Are blows to the head in youth football linked to cognitive decline?
Football is synonymous with touchdowns and, of course, tackles — which sometime result in injuries.
Among high school athletes, 71.5% of concussions are because of a football injury, said Ginger Yang, an associate professor of pediatrics at Nationwide Children’s Hospital in Columbus, Ohio.
“Parents so often think you can get up, shake it off, be tough, get back in there ... And it just isn’t so,” said Stephanie Ramsey, president of the Brain Injury Association of Ohio based in Cincinnati.
About 15% of students reported having at least one concussion related to sports or physical activity, according to the federal Centers for Disease Control and Prevention. Signs of a concussion include memory problems, difficulty concentrating, irritability, nausea, sadness, vision disturbances, sluggishness and headaches.
However, a recent study by a Nationwide Children’s doctor found no correlation between brain function and blows to the head among youths after they had played two seasons of tackle football.
Dr. Sean Rose, a pediatric sports neurologist and co-director of Nationwide Children’s Complex Concussion Clinic, is conducting a four-year study following children to examine how repeated hits to the head affect neurocognitive outcomes in youth tackle-football players. The study is halfway over, and 70 players from Michigan ages 9 to 12 and 96 high school players ages 15 to 18 have participated in the study.
“The amounts and severity of the head impacts the kids took over the course of the two seasons did not correlate with changes in their brain performance,” Rose said.
He acknowledged being surprised by the study’s findings so far.
“The biggest limitation of our study is that we can’t fast-forward 40 years and test them,” Rose said.
The study puts sensors in youngsters’ helmets that detect G-force, the force of gravity, and it monitors the impact of hits to their heads during practices and games. Before and after each game, the researchers conduct a series of cognitive and neurological tests to look for potential changes in brain functions, Rose said.
“As sequential concussions take place, the chances for increased damage increase also, so it’s a double whammy,” Ramsey said.
Even with the research that has been done, parents might still have reservations about letting their child play football, he said.
“I can’t tell you if it’s safe for your child to play football or other contact sports because right now it would be irresponsible for me to come down on one side or the other because there’s not sufficient evidence,” Rose said. “There is evidence on both sides.”
Football was the most popular sport among boys in Ohio in the 2017-18 school year; 42,637 players of both sexes participated, according to the National Federation of State High School Associations.
In the Dublin Football League, youth tackle football starts in the third grade, when players are 8 years old, said Jeff Galvin, president of the league’s board of directors. The league has about 150 kids, ranging from kindergarten through sixth grade; kids in kindergarten, first grade and second grade play flag football, Galvin said.
“You’re not getting concussions playing pee-wee football,” he said. “The emphasis is no longer on hitting; it’s more on the technique and safety.”
A child’s brain establishes the connections that serve as the foundation for cognition, emotional development and psychosocial behavior in elementary school, Ramsey said. A brain injury during that time, she said, can lead to an increased risk of neurological consequences.
Chronic traumatic encephalopathy, or CTE, a degenerative brain disorder associated with repetitive head trauma, is a major concern for football players. A 2017 study published in the Journal of the American Medical Association examined the donated brains of deceased former players and found the disorder in 99% of the NFL players, 91% of the college players and 21% of the high school players.
Several high school football coaches say they take a serious stand on football concussions.
Reynoldsburg coach Buddy White said he pulls players from games or practice if they lead with their head in making a tackle.
“Anything that deals with any kind of head injuries is going to be serious,” White said.
In 2013, an Ohio law went into effect requiring that when a concussion is suspected, a young athlete must be removed from play until a health care professional says the player can return. A separate study by Nationwide Children’s in 2017 discovered that the state law and others like it around the country have greatly reduced the rate of repeat concussions.
Teaching football players the proper way of tackling — keeping the head up and not leading with the helmet — also is important and helps minimize concussions.
“We do all we can do to teach the proper techniques,” White said. “The last thing you need is one of your players to sit out for a game because of a concussion.”
Licking Valley coach Randy Baughman has noticed that players are now being taught from a young age to keep their heads out of their tackling.
“We take all head trauma seriously, but we have been very blessed, knock on wood,” he said. “We really haven’t had any concussion issues for the last couple of years, and I think a lot of it is better tackling techniques, emphasizing keeping the head out of the game and keeping the head up.”