Tom Farrey, director of the Aspen Institute’s Sports & Society Program, began the “Playing Safety: The Future of Youth Football?” panel discussion -- held last week in Washington, D.C. -- by bringing up two data sets.
The first statistics he spoke about pertained to the positive aspects of youth sports. Generally, he said that young people that are active in team sports like football have stronger bones, better heart health and report lower levels of depression than their peers, while also being eight times more likely to be physically active when they become adults.
His second list of stats, however, was much different. Regarding concussions in youth sports, Farrey said that football represents a vast majority of reported cases, mentioning a recent study that found that more than half of parents with sons under the age of 15 were “very concerned” about the possibility of their child sustaining serious injuries while on the field.
“Is this a game that’s safe for my kid? Should I introduce them to it?” he asked. “Should we just hold off on football until high school, or can it be made safer through reforms on the lower levels?”
As a contact sport, Farrey said that head injuries, including concussions, were very difficult to prevent in football. He likened teaching young people “safe tackling” skills to the concept of constructing “a safe cigarette.”
“How can football, the institution of football,” he said, “best serve the interests of children, communities and public health?”
Dr. Robert Cantu, co-director of the Center for the Study of Traumatic Encephalopathy at the Boston University of Medicine, said that he was adamantly opposed to the idea of adolescents under the age of 14 playing tackle football.
“Youngsters are not miniature adults,” he said.
Dr. Cantu said that young people were not only more vulnerable to concussions than adults, but require much more time to recover from such injuries fully. He believes that if flag football was offered as an alternative to tackle football, head injuries would decrease dramatically for younger players.
He said that while tackle football consisting mostly of aerobic exercise, the danger from accumulated “milliseconds of bashing heads” was apparent. Roughly 97 percent of head injuries in youth sports, he said, occur during football games.
“There’s not solid science to tell you what the scope of this problem is,“ he said, “but what we do know, from a wide variety of sources, is that the brains of our youth are more susceptible to injuries.”
Dr. Cantu said that health precautions in some Pop Warner football leagues are hazardously inadequate. Among other risk factors, he noted older equipment being used during play, a lack of informed consent protocols for youth, untrained coaches and a lack of professionally trained medical personnel on the sidelines. He said he heard about a youth football game recently in which five players had to be taken out of play due to displaying concussion-like symptoms.
“You don’t need recognized concussions to lead to brain deterioration,” he said. “No brain trauma is good trauma.”
At the high school and college level, Dr. Cantu said that 97 percent of “catastrophic injuries” resulting from athletics involve football accidents, with about 80 percent of reported concussions likewise stemming from gridiron-related injuries. He said that he’s now seeing 17- and 18-year-olds with signs of the degenerative brain disease chronic traumatic encephalopathy (CTE).
While the National Football League (NFL) has made several sweeping changes to its player safety regulations over the last decade, Dr. Cantu said those standards aren’t being replicated in youth football.
“These kids,” he said, “[are] playing a sport that, in the late 1800s, was designed for adults.” Some youth league players, Dr. Cantu, said, are practicing at a rate that’s 500 percent higher than in the NFL, and without qualified medical personnel present.
“Parents want to see their kids emulating their Sunday heroes,” he said. “If anything’s going to happen, it’s going to involve educating parents about concussion safety.”
Although Dr. Cantu believes more evidence is needed to fully understand the nature of concussions and youth football, he believes that it’s a matter that needs to be direly addressed at the current.
“This is an issue that is serious enough that we need to talk about it while we accumulate data,” he said.
Christopher Nowinski, executive director and co-founder of the Sports Legacy Institute, said that high school and youth football organizers should look to the NFL and its Players Association as a model for improving safety standards on the field, referring to the National Football League’s current medical infrastructure as “incredible.”
It’s hard to justify subjecting young adults to the same risks that NFL players experience, he said, without implementing the same safeguards for adolescent players.
“It’s the only real game where head contact is not rare or accidental,” he said. “We are refusing to give children the things we think grown men deserve.”
Nowinksi said that approximately 42 percent of high schools currently do not have athletic trainers, and in youth football, the likelihood of certified personnel being on the sidelines is even lower. Overall, he believes that youth football is “probably more dangerous” than high school play.
“We are not going to spot concussions without medical personnel,” he said. And in the world of pee wee football, where safety standards are less regulated or sometimes nonexistent, “youth [football] is often the wild west.”
“Our players play the way they were coached,” said DeMaurice Smith, executive director of the National Football League Players Association (NFLPA). “What’s the best for people playing this game, and what can we do to make it better?”
Smith said he doesn’t think that improving youth safety in football requires “an advocacy group,” because he believes “all of us have an obligation” to ensure the wellbeing of junior-level players.
He said that he doesn’t think that safety standards in youth football will ever be truly satisfactory, but believes that it shouldn’t be a deterrent to keep coaches, parents and league officials from developing newer and safer practices.
Smith said he grew up playing in extremely aggressive youth football leagues, stating that he still cringes whenever he hears the term “bull in the ring,” a practice drill in which players form a circle around a lone team member and repeatedly tackle him.
Improving youth standards would require better educating coaches about what practices are safe and unsafe, he said. Smith said that he knows of more than 200 NFL players that run youth football camps, adding that not a single one involves practices that are banned by the National Football League.
“If there is any one aspect of what we do on the pro level that I hope gets replicated on the college and youth level,” Smith said, “[it’s the] issue of accountability.”
Smith said that he does not find it “morally acceptable” to make players sign no-liability waivers, stating that increased expectations of neutral physicians and credentialed coaches represents a “fundamental sea change in the culture of football.”
“This education piece where we insure that parents have a greater expectation of how their kids are going to be taken care of, that’s critical,” he said. “It’s not good enough to just say that a kid is OK and not take a look at him.”
Ultimately, the issue of safety of young people in football is in the hands of parents, Smith believes. “I think the real issue is the candor and the fact that parents should be empowered to make the best decisions for their kids as possible.”
Photo from Flickr via M I K E M O R R I S.