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.