Should you let your kids play football?
Photo: © 2009 Jupiterimages Corporation
Football is one of the most popular sports in America, with an estimated one in eight boys in America playing. As with any physical activity, there is a risk of injury—pulled muscles, twisted ankles and even broken bones. But football is unique in that it adds a risk of a class of injuries that other sports do not: brain injuries.

A study by Nationwide Children's Hospital in Columbus, Ohio, and Ohio State University found that of the roughly 400,000 concussions that occurred in high school sports in the 2008–2009 school year, most were suffered by football players.

A concussion is usually caused by a significant blow to the head, resulting in loss of consciousness, confusion, severe headache or memory loss of the incident that caused the concussion. While people have long recognized that concussions can be serious injuries, just a few years ago it was not uncommon for a football player to return to a game after suffering one.

One group raising awareness of how dangerous this can be is the Sports Legacy Institute, a research and education organization co-founded by brain injury expert Dr. Robert Cantu and Chris Nowinski, a former Harvard football player and professional wrestler who was forced to retire after suffering six concussions in four years. His last two concussions were just weeks apart. "Both involved blackouts in the ring where I forgot who was supposed to win the match once I came to," he says. "At that time, in 2003, concussions weren't discussed. Doctors didn't understand them either. It wasn't until I met Dr. Cantu that even I, at 24 and a Harvard grad, even understood that there are long-term consequences from head injuries."

Those long-term consequences can include physical debilitation, depression, reduced intellectual function and even death.

Due to the work of groups like the Sports Legacy Institute, understanding of the dangers of concussions has grown significantly in recent years, and doctors are more aware of how to treat someone who has suffered one. "You help concussions recover more quickly and, theoretically, you reduce long-term damage by letting your brain rest after a concussion. It's both physical rest and cognitive rest," Nowinski says. "The idea is that you don't tax your brain for a few days. Sometimes kids stay home from school, you don't play video games, you don't go take the SAT for fun."

Recent laws in Washington, Oregon and Texas also strive to make football less dangerous. The Washington law, for instance, requires a doctor's note affirming that a player who has suffered a concussion is healthy enough to return to the field. However, there is still a wide gap in the safety net for young athletes and brain injuries—the education of adults. "The idea that the coach has never been trained on an injury that half of the kids will get and could kill them if they're back too soon, it's starting to look crazier and crazier," Nowinski says. "We don't educate coaches, we don't educate kids and we don't educate parents about brain injury in contact sports."

Even if parents and coaches do become educated on how to diagnose and treat concussions, new research is uncovering the link between a different brain injury and football that could be devastating to the sport.

Chronic traumatic encephalopathy (CTE) is a rare degenerative disease that can cause symptoms of Alzheimer's or dementia in people who are literally decades younger than typical patients of those diseases. Their brain cells are damaged and, over many years, die. Unlike the kind of single strong blow to the head that results in a concussion, CTE is caused by damage from the cumulative effects of repeated blows to the head.

Research shows that some football players take hits to the head that are similar to being in medium-speed car accident without wearing a seatbelt. These hits aren't unusual; they're typical during games and practices, and players routinely don't even miss a single play from them. Some college and high school players will take as many as 1,000 severe blows to the head every season during games and practices. This means a player could theoretically develop CTE without ever even suffering a concussion.

The danger of CTE goes right to the heart of football. "If 10 years of exposure to the sport will dramatically increase your risk, we can't let football be destroying people's lives," Nowinski says.

A recent New Yorker article on CTE and football by best-selling author Malcolm Gladwell bluntly asks, "How different are dogfighting and football?"

The question of football safety was asked in a recent Congressional hearing. At that hearing—in which National Football League commissioner Roger Goodell pledged his support in creating public service announcements about concussion safety—the Sports Legacy Institute unveiled its ambitious "10-Point Plan to Save Football."

The plan is comprehensive—covering everything from educating coaches, to protective equipment, to curbing glorification of dangerous plays by TV announcers. And it isn't limited to the highest level of the sport. In fact, Nowinski says the sport must change at its very earliest levels. "Kids are much more at risk for brain damage from sports because a concussion is much more damaging to the developing brain," he says. "And biomechanically, kids are in worse position because they have these small, weak necks and their head are much bigger relative to their size. A strong neck reduces force going to a brain. Kids don't have that way to defend themselves."

Besides education and diagnosis of head injuries and medical staff on the sidelines, one of the plan's most significant calls is for changes in practice. "You can reduce trauma by 75 percent tomorrow if you reduce hitting in practice," Nowinski says.

The good news is this kind of groundbreaking shift in the sport has a precedent. In 1905, President Theodore Roosevelt called a summit of college football coaches to reform rules to reduce violent collisions. Is football now facing a similar safety crisis? "Without immediate change in how the game is practiced and mandatory brain trauma education for coaches, among others changes," Nowinski says, "I would hesitate to let my son play football."

Do you feel there are enough precautionary measures taken with kids and sports? Share your comments below.


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