Football’s Fumbled Solutions to Its Concussion Problem

In all its guts and glory, this past Sunday’s Superbowl was another reminder of America’s love affair with the violent sport of tackle football. While the sport maintains its immense popularity, the grave health risks to players have never before been so widely understood. The movie Concussion, released late last year, tells the real-life story of pathologist Bennet Omalu, played by Will Smith, who forced the NFL to admit to the reality of chronic traumatic encephalopathy, or CTE, a brain disease that results from years of hits to the head that start when players take up the game as children. Notwithstanding the visibility of the NFL, the majority of football players are not well-paid professionals: they are teenagers.

“Tackle football is one of the most dangerous sports kids can play,” says Kathleen Bachynski, a doctoral student in Sociomedical Sciences who studies ethical and historical questions related to the health risks of youth sports. “I like to describe it as a collision sport, which distinguishes it from a contact sport. Unlike sports such as volleyball or soccer, where there is contact, football has repeated full-body collisions that are an inherent part of the game.”

Bachynski first became interested in the subject after reflecting on the lifelong consequences of an ACL injury she sustained as a high school soccer player. Today, her attention is on the unique risks of youth tackle football, a topic she explores in a Perspective article in the current issue of the New England Journal of Medicine, and the theme of her dissertation, which she will defend this April.

She argues that methods used to reduce the risks of football-related brain trauma—either better adult supervision or improved technology—are insufficient to protect children. Examples include the “heads up” technique, promoted by the NFL and the Centers for Disease Control and Prevention, for keeping the head up and out of contact during tackling, and the “concussion collar,” which partially restricts blood from leaving the brain in order to cushion it in case of a hit. More outlandish was a recent unpublished report by University of Maryland researchers that purported to find players who drank a specific brand of chocolate milk were less likely to experience symptoms of concussions.

According to Bachynski, there is little to no systematic evidence that any of these strategies can reduce the risk from blows to the head. Moreover, their proliferation suggests that awareness around the sport’s risks is being met with an equally strong push to maintain the status quo.

Across the country, children, some still in middle school, are pressured to play tackle football, which is often a centerpiece of community life. At the same time, these children, whose brains are still developing, are ill equipped to understand the risks. Ultimately, says Bachynski, the decision of whether or not kids should play tackle football is up to the adults in their lives, starting with their parents. Absent any serious rule changes, increasing numbers of parents are deciding to keep their kids on the sidelines.

“In order to safeguard children’s health, we need to consider ways of playing the sport more safely, even if those ways include some fundamental rule changes,” she says. “I think removing tackling, which is by far the riskiest aspect of football, toward touch football or flag football, is a way that children can still enjoy physical activity and the fun of the sport without having repeated hits to their heads and the potential for long-term harms that go along with those hits.”

For more of Bachynski’s thoughts on youth football, read a recent Q&A she did on Reddit Science.