During my football days at Harvard, after a big hit to the head, I’d sometimes taste blood in the back of my throat.
I took pride in that; I assumed I hit the other person so hard I burst small blood vessels in my throat. The hits never caused concussion symptoms, and I never considered what they could be doing to my brain. Research released earlier this month by a team out of Boston University (a team I’m proud to be part of) sheds light on what was happening inside my head ― and has profound implications for the future of youth tackle football.
When I wrote Head Games: Football’s Concussion Crisis back in 2006, only two deceased American football players’ brains had ever been studied by scientists. Both were diagnosed with the degenerative brain disease chronic traumatic encephalopathy (CTE), which at the time was thought to be caused by concussions. I was forced to retire from a professional wrestling career three years prior because of post-concussion syndrome, so this was an alarming finding.
Still, it was difficult to fully address the issue based on just two cases. We needed more research. In 2007, I co-founded the Concussion Legacy Foundation and, alongside other experts, helped create the first research center dedicated to CTE. Our team has now studied the brains of 202 deceased former football players and diagnosed CTE in 177 ― or 88 percent ― of them.
When weighing the benefits of youth tackle football versus the risks involved, the choice is clear.
CTE is an ugly disease that isn’t found in the general population absent brain trauma. What begins as personality changes can turn into depression, impulsivity, aggression, and memory and cognitive changes that evolve into dementia. Watching 110 out of 111 NFL families be told their deceased loved one had been living with CTE changed my opinion about football’s future. In 2006, when I first wrote Head Games, I believed youth tackle football could be reformed to help prevent CTE.
After studying this disease for a decade, I no longer believe that.
In our most recent study, our team analyzed the brains of four teenagers with early signs of CTE and compared them to the results of head impacts in mouse models. CTE appeared to be caused by head impacts independent of concussion. That finding makes sense, considering both my personal background and the fact 20 percent of our 202 CTE cases never experienced a diagnosed concussion.
This new research also gave us insight into what exactly sets CTE in motion. The head impacts in our mouse models caused breakdown of the blood-brain barrier ― essentially, they caused blood vessels in the brain to become leaky. This led to inflammation. Considering I used to taste blood in my throat after football plays, I wasn’t surprised to learn my brain may have been bleeding, too.
Knowing what I know now, I thank my mother every day for not allowing me to play tackle football before high school. A child’s cognitive capacity at age 9 compared to age 12 is drastically different; the brain is physically changing every day to become more like that of an adult. Last September, our team published a study that found football players who began playing before age 12 were twice as likely to have problems with behavioral regulation in adulthood (e.g., impulse control, controlling emotional responses) and three times as likely to struggle with depression. This relationship was independent of the number of years played or the highest level played, so it wasn’t simply the consequence of having a longer career. Studies on NFL players have also found those who began playing before age 12 were more likely to have impaired memory and decreased mental flexibility as well as structural brain abnormalities in a critical region involved in cognition.
NFL coaches, college coaches and former professional players appear to be overwhelmingly in favor of waiting to play tackle football until high school. Some even recommend taking up a different activity entirely until then. Don’t take my word for it. Ask University of Michigan head coach Jim Harbaugh, who said, “I think every American boy should play soccer till the eighth grade. Then they should play football.” Professional and College Football Hall of Famers Mike Ditka, John Madden, Jim McMahon, Harry Carson, Nick Buoniconti and Brett Favre have expressed similar sentiments.
And they are not alone. Most youth sports leagues understand this logic. USA Hockey bans checking until age 13, and U.S. Soccer bans heading until 11 and limits repetitions through age 13. But USA Football ― and youth football in general ― is still trying to convince us exposing a 7-year-old to 500 hits to the head in a single season is a good idea.
I attended the USA Football annual conference in Orlando, Florida, last weekend, and it was clear the people in charge of youth football’s future are not taking CTE seriously. I witnessed multiple presentations about saving the game by “changing the narrative” but zero presentations about saving the players by making changes to the game that lower CTE risk.
I believed youth tackle football could be reformed to help prevent CTE. After studying this disease for a decade, I no longer believe that.
I also heard something during the keynote that made me even more concerned about the people we’ve put in charge of young athletes’ brains. Sen. Marco Rubio (R-Fla.), a youth tackle football coach, kicked off the keynote by promoting what, to him, makes football more conducive to teaching life lessons than other sports. He said, “Football accountability is a little different. In football accountability, if 10 people do the job right but one guy does the job wrong, someone gets hurt or gets messed up pretty bad.”
Should this high-stakes game Rubio described be played by children?
I can’t be sure if I’m living with CTE today, since it can only be diagnosed postmortem, but I’ve learned enough over the last decade to know we must protect children from brain injury. When weighing the benefits of youth tackle football versus the risks involved, the choice is clear. The time has come for American parents to walk away from youth tackle football. If we want our children to have a chance at a successful football career and a successful life post-football, we will keep them in flag football until age 14 ― or encourage them to take up another sport.
Chris Nowinski, Ph.D., is founding CEO of the Concussion Legacy Foundation and co-founder of the Boston University CTE Center and VA-BU-CLF Brain Bank.