Jonathan P. Baird

Football is back. Along with the NFL and college football is the running discussion about chronic traumatic encephalopathy or CTE, the degenerative brain disease caused by repetitive hits.

While most of the CTE focus has been on NFL players, one other group has garnered attention. That group is children under age 12 who play tackle football.

New scientific information from Boston University School of Medicine shows that hits absorbed by young players are more damaging because their brains are not fully developed and because young brains are less capable of repairing themselves.

Children who get brain injuries before the age of 12 also seem to recover slower.

We have learned that playing youth football may lead to earlier onset of cognitive, behavioral, and mood symptoms in later life. The Boston University study shows that those who played tackle football before age 12 experienced symptoms 13 years earlier than those who started playing at age 12 or later.

Dr. Ann McKee, chief neuropathologist at the Boston VA Healthcare System and Director of Boston University’s CTE Center, commented:

“It’s as though the brain of these people who started playing early football was less resilient to pathology. It’s sort of like they have a weakened nervous system, and set you up for earlier onset of any of these disorders. That was a surprising finding.”

I do think there is a serious public health issue here. Over one million American children age 6 to 12 played tackle football in 2016. We know that the years before age 12 are critical for brain development. Just to refresh recollection, CTE’s early symptoms include: headaches, impulsive behavior, depression, suicidal ideation, irritability and short-term memory loss. Later, CTE leads to dementia, explosively aggressive behavior, paranoia, and impaired motor function.

Dr. McKee has recommended that children under age 14 should not play tackle football. Another leading sports injury neurologist, Dr. Robert Cantu, has recommended that kids under 14 only play flag football.

While I would acknowledge that playing youth tackle football has benefit as a form of exercise, can build character, camaraderie and a great feeling of collective accomplishment, it is difficult to escape the awareness that brain trauma is a particularly insidious injury. It is not like another broken body part. The injury is life-compromising.

Brett Favre, the now-retired Green Bay Packers quarterback and an iron man player with a streak of 297 consecutive starts, has stated:

” I got three grandsons. I’m not going to encourage them to play football, I’m not going to discourage them, but I would much rather be their caddy for them in golf than watch them play football.”

Nick Buoniconti, a Miami Dolphins Hall-of-Famer who also played for the Patriots, was quoted in the New York Times:

“I made a mistake starting tackle football at 9 years old. Now, CTE has taken my life away. Youth football is all risk with no reward.”

Buoniconti has a dementia diagnosis.

Favre and Buoniconti are not alone among NFL players in not wanting family members to play youth football. Among others, Zach Ertz, Adrian Peterson, Terry Bradshaw and Fran Tarkenton are all on record voicing a similar sentiment.

This past legislative session, five states introduced legislation that aimed to ban youth tackle football under age 12. The states were Illinois, Maryland, California, New York and New Jersey. None of the bills met with initial success but it was interesting to see the response of Pop Warner Football. They have limited contact in practice and they also eliminated kickoffs entirely.

Michael Wagner, the executive commissioner for Southern California Pop Warner Football, responded to the reform effort in his state:

“This is downright un-American. I think [for] the government to tell parents that they’re mistreating their children because they’re allowing them to play a sport…is an infringement on their freedoms.”

Pop Warner is facing a California-based class action lawsuit brought by the parents of two young men who were found to have suffered from CTE during post-mortem autopsies. The plaintiffs in the lawsuit are arguing that Pop Warner failed to institute league-wide safety protocols and guidelines.

Whatever opinion one ultimately holds about football, I think discussion of tackle football for those under the age of 12 can be separated out as a distinct matter of public health. Just as we recognize the harm of lead poisoning to children, there is a strong case we need to prevent young athletes from experiencing repetitive head impacts.

The science is clear: youth tackle football is bad for the brain.