Football’s Risks

It’s just a “ding,” the coach would tell the parents. “He will be fine. He needs to be a man and get tougher. Everything is fine.” This is what I heard growing up in a place where football was valued more than religion. In fact, it was our religion. Unfortunately, we now know that a “ding” is not just a ding. It’s a potential tragedy.

Two years ago, a friend’s son was dazed from a hit to his head while he was playing in his eighth grade football game. The boy was a straight-A student, but following his injury, he struggled to earn passing grades. He gradually recovered, but it took nearly 6 months for him to fully heal.

Apparently, the association between football and brain trauma has caused a decline of almost 5 percent in students’ participation in high school sports. In 2008, 1.11 million high schoolers played football. In 2017, that number dropped to 1.06 million.

With all of the risks associated with football, some people have debated the merits of banning it at the high school level.

Head Trauma Linked to Football

It is hard to know how many hits to the head are necessary to cause irreversible damage. The New York Times reports that Kevin Turner, who played eight seasons of professional football, “suffered for six long years with a brain disease that research has linked to head trauma in football.” He died in March of 2016.

Turner’s situation isn’t unique. The Journal of the American Medical Association (JAMA) published an updated study that found 99% — 110 out of 111 — of deceased National Football League (NFL) players whose brains had been donated to science suffered from chronic traumatic encephalopathy (CTE). Among deceased players across all levels of American football (including high school, college, and professional) whose brains were studied, 87% — 177 out of 202 — were diagnosed with CTE. This is a neurodegenerative brain disease caused by repeated head trauma, including concussions.

Dr. Ann McKee, the study’s senior author, warns against accepting the results at face value. By her own admission, the study was biased, because all the brains were donated. According to NPR, Dr. McKee cautions, ” ‘Families don’t donate brains of their loved ones unless they’re concerned about the person. So all the players in this study, on some level, were symptomatic. That leaves you with a very skewed population.’ ”

That said, the National Football League (NFL) formally acknowledged a correlation between football and CTE in 2016. Jeff Miller, the NFL’s senior vice president of health and safety policy, said there is “certainly” a link between football and degenerative brain disorders such as CTE.

In June of this year, the NFL approved a total of $500 million claims to former football players. Although rules regarding helmets recently have changed, “the NFL seems to be reframing the issue of head injuries as a matter of proper playing technique, and not an inherent risk of the game,” according to the Daily Star.

Despite awareness of the disease, some players are willing to accept the consequences. For example, New York Jets player, Jamal Adams, told his fans “he would be fine with dying on the football field.” Others who are less cavalier may still succumb to pressure from their coaches and managers to get back in the game since “everything is fine.”

But, often, everything is not fine. We now know the effects of brain trauma are cumulative, and the onset of symptoms can be delayed by years.

Preventing Brain Trauma

However, we should not allow the brain trauma and destruction to continue without efforts to prevent it from occurring. The NFL, National Collegiate Athletic Association, and the National Federation of State High School Associations could help prevent harm if they were to come up with new rules regarding how to monitor the health of players and maintain their safety while they play the games.

Brain imaging with CT scans are not useful in diagnosing injury from concussions, because the trauma produces microcellular injuries not seen on scans.

But there is a promising alternative. The University of Pittsburg Medical Center-Center for Sports Medicine has developed an on-line computer-based neurocognitive test to assess the real-time effects of brain trauma. It is intended to be used at baseline before a player begins a season. In the event of concussion, the player can be tested at the time of the injury and then periodically until the test results return to baseline. There should be medical guidelines that, based on tests results, recommend the timing of future play.

Players at all levels (and, if appropriate, their parents or guardians) should receive pre-season information about potential harm. This could be similar to an “informed consent” document that is used in the medical field before surgery/procedures.

If the game is to be played, let’s ensure that brains are protected and that the safety of the individual is always the top priority. We have to care more about football players than we do about the game.

Note: This blog first appeared August 9, 2017 on The Hill. I have edited and updated it.