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Ryan Freel and CTE: What does it mean for baseball's future?

In the wake of the news that former major league player Ryan Freel was suffering from chronic traumatic encephalopathy (CTE) at the time of his suicide, Major League Baseball is joining—and being included—in the ongoing discourse over concussions in sports.

In the wake of the news that former major league player Ryan Freel was suffering from chronic traumatic encephalopathy (CTE) at the time of his suicide, Major League Baseball is joining—and being included—in the ongoing discourse over concussions in sports.

Freel, who played for five teams during his nine-year career, died of a self-inflicted gunshot wound almost one year ago. He was 36.

At last week's MLB Winter Meetings, representatives of the Boston University Center for the Study of Traumatic Encephalopathy and Sports Legacy Institute issued their findings to Freel's family, who revealed Sunday that the player indeed suffered from Stage II CTE, where victims can experience headaches, confusion, depression and short-term memory loss.

"Sadly, that's in line with what we've seen," says Dr. Todd Lewis, Ph.D, neuropsychologist and brain injury clinical specialist and co-director of the Concussion Clinic at Magee Rehabilitation Center. "In the cases they've studied at Boston University, onset typically begins around age 40."

In the sports world, CTE has come to be associated with retired football players who sustained head injuries during their careers. Freel is the first MLB player confirmed to have suffered from the condition.

"This is a sign that this is present in baseball players," says Dr. Lewis. "Why not be proactive and institute some measures to protect players coming up through the ranks?"

The Future of Baseball

Like the NFL before them, there's a strong possibility that Major League Baseball will be enforcing rule changes in the coming years to reduce the likelihood of head injuries during play. You can't legislate away hard-nosed players like Ryan Freel crashing into outfield fences, or accidentally colliding with teammates when racing for fly balls. But you can outlaw home plate collisions between catchers and baserunners, and promise stiffer penalties for pitchers suspected of throwing at batters—just a couple of the measures that have been proposed.

Dr. Lewis suggests a two-pronged approach. Youth leagues can get out in front of the problem by mandating certain changes—for example, head/face protection for pitchers and infielders. At the same time, Dr. Lewis cautions against an over-reliance on equipment.

"Equipment does not prevent concussions," clarifies Dr. Lewis, "but it may reduce the severity of the injury."

If you went to current Major League pitchers and told them to wear a helmet the next time they took the mound, you'd likely meet considerable resistance. But if that pitcher has been wearing a helmet since age 9, that just becomes part of the uniform.

"How long did they play hockey without goalie masks?" asks Dr. Lewis. "Batting helmets, football helmets… all these changes come about slowly, but they do happen and with good reason."

On the flip side, Major League Baseball can help its own players and those of future generations by outlawing the baserunner/catcher collision at home plate. Such collisions are not permitted at the Little League or Cal Ripken levels. While home-plate collisions aren't grand slams—nobody becomes a baseball player so that they might someday be able to flatten a catcher on national TV—it stands to reason that a play so jarring, so attention-grabbing, could be attractive to young viewers watching MLB highlights.

To their credit, Major League Baseball has gotten out in front of the concussion problem in some areas, most notably the creation of a 7-day disabled list specifically for players who exhibit concussion-like symptoms.

Of course, not all players or former players are likely to embrace rule changes or other measures meant to decrease head injuries. The ink wasn't even dry on Freel's report when MLB legend Pete Rose made the following comments this weekend:

"Doesn't it seem like with all the concussions being reported in the world of football and hockey that baseball's sort of overreacting?" he asked. "Name me a catcher in the last 10 years that's got a concussion."

Rose is more than qualified to speak on colliding with catchers, barreling into bases to break up double plays and other plays that are suspected of causing head injuries in baseball. But his comments ignore the dozens of catchers—and other players—who have indeed missed time with head injuries in recent seasons. It's almost as if Rose doesn't want to know.

"We just don't know enough about CTE yet," admits Dr. Lewis. "But that doesn't make it any less real. Just because it doesn't happen to one player doesn't mean we can't take measures to prevent it from happening to others."

The suicides of Andre Waters, Dave Duerson and Junior Seau led directly to the study of CTE, and indirectly to an increase in awareness about head injuries in the NFL and football in general. Hopefully, last weekend's report on Ryan Freel will have the same effect on the sport of baseball.

Read more Sports Doc for Sports Medicine and Fitness.