Children and football A cautionary tale

As even any casual American sports enthusiast can attest, the football season occupies a special position in the popular imagination. Fans flock to stadiums and televisions to watch their teams perform in this increasingly violent contact sport, and among these fans, children may come to idolize star players and be almost irresistibly drawn to the gridiron. Parents and coaches may also exert substantial pressure on children to take up the sport. Whereas the benefits of physical exercise are undeniable for the promotion of cardiovascular health and psychological well-being, participation in football may result in neurologic sequelae ranging from mild traumatic brain injury (mTBI)(1) to death,(2) and repetitive mTBI has been associated with a degenerative dementia in later life known as chronic traumatic encephalopathy (CTE).(3) Football has the highest injury rate among team sports, and given that 70% of all football players in the United States are under the age of 14 and that every child aged 9-12 can be exposed to 240 head impacts during a single football season,(4) a better understanding of neurobehavioral sequelae among children who play football is urgently needed. Wide gaps exist in our knowledge, but an area of particularly limited information is the long-term outcome of repetitive mTBI among children in whom recovery from the acute event was apparently complete.