closing the gap in concussive injury care


To Play, Or Not to Play, That is the Question.

As a cognitive therapist, I have worked directly with hundreds of people who have had multiple concussions.  I am also a mother. One of the questions I am frequently asked is, “Would you ever let your kids play football?”  With stories of suicides, severe depression, cognitive challenges, and persistent physical symptoms (e.g., headaches, ringing in the ears) associated with chronic traumatic encephalopathy (CTE) making headlines, a lot of people see this question as a no-brainer.  Personally, I probably wouldn’t, but it just so happens my children have never expressed a desire to play football, and it likely will never come up. I think this issue is quite complex, and while I would choose not to let my children play, I don’t harshly judge parents who do.  After all, I allow my children to participate in sports such as alpine skiing and soccer, which also have risks.

You may have heard that a post-mortem research study on NFL players showed CTE in 99% of their brains.  However, the research sample included only players who had concerns about CTE. Twenty-one percent of the people included in the study who played in high school were positive for CTE.  Most high school players will not go on to play in college or beyond. For some parents, seeing their children display enthusiasm for anything is a relief. It keeps them out of trouble after school, and gives them something to care about.  It allows children to understand what it means to be part of a team, to commit, and to be fit. It may motivate teenagers to get better grades. The one thing I know, is that if I were to let my children play football, I would stay involved. I would talk to the coach and learn about what education he or she was providing to the players.  I would want to know whether the coach was up to date on the research around concussive injuries. I would talk to my own children about the risks and the importance of reporting symptoms. One of the scariest things, I think, is that many players will hide their symptoms for fear of being benched.

If parents do decide to let their children play, they should encourage the coach to hold a meeting at the beginning of the season for both players and parents.  Topics covered should include concussion protocols, signs and symptoms of concussive injury, risks, and treatment options. These meetings should not be limited to football teams.  Another option for parents is to look into and support a shift to flag football. The Aspen Institute’s Sports and Society Program has recommended that youth leagues shift to flag football for children under 14 years old.  It is important to remember that children are counting on adults to be informed and make choices that are in their best interest. The brain is a precious organ, and protecting it, especially in young people, should be a priority.  

  • Ramya Shyam MS CCC-SLP