I hope my son never asks me if he can play tackle football

Last fall, I went with my 12-year-old son to his middle school’s opening home football game. The bleachers were lined with parents, the smell of hot dogs and nachos wafted over the field, the announcer’s voice blared, and the cheerleaders jumped out of sync.

The boys were dressed in shoulder, chest, thigh and kneepads covered with clean white numbered uniforms. They each wore a helmet that seemed to weigh more than their head.

It reminded me of the days when I played Pop Warner football in the suburbs of Boston 35 years ago. I was a skinny tight end who spent more time getting hit in practice than in the games, but it was the route to my dream of becoming an NFL player. Even though my parents discouraged me, I insisted on playing tackle football with some kids twice my size.

Football is in our blood. My hometown of Needham, Mass., has had what must be one of the longest Thanksgiving Day high school football rivalries in history — 124 years — with neighboring Wellesley. My favorite team, the New England Patriots, and my wife’s favorite, the New York Giants, made for a divisive Super Bowl party at our house this January.

Yet for me the toughness and glory of football began to tarnish when report after report showed that the brains of football players were being adversely impacted. At first I was hoping the data would go away or be false, but the findings only get worse.

A 2000 study of more than 1,000 NFL players showed that 26 percent of players who had suffered three or more concussions were more likely to have memory deficits, poor concentration, speech impairments and headaches.

A 2007 study showed that retired NFL players with concussions were three times more likely to develop depression.

A 2009 study by the NFL Commission found that Alzheimer’s disease or other memory problems were occurring at a rate 19 times greater among football players ages 30 to 49. All this has led to many rule changes regarding concussions and better standards on helmets.

But what about high school or middle school football? Sitting on the bleachers and watching my son’s friend take a hit in the chest — I felt it in mine. There were no concussions in the game, but there easily could have been.

A brain, which I held in my hands in my medical school anatomy class, is a Jell-O-like walnut-shaped mass surrounded by a sac of fluid and then sheltered by a bony calcium shell, our skull. A hit to the head ricochets the brain inside the skull, disrupting billions of brain cells. If the impact is significant enough, it leads to loss of consciousness.

The brain of a middle school or high school student is more vulnerable to injury because it is still developing. The father of New England Patriots quarterback Tom Brady said that he is not certain if he would have let his son play football if he knew about the long-term health risks.

What concerned me most was a May 2012 study of former college athletes who had played a contact sport. Some had sustained a concussion. MRIs of players 30 years later showed the concussed brain had aged 10 years more than an uninjured brain, with less volume in the hippocampus (which is the memory area), thinner cortexes (the thought and consciousness area), metabolic slowing of brain cells, and radiological changes similar to Alzheimer’s disease. Fortunately, the former athletes in the study did not have significant clinical memory loss or cognitive problems.

What should we do? Pop Warner, the nation’s largest youth football organization with nearly 300,000 children ages 5 to 15, has changed its rules effective this month. There will be no contact for two-thirds of the practice — because research shows that in youth football the hardest hits occur during practices. Also, no head-to-head contact or full-speed head-on blocking will be allowed. A neurologist for the Pop Warner advisory board believes this will eliminate 60 percent of the brain impacts or concussions.

So what persuaded the Pop Warner officials to make this change? A study on second-graders, published in February 2012, in which researchers put sensors in the helmets of the youngsters, found an average player sustained 100 head impacts over a season. Most were minor, but some were at the force of college-level football.

Parents and school coaches have a choice this fall. I believe few, if any, of our children will likely play for the NFL, but all will require their brains to be functioning at peak capacity when they are adults, not aging at a faster pace.

We need to be concerned about the long-term consequences of middle school tackle football. We have an option. The skills of passing, catching, running and kicking can all be developed in flag-football, which would significantly reduce the risk of head injuries.

I hope my son never asks me if he can play tackle football.

Manoj Jain is an infectious disease physician and contributor to the Washington Post and The Commercial Appeal, where this post originally appeared.  He can be reached at his self-titled site, Dr. Manoj Jain.

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  • http://twitter.com/AmJNurs Amer Jnl of Nursing

    You might also see this post a couple days ago from the clinical managing editor of the American Journal of Nursing, “A Nurse and Mother on Dialing Back the Risk in Football” : http://ajnoffthecharts.com/2012/09/14/a-nurse-and-mother-on-dialing-back-the-risk-in-football/

  • Marc Katz

    Couldn’t agree more. Even in little league or high school baseball, kids are allowed to use metal bats which give the ball the potential energy necessary to cause severe concussions, and even death in severe cases, if it gets sent back to the pitcher. We love sports in our country, but more safe-guards should be put in place to protect the participants.

    (Hmmm, maybe that’s why my parents had me play soccer…)

  • Laura Harwood

    I agree. My son played football and in his sophomore year he developed a head injury during a game. I quickly realized how debilitating it can be. For about two months my son suffered daily headaches and an inability to concentrate in school. His head hurt so bad he had to come home from school and turn off all of the lights and sounds and go to sleep. I’ve also developed depression because he could barely function and he couldn’t hang out with his friends and his headaches were too painful to stand on the side lines and watch the game. The neurologist said he couldn’t listen to music because his brain had to heal. The neurologist also informed us these symptoms may never go away.

  • Shawn Jackman

    I struggle with the affect I likely caused myself in my youth from football. I played on a team that went undefeated all 4 years of my high school and had two years of pop warner before that. I was pretty viscious to both my opponents and the use of my head. Being one of the smaller framed guys on the team I focused on 1) weight training (strength) and 2) aggressiveness. I am nearly 40 now and do not suffer any any significant brain injuries, but that almost surprises me given what I read as an adult. I have a strong memory and have a great job in Information Technology.
    My son, at the age of 8 (two years ago) wanted to play football so bad, so I decided to go out to practice to see how I felt about it. I wasn’t even sure if he would want to go to the next practice. Their impact was very minimal and there was such a different coaching style to limit any type of helmet to helmet contact and neck injury. I was more impressed than I expected to be.
    Your article resonates with me. Am I lucky? Do I encourage my son to avoid football? While I may not have (yet) become a statistic to fall into your ranges, there are always exceptions to the rule that are hard to explain. Will that work the same way for my son? …with all of the new information available, I’m personally wanting to embrace other sports as primary options. Even though I love the game, I love my son more.

  • bill10526

    The problem with the post is whether is is part of a campaign to support lawsuits for lawyers.

  • http://www.facebook.com/Head.Mirror Bruce Campbell

    In the 1990′s, one of our boys wanted to play football and we said “no.” He was big and strong enough, but I had seen friends get hurt when I was growing up and did not like the gladiator mentality that fuels some teams. Later, there were too many bad knees, headaches, chronic pain issues. Now that he is in his late 20s, our son has finally decided that we made a good decision.

  • militarymedical

    Football is not the only sports-related brain injuries – we fool ourselves if we think it is. “Headers” in soccer – the other football – plus contact or hits in lacrosse, hockey, baseball and basketball add to the toll. Cheerleading injuries or falls, lacrosse, field hockey and other sports contribute to injuries among girls and young women. Banning competitive contact sports is not the answer, but perhaps better, smarter coaching and coaches along with the best protective gear possible at all levels would help.

  • buzzkillersmith

    Tackle football is great, unless of course you plan on using your body or brain as an adult. I say this as I sit rubbing my football-injury-induced arthritic left knee, status post two surgeries, the first at age 29. And pondering, in a somewhat confused manner, the concussions back in the day.
    I’m a bit of slow learner, but my son’s not playing football.

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