Posted on 10/12/2017 5:23:55 AM PDT by Colonel Kangaroo
We need more research of CTE, but the relationship between brain injury risk and contact football before age 12 is clear.
Note to readers: Last weekend I attended a ceremonial event, and paid no attention to sports. But how can you miss me when I won’t go away? Please note that I wrote today’s column in advance, not knowing what happened last weekend in sports or current events.
In our increasingly polarized society, too often discussion is compressed into “for” and “against” positions. But a person can endorse or admire something while simultaneously feeling change is needed. That’s how many regard the United States, and it’s how we ought to regard football, America’s preeminent sport.
The big question in football is traumatic brain injury: concussions from dramatic knockout hits, gradual accumulation of damage from subconcussive impacts (this probably does more total harm), early-onset dementia in former football players, and hanging over it all, increasing indicators of chronic traumatic encephalopathy in deceased former players.
The evolution of language on this issue is revealing. A generation ago, “concussion” was a taboo word. Coaches and players spoke of “getting your bell rung,” which had a badge-of-honor connotation. It was seen as unmanly to admit head pain, especially since, while a bruise or swollen joint is easily observed, no one but you really knows whether the inside of your head hurts. Now the word concussion is employed regularly by sportswriters, broadcasters, coaches, athletic trainers, and high school nurses. And the language evolution may not be finished. The former football player and professional wrestler Chris Nowinski contends that “brain injury” should be the proper term.
Neurological harm, ignored or actively covered up for decades by the football establishment, has become the subject of extensive research since around the year 2000. That research boils down to this sentence: Professional football may be less dangerous than generally believed, while youth football is far more hazardous than expected, and must be banned.
Surely you’ve seen frightening reports about neurological harm among former football players. Three months ago, Boston University researchers found that 87 percent of all deceased former football players, and 99 percent of former NFL players, exhibited CTE. This can sound like an open-and-shut case against the sport.
But the study was a “convenience sample”—not scientific. Researchers autopsied the gray matter of former concussion sufferers who had exhibited early-onset dementia, and had also decided to leave their brains to science. That is, the only brains studied were those of persons who were very likely to have a degenerative neurological condition.
Autopsying brains is difficult and expensive, and few dying people ask that their brains be studied. Researchers need to obtain a large randomized sample of brains from many people who did and did not play contact sports, and who did and did not exhibit dementia, and that is easier said than done. This 2015 study, led by Kevin Bieniek, a postdoctoral student at the Mayo Clinic’s graduate school, found an association between contact sports and CTE, and also between CTE and two genetic markers. More such study is needed: For now, knowing that a high percentage of deceased persons who displayed the symptoms of brain harm did, in fact, have brain harm doesn’t settle much.
The 2015 Will Smith movie Concussion, loosely based on the life of Bennet Omalu, a forensic pathologist who now teaches at the University of California, Davis, concerns Omalu’s horror at discovering, in 2002, that the brain of a deceased former Pittsburgh Steeler exhibited what has since been named chronic traumatic encephalopathy. Omalu has since said he believes all contact sports, including girls’ soccer, should be banned before age 18, then unregulated after age 18. That is, contact sports should be treated like cigarettes and alcohol: forbidden for minors, and for adults, well, you’ve been warned. Here is me, Omalu, and two other guests discussing this on WAMU’s terrific new show 1A, the follow-on for The Diane Rehm Show.
Omalu may have made what will eventually be seen as a major medical discovery. The problem is that it’s not clear exactly what Omalu discovered, beyond the neurological indicators of CTE. Does this condition develop only in those who play contact sports? Only in those who play football? In anyone who experiences hard impacts to the head and exposure to overpressure, as often happens to soldiers and sailors? Is CTE simply caused by being alive, a chronic condition of decline like so many associated with aging, and will eventually be detected in millions of people? Until there are answers, the significance of Omalu’s finding is hard to weight.
Given this, let’s turn to what seems clearer. Professional football is assumed to be terrible for long-term health, but this view may not be correct. Research published in 2012 by the National Institute for Occupational Safety and Health, a division of the federal Centers for Disease Control, found that aging former NFL players live longer than other men of their birth years, have fewer cardiovascular problems, suffer less cancer, suffer dramatically less diabetes, and despite the media impression, are less likely to commit suicide than same-aged men.
No one wants NFL players to be harmed. But professional football players are few in number, are adults who knowingly assumed a risk, and are well-compensated in money and status. Media coverage focuses on aging NFL stars, because their names are known, their profiles are high, and stories can be spun as the shocking truth about how America’s game betrayed those who played it.
This approach is wrong for two reasons. One is that most who appeared in the NFL were better off playing than they would have been not playing, even taking into account that pay was much lower in past decades. The second and more important reason is that focusing on former NFL stars distracts attention from the real worry—youth players.
There are about 700 boys, and a few girls, in youth tackle leagues for each one man in the NFL. That’s 700 times as many victims as the worst-case view of the NFL. Youth players are too young to consent to risk, and their adolescent brain cases and necks are more vulnerable than those of adult athletes. Society does not allow cigarettes to be marketed to 10 year olds. Yet the NFL actively markets tackle football to the very young.
A bombshell Mayo Clinic study found that from high school age onward, playing football is not particularly associated with late-life mental disability—it’s bashing heads before high school age, when the neck and brain case aren’t finished forming, that sets in motion bad neurological outcomes. This study, completed in 2011, had a control group, unlike the recent Boston University study, and followed up on the late-life outcomes of males who played high school football in Minnesota from 1946 to 1956. Researchers concluded, “We found no increased risk of dementia, Parkinson’s disease or ALS among the 438 football players compared with the 140 non-football-playing male classmates. Parkinson’s disease and ALS were slightly less frequent in the football group, whereas dementia was slightly more frequent, but not significantly so. When we compared these results with the expected incidence rates in the general population, only Parkinson’s disease was significantly increased.”
Another 2015 study, also from Boston University, found that aging former players who entered full-pads tackle leagues before age 12 performed “significantly worse” on tests of mental acuity than aging former players who did not don helmets until middle school. For those who waited until they were more than 12 twelve years old, late-life drop-off in mental faculties was not much different from the norm.
If the above studies were bombshells, this research paper, published last month, is a guided missile. Researchers led by Robert Stern of Boston University found yet another association between tackle football before age 12, and neurological problems later in life: “The study showed that participation in youth football before age 12 increased the risk of problems with behavioral regulation, apathy and executive functioning by two-fold and increased the risk of clinically elevated depression scores by three-fold.”
This and other research tends to show, though cannot be said yet to have proven, that for those who wait until they are more than age 12 to don helmets and play the tackle version of the sport, late-life drop-off in mental faculties was not much different from the norm.
Such research suggests a bright line. Organized tackle football before age twelve does engage tremendous neurological risk; but don’t start football until middle school and the sport’s neurological hazards are roughly the same as those associated with soccer, diving, and bicycling. Maybe someday soccer, diving, bicycling, and football all will be banned as too dangerous. Based on what’s known today, football is not notably more dangerous—so long as you don’t start until middle school age.
If youth tackle football were abolished by legislation—or if parents and guardians refused to allow young children to join full-pads leagues and endure helmet-to-helmet hits—the societal harm caused by football would decline dramatically.
There are complex arguments about the risk-reward situation for high-school players who learn life lessons through sports, for college players who receive scholarships in return for donning pads, and for pros whose participation brings them large amounts of money and a glamorous lifestyle. There is no complexity about the risk-reward situation for youth tackle football. It’s all risk, no benefit, and should end.
Beyond this, the problems of aging professional football players should be placed in context. Former NFL star Frank Gifford died in summer 2015. Because Gifford declined mentally in his final years, his surviving family authorized a brain autopsy, which showed he had chronic traumatic encephalopathy. Gifford’s CTE was headline news, including on major network evening newscasts, and presented as a deplorable indictment of the sport.
The missing context is that Gifford died at 84, an age when dementia is sadly common. Gifford was born in 1930. An American male of that birth year had a life expectancy of 60, while an American male born in 1930 who had reached age 65 had a life expectancy of 76. Battered by a long career in football, including during the decades when water was forbidden at practices and “headhunting” (deliberate helmet-to-helmet hits) was encouraged by coaches, Gifford nonetheless surpassed his longevity projection by nearly a quarter of a century. He appeared on national television as a Monday Night Football analyst until he was 67 years old—sharp enough mentally at that age to handle three-hour live television events.
Gifford lived a long, full life, then developed dementia at the last. Many American families experience the sadness of someone’s bright promise of youth giving way to mental disability at the last. Would Gifford really have been better off if he had foregone all the good things that football brought him in exchange for a slight improvement in his odds against late-life mental decline—something that might have happened anyway?
There have been cases of football players who are not old who exhibit mental debilitation, and such cases are heartbreaking. But many who are not old develop heartbreaking health problems: society only notices if the person is an athletic star or other kind of celebrity.
Looking at the big picture, football is not especially dangerous—except to children. That’s a problem that can be solved by banning youth tackle leagues.
Till age 12, flag football is just as much fun as tackle, a better teacher—youth flag players learn how to be in the right place at the right time, and tackling can be learned later—and a way to cut risk, to say nothing of pain. Tackle football hurts; flag doesn’t hurt. Why should 10 year olds accept brain risk and experience pain to learn a sport they could learn nearly risk- and pain-free?
But don’t take my word for it, take Archie Manning’s. He did not allow Peyton and Eli to don pads and helmets till they reached seventh grade. Before that, these quarterbacks who would go on to four Super Bowl rings played flag, a game in which heads are not bashed. Everyone else, including legislators, and parents, and guardians of young boys and girls eager to play football, should follow this example
“The NCAA just released a study about head injury and sports.”
Is this available to the public? I can’t find this anywhere.
We must ban mini-bikes, bicycles, BB-guns, climbing trees, swing sets, tree houses, skate boards, and swimming for those under 12. We must remove all risk from life. I am looking forward to the Government approved bubble wrap that must be worn by all children under 12. And if you disagree you must hate children.
See the graphic below for starters. Or above I guess.
Are we saying this a problem that no manner of equipment can mitigate? Just asking?
And what you heard on the radio could have been a whole differnet study being cited. The bottom line is there is a number of sports with risks of head injury. I think if they want to fight concussion danger a focus also needs to be on allowing girls and women to play sports better suited for men such as hockey and fullcourt basketball.
Yes, well the graphic in post 17 does not seem to agree with what you said in post 8.
Per 17, its wrestling, than hockey, then football in terms of concussion danger.
Like the global warming hoax, this is about behavior control and money.
1. Who is paying for all these studies and who is benefiting?
2. Lawyers are recruiting former players for massive lawsuits.
3. Brain Trauma symptoms can easily be manipulated for lawsuit purposes. Anyone can claim to be confused.
4. Why wouldn’t a former player join the lawsuit? Most are bitter that current players are making much more money than they ever did. This is their final chance to cash in.
It is especially urgent that we ban baseball. Untold numbers of innocent spectators have been severely injured by balls batted into the stands. A friend of mine witnessed one such incident. Players have even been killed after being hit by pitches. Baseball bats are also used as weapons.
This barbaric “sport” has to go.
Computer technology provides a solution. Instead of allowing kids to engage in outdoor activities that expose them to the risk of severe injury or even death, we should encourage them to spend their free time playing video games.
Rush warned years ago this would happen ,,, it’s part of the WUSSIFICATION of AMERICA . I’ll bet the Boy Scouts will be next accepting girls , faggots and perverts should ruin a once great institution for boys .
You can’t live life that way.
That makes all the sense in the world - right up to the point where your family has a member’s number come up. My brother lived to be 76, and he was a football fan all his life. But his playing - and essentially all physical activity - ended abruptly one Saturday in in October. And, according to his death certificate, he presumably would still be alive today but for that accident.On the occasion of my brother’s death, the son of one of Mother’s friends emailed me to the effect that his mother told him of my brother’s accident - and pleaded with him not to play football. I myself was on the JV team, and continued through the rest of the season - but after that, the subject of my playing football just never came up.
According to this article I suffered brain damage when I tackled a big kid in a 3-on-3 game, and saw stars (and also, it must be said, even more so when I inadvertently ran into a telephone pole which should not have been placed in the middle of a school playground). But it is also true that most spinal cord injuries, including my brother’s, happen to HS aged boys.
Maybe football should only be played in college and professionally . . .
Exactly. Before playing in junior high and high school, I played sandlot tackle football (without pads or helmets) for years. And I can remember a few collisions that left me woozy for a moment, after bumping noggins with another player.
Of course, we were “protected” (if that’s the right word) by our size and relative lack of speed; we couldn’t generate the force necessary to generate concussions and similar injuries. Also worth remembering that, in those days, we were taught to tackle by leading with our shoulders, not our heads. That alone prevented a lot of head injuries.
And it’s not surprising that most of us survived playing football without long-term consequences for a very simply reason: we only played as part of a team (with full pads and helmets) for a relatively short period. For me, it was two years in junior high and one year of high school. The type of brain injuries found in deceased pro football players are the result of playing the game for years, at the highest levels of the sport.
Consider the typical NFL player. Many of them were identified as potential stars as early as junior high. So, by the time their pro career is over, they have been playing for an average of 14 years, with a much greater likelihood of suffering concussions and other head injuries. You can’t transpose their experiences over a much larger population that played the game at lower levels, with much less exposure to severe head blows.
I also believe there is a genetic component to this as well. Archie Manning, who is cited in the article, endured some of the worst pounding experienced by a QB in the NFL (playing for the Saints in the 70s would do that for you). But I’ve met him a couple of times and know people who are friends with him. Despite his experience in the NFL, Archie is in remarkably good shape and (so far) has avoided some of the issues affecting other players from his era. In fact, there are a number of ex-QBs who seem to be doing quite well, despite their injuries on the gridiron.
This is a part of the war on masculinity and an effort to neuter one of its last bastions, football.
the problem with using college data, is that I am referring to youth sports where helmetless kids playing soccer have a higher rate of concussion than little boys in football gear.
I’m not completely writing off what you say, I’m just asking for a reference to the data.
I think you may be confusing “total injuries” in soccer vs football, with just “head injuries”. But I could be wrong.
Also, when doing the comparison, I think you need to back out girls soccer from the soccer totals, as football is generally not an alternative for them and, at least based on the college data, they would seem to skew the data.
I gave up band after Middle School. Accidentally trashed my trumpet (dropped a valve) and was handed a sousaphone. A nasty beast to haul in a marching band...in the rain. Phooey.
Awesome. I just hope everyone realizes our sarcasm.
Moot point then. No one would ever know HOW to play football if they never started until College.
My point is, I played tackle football with my friends with no equipment. I played organized football. Baseball and hockey. You just can’t live in fear at every turn.
I don’t discount your brother’s apparent injury or demise. Accidents happen. My point is, I simply do not believe football to be materially worse than other sports. It just appears that way because of the NFL’s visibility and it’s former athletes who are dying. But those athletes were treated so differently then - playing through when they had their “bell” rung. That doesn’t happen anymore and the precautions in youth football have never been greater.
When my daughter played soccer, I forbid her to head-butt the ball.
Soccer headshot collection
https://www.youtube.com/watch?v=2GrUFD0FC0s
Sure, I played sandlot tackle football with my friends as well. But we didn't use our heads as weapons. And our friends didn't try to hurt us. Just as boxing gloves made boxing more dangerous, not less, so has football equipment, especially helmets, made tackle football more dangerous.
You make several excellent points.
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