concussion

What started as musical chairs is beginning to sound like a sad trombone.

There’s only so many times you can reshuffle an offensive line before it has a ripple effect on the entire football team. The Chargers are reminded of that now as they head into Sunday’s game with the Washington Commanders hoping — as opposed to knowing — they can provide adequate protection for quarterback Justin Herbert.

After reaching a comfortable cruising altitude with victories over three consecutive AFC West foes, the team is headed for a patch of severe turbulence.

The outstanding Joe Alt, who stepped in at left tackle after Rashawn Slater’s season-ending knee injury, is nursing a high ankle sprain and will not play against Washington. Right guard Mekhi Becton is coming off a concussion and is listed as questionable. So they’re a month into the season and the offensive line is a stitched-together hodgepodge that couldn’t handle the defensive front of the New York Giants last week.

“It’s like the Cinderella story at some point,” said Duke Manyweather, widely respected offensive line expert. “You know when that clock hits midnight that carriage is going to turn into a pumpkin. You don’t have an answer. You kind of saw that against New York.”

That’s not to say the situation is hopeless. Teams have lost key offensive linemen before, and there are different ways to compensate for that. But it’s a quandary for Jim Harbaugh, maybe the biggest since taking over as coach before last season. Heading into training camp this summer, the offensive line was a strength of the team, with Slater at left tackle and Alt on the right.

The Chargers didn’t do a lot to upgrade the interior of their line, a liability in January’s playoff loss at Houston, but signing Becton was a step in the right direction. He was a solid run blocker for the Super Bowl champion Philadelphia Eagles last season.

Chargers offensive tackle Joe Alt (76) will not play on Sunday because of a high ankle sprain. It’s unclear when he might return.

(Al Bello / Getty Images)

Becton sustained a concussion in the Week 3 win over Denver and missed the Giants game. He remained in the concussion protocol this week, and his status for Sunday’s game is unclear. He was back at practice Wednesday wearing a yellow no-contact jersey as a precaution.

Communication among the linemen is key.

“Especially with new guys, you have to speak it out for a while before you get to that point of unspoken communication,” right tackle Trey Pipkins III said. “Once you’ve played next to someone for a long time, you know what they want and what they’re going to do. Until then, it’s about over-communicating everything at the line so everybody’s on the same page.”

It’s unclear when Alt might return after the second-year player was carted off to the locker room against the Giants and watched the second half on the sideline in street clothes and a walking boot. The tackle wore that boot all week.

The Chargers are on their third left tackle in Austin Deculus, who bounced around the league and started one game in the past three seasons, second right tackle and second right guard.

Chargers offensive linemen, including Jamaree Salyer (68) and Bradley Bozeman (75), stand on the field during a win over the Denver Broncos on Sept. 21.

(Ronald Martinez / Getty Images)

“At some point you’re starting to play people you haven’t even prepared to really be in there, much less their physical talents,” said Andrew Whitworth, retired All-Pro left tackle and now an analyst for Amazon’s “Thursday Night Football.” “They’re still trying to figure out the offense, the terminology, and they’ve never played beside the guy they’re next to. The war of attrition really starts to take its toll.”

What that does is test the creativity of Harbaugh and offensive coordinator Greg Roman to devise ways to fortify the line and protect Herbert without whittling away too many offensive options. They can keep a running back in the backfield to help out with protection, for instance, or add an extra tight end for blocking. But that also handcuffs what the offense can do.

“Sure, you can chip with a back or keep an H-back in there,” Whitworth said. “But then you’ve got fewer guys in the route, you’re holding the ball longer, and now the interior linemen are under even more pressure. You can get by for a few snaps, but you can’t live there.”

In the past two games, Herbert has been pressured in 46 dropbacks, more than any quarterback in the league, according to TruMedia.

Chargers quarterback Justin Herbert is sacked during a win over the Denver Broncos on Sept. 21.

(Allen J. Schaben / Los Angeles Times)

Herbert expressed confidence this week in some of the lesser-known players blocking for him.

“They’re guys that have seen big football games and guys that played in national championships and huge games like that,” he said. “Maybe it’s new to them for the NFL, but they’ve played in big football games before.”

It’s easy to get carried away with what all of this means. The Chargers are 3-1 and atop their division, and are coming off a 21-18 defeat to the previously winless Giants, whose pass rush is a strength of their team. What’s more, the Chargers had to make those line adjustments in the heat of the action, as opposed to having a week of practice to work with the reconfigured line.

The season is young. Teams have overcome these types of challenges before. The Rams had to reshuffle their line on multiple occasions last season and wound up coming close to knocking off the Eagles and advancing to the NFC championship game.

Still, the next few weeks will be illuminating for the Chargers.

“We’re going to learn about the depth of this team,” said Manyweather, founder of OL Masterminds, which trains offensive linemen of all levels.

“We’re going to learn about the coaching. And we’re probably going to learn even more about Justin Herbert and his ability to create and carry the team.”

We’ll also learn if a pumpkin can turn back into a carriage.

Times writer Benjamin Royer contributed to this report.

Shane Tamura, the gunman who killed four people and himself in a New York City office building in July, had CTE, a degenerative brain disease linked to head injuries sustained in football and other contact sports.

The New York medical examiner “found unambiguous diagnostic evidence of Chronic Traumatic Encephalopathy, also known as CTE, in the brain tissue of the decedent,” according to a statement. “The findings correspond with the classification of low-stage CTE, according to current consensus criteria.”

The 27-year-old, who took his own life, was a high school football player at Granada Hills Charter School in the San Fernando Valley and Golden Valley High in Santa Clarita.

Tamura drove this summer from Nevada — where he worked as a security guard at the Horseshoe Las Vegas hotel and casino — to New York, leaving behind a three-page suicide note stating that he believed he had CTE and that his motive was anger at the NFL for making profit a priority over players’ brain safety.

“Football gave me CTE,” Tamura reportedly wrote. “Study my brain please.”

Tamura entered the skyscraper on Park Avenue that houses NFL headquarters but ended up on the wrong floor. He killed police officer Didarul Islam, security guard Aland Etienne, Blackstone senior executive Wesley LePatner and real estate employee Julie Hyman. He also shot and wounded NFL employee Craig Clementi before killing himself with a shot to the chest.

CTE, caused by concussions and non-concussive impacts, tends to be diagnosed mostly in those who have played football for a decade or longer. However, four years of high school football could expose a player to CTE, said Chris Nowinski, co-founder of the Concussion Legacy Foundation, a nonprofit group that supports athletes and others affected by CTE and concussions.

“The odds of having CTE are best correlated to the number of seasons played,” Nowinski said. “The best window we have is we have studied 45 former high school players who died before 30, and 31% had CTE.”

Daniel Daneshvar, chief of brain injury rehabilitation at Harvard Medical School, said high school football players warrant greater study and treatment.

“Can a high school player get it? Yes,” Daneshvar recently told The Times. “Of the 3.97 million football players in this country, those that are playing at the college and the professional level are less than 4%, so we’re talking about over 96% of people are playing at some youth or high school level.”

Nowinski stressed that being diagnosed with CTE didn’t necessarily cause Tamura to commit a crime.

“It’s very clear that most people who have developed CTE have not become murderers, and most people have not had extraordinary psychiatric symptoms that involve them to have involuntary psychiatric holds,” Nowinski said.

Tamura was remembered as quiet and respectful in high school. Granada Hills teammate Anthony Michael Leon told NBC News, “This is so shocking. I’m telling you, this was one of those kids who never exerted bad energy or a negative attitude.

“He was quiet, but when he did actually talk, people listened.”

With great power comes a great risk of injury, it seems.

Tom Holland, 29, who plays Spider-man in the most current iteration of the web-slinger film franchise, suffered a mild on-set concussion that has resulted in a one-week production pause on “Spider-Man: Brand New Day,” Variety reported Monday.

Filming is expected to restart Sept. 29, the trade said, and the delay shouldn’t keep the fourth Holland-as-Spidey movie from swinging onto the big screen on its scheduled release date.

Holland is taking it easy “out of an abundance of caution,” a source close to the production told the outlet.

Since production began in early August, the actor has been sharing his experiences on his Instagram, hyping fans before the film is released.

“Someone is cooking … again,” chef and fan Gordon Ramsay commented on one post, adding a winking emoji to capture his excitement.

Holland posted a video last month where he revealed the film‘s release date while wearing the iconic Spidey suit. A few days later, he posted behind-the-scenes footage where he was interacting with fans on set. It was the first time, he wrote, that fans were on set on Day One of filming.

The fourth film in Peter Parker‘s Holland era will reunite him with his on-screen girlfriend and offscreen fiancée, Zendaya, and actor Jacob Batalon, who plays his friend Ned Leeds.

A few newcomers are in the cast — Emmy winner Liza Colón-Zayas from “The Bear,” Sadie Sink from “Stranger Things” and recent Emmy winner Tramell Tillman from “Severance” — and in true Marvel Cinematic Universe style, audiences can expect to see the Hulk (Mark Ruffalo) and the Punisher (Jon Bernthal) up there with Holland’s hero as well.

When is AI not artificial intelligence? When it refers to ammonia inhalants, aka smelling salts.

When are these AIs in the news? When it was reported that the NFL banned their use, San Francisco 49ers star George Kittle protested, and the NFL walked back the ban a day later. The league’s players association clarified that players can still use AIs as long as teams don’t provide them.

Got it?

The NFLPA sent a memo to players on Wednesday saying that the ban only prohibits team employees from distributing AIs during games.

That must have pleased Kittle, who when under the impression that AIs were banned completely, grabbed a microphone on an NFL Network broadcast to say, “I honestly just came up here to air a grievance. Our team got a memo today that smelling salts and ammonia packets were made illegal in the NFL, and I’ve been distraught all day.”

The five-time All-Pro tight end said he used the substances for an energy boost before every offensive drive and joked that upon learning of the ban he “considered retirement.”

Except that it isn’t a ban. Kittle will just have to bring his own AI stash to ballgames.

“To clarify, this policy does not prohibit player use of these substances, but rather it restricts clubs from providing or supplying them in any form,” the NFLPA memo said. “The NFL has confirmed this to us.”

The use of AIs by NFL players has been under the radar despite apparently being a common practice. Their primary use is to prevent and treat fainting, with the Federal Aviation Administration requiring U.S. airlines to carry them in the event a pilot feels faint.

The ammonia gas irritates the nasal membranes, causing a reflex that increases breathing and heart rate. That can keep a person from fainting, and apparently can also help a person block and tackle.

In short, an AI — which has been described as smelling like cat urine — is a performance-enhancing substance.

The NFL, however, cited a warning from the FDA that AIs can mask symptoms of a concussion and have not been proven to be safe or effective simply to increase energy.

“In 2024, the FDA issued a warning to companies that produce commercially available ammonia inhalants (AIs), as well as to consumers about the purchase and use of AIs, regarding the lack of evidence supporting the safety or efficacy of AIs marketed for improving mental alertness or boosting energy,” the NFL memo to teams stated. “The FDA noted potential negative effects from AI use.

“AIs also have the potential to mask certain neurological signs and symptoms, including some potential signs of concussion. As a result, the NFL Head, Neck, and Spine Committee recommended prohibiting the use of AIs for any purpose during play in the NFL.”

Tampa Bay Buccaneers quarterback Baker Mayfield — who says he uses AIs — said the logic behind the NFL no longer supplying them is convoluted.

“I think the reasoning was that it masked concussion symptoms,” Mayfield said on “Up and Adams.” “But if you get knocked out, which is the whole purpose of smelling salts — to wake you up — you’re not allowed back in the game.

“I think it was a quick trigger to ban them, just to kind of CYA [cover your ass].”

Maybe NFL officials figure that by no longer supplying AIs and forcing players to bring their own batch to games, their liability in case of concussions or other medical complications is reduced.

“You just got to bring your own juice to the party, got to wake up ready to go,” Mayfield said.

Every fall, more than a million young Americans don helmets and padded shoulder pads to play high school football. But this year, questions are intensifying over the risk youth athletes face from repeated head injuries after a gunman who played football in Southern California claimed he suffered from a degenerative brain disease.

After killing four and taking his own life, Shane Tamura — a former varsity player at two Los Angeles-area high schools — left behind a three-page suicide note, authorities say, alleging he suffered from chronic traumatic encephalopathy.

“Football gave me CTE,” Tamura reportedly wrote. “Study my brain please.”

It remains unclear whether the 27-year-old actually suffered from CTE, because the disease can only be diagnosed definitively through brain dissection. However, the claim comes at a time of growing concern over the health risks of contact sports in high school — football in particular.

Caused by repeated head injuries, including concussions and non-concussive impacts, CTE tends to be mostly diagnosed in those who have played football for a decade or longer. However, four years of high school football could expose a player to CTE, said Chris Nowinski, co-founder of the Concussion Legacy Foundation, a nonprofit group that supports athletes and others affected by CTE and concussions.

“The odds of having CTE are best correlated to the number of seasons played,” Nowinski said. “The best window we have is we have studied 45 former high school players who died before 30, and 31% had CTE.”

The issue of chronic brain injury and youth football has been a heated one in Southern California.

Facing political pressure last year, Gov. Gavin Newsom vowed to veto any legislation that sought to ban youth tackle football in the state. Citing parental freedom to decide on which sports their children can participate in, Newsom said he would work with legislators to strengthen safety in the sport.

Currently, California maintains protocols for student athletes who experience concussions or a head injury during a game. Those measures include removing the student from play and evaluation from a licensed health care professional.

The California Youth Football Act also limits full-contact practices for youth football teams to no more than 30 minutes a day for no more than two days per week. It also bans full-contact practices for youth football teams during the off season.

While such laws attempt to limit the risk of injury, experts say the threat cannot be removed entirely.

“What ends up mattering more than anything else, really, is just how long you’re playing, how many hits to the head you’ve gotten over that time, and the intensity of those hits to the head that you experience: Those are what play the biggest role in someone’s risk,” said Dr. Daniel Daneshvar, chief of brain injury rehabilitation at Harvard Medical School.

“So can a high school player get it? Yes,” Daneshvar said.

Tamura appeared to blame the NFL for his condition, according to officials, although he never played football beyond high school.

Experts say players such as Tamura, who is listed in online player profiles as performing offensive and defensive roles, are particularly at risk for CTE.

“On his online Huddle profile, it says he was also a defensive back, and he was clearly a very good running back, which would have twice the exposure,” Nowinski said.

It could take from two to six months for scientists to determine whether the gunman actually suffered from CTE, experts say. Such an examination however would require the family’s permission.

High school athletes who are playing football warrant greater study and treatment, Daneshvar said.

“Of the 3.97 million football players in this country, those that are playing at the college and the professional level are less than 4%, so we’re talking about over 96% of people are playing at some youth or high school level,” Daneshvar said.

“Although they’re likely to be at lower risk, based on the fact that they likely have played fewer years than someone who plays at the collegiate pro level, their numbers are greater.”

One of the most well-known cases of a young football player who developed severe CTE is Aaron Hernandez, a tight end in the National Football League who played three seasons with the New England Patriots until his 2013 arrest in the murder of fellow football player Odin Lloyd.

Hernandez was convicted in 2015, and when he died at the age of 27, researchers at Boston University studied his brain and diagnosed him with CTE Stage 3, caused by repeated head trauma.

“When you see someone with Stage 1 and a couple of microscopic lesions, it’s tough to make an interpretation as to how that might affect their behavior,” Nowinski said. But with a person with Stage 3, such as Hernandez, he said, “you can be confident he was not the same person at 27 as he was at 15. Everybody in Stage 3 has some level of symptoms and impairment. “

The disease starts with small lesions developing in the prefrontal cortex, along the brain stem, which sets off a chain reaction that slowly kills brain cells. It’s a reaction that can continue to spread long after repeated impacts stop, Nowinski said.

If scientists determine that Tamura had CTE, Nowinski stressed that did not mean the brain disease caused him or others to commit crimes.

“It’s very clear that most people who have developed CTE have not become murderers, and most people have not had extraordinary psychiatric symptoms that involve them to have involuntary psychiatric holds,” Nowinski said.

However, other forms of brain damage could have affected his behavior.

“CTE is not the entire story,” Nowinski said, noting that experts have identified at least 15 other types of changes to the brain that are associated with traumatic brain injury and repetitive traumatic brain injury. “Even in the absence of CTE, it doesn’t mean that brain damage can’t be driving this. And in many cases, we think that the non-CTE changes are more profound than the early stage CTE changes in people who are young, who have changed”

Diagnosing CTE is a complex process and involves the study of more than 20 regions of the brain, Nowinski said.

First, the brain is preserved in formalin for two weeks. When it is pulled out, it is examined for patterns of atrophy or old contusions. Then, the brain is sliced up and very thin sections are put on glass slides and stained with antibodies that help make abnormal proteins visible.

There is currently no treatment for CTE, but Daneshvar said it should not be viewed fatalistically.

“We have many patients who are experiencing symptoms that may be associated with CTE pathology, and we’re able to identify their symptoms and treat them, and they get better,” he said. “If somebody has a severe depression, there are medications and interventions we can do to help manage their depression.”

As another high school football season approaches, California legislators are proposing Assembly Bill 708, which would allow youth players to wear padded helmet add-ons that are sometimes worn by NFL players. Such equipment is currently prohibited.

More than 520 additional former rugby players have joined a concussion lawsuit against the sport’s authorities, according to the law firm bringing the case.

Rylands Garth says there are now more than 1,100 former players involved, with 784 from rugby union and 319 from rugby league.

Steve Thompson, Mark Regan and Phil Vickery – part of England’s 2003 Rugby World Cup-winning squad – former Wales stars Gavin Henson, Colin Charvis and Ryan Jones and England and British and Lions scrum-half Harry Ellis are among those seeking damages from World Rugby, the Rugby Football Union and the Welsh Rugby Union.

In November, former British and Irish Lions duo Lee Byrne and Phil Greening were confirmed to have joined the concussion lawsuit.

The former players claim the governing bodies were negligent in failing to take reasonable action to protect them from serious brain injuries.

A similar action is being taken against the Rugby Football League (RFL) and the British Amateur Rugby League Association (BARLA).

“Players continue to play almost all-year round, with many elite players soon to embark on extremely physical summer tours across the rugby world. We will continue to fight for justice for those who gave so much to the game,” a Rylands Garth spokesperson said.