End of an Era for Gridiron?

Threat of Longterm Brain Injury Threatens the Future of Youth Football

For generations, football has been a mainstay of American culture. During football season, millions of Americans tune in and show up to watch games at the professional level all the way down to Pee-Wee leagues. Children grow up watching college and NFL football dreaming of participating one day. Like all sports, football provides youth with exercise, camaraderie, discipline, physical and mental resolve. Despite this close association with the heart of American culture, new advances in medicine have increased criticism and scrutiny of football as something that should be widely played.

In 2015, a controversial film called Concussion highlighted the dangerous side of the game. The film detailed that for many years the NFL had intentionally kept the research that chronic traumatic encephalopathy (CTE) was directly linked to playing in the NFL. This was a defining moment in the future of football in America. People who had once loved and praised football now began to acknowledge that the sport encouraged dangerous practices that caused long term, debilitating injury.

This news is far more black and white for NFL players, who have been noting the debilitating effects of playing a lifetime of football. Neuropathologist Dr. Ann McKee surveyed the brains of deceased NFL players found that 110 of 111 had severe CTE. Her research was published in the Journal of the American Medical Association and suggests that those individuals would have experienced symptoms such as depression, loss of memory, and dementia.

Aaron Hernandez, a former NFL player who had been convicted of murder in 2013, committed suicide in 2016, giving researchers a rare opportunity to see the effects of CTE on a 27 year old. They found, to their surprise, that Hernandez had advanced Stage 3 CTE, the worst ever observed in someone his age. The effects on his ability to control his impulses and decision making would have been profound. This doesn’t excuse his murder of Odin Lloyd, but it does present numerous questions about the long term effects of tackle football.

This news shouldn’t be shocking. All contact sports have a higher chance of injury. In fact, a study by the the American Academy of Orthopedic Surgeons found that “soccer players suffered concussions at a, ‘significantly higher rate’ than football players, and boys in matched sports.” This could be due to that fact that football players might not accurately be reporting their injuries, or overestimating the protection that helmets provide. There have been multiple studies that suggest tackle football for youth may lead to long-term neurological damage and cognitive functions.

In October 2016, a research team at Wake Forest School of Medicine compiled data from young football players using a type of neuro-imaging software that identifies microstructural changes to the brain, discovering that, “young players who experienced more cumulative head impact exposure had more changes in brain white matter, specifically decreases in fractional anisoptropy, [a unit of measurement for the movement of water molecules in the brain], in specific parts of the brain.”

A study conducted by Boston University in September 2017 showed that youth participating in tackle football before the age of twelve may risk the following: “behavioral regulation, apathy and executive functioning by two-fold and [increase] the risk of clinically elevated depression scores by three-fold.”

According to one of the principal authors of the study, Dr. Michael Alosco states that there is a growing body of literature that all seem to arrive at the same conclusion, “This study adds to growing research suggesting that incurring repeated head impacts through tackle football before the age of 12 can lead to a greater risk of short- and long-term neurological consequences.”

On October 17, 2017, Democratic members of the House Energy and Commerce Committee issued a letter to USA Football, the sport’s national governing body. This letter followed on the heels of a forum convened by the same committee earlier that week, where former NFL players and medical researchers warned the congressional panel of the risk of long-term neurological damage to young players. In their letter, House Democrats tasked USA Football to explain in detail the logistics of their rookie tackle program, “which uses smaller teams and playing fields and has rules which it claims reduce player contact” and supposedly backed up by research.

The congressional members raised the issue of USA Football’s false claim in 2016 concerning their Heads Up Football program, which they’d asserted, “[reduced] injuries by 76 percent and concussions by 30 percent” by way of an independent study. In reality, the study had produced no such results. This particular fact was referenced in their strong letter to the organization, “USA Football asserts that the development of rookie tackle ‘relied heavily on research and advice from medical and youth football experts.’ However, USA Football’s selection and use of experts to study the effectiveness of its programs has previously come into question.”

It remains to be seen whether the organization has a youth tackle football program that produces substantive results in reducing player contact. Until that is determined, the districts that host football, and parents, have a few options.

Many parents say they would simply not let their children play football. Participation in tackle football has fallen almost 20% since 2009 among children aged 6 to 12. In fact, USA Football changed the game in early 2017 to address these stark declines. Time will tell whether or not their efforts are effective.

Flag football is an obvious and far safer alternative to traditional tackle football. Flag football participation is actually up more than 8% according to USA Football. Short of that some coaches have also experimented with revising their tactics to avoid direct collisions in favor of less aggressive plays. It remains to be seen if that will be effective in reducing instances of head injury over the long term. There are companies working on improving football helmets to provide additional support, but the timing, effectiveness, and cost of those products are total unknowns.

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