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Wednesday, 07 February 2018 06:47

Develop Minds, Don't Damage Them: Ending Violent Youth Sports

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Brains 0207wrp opt(Photo: Neil Conway / Flickr)The Super Bowl is the US's biggest TV night of the year, watched by over 100 million viewers every year. This one game earns the NFL about $3 billion, and generates tens of billions for the overall economy. The Super Bowl is the country's iconic sports and cultural extravaganza, and I can no longer bring myself to watch it, or any other football game.

I used to play football in little league, and as a teenager. I loved it; it was my favorite sport and I was pretty good at it. I enjoyed the contact, hitting other boys as hard as I could. As a running back, I especially enjoyed running over other boys to make touchdowns. Every Saturday was filled with the thrill of great expectations, every game was exhilarating, every time they handed me the ball I felt like I owned the world. Even when my team lost I felt like I was still on top of the world.

And then I got injured, and had to give up the game at the ripe old age of 13. I was devastated, almost inconsolable. My dreams were shattered. And it was probably the best thing that ever happened to me.

Maybe because I quit after only three years, I still have decent brain function left. Many others are not so fortunate. Football today has become the equivalent of Roman gladiators, the sacrificing of young men for the guilty pleasures and profit of others.

Chronic Traumatic Encephalopathy (CTE) will likely lead to the death of football. And it should. In the meantime, it is leading to the death and suffering of hundreds, if not thousands of men, at ages far too young. After years of obscuring and trying to deny the evidence, the NFL has taken what they wish to portray as a noble and aggressive action to protect players from concussions, which they assume will decrease the incidence of CTE, or at least refurbish the NFL's reputation.

But new research shows that concussions, i.e. head trauma associated with obvious symptoms of brain injury, are not the primary factor in the development of CTE. Twenty percent of athletes ultimately diagnosed with CTE were never diagnosed with a concussion. In fact, a new study shows that CTE is more related to repetitive, lower impact hits to the head that are part of just about every play for a majority of all 22 players on the field. Dr. Lee Goldstein, an associate professor at Boston University School of Medicine and College of Engineering, an author of the study, stated, "A concussion doesn't tell you anything about a TBI [traumatic brain injury]. Nor does it tell you anything about CTE."

The study had two separate components. One part examined the brains of four teenagers who died shortly after a closed head injury and compared them to teenagers who had died without a history of brain trauma. The other leg of the study created acceleration/deceleration head injuries to lab mice. In both, the brain pathology of the mice and the teenagers was very similar and not related to concussions. The authors concluded that their results indicate "that closed-head impact injury, independent of concussion, represents a potent insult with potential to induce enduring neurophysiological dysfunction and persistent (and possibly progressive) sequelae, including CTE brain pathology." In other words, the trauma from repetitive head injuries inherent in the game of football, shows that even in teenagers, the process of neurodegeneration has already begun.

Furthermore, the implications of the study are that focusing on preventing concussions does not prevent the development of CTE. The vast majority of hits to the head are more minor trauma. But chronic repetitive, minor trauma to the head -- not severe enough to produce concussion symptoms, and occurring in quick enough succession that the brain does not have time to heal -- is, in fact, the precursor of CTE. That scenario virtually defines the game of football. Because they don't have symptoms, players aren't aware of what's happening, they don't get taken out of a game, and invariably they get hit again, and again, many times throughout a game.

One of the prominent researchers in the field, Dr. Ann McKee, chief of neuropathology at the VA Boston Healthcare System and director of the CTE Center at Boston University, has said that linebackers who play in the league for 10 years could sustain upward of 15,000 of these sub-concussive hits.

A Stanford University study followed a college offensive lineman and documented 62 of these hits in a single game. "Each one came with an average force on the player's head equivalent to what you would see if he had driven his car into a brick wall at 30 m.p.h."

Symptoms of CTE include the full spectrum of disorders, including "memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, suicidality, parkinsonism, and eventually progressive dementia."

The evidence is now clear that the younger a boy starts playing tackle football, the more likely he is to suffer behavioral and intellectual deficits later in life. Researchers from Boston University's CTE Center found that of 214 former football players, 43 of whom only played through high school, and 103 played only through college, those who began playing before the age of 12 had double the risk of cognitive and behavioral problems, and triple the risk of clinical depression. 

"The increased risk was independent of the total number of years the participants played football, the number of concussions they reported, or whether they played through high school, college or professionally." The age of 12 was chosen specifically because between the ages of 10 and 12 is a critical period of brain development and maturation in males. Adjusting the data for other cut-off points yielded the overall finding that the younger the age at which the player started the sport, the worse the outcome for brain function. The average age of the subjects at the time of this evaluation was 51. This study showed similar results to a previous one by the same research center of former NFL players.

Other studies have shown truly shocking results. A neuropathologist found CTE in the brains of 110 of 111 former NFL players at autopsy. There is selection bias in this population, given that the brains were donated by family members because they had concerns about the players, but the results are shocking nonetheless. While this part of the study received a lot of national attention, this was part of a larger survey of 202 deceased football players, and what didn't get much attention was perhaps even more disturbing. Of these 202 deceased former football players, 14 did not play after high school and three of those 14 (21 percent) still had CTE; 53 players did not play after college and 91 percent of them had CTE. There was a correlation between the severity of the disease and those who played the longest.

Furthermore, "among 27 participants with mild CTE pathology, 26 (96 percent) had behavioral or mood symptoms or both, 23 (85 percent) had cognitive symptoms, and 9 (33 percent) had signs of dementia. Among 84 participants with severe CTE pathology, 75 (89 percent) had behavioral or mood symptoms or both, 80 (95 percent) had cognitive symptoms, and 71 (85 percent) had signs of dementia. Lineman and linebackers seem to be the players most at risk because they are most often involved in the play by play combat.

Even before the information on CTE became widespread through books and the movie Concussion, there was ominous research in the public sphere. A 2011 study from the Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center at the University of North Carolina found that the life expectancy of professional football players is a stunning 55 years on average, a loss of about 25 years compared to the rest of the population. It also found that "repeatedly concussed NFL players have five times the rate of mild cognitive impairment as non-players. Retired NFL players have a 37 percent higher rate of Alzheimer's.

Not surprisingly the NFL disputes this study, with a less than robust rebuttal using a study funded by their players association. But an older study from 1988 found a similar startling number.

Polls show that the number of people who could be classified as committed fans of the NFL and/or who want their children to play football is declining, specifically dropping from 58 percent in 2014 to 49 percent in January 2018. Granted, most of that decline has occurred among white males, a stronger decline among Republican white males, and there is likely a racial component attributed to the recent national anthem protests. But even among Democrat white males, the NFLs popularity has dropped 8 percent, and 4 percent among independents. Moreover, 48 percent of parents polled in January said they were concerned enough about concussions that they would encourage their sons to play a sport other than football.

There is more than enough research to conclude that playing football is a dangerous sport, and for a significant percentage of its participants, is a slow-moving death sentence. It is indisputably a significant risk for brain damage. And that fact brings up this question: Why does the public education system of this country still openly sponsor, endorse and underwrite a sport as damaging to the brains of teenage boys as football?

No one is forcing parents to send their kids to play football, and with the increased awareness of head trauma, participation in youth leagues is finally dropping. Likewise, no one is forced to support your local college football team. One can choose to attend, watch, or not. But it is a legal requirement that our youth attend high school.

It's time to terminate the association of public high schools with the game of football. High schools should be public institutions of education, training grounds for critical thinking, civic participation and career-building. They should not be tied at the waist to the brain damaging, cultural equivalent of teenage gladiators. The coliseums under today's Friday night lights are filled with parents who may not realize that even if their team wins, their child is likely to lose.