’s and McMichael’s misfortune, as tragic as it may be, certainly is not senseless. In fact, based on the science, it makes perfect sense. Research outlined in this space since 2006 has demonstrated a link between ALS and traumatic brain injury (TBI). McMichael played 15 years in the NFL and then was a professional wrestler for another five. Depending on the study, playing professional football increases one’s likelihood of developing ALS by four to eight times.
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Gehrig may not have played in the NFL but, before becoming a Hall of Fame baseball player, he was a fullback at Columbia University. Furthermore on the diamond, Gehrig suffered his share of concussions induced by beanings and on-field collisions. But he never allowed himself to adequately recover, always playing the following day.
Until he was halted by ALS, Gehrig played in 2,130 consecutive games after entering the lineup in 1925, a record which stood until Cal Ripken of the Baltimore Orioles broke it in 1995.
Another disease linked to TBI is chronic traumatic encephalopathy (CTE), well-known and dreaded among retired professional boxers and football, soccer and hockey players for causing dementia and sometimes violent behavior.
However, motivated by the facts that ALS is generally a disease of the elderly and the condition among athletes tends to appear at much younger ages, researchers at Boston University started looking for an ALS/CTE connection. In 2010, they published their findings in the Journal of Neuropathology and Experimental Neurology. ALS, in relatively young ex-athletes, is actually a form of CTE that attacks the brain and the spinal cord.
Consequently, when I started reading in the Indianapolis Star last week about Bob Knight’s last IU basketball team manager being diagnosed with ALS, I wondered if he had played a collision sport in high school.
Andy Murphy, 43, started showing symptoms in the summer of 2019 and — after months of doctors’ visits and testing — learned the bad news that same year, the day after Christmas.
Murphy played only basketball in high school. No real connection to ALS/CTE there. However, near the story’s end, one anecdote stood out. Murphy was mugged and beaten in Cincinnati by four men with baseball bats shortly after his graduation from IU and found unconscious in a pool of blood.
A definitive link? The only way to diagnose CTE is on autopsy.
Meanwhile, Murphy slowly but steadily deteriorates, no longer able to speak and confined to a wheelchair. A GoFundMe account (Search "Andy Murphy on his ALS journey") has been set up to help the former IU student manager and his young family.
Vitamin D deficiency
In October of last year, I wrote about how important Vitamin D was to bone health, injury prevention, athletic performance, and even the prevention and treatment of COVID-19.
The problem is that the darker one’s skin and the farther one lives from the tropics — even for those with fair complexions— the more difficult it is for the skin to manufacture the stuff from sunlight. Without it, our bones have a difficult time absorbing dietary calcium. A chronic calcium deficiency, particularly in childhood, portends disability in later years due to osteoporosis and subsequent fractures. For competitive athletes the problem is far more immediate. Vitamin D and calcium insufficiencies are linked to multiple injuries, decreased performance and shorter careers.
Basketball players seem to be particularly susceptible, particularly in the winter.
However, an article published online last week in Sports Health offers encouragement regarding the effects of Vitamin D supplementation. Authored by a team from Russia, Serbia, Slovakia, and the United States (Wayne State University, Detroit), the literature review found that high daily doses reversed Vitamin D insufficiency.
Looking at multiple previous studies, the researchers found that 77% of basketball players, regardless of age and level of play, had a measurable Vitamin D deficiency. How much they needed to supplement varied with the severity of the deficiency.
Those moderately deficient were able to attain normal levels on 4,000 IU per day, while those defined as having “inadequacy” needed 50,000 IU per week.
The studies cited were not long-term enough to determine if restoring adequate levels actually resulted in fewer injuries and better performance for the basketball players. However, the studies cited in my October 2020 column, on NFL football players and Royal Marines, are pretty definitive.
Competitive athletes should ask their physician to check their Vitamin D levels at the time of their annual physical. Meanwhile, now is the time to take advantage of the weather. Spend some time in sunshine, as little as 15 minutes per day for those with fair skin and two hours for those who are darker, without overdoing it all at once and getting sunburned.
John Doherty is a licensed physical therapist and athletic trainer. This column reflects solely his opinion. Reach him at jdoherty@comhs.org. Follow him on Twitter @JDohertyATCPT.