Kids Play Sports at What Cost?

Photo by Carol Duff

Health Editor’s Note:  Kids want to play sports.  Parents want their kids to play sports. Everyone thinks if a kid plays sports he or she is going to be healthier, accepted by peers, somehow a VIP of that chosen sport if they are successful. Somehow the sports-playing kid is going to be seen as more valuable as a human being.  Should we let our kids play football or for that matter soccer, baseball, basketball, well, any sport in which contact is welcome/expected?  We could add boxing, baseball, cheer leading, any sport where a head can meet an immovable object whether it be another head, a fist, the ground, hard floor, baseball, etc. 

Who I believe to be the greatest boxer of all time, Muhammed Ali (Cassius Clay) was diagnosed with Parkinson’s disease(caused by death of neurons (brain cells) at the age of 42). Although family and doctors would deny the connection between this diagnosis and years of being concussed from the age of 12 when he started to box, Parkinson’s IS a disease of the brain. You have read from time to time accounts or football players who have met early deaths, have had major personality changes, and upon autopsy, the brain is very abnormal/damaged.

According to the American Association of Neurological Surgeons ” Over time, professional and amateur boxers suffer permanent brain damage. The force of a professional Boxer’s fist is equivalent to being hit by a 13-pound bowling ball traveling at 20 miles per hour, or about 52 times the force of gravity.”

A traumatic brain injury (TBI) is a blow to the head that disrupts the normal function of the brain. The process is that the brain is violently moved inside the hard skull, hits the skull, and can become bruised and damaged. There are different stages of TBI that depend on the severity of the trauma to the brain.

According to the Consumer Product Safety Commission (CPSC) data “there were an estimated 446,788 sports-related head injuries treated at U.S. hospital emergency rooms in 2009. This number represents an increase of nearly 95,000 sports-related injuries from the prior year. All of the 20 sports noted below posted increases in the number of injuries treated in 2009, except for trampolines, which posted 52 fewer injuries in 2009. Sports that exhibited substantial increases from 2008 to 2009 included water sports (11,239 to 28,716*), cycling (70,802 to 85,389), baseball and softball (26,964 to 38,394) and basketball (27,583 to 34,692).”  Not all head injuries were reported. Sports and recreational activities contribute to about 21 percent of all traumatic brain injuries among American children and adolescents.”

Also, according to the American Association of Neurological Surgeons ” Over time, professional and amateur boxers suffer permanent brain damage. The force of a professional Boxer’s fist is equivalent to being hit by a 13-pound bowling ball traveling at 20 miles per hour, or about 52 times the force of gravity.”

When did sports move from the playground, with the neighbor hood kids playing that pick-up game of baseball, to an activity where you can be killed?…..Carol

Should We Let Our Kids Play Football?

Milton Packer wonders if we learned anything from the Roman Empire

by Milton Packer MD

When I moved from New York to Texas more than 14 years ago, my life changed in many ways. I graduated from being a division chief to a department chair. I moved from a “blue state” to a “red state.” These changes were fairly minor compared with one seismic shift.

In 2004, I moved from a state that loved baseball to one that loved football.

I still vividly remember Game 6 of the 1986 World Series. When Boston Red Sox first baseman Bill Buckner made his infamous fielding error (which allowed the New York Mets to prevail), I was at a medical conference and watched the game with four cardiologists from Harvard. They went to bed in tears, but I was ecstatic beyond words.

But no one in Dallas cared very much about baseball in 2004. The stadium in Arlington was filled to capacity only when the Yankees were in town. My 10-year-old son was a lefty pitcher. When the parent who coached the team decided to retire and no one volunteered to replace him, I stepped up as the head coach for four seasons. It was the most fun a parent could ever have. It did not matter that the stands (meager as they were) were rather empty.

In Texas, football is a religion. (One church even set up a widescreen TV so that congregants could watch the Cowboys during the prayer services!) But it isn’t just professional football that commands this devotion. Every Friday night in the fall, parents ecstatically swarm into stadiums to watch their school-aged kids play. One suburb of Dallas paid nearly $20 million to build a stadium for their high school team. Within a few years, it was enlarged so that it can now seat more than 10,000 people.

Every October, the city of Dallas hosts the annual rivalry between Texas and Oklahoma in the Cotton Bowl. The stadium no longer exudes its glory from 50 years ago. But once a year, it is filled to capacity. Just a few days ago, the fans were treated to an outstanding game, with Texas edging past Oklahoma on a field goal in the final seconds of play.

Texas is enthralled by football, both at the high school and college level. If you are younger than 22 years old and play football, your social status is guaranteed. It does not matter if your family has made a fortune dealing in heroin or your grades in school are abysmal or you spend your free time watching dogfights. If you play football well, you walk on sacred ground.

But at what price?

Last week, Dylan Thomas — a 16-year-old star linebacker for a high school team in rural Georgia — became incoherent during a game and passed out. He woke up transiently only to say, “I can’t feel my body,” and then lost consciousness again. He died a few days later from head trauma.

Deaths of football players during a game are rare, but they happen every fall. According to CNN, 13 died from the sport last year (of an estimated 4 million young people who played organized football).

But immediate deaths are not the major concern here. The repeated head trauma that is an integral part of football has a long-term toll. Repetitive brain trauma in athletes can lead to chronic traumatic encephalopathy (CTE). The problem is not only with symptomatic concussions but also with subconcussive hits that do not cause any symptoms. Repeated trauma triggers progressive degeneration of the brain tissue, which can lead to memory loss, confusion, a loss of impulse control, depression, suicidality, and dementia.

Crucially, CTE is not limited to current professional athletes; it happens in athletes who did not play sports after high school or college. The process of CTE can begin months, years, or even decades after the last brain trauma or end of active athletic involvement.

The simple truth is that the head trauma experienced by young people playing football — even when it is never recognized contemporaneously — is likely to have important adverse consequences for brain health, years after our kids have stopped playing the game. Conceivably, for many players, even “minor” degrees of CTE could be clinically devastating 15 to 20 years later. School-aged participation in football could influence cognition and behavior in middle-aged men in ways that are never diagnosed by a physician.

Those involved in the oversight of football have made a few changes to minimize the opportunities for overt head injuries. But no one has adequately evaluated the long-term consequences for brain health in young football players. And no one can claim that recent changes in the conduct of the game will make any difference.

So, what would you say if your 15-year-old son came to the dinner table one evening and announced that he wanted to play football?

Dylan Thomas’s parents were worried. According to CNN, they used their own money to buy an NFL-quality helmet for their son, because they were “somewhat concerned about head injuries.” It wasn’t enough.

Football can be wonderful to watch; some validly consider it to be a competitive form of ballet. And it can certainly stir human emotions. Undoubtedly, for some players, it provides an unparalleled opportunity for recognition, and for some, redemption.

But that was also true for gladiators in the Roman Empire 2,000 years ago. The gladiators were glamorous, but typically they were slaves or prisoners, who saw combat as the only opportunity for short-term advancement. Gladiator spectacles were one of the popular forms of entertainment in the Roman world; the Colosseum was regularly filled with 40,000 people, consumed by fervor.

As you know, in the end, most of the gladiators did not fare very well, but they knew they faced an abysmal outcome from the start. Our kids don’t.

You are at the dinner table, and your son has just told you he is interested in playing football. What do you say?

Packer recently consulted for Actavis, Akcea, Amgen, AstraZeneca, Boehringer Ingelheim, Cardiorentis, Daiichi Sankyo, Gilead, Novo Nordisk, Pfizer, Sanofi, Synthetic Biologics, and Takeda. He chairs the EMPEROR Executive Committee for trials of empagliflozin for the treatment of heart failure. He was previously the co-PI of the PARADIGM-HF trial and serves on the Steering Committee of the PARAGON-HF trial, but has no financial relationship with Novartis.

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  1. Life is full of a myriad of different human activities. So called “sports” is only one of them. Much of what is called “sports” does not even properly address true sportsmanship at all. We often read about fights at high school events. These events do not necessarily improve the human body but are dangerous as the article indicated. We must turn to improving brain function by encouraging all students to take challenging courses in mathematics and physics. Most students hate and avoid these subjects like the plague as most of their parents did. One learns to think by thinking and studying challenging subjects like these. The earlier the better. When I grew up I loved cars and hot rods so I stayed up until after midnight pulling engines out of old Fords or Chevrolets in my Dad’s garage.
    Sports past high school is nearly all fixed by gambling interests. Money runs the show.
    Let’s stop the rude emphasis on so called “sports” with kids and encourage brain function instead.

    • Each generation the standards for high school graduation get worse. Most kids who graduate from high school are not only not prepared for college, they are not prepared to enter the workplace with developed basic job skills. Our country is in serious competition with others especially China. Many of their students work much harder in school than ours do. A few years ago there were two pictures circulating. One was of an American college class, mostly bare breasted females and mostly naked males getting ready for party time. The other was probably a group from China, dressed in business attire, with serious facial expressions, ready for hard work to learn something useful for life and improving brain function. America is going down quickly now and public education is largely responsible. Americans must get serious about learning and improving brain function. It may be too late now. Advanced mathematics and physics courses are the best place to begin this journey.

  2. The NFL is the recruitment and propaganda arm of the military industrial complex. The last HS game I went to in my home town, the parents working the concession stand wore red shirts emblazoned with ‘Let’s Start a War”. They won the class D NYS championship that year, after attempting to do so for 70 years. The next year, a kid died in a game in the same division. Now the school that never once had trouble fielding a team, is a combined team with another school, because they didn’t have enough players. This is a positive trend and one that will reduce the violent tendencies of our society. Football has reinforced the violent nature of US persona for too long. Baseball is America’s sport, not football.

  3. When I coached LaCrosse, we cut a field down to 90 yards from 110 yards for the 7 and 8 year olds. We actually had complaints from opposing coaches. I asked them if they actually thought that 7 and 8 year olds should run the same field as NCAA and professional teams? Of course the children never complained. Lots of wacko parents out there. Same coaches kept their best players on the field too long trying for the win. This was C-class rec ball. It was supposed to be fun.

  4. When I was a kid we didn’t have organized teams playing in leagues with coaches. We met in a field, picked teams, and played what ever sport we felt like playing. Baseball, football, soccer and pick-up basketball on an asphalt court. No parents and no cell phones. We made our own fun. I don’t recall any major injuries. If we saw any parents we were likely to get on our bikes and ride away. Punishment was being grounded and forced to stay inside; something we never did, even in blizzards.

  5. The other problem with sports and particularly that of football and NASCAR is the rampant militarization of the event with military color guard, jets(F-22) flying overhead while some one sings the national anthem. Intended to whip people into some twisted patriotic fervor for more wars.
    Televised sports, the most popular forms ,are nothing more than selling eyeballs to advertisers.
    There are some schools who have dropped the football game entirely.
    If Dale Earnhardt had worn the proper protective gear, he would probably be still alive today.
    Grand Prix racing was once called the “cruel sport” for killing so many drivers during the season. Drivers such as Jackie Stewart eventually were able to get the ruling body to force car builders to make them safer. since then, the numbers of injuries and deaths have declined, however drivers will continue to be killed and that’s the risk they’re willing to take when driving over 200MPH on twisting roads.

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