Is Tackle Football for Children Harming Their Brains?
Football may be America’s favorite sport, but concussion research shows that the game can be dangerous to young children.
By Lisa L Lewis
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March 6, 2019
In families and communities across America, it starts early, with kids as young as 5 signing up to play tackle football. That age-old tradition could change, though. In the first two months of 2019, in the legislatures of four states — California, Illinois, Maryland, and New York — bills have been introduced that would ban children from playing tackle football because of the risks of traumatic brain injury.
The bills are based on a growing body of research looking at the brains of former football players diagnosed with chronic traumatic encephalopathy (CTE), a degenerative disease resulting from repeated blows to the head that causes increasing mood and behavior problems and affects memory and judgment. Currently, CTE can only be diagnosed after death, with an autopsy of the brain.
“The word is finally getting out that we might be doing something seriously damaging to our children by letting them play football,” says Michael Benedetto, a state assemblyman in New York. Benedetto first introduced a bill to ban tackle football for children in 2013, and said he was accused of “trying to wussify America.” Now, however, the increased awareness of the risks are starting to turn the tide.
“We’re beginning to see a major trend of parents holding back their kids from playing football, especially at a young age,” he says.
The Research on Tackle Football and Traumatic Brain Injury
Ever since Bennet Omalu, MD, MPH, first discovered CTE in the brains of deceased football players while working at the Allegheny County Coroner’s Office in Pittsburgh, more and more research has confirmed the existence of this degenerative brain disease.
A study published in July 2019 in theJournal of the American Medical Associationshowed that 110 of 111 brains studied from former NFL players had CTE. The brains had been donated to the VA-BU-CLF Brain Bank, a collaboration between the VA Boston Healthcare System, Boston University, and the Concussion Legacy Foundation, and were examined by Ann McKee, MD, chief of neuropathology at the VA Boston Healthcare System and director of the BU CTE Center.
Adding to the debate on the long-term effects of tackle football, an article published in February 2019 inBrainshowed that subconcussive hits — the ones thatdon’tresult in a concussion — may contribute to CTE. Researchers documented the cumulative effect of these hits by studying the brains of four teenage athletes after they died. All four showed signs of traumatic brain injury, with one diagnosed as having early-stage CTE and two showing the buildup of the protein tau, a characteristic of brains that have CTE. These findings marked the first time signs of CTE were discovered in youth athletes. The researchers also replicated the injuries in mice, with similar results.
Christopher Giza, MD, a professor of pediatric neurology and neurosurgery at the David Geffen School of Medicine and UCLA Mattel Children’s Hospital and the director of UCLA’s Steve Tisch BrainSPORT Program, notes that as CTE research continues, one question that needs to be addressed is how subconcussive hits are defined, including what the lowest level of force is for a hit to qualify as subconcussive.
Given the findings to date, however, many researchers and former NFL football players now support channeling children into other sports, such as flag football, to minimize the potential future risks to young players.
At “Future of Football: Reimagining the Game’s Pipeline,” a conference hosted by the Aspen Institute in January 2019, Robert Cantu, MD, the co founder and medical director of the Concussion Legacy Foundation and cofounder of the CTE Center at the Boston University School of Medicine, noted that kids who play tackle football before age 12 have a higher chance of developing cognitive, behavioral, and mood problems later in life.
“When we look at who’s at highest risk for CTE, it’s the person who had brain trauma over the greatest number of years and had the greatest number of total hits to the brain,” he said at the conference.
Alternatives to Tackle Football
The same day that the study on subconcussive hits was published inBrain, the Concussion Legacy Foundation launched a campaign encouraging parents to have their kids wait until they're 14 to play tackle football and have them play flag football instead.
Chris Nowinski, PhD, the cofounder and CEO of the Concussion Legacy Foundation, cites “the bobblehead effect,” which puts children at increased risk for injury in a head impact because their heads are proportionally much larger and their necks weaker compared with adults. “This creates a high level of acceleration, even though it may not look like a big hit,” he explains.
“We need to ask if tackle football is an appropriate activity for a 5-year-old,” he says. “Now that we have sensors in the helmets of young football players, we’re finding that they can get hit 500 times in a season.”
There are ways to minimize the risk from tackle football, such as eliminating having players tackle each other in practice. , the head football coach at Dartmouth College, updated Dartmouth’s practice policies in 2010 so that players hit pads or robotic tackling dummies instead of each other.
“It’s productive in terms of teaching the skills, and it’s helpful and healthy for my players,” he says. “We practice the skill of tackling more than we used to, and we have fewer injuries.”
Teevens also notes that mistackles (attempted tackles that aren’t successful) during games have gone down dramatically.
Support for Changes to the Sport Is Mixed
While overall awareness of player safety has increased, not everyone agrees on what changes should be made to youth football.
At the USA Football 2019 National Conference, which took place January 26–28 in Orlando, Florida, Scott Hallenbeck, the executive director of USA Football, said that it’s important to provide families with several points of entry into the sport. The governing body for youth football, USA Football has piloted a new level called Rookie Tackle (a modified version of tackle) as a bridge from flag football to traditional tackle football. In addition to using a smaller field and fewer players per side, Rookie Tackle has players start in a crouching position rather than a three-point stance.
USA Football also launched its own program, Heads Up Football, in 2013 to promote increased training for coaches and emphasize key safety issues such as concussion education and safer blocking and tackling.
In an opinion piece published in February in USA Today High School Sports, Hallenbeck criticized the proposed state bills banning tackle football for kids as overreach.
Dr. Giza acknowledges that anything to minimize unnecessary contact is probably a good thing, but believes the decision to let kids play tackle football is best left to each family.
“There’s a risk and benefit to each activity we choose for our children,” he says.
He’s concerned that kids may not necessarily transition to a different sport, noting that lack of activity also has long-term health risks. “Inactivity can be associated with cognitive impairment and is a major modifiable factor for long-term brain health,” Giza says, while in contrast, the data linking youth tackle football with long-term brain health is still incomplete.
Still, several former NFL players and their families publicly support banning tackle football for children, with some even saying they wouldn’t want their own kids to play.
For now, with none of the four state bills yet signed into law, the decision still rests with parents.
Video: Head injuries Don’t Have To Be Concussions To Harm Kids | TODAY
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