For the past year I have been digging into the literature regarding concussions and sports. I believe that I have a firm grasp on the topic of concussions, I’ve read the research and I know the neuroanatomy and neurophysiology involved. When I read about this proposed bill in my state it made me mad. While I want children to be protected I do not believe that the government needs to step in to do that for you or I as parents. We are all capable of understanding the risks, evaluating them, and making an informed decision for our children. Banning youth football in Illinois is bad policy in an effort to “do something” to reduce the risk of chronic traumatic encephalopathy (CTE.)
CTE is s a progressive degenerative disease of the brain found in people with a history of repetitive brain trauma, caused by symptomatic or asymptomatic concussions or even repetitive head trauma without concussion. There is no way to diagnose CTE at any point before you die, it can only be diagnosed by physically looking at your brain for this injury. Anyone who says they have CTE is just guessing based upon how they think or feel combined with a history of repetitive head trauma. These feelings or history is not exact, though. The famous Boston University study published July 2017 examined the brains of 202 individuals who had died and whose family donated the brain to be studied because while alive the person showed these feeling or actions associated with CTE. All of the 202 had played football at some time in their past, some NFL, others CFL, or college only. Of the 202 they found CTE in 177 brain samples, a significant percentage for sure but not 100%. I find it important to note that 0 out of 2 samples of persons who only played youth football had CTE and only 3 out of 14 samples that only played up to the high school level had CTE. Important statistics I don’t want to leave out include that 91% of athletes who played up to college had CTE, 67% of semi pro players had CTE, 88% of CFL had CTE, and 99% of NFL brain samples had CTE.The risks appear to be far worse when players reach the higher levels than they are in the lower levels, but remember this paper cannot be used to calculate risks.
This study is important to help advance our understanding of CTE and it’s relationship with sports but it can only take us so far. The Boston U study involved brain samples that was sent by the surviving family of the deceased who showed signs and or symptoms associated with CTE. They had no controls, no samples from persons who showed no signs or symptoms of CTE. This study cannot be used to estimate risk because it was not a random sample representative of our community, of everyone in the country. The authors of this study have been quoted saying that too, by the way. I hammer the Boston U study so much because it got a lot of press, in which the focus was on the 110 out of 111 NFL players with CTE and little about these other issues. The way this study was presented in the press was generally that football=concussions=CTE. In reality the issue is far more complex.
If I wrote out all the things I read to get me to this concussions this post would never end. Just know that I have read a number of studies to get me to the point where I am at regarding concussion injuries. I can write about these individual studies in the future. The body has an amazing ability to heal, even in the most severe cases, the problem is how much time are you willing to wait for that healing to occur. It is easy to understand this in regards to a broken arm, after getting set you wear a cast and are limited in activity until the cast is removed. Typically there is some therapy involved until the process of healing and recovery are complete and you can return to normal activity. Brain injuries need to be looked at in the same manner. The length of time for enough rest to heal the brain should be, in part, related to the severity of the injury. For example, getting knocked out might mean a month of rest vs mild head injury might be a week of rest. These numbers are not true recommendations just examples to help you understand that a concussion is an injury to the brain like a fracture is to your skeletal system. You need significant healing time and perhaps some therapy, after a period of rest, in order to fully recover. If you return to play too soon the risks for long term damage is likely increased, and if you get a second concussion before your brain is healed from the first there is potentially life altering consequences. Identifying a concussion and allowing for adequate healing time is crucial.
Back to the topic at hand, Banning Youth Football In Illinois is Bad Policy. I think this is the case because as parents we care capable of understanding the risks and making informed decisions. We are also capable of understanding what is necessary for an injured child’s brain to heal. As I mentioned the Boston U study found the lowest rates of CTE in brains of athlete who did not play past high school. While we cannot use that study to estimate risk, this data does seem to indicate that there is little to no risk of CTE if you only play up to the high school level. This is the vast majority of us. In the 2015-2016 school year there was 1.08 million boys playing high school football and only 3-4% of high school football players make it to the college level. Looking at these numbers, compared to the data we have from the Boston U study, that we cannot accurately use to estimate risk, this means that it is very unlikely for the majority of youth football players to end up with CTE. Today we have a huge level of awareness that we didn’t have 20 years ago so identifying these injuries is more common and the proper healing and recovery is improving. We can also realize that an injured child might have to discontinue his participation in football if he has suffered multiple concussions.
This policy will not “save” very many people from a risk of CTE and instead will keep children from the benefit that they get from being involved in an organized sport. Sport has great benefit for physical health as well as helping kids learn good sportsmanship, teamwork, and taking instruction from coaches. Additionally football isn’t the only sport with a risk for concussion and subsequently CTE. According to a survey on concussion injury in the NCAA wrestling had the highest rate of concussions followed by men’s ice hockey, women’s ice hockey, and then football. If the government starts banning more things in order to “save” us from ourselves football shouldn’t be top of the list it should be wrestling and hockey.
Banning football is not the answer to this problem. Greater understanding through more research as well as a properly informed public. We as parents can weigh risks and decide for ourselves what is best for our children. I teach a workshop on concussion that discusses concussion and what the appropriate course of action should be in order for your children to play safely. Give me a call and I will come speak to your group about this serious issue.