01 Feb 2019

CTE: An urgent neurological health issue in young athletes

This Sunday, millions of Americans will tune in to watch the Patriots face off against the Rams. But as the nation cheers, it’s likely that these athletes are slowly accumulating brain damage. And it’s not just NFL players—children in your own community are at risk as well. Read on to learn more about how to protect young athletes.

Huge numbers of former NFL players suffer from chronic traumatic encephalopathy (CTE). CTE is a progressive, degenerative brain disease that is linked to repeated blows to the head, especially concussions. Symptoms include cognitive impairment, depression, emotional instability, dementia, and suicidal thoughts and actions.[1] CTE can only be diagnosed after death, with a brain autopsy. There is no known cure or treatment for CTE.[2]

CTE is common in National Football League (NFL) players because of high rates of head injury and collisions in football. In a recent study, 110 out of 111 deceased NFL players were found to have CTE.[3]

But CTE isn’t only a problem of elite, professional football players. CTE has been found in boxers, soldiers, and even domestic violence victims.[4] Recent research reveals that CTE can strike athletes at all levels of play, including high schoolers.[5]

High school football players experience an extraordinary number of blows to the head. One study found that on average, each high school football player takes 652 impacts to his head a season, or 6.65 hits a day.[6] Imagine hitting your head hard, six or seven times a day, for an entire 14-week football season. Autopsies prove that even people who only played football through high school can have CTE.

The media often suggests that concussions cause CTE. But researchers have found that many high school football players who never had a concussion nonetheless showed changes in their brains throughout the football season. Although these players did not experience concussions, they did receive many smaller head impacts, also known as subconcussive blows.[7] Increasingly, science shows that subconcussive blows are linked to a buildup of tau proteins, which are the calling card of CTE.[8] And although all athletes should wear properly-fitted helmets, helmets do little to reduce a player’s risk of brain injury.[9]

The issue starts young. Children who began tackle football before age 12 suffer cognitive issues earlier in life than those who began after age 12, and the earlier a child starts playing, the earlier their symptoms manifest.[10] Because of this, the American Academy of Pediatrics (AAP) discourages illegal tackling, supports non-tackling leagues, and suggest parents educate themselves about the risks of youth tackle football.[11]

The takeaway? Youth football has dangers. Talk to your patients and their families about the risks of youth football.

Start young. Many children begin playing football in elementary school—so make sure to discuss CTE with families of young children.

Explain the risks. Increasingly, the scientific community is realizing that youth football has lifelong repercussions for a child’s mental health. Your patients and their families need to understand this.

Suggest safer sports. Although no sport is risk-free, swimming and soccer are good options.[12]

Encourage non-tackling leagues. As the AAP suggests, non-tackling leagues are a good option for families interested in football. Look up non-tackling leagues in your community to suggest to parents.

Discuss what concussion is, and what to do. Concussion symptoms include headache, confusion, nausea, irritable behavior, and sleep problems. Players must be removed from play immediately if a concussion is suspected, and must rest while the concussion heals. Your young patients should not “tough it out” if they suspect a concussion.[13]


[1] https://www.mayoclinic.org/diseases-conditions/chronic-traumatic-encephalopathy/symptoms-causes/syc-20370921
[2] https://www.mayoclinic.org/diseases-conditions/chronic-traumatic-encephalopathy/diagnosis-treatment/drc-20370925
[3] https://www.nytimes.com/interactive/2017/07/25/sports/football/nfl-cte.html
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/
[5] https://www.wbur.org/onlyagame/2018/02/02/zac-easter-cte-concussion-football
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346237/
[7] https://cmsw.mit.edu/subconcussive-blows-high-school-football/
[8] https://www.aafp.org/news/health-of-the-public/20180126subconcussivecte.html
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5349115/
[10] https://onlinelibrary.wiley.com/doi/abs/10.1002/ana.25245
[11] https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Youth-Football-Injuries.aspx
[12] https://www.hopkinsmedicine.org/healthlibrary/conditions/pediatrics/sports_safety_-_injury_statistics_and_incidence_rates_90,P02996
[13] https://www.cdc.gov/headsup/pdfs/youthsports/athletes_eng.pdf

Leave a Comment