In the 1990s, no one really asked, "Should you let your kid play football?" For orthopedic surgeon Barbara L. Bergin, M.D., registering her son, Matt, for the Pop Warner youth football program was natural. Her husband and brother-in-law both played. "There would have been no talking him out of it," says Dr. Bergin.
On the first play of his first game, Dr. Bergin noticed Matt did not get up. He had fractured his ankle. But Matt went on to play through high school. Now in his 30s, he has some arthritis but no chronic pain or signs of brain damage.
Since then youth participation in football has been declining, but the questions about football's safety are rising as more than a million will still participate in both youth and college teams in the fall. As with any sport, the long-term effects of the game on their bodies won't be known for decades. But chronic traumatic encephalopathy (CTE), a neurodegenerative disease caused by repeated hits to the head, has become a prevalent fear in recent years. It's a reason why many parents are having difficulty determining whether they should register their child for football. Experts weighed the risks, benefits, and ways to keep your child safe when they are on the field.
Is Football the Bad Guy?
Truth is, any physical activity carries risks of injury. There is a big focus on football because of the statistics. A 2008 study showed that high school football players were more likely than other athletes to suffer strains, sprains, and fractures. The players also experience the most concussions in youth sports. Girls soccer was second, according to research published in The American Journal of Sports Medicine in 2012.
Despite the publicity of CTE, doctors cannot predict whether a child will have it later on, says Julie Stamm, Ph.D., LAT, ATC, who researched the issue at the Boston University CTE Center. "We do not understand why one person gets it and the other does not get it," adds Dr. Stamm, also a clinical assistant professor in the department of kinesiology at the University of Wisconsin-Madison.
It's also often misunderstood how common CTE is. A Boston University study looking at 202 deceased brain donors grabbed headlines in 2017 when it found CTE in more than 80 percent of football players, including 99 percent of NFLers. Dr. Stamm called it a "convenient sample" focused on "people who were oftentimes having symptoms." But the risk of CTE, which can occur without a concussion, does intensify with repeated blows, often an issue in football. "Linemen are hitting each other as nearly every part of the game," says Dr. Stamm.
The longer people play football, the greater the risks. "Some people say, 'Oh, they're just playing as a kid,' but if you start at 8 and play until you are 18, that's 10 years of repeated head impact," says Dr. Stamm.
Signing children up for flag football through at least seventh grade can reduce exposure while still letting them play. "They're still advancing the ball 10 yards...and getting physical activity, which kids should have, but somebody is not hitting your head with every play," says Stamm.
How to Keep Children Who Play Football Safe
Stamm warned that there is "no such thing as a concussion-proof helmet," but having proper headgear can lower risks. Virginia Tech has a safety rating system. Raters determine a helmet's ability to minimize the impact of hits with a series of tests.
When a child is playing tackle football, parents can speak to coaches about the time spent practicing hits. Drills like "Oklahoma" or "bull in the ring" are red flags—they typically involve running at one another full speed, which experts say should never be done.
Parents should also know the signs of concussion. They include dizziness, erratic mood swings, headaches, confusion, and sensitivity to light. "One important thing is that you do not have to lose consciousness," says Dr. Stamm.
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Youth sports receive praise for character-building, but when a child is sidelined due to injury, they may push to play before recovering. It's important parents not condone this, regardless of any hopes they have for their child's athletic futures.
"You want to raise your children to have some grit, and sometimes grit is holding back and waiting until you heal," says Dr. Bergin, who wouldn't change a thing about her son's athletic past.
Dr. Bergin's son credits football for preparing him for adulthood. Though Dr. Bergin admits her views on football have shifted as the reports of CTE have increased, she has loved watching her son grow up to be successful—and gritty. Despite the controversial risks, she doesn't regret letting her son play.
"The football experience helped him become who he is today," says Dr. Bergin. "He really believes that, and I do, too. If I had to do it over again, I probably wouldn't have allowed him to play in that first football game, but I would not keep him out of football."