OT: Age of first exposure to football and later-life cognitive impairment in former NFL players

Submitted by Sextus Empiricus on January 29th, 2015 at 12:11 AM

There is an association between participation in tackle football prior to age 12 and greater later-life cognitive impairment measured using objective neuropsychological tests. These findings suggest that incurring repeated head impacts during a critical neurodevelopmental period may increase the risk of later-life cognitive impairment.

Published online before print January 28, 2015, doi: 10.1212/WNL.0000000000001358 Neurology 10.1212/WNL.0000000000001358

NYT write ups...

Study of Retirees Links Youth Football to Brain Problems

To Allay Fears, N.F.L. Huddles With Mothers

The hits keep coming.  Having played pop warner ball I have to wonder about my own precocious senior moments.  This goes beyond NFL players.

The CTE story is the stake in the heart of the game that is slowly being twisted deeper with every study despite NFL huddling with mothers and settlements with players.  

Do players sign releases in college?  It's getting to that point.  Michigan's exposure is already played out in past stories with first hand accounts from Michigan players.  In my heart I think it is time to find another past time.  Baseball anyone?



January 29th, 2015 at 6:54 AM ^

I don't think this has anything to do with fearmongering.

Having casual sex without protection doesn't guarantee that you will contract HIV, yet we still suggest that you protect yourself and avoid activities that expose yourself to the virus. Is that fearmongering? Is studying a phenomenon (CTE and participation in football) to determine where the highest risk is found in order to prevent future issues? There are now numerous studies, both population and case, that have shown a significant linkage between these two variables. It would be irresponsible to not gather more information and warn of potential hazards.


January 29th, 2015 at 10:14 AM ^

There are varying levels of CTE.  It is possible that most players suffer from some sort of brain damage.  It wasn't until recently that they realized that the repeated small truamas to the head of linemen could be as damaging as a concussion.  Every study that comes out points to more players having brain trauma as a result of football.  Not sure why your head is so far in the sand as to the reality of that.

Lou MacAdoo

January 29th, 2015 at 10:52 AM ^

It really is a very sad development and some people just aren't willing to see the truth. These players are killing themselves to end the misery and to have their brain examined. With the continued research into this and the wussification of our country I see this as the potential end of football as we know it. It will be interesting to see how they try to flip this around on people. No helmet can prevent this unless they find a way to put it inside your skull to stabilize the brain. Not happening. Maybe they'll go to flag or two hand touch.


January 29th, 2015 at 10:58 AM ^

"Most" people didn't get Spanish Influenza, either. Killing 20 million people was still really bad. I don't want my kid's brain at risk when there are a lot of other perfectly good sports to play. If that risk is small vs. large seems like a really important distinction, but I would play odds much different than 0% vs. 100% (or vs. 50%). 


January 29th, 2015 at 4:05 PM ^

I don't want my kid's brain at risk when there are a lot of other perfectly good sports to play.

There really aren't a lot of sports with no brain injury risk - and even most non-contact team sports have surprisingly high risk.

Football and ice-hockey are generally the worst - but soccer and lacrosse aren't great either.

From a study of 10 sports in high school -

The injury rates per 100 player-seasons were 3.66 for football, 1.58 for wrestling, 1.14 for girls' soccer, 1.04 for girls' basketball, 0.92 for boys' soccer, 0.75 for boys' basketball, 0.46 for softball, 0.46 for field hockey, 0.23 for baseball, and 0.14 for volleyball.


Another study:

Football had the highest concussion rate (6.4), followed by boys’ ice hockey (5.4) and boys’ lacrosse (4.0)



Football accounted for more than half of all concussions, and it had the highest incidence rate (0.60). Girls’ soccer had the most concussions among the girls’ sports and the second-highest incidence rate of all 12 sports (0.35).



Cycling was also the leading cause of sports-related head injuries in children under 14, causing 40,272 injuries, roughly double the number related to football (21,878).


January 29th, 2015 at 9:33 PM ^

This research comes directly from authors at Boston University's Center for Study on Traumatic Encephalopathy (CSTE), where the disease of CTE was initially defined, via their research. The research from this institution puts forth is highly respected.

Interestingly, they have the largest brain bank for study on CTE. Any athlete that any of us has heard donated their brain after death to CTE research most likely went to this research facility. Furthermore, the CSTE has support from the NFL, as the NFL has donated $1M supporting future CTE research at Boston University's CSTE.

So basically... this article is not junk science.


January 29th, 2015 at 12:22 AM ^

Personally I don't see the need to play tackle football until high school. We had to play flag football in junior high back in my day and a handful of guys still managed to get D1 football scholarships by the time we finished high school. We also put a ranked team in class A on the filed my JR and SR yrs.


January 29th, 2015 at 5:26 AM ^

I agree that tackle football should be abolished until at least high school.  What I really think has to happen, though, is that the game is going to have to be changed so that players are no longer rewarded for delivering the "big hit."  People who sit on their couches with their beer and potato chips while preaching the gospel of "toughness" are going to whine, but it's going to have to be done.

My suggestions:

Fumbles go back to the offense.

A hit cannot cause an incompletion.

Any player who accelerates the second impact (the one where the player hits the ground) is automatically ejected.

Revamping and enforcement of "unneccessary roughness."

No more gratuitous hits on QB's after they have released the ball.

Those who just want to see hitting are going to whine about the "lack of toughness" in the game, but they aren't the people getting their brain cells systematically killed, practice after practice and game after game.  Fans have no right to whine or to expect players to sacrifice their quality of life after football for fans' enjoyment.  

The alternatve is for football to look like basketball.  At least with the changes I suggest, it can still look a lot like football, but without all of the debilitating brain damage.


January 29th, 2015 at 6:31 AM ^

I'll make it even easier - take away the helmets. Otherwise, you'll still have those hard hits with additional refereeing issues. Helmets are the #1 weapon. As long as those are still being used - no matter how technologically advanced they become - head related injuries will persist.

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January 29th, 2015 at 10:53 AM ^

I'm sorry, but this is ridiculous. Just think of how many times a group of people tackle the ballcarrier and, in falling, someone's head hits someone's knee. With helmets on, that's a non-issue. Without? You're talking about concussions and potential skull fractures (which used to happen all the time before helmets!). Those sorts of events happen every down in a football game. Don't forget that the game of football was almost outlawed due to so many people dying before we introduced modern helmets and safety measures.

Someone can come along and correct me on the exact history of it since I'm no expert, but I feel like helmets are used as a scapegoat for concussions when they actually do much more good than harm.


January 29th, 2015 at 6:59 AM ^

I don't think you need to go that far. Football is a dangerous sport, but you don't need to deviate drastically in the name of safety. Some of your ideas are great (no tackling until high school is necessary IMO), but others would never take hold. As long as the players are voluntarily participating in this game while being hansomly paid  to do so, I don't think you need to revamp the game to an extreme. Some occupations are just dangerous in both the short term and long term (mining is a good example). 


January 29th, 2015 at 7:01 AM ^

but I'd take away the face masks, or reduce them to the single bar that was typical in the mid-1950s. The effect of this would be that a player leading with his helmet trying to make a SportsCenter-style hit is going to lose teeth and sustain a broken nose and cheekbones in short order.


January 29th, 2015 at 10:17 AM ^

Small collisions between linemen have the cumulative effect of a major consussion.  You'd have to remove line play too if you are trying to remove these issues.  Big hits aren't the problem that people make them out to be it is the repeated head trauma.

Sac Fly

January 29th, 2015 at 6:58 AM ^

Kids need to learn how to tackle right, not like they see on TV. Until they learn proper form, it won't matter what age they're allowed to start at, the hits to the head will still be just at bad.

In Illinois, the state cut the number of full contact practices a team is allowed to have and it made things worse.

Players aren't taking the same number of hits to the head, but the fundamentals are worse. We see more helmet to helmet hits and leading with the crown.

Space Coyote

January 29th, 2015 at 9:50 AM ^

I think a lot of the problems stem from a few things: not teaching proper technique in all aspects of the game (tackling, blocking, etc); at one time teaching or advocating for bad technique; and not understanding concussions and their impact for a long time.

I'm not sure waiting to play tackle football is the right approach though. Why wait until kids are 16, some are 6'2" 250 lbs and others are 5'6" 120 lbs, some can run 4.5 40s and hit like a sack of bricks, and trust that the technique they need will just come? That is making things worse. They are at an age where they can actually hurt each other more seriously but they don't have the fundamentals to at all mitigate the risk.

People need to know how to block. They need to know how to tackle. They should be taught these things early and often and essentially punished when they do things that could cause potential injury to themselves or others. Concussion protocals should be followed. If we want the game to be safe, in my opinion, that's the way to handle it. The game can be safer. Not completely safe, but basketball isn't safe, baseball isn't safe, no contact sport is safe; but in my opinion the positives of sport (and in my opinion football) far outweigh the potential impact, as long as we are taking the appropriate steps to make it safer.

I don't like the fear mongering over sports for kids. We protect our kids, we organize every activity, and a lot of the benefits of sport and unorganized/unsupervised/spontaneous play is lost, and those things are very important to growing up and shaping people. Don't take all that away from kids, that just seems like "the easy way out" without actually making things better.


January 29th, 2015 at 5:11 PM ^

I was in a boxing club in high school.



Mixed Martial Arts Makes Its Way to High School



Cincinnati High School MMA Club



Mixed Martial Arts at Clemente High School: Where Street Life and Ring Life Don't Collide



Saluda High MMA Club

https://www.facebook.com/pages/Saluda-High-MMA-Club/307823937973 Clear Creek


High School Boxing Team



Home of the Cincinnati High School Boxing Team http://cincinnatiamateurboxingclub.com/chb/


Throwing punches: Grand Blanc High School female students form a boxing club http://www.mlive.com/sports/flint/index.ssf/2012/03/throwing_punches_gr…


January 29th, 2015 at 4:28 PM ^

I should have said the other sports he mentioned.

But leaving that aside, the other sports you mention, except boxing, do not involve skull-rattling contact during every second of game play the way football does on the lines, from day one of participation. Amateur boxers get headgear, beginner hockey is no-checking, etc.

I do not agree with Space Coyote that we just need to be more vigilant for hurt players and define a few rules to fix this issue. I fear that unless technology/medicine bail us out, the question we will increasingly faced with is "What does football offer that soccer/basketball/baseball do not?" If the only answers are tradition and the visceral thrill of watching people hurt each other, versus the increasing likelihood that we're watching them shred their brains ...


January 29th, 2015 at 5:23 PM ^

But leaving that aside, the other sports you mention, except boxing, do not involve skull-rattling contact during every second of game play the way football does on the lines, from day one of participation. Amateur boxers get headgear, beginner hockey is no-checking, etc.


Yet they have traumatic brain injury rates which aren't that much different.


For high school -

Football had the highest concussion rate (6.4), followed by boys’ ice hockey (5.4) and boys’ lacrosse (4.0)

The injury rates per 100 player-seasons were 3.66 for football, 1.58 for wrestling, 1.14 for girls' soccer, 1.04 for girls' basketball, 0.92 for boys' soccer, 0.75 for boys' basketball, 0.46 for softball, 0.46 for field hockey, 0.23 for baseball, and 0.14 for volleyball.


For 2007:

The top 10 head injury categories among children ages 14 and younger:

Cycling: 32,899
Football: 17,441
Baseball and Softball: 13,508
Skateboards/Scooters (Powered): 11,848
Basketball: 10,844
Skateboards/Scooters: 10,256
Winter Sports: 7,546
Powered Recreational Vehicles: 7,460
Water Sports: 6,498
Trampolines: 6,360




February 1st, 2015 at 7:06 PM ^

Which, as I read it, is that subcritical contact *which is not immediately diagnosable as injury* is a leading indicator for later irreversible brain injury, and this begins in youth football, as soon as they start blocking.

No other sport except boxing has that level of contact in the youth leagues. It is potentially more dangerous for that because the contact doesn't lead to signs of immediate injury, so the rate of injury doesn't reflect it.


January 29th, 2015 at 12:27 AM ^

Why isnt everyone walking into walls right now? While I think the research is important I think people are stretching facts to fit a narrative.

I still think you need to look at a baseline for certain types of people. Are some people more easily affected by blows to the head? This research is still in its infancy but you can't deny the facts that the overwhelming majority of men who played high school football from 1950-2000 knew next to nothing about concussions but yet as a society we managed to function with this not being much of an issue.

I think the increase in cte is the extreme size and speed of the NFL player. I think that is the biggest problem. The collisions at that level are just so violent. I think the danger at the high school level is minimal.

Sextus Empiricus

January 29th, 2015 at 2:03 AM ^

Don't mess with Data. 

In the journal of the American Academy of Neurology it is reported that NFL players who played youth football scored 20 percent worse on cognitive tests than an already depressed population of NFL players who did not play youth fooball.  Yet you think CTE is an NFL problem only?  Hmm... I'm not sure.  Definitely it is an NFL problem.

I'm also not sure there is an increase in CTE at all but rather greater reportage and diagnosis (which can only be definitive through elective posthumous postmortem.)

The best response to this is caution in allowing youths to play the game along with more study.  The Heads Up program put on by the NFL on the other hand has no data to support it's effectiveness.  It's premised on the idea that head to head collisions can be coached out of the game.  That I don't see.

If Michigan gave up football due to CTE risks I would be sad but I would understand.  Data would kick my ass for saying that but that is what I think at this point.  Data will eventually tell the story.


January 29th, 2015 at 12:54 AM ^

It messes up lots of things in your body if you play a full blown full speed game before you're 13-14. You for sure should be playing two hand touch before 6th grade. Middle School wouldn't be advisable but better than 4th graders playing it.

Sextus Empiricus

January 29th, 2015 at 2:00 AM ^

Youth football is not relatively a tough hard hitting contact sport compared to HS, college or professional football.  The brain of a <=12 yo is in a compromised developmental state that is perhaps more susceptible to the lower range of impact in youth football.  Regardless playing Pop Warner (or what ever youth league) has consequences.

Some kids use football as a way to avoid other issues and garner opportunity.  It's not an irrational decision by parents to let their kids play.  When the NFL puts money into convincing parents it is OK to play with a "Heads Up" I don't think they are really giving the parents any literal warning of the dangers.  Big money is coming after parents to assuage their fears, obscure the truth and belay their judgment.

If you don't want your kids to get hurt, do what is best for them.  As a parent I'm going to honestly say I have no idea what that is most of the time.

Mr Miggle

January 29th, 2015 at 7:28 AM ^

It isn't about being afraid of having your kids gets hurt. It's about hidden injuries. Things no one may have even noticed that accumulate and cause serious, irreparable damage. That's scary on a whole different level and one where the dangers have never been well understood.

M go Bru

January 29th, 2015 at 3:44 AM ^

It's a Frontline Program currently being aired on PBS.

You will get an understanding on how serious a problem this really is. 

They even found that a 21 year old's brain was examined after death revealing advanced brain damage in an individual who never reported suffering a concussion. It appears that even a series of minor traumas can cause major problems.

Dr. Robert Stern, from Boston University School of Medicine who authored the "Study of Retiree Links to Youth Football Brain Problems" referenced at the beginning of this forum topic appears on the Frontline program.

Probably should not even begin playing football until High School.

The_Mad Hatter

January 29th, 2015 at 10:19 AM ^

Once he gets to be that age I'll obviously be taking his opinion into consideration.  I guess I should have been more clear.  I won't be starting him in football in grade school, nor will I encourage him to play.

I don't think I would forbid him from doing so in high school if he really wanted it though.

Darker Blue

January 29th, 2015 at 6:39 AM ^

Humans have always risked their bodies for money, sex or anything else that they may fancy. If football goes away, something else will be right behind it to take its place.