By James Fell, Special to Tribune Newspapers
8:58 PM EDT, March 27, 2013
I didn't play football growing up. Never got to date a cheerleader. But, as a consolation prize, I have had an ambulatory adulthood.
I know guys who did play and aren't as lucky, and I don't want my kids to be like these guys.
Matt, for example, wore his football jacket to our 25th high school reunion for nostalgia's sake. Several months later I ran into him at a water park, one with high-rise water slides. I'd been climbing stairs with my kids all day to hit the slides with them, but Matt hadn't. His knees were trashed from football and rugby; multiple surgeries hadn't fixed them. That's a hefty price to pay for sports most kids stop playing after high school.
There's also the real risk of brain damage. This year, in an interview with The New Republic, even President Barack Obama stated his wariness to let a son play football.
I'm not wary, I'm adamant. I'm a big fan of physical activity, but no kid of mine gets to play football, hockey or any other sport where the intent is to hit someone else as hard as they can.
But am I being one of those overcautious helicopter parents surrounding his kids with bubble wrap? Let's hit the books.
I began with a 2002 study of 1,659 children ages 7 to 13 by University of Pittsburgh researchers, published in the journal Pediatrics. They compared two seasons of soccer, football, baseball and softball, and found that the injury rates were similar across all four sports. But when you look at serious injuries (fracture, dislocation, concussion), the results skew.
For baseball, 3 percent of injuries were serious, for soccer it was only 1 percent, yet for football 14 percent were serious.
Another study, conducted in 2009 by Ohio State University researchers and published in the American Journal of Sports Medicine, also pointed the finger at football for serious injury. The study, which looked at data for nine sports from 100 high schools during a two-year period, found that football resulted in 0.69 severe injuries per 1,000 athletes. Wrestling was second at 0.52 per 1,000.
The nine sports the study tracked yield an estimated half-million severe injuries for high school students each year in the U.S., with knees bearing the brunt of punishment. But it's not just the neck down I'm worried about. After all, surgeons can do wonders with repairing knees, but I have yet to hear of a successful brain reconstruction.
The American Medical Society for Sports Medicine published a position paper this year in the British Journal of Sports Medicine about concussion in sport. The statement said there are close to 4 million concussions in the U.S. each year from both competitive and recreational sports, but an estimated half of those concussions go unreported.
That last part is bad, because the statement says, "a second blow before the brain has recovered results in worsening metabolic changes within the cell." The authors then noted a concussed brain is "less responsive to usual neural activation" and that there is a fear of "prolonged dysfunction."
Oh, and football topped the list again for concussions, with hockey and rugby taking second and third place.
But am I being too paranoid about the risks? My brother-in-law was the high school quarterback, played rugby in college and seems to have emerged unscathed. I asked Dr. Gary Small, a professor of psychiatry at the University of California at Los Angeles if he thought I was being overprotective.
"It's a decision that I can respect and understand," he said. Small has seen the outcome of repeated concussions in his practice and was lead author on a study just published in the American Journal of Geriatric Psychiatry that scanned the brains of retired NFL players for signs of neurodegeneration. He told me that NFL players have four times the risk of dying from Alzheimer's than the general population.
"There are definitely risks to the brain with contact sports," Small told me. "Every time you get tackled, your brain moves against your skull. Even if you don't feel like your brain got rattled, it still may have, and this creates cumulative damage."
And younger people may be at greater risk. "Empathy and frontal lobe skills are developing, and we're not sure how these contact sports can affect (them)," Small said.
Dr. Teri McCambridge, a sports medicine pediatrician in Baltimore, also noted that "some kids are more susceptible to the lingering effects of concussions." Apparently children with ADHD, chronic headaches and learning disabilities have more trouble recovering from concussions.
But McCambridge was less forgiving of my helicopter parenting.
"You can't look at the outcome (mood disorders or Alzheimer's in aging football players) and say it was from concussions," she told me. "You have to wonder if people are confusing causation with correlation." She explained that it could be due to use of performance-enhancing or other illicit drugs, or a pre-existing condition. "We need more data."
McCambridge, whose son plays football, gave me some perspective, explaining that kids can get hurt doing anything. I'll attest to that. I've broken bones skiing and never regretted a day on the hill. I take my kids skiing too.
But still, my big issue with contact sports is the intent to hit other people. Hard hits are often the objective, though the tide may be changing.
Last fall, the book "Concussion and Our Kids," co-authored by Dr. Robert Cantu, chief of neurosurgery for Emerson Hospital in Massachusetts, called for a ban on tackling in football, heading a soccer ball, or body checking in hockey for those under 14. The book received coverage by CNN, Time and Slate.
Parental opinion is mixed. Last fall, a poll of 300 fathers who had played football — 60 percent of whom had experienced football concussions themselves — by the nonprofit arm of i9 Sports found that 77 percent felt tackling was safe for children under 12.
Conversely, last summer ESPN conducted a survey of more than 1,000 parents and found that 57 percent were less likely to let their children play football because of the risk of concussion.
A recent poll of Canadian hockey parents by the Rick Hansen Institute found more than 80 percent favored a ban on checking for kids ages 11 to 14.
I'm raising active kids who run, cycle, ski, swim and do martial arts. I don't regret keeping them out of contact sports, but I won't tell other parents what to do. How much you bubble-wrap your own kid is an individual decision.
Even a single concussion appears to cause changes in the structure of the brain that may make cognitive problems and depression a higher likelihood, a new study, published in the journal Radiology, has found.
The study, which used 3-D MRIs to compare healthy subjects' brains with those of patients a year after a mild traumatic brain injury, indicated that those with such injuries had shrinkage in brain regions that are key to memory, executive function and mood regulation.
Fell is a certified strength and conditioning specialist.
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