Yesterday, the medical journal Neurology published a study suggesting that professional football players are 4 times more likely to die from the Alzheimer’s disease and ALS (Lou Gehrig’s disease) than the general population. This is just the most recent addition to a growing body of evidence linking football to neurodegenerative disease.
As a pediatric health care provider, this body of research continues to be alarming and thought-provoking. As a mother of two boys* (and another on the way), it is terrifying. And complicated.
My husband and I both grew up in small towns where football was a huge part of the community. I was a member of the high school pep band and attended every single home high school football game. I loved those Friday nights when it seemed that everyone in town had come to the football field to cheer on the local team. My husband was a player for his team and has fond memories of the physical challenges of the sport as well as the camaraderie he developed with his teammates. We both continue to enjoy the game, and watch our Mizzou Tigers faithfully during football season. If – when we were expecting our first son in 2006 – you would have asked us if we thought football was too unsafe to allow our son to play, we both would have laughed. But a lot has changed since then, and there is now strong evidence (most released just within the last few years) that the repetitive trauma experienced in football is linked to depression, memory loss, suicide, and neurdegenerative disease. My husband and I have had many thoughtful conversations about this issue, and we are both unsure we can ever let our sons play. We agree that we will encourage other sports and interests and will be perfectly content if our sons never want to play. And we certainly won’t sign them up to participate in local youth football leagues, where – at least in our community – children as young as 8 years old practice up to 6 hours a week in full pads. But we haven’t decided what we will do if one of our boys asks us to play in junior high school. Luckily we have at least 7 years to make that decision.
Many have argued that the study published yesterday applies only to professional football players, elite athletes who take much harder hits for many more years than your average youth football player. That may be true in this case and, of course, research and statistics are tricky things. You can’t make decisions based on one study, and – at the end of the day – statistics are good at telling you what will happen to a group of 100 people, but not necessarily good at telling you what will happen to an individual. But isn’t about just one study or one group or one individual. Boston University’s Center for the Study of Traumatic Encephalopathy has an entire list of published studies on the effects of concussion and repetitive head trauma on young athletes. They are just one of the research teams finding that in football players – particularly those in “speed positions” who experience the hardest hits and are at greatest risk for concussions and repetitive head injuries – brain structure and function are altered. It is hard to ignore heart-wrenching stories (like this one) of boys who have died because their brains were damaged from the repetitive head trauma experienced in football. And consensus is growing among the medical community that football is bad for kids – it seems that every time I turn around, a pediatrician or orthopedic physician has written a blog post outlining why she won’t let her own children play football (see this one by Wendy Sue Swanson, MD).
Many supporters of youth football concede that the risks of neurological damage are increased, but argue that they are still small. They say that kids can get hurt doing a lot of things, that their child enjoys the sport. They cite the benefits of football – the exercise and physical activity, learning to be a part of a team, to be disciplined, to push themselves – and they choose to let their son play. I don’t think those parents are necessarily wrong. Parenting (and life, really), is about weighing benefits and risks and making informed – and often difficult – decisions. But I would argue that kids can get all those things – exercise, team building, discipline – from other activities that don’t carry the risk of head injury (I would also argue that – given the Greg Williams “Bountygate” and recent events at Penn State – the culture of football seems to be a lot more about winning games than caring about the mental and physical health of children and players, but that’s a post for another day).
I don’t judge the parent whose child plays youth football, but I do think he would be remiss if he didn’t educate himself and thoughtfully consider the risks and benefits associated with the sport. Taking an “I played and I turned out just fine” attitude doesn’t cut it – we have to set aside the fond memories and emotions we associate with the game and take a real look at the science and evidence before us. We have a lot more information than we did 10 years ago, and we are fortunate we can use that information to make better decisions for our children. And in our family, I think the decision is no football…for now.
*I in no way intend to be sexist or offensive by only referencing boys in this post. I know that girls do play football and I encourage parents of female football players to also seriously consider the evidence before letting their child play. But because that is a very rare occurrence – and because all research referenced in this post was done on boys – I chose to male pronouns throughout this post.
As the school year winds down, many kids’ activity levels (thankfully) start to ramp up. With end-of-the-year field days and the beginning of summer ball, my Facebook news feed is exploding with comments and articles expressing a similar sentiment:
Remember when there were actually winners and losers? When everybody didn’t get a medal?
Sort of has a “good old days” (or “kids these days“) ring to it, doesn’t it?
As a parent myself, I don’t neatly fall into any of the media-hyped parenting categories (who does?), but I do tend toward being a bit free range. I believe that the world isn’t nearly as scary of a place as most people think it is, and that the best way for my children to learn to be citizens of the world is to live in it, without me hovering over them at all times. I know my kids need to try (and fail) before they learn to do something themselves. They won’t always be the best at everything, and I want them to know that (and also know that it’s okay). I understand that winning and losing is part of life, and that learning to be gracious in victory and defeat – although difficult – builds character. So you might think I would oppose the everybody-gets-a-medal-just-for-trying philosophy. But I don’t.
I think it goes back to the first (and only) season I ran track in school. I was in 8th grade. I had always been okay at sports, but I had recently gone through puberty and – once my body starting changing – I became slower, weaker, clumsier, and much less confident in my physical skills. I had never been interested in track and I’m not sure why I decided to join the team that year. I wasn’t fast and couldn’t really jump or throw, but – to my and my coach’s surprise – I was a decent distance runner. So my coach put me on the 800-meter relay team with 3 other girls. At our first track meet, I was the third leg of the race and our team was in second place as I waited for the hand-off. I took the baton and started running, overtook the girl in front of me, and finished my leg of the race with our team in first place. It felt good, until I realized that the next member of my team wasn’t there to take the baton, the ref (a coach from the home team) was in my face yelling about something I didn’t understand, and my coach was grabbing me and pulling me off the track. Apparently, I had my foot on the line of the handoff zone when I grabbed the baton, and I had disqualified my team. Looking back, I realize that this was at least partially my coach’s fault – she had not thoroughly gone over handoffs with us, and I didn’t know about the handoff zone or the rules surrounding it. I also know now that the ref who was screaming and yelling at me about how I was disqualified was totally over-the-top about the whole thing. But I didn’t get any of that at the time. I was a kid. A kid who had failed not only herself, but her team. I was mortified and embarrassed and sorry I had ever even gone out for the track team. I finished that track season (my parents made me), but my heart wasn’t in it. I never came close to running the 800 in the time I had run it in that first track meet, and I begged to come off the relay team for the rest of the season.
That was the beginning of the end of competitive sports for me. I stopped playing softball and basketball, deciding to get an after-school job to earn some money instead. The only high school sport I played was golf (a much more individual and somewhat less active sport), and I became a chubby teenager who didn’t get nearly enough physical activity.
I think the idea that participation medals are bogus and that it builds character for kids to lose rests on the assumption that all kids are competitive, and that losing a competition will drive kids to to better and work harder next time. But there is another side to that coin, and 13-year-old Kendra is a perfect example. For some kids, the competition itself will be enough to drive them away – they’ll never be brave enough to join the team or enter the contest. And those who muster up the courage to participate once, like me, may never come back once they feel that first sting of defeat. Those are usually the kids who need that physical activity the most – the kids who are clumsy or overweight, who have an intellectual or learning disability that makes it harder for them to understand the game, or who don’t have a parent who models physical activity or works with them on playing catch in the back yard.
Don’t get me wrong – I certainly think there is a time and place for competition. That includes junior high and high school sports, and I’m sure I deserved to be disqualified from that race. But I wonder if it would have been handled differently – if our team could have finished, if they would have quietly talked to me and explained what I did wrong and how I could do better next time, if there would been a little less emphasis on winning and losing – if I would have kept up with track and been a healthier teen. I wasn’t a competitive kid and I’m still not competitive as an adult, so I wonder if I would have thrived in a program like Girls on the Run (that promotes self-esteem and healthy activity rather than competition) instead of a competitive track team. I wonder if the parents and coaches who scream the loudest about how “kids need to learn that there are winners and losers” really care much about the kids at all, or if they are just somehow trying to relive their days of competitive sports. Do they assume that, because they are driven by competition, that all kids must also have that same competitive drive? Frankly, I suspect many of them aren’t all that interested in their own kid learning about losing, but are convinced their kid will end up in the winner’s circle so others can learn the lesson.
There is a time and place for competition, but 7-year-olds don’t need to play tackle football. Nine-year-olds don’t need to throw 100 pitches a day 10 months out of the year. 3-year-olds don’t need to run soccer drills. And a chunky 13-year-old who makes a mistake running her first track meet doesn’t need to be dragged off the track and disqualified in front of all her teammates in dramatic fashion. Activity should be fun, and should be part of everyone’s daily life.
Kids are fatter and less active than ever. Of course kids need to learn about winning and losing, but – when it comes to physical activity- the main lesson kids need to learn is that it feels good and is fun to move! For some kids (usually the ones picked first for the team), competition is part of the fun, and those are the kids who should join competitive teams. But in some ways, competitive sports reward the kids who are more active, who are “better” at physical skills, while the kids who aren’t so good (and frankly need more practice and activity) get cut from the team and sit the bench. Competitive sports have their place, but they widen the gap between kids who are “athletic” and those who are not. Perhaps we should realize that there is value in sports (and in people), even if they’re not competitive. We need to reach out to the kids picked last for the team, and provide opportunities for healthy activity that doesn’t divide everyone into winners and losers. Physical education class, school field days, and local parks & recreation sports should be places where ALL kids can feel comfortable participating in sports without worrying about being labeled a failure or a loser.
There are plenty of opportunities in life to learn about winning and losing. But when it comes to physical activity, the consequences of failure – obesity, diabetes, heart disease, and premature death – are just too high.
I say keep the participant medals, and everyone wins.
[Creative-commons licensed photo by Flickr user Mike Saechang]