Count me among those who believe that the end is in sight for organized tackle football as we now know it on the youth and scholastic levels. Participation has been trending downward for years for both youth-level and high school teams, and that trend will accelerate once parental attitudes about the dangers of the sport arising from head trauma reach the tipping point.

In my opinion, it no longer is a matter of if, it is a matter of when. As a football fan for as long as I remember, I hope that I am wrong – but only if it can be established with reasonable certainty that the risks to children can be reduced to insignificant levels.

My belief that organized youth and scholastic football is doomed is based on a confluence of factors, at the center of which is, of course, the evolving research on the dangers of long-term sub-concussive head trauma. As applied to youth and scholastic players, the research on long-term effects remains inconclusive. What we do know with reasonable certainty, however, is that there is only a “window” of safety. It’s dangerous for a child to start playing too early, and it’s dangerous if a child continues playing for too long into his adult years.

Neuroscientists warn that the undeveloped brains of younger children are much more likely to be damaged by repetitive head trauma than adolescents. At the other end of spectrum, there is no doubt that NFL players – and very probably college players who have played football from a young age – are at much higher risk than the general population for developing chronic traumatic encephalopathy (CTE), a devastating and degenerative brain disease.

These therefore are the questions facing parents: When can my child play football without compromising his or her long-term health? How many blows to the head are too many? In no other extra-curricular activity must a parent worry about a child getting too successful and wanting to continue the activity when entering high school or college. In other words, this isn’t like deciding when Johnny should start piano lessons.

There appears to be an emerging consensus that children should not play tackle football before the age of 14, while a majority still believe that tackle football is safe for high school students. A recent Washington Post/UMass Lowell Center for Public Opinion poll found that 53 percent of adults surveyed believe that tackle football is not a safe activity for kids before they are in high school. Fifty-seven percent believe that high school football is a safe activity. These numbers are getting close to what I believe will be the tipping point.

I read a compelling article by Luke O’Neil of Esquire, in which described his experiences playing youth football and his concerns about the effects on his own future. He began by recalling one Thanksgiving Day game in particular:

“Everything turned yellow on Thanksgiving. I don’t remember much else from that day, now over 20 years ago, but a shift in the world’s color palette tends to stay with you. . . You can hit people so hard that long after they beat you, they remember you were there. You can hit so hard that you knock yourself out and wake up confused and distraught on the sideline, seeing yellow, and no one thinks to check if it was anything serious. I remember crying on the bench as the hitting continued on without me. For years, I thought they were only tears of frustration.”

In his article, O’Neil cited evidence that attitudes toward football are beginning to change rather quickly. The link between football and chronic brain damage was not on the national consciousness until after Dr. Bennet Omalu of Pittsburgh published his landmark article on Chronic Traumatic Encephalopathy (CTE) in the journal Neurosurgery in 2005.

Predictably, the NFL – and its committee of medical experts – fought back vigorously against Dr. Omalu and his findings. In 2009, the NFL finally admitted that its own determined its former players were suffering from memory-related diseases at a higher rate than the normal population, which it attributed to histories of concussions.

By 2013, an HBO/Marist poll found that 33 percent of Americans said the link between brain injuries and football would make them less likely to allow their sons to take part. Three years later, the same poll found that number had increased to 40 percent.

It would not be until 2016 that the NFL formally admitted the link between playing football and CTE, and conceded that permanent impairment may not be limited to the effects of multiple concussions. Since then, concerns about the effects of repetitive sub-concussive trauma have taken center stage.

Fear of football-related brain injuries is having a significant impact on participation at the high school level, even in states with a rich tradition of scholastic football. The Ohio High School Athletic Association reported that the number of high school football players in Ohio last year was 42,490. That’s down more than 23 percent from a peak of 55,392 in 2009, when the NFL first admitted that there was a problem. we

The effects of multiple concussions on young players has been well-established. As noted above, it is the long-term consequences of repetitive sub-concussive trauma that are less clear.

There is significant evidence, however, that even moderate exposure to the head trauma associated with football by players younger than twelve can have devastating long-term effects. Robert Stern, a senior author on a recent study done by Boston University’s Chronic Traumatic Encephalopathy (CTE) Center told the Boston Globe last month:

“I’m at a point where I feel comfortable saying that, based on logic and common sense and the growing totality of the research, I don’t think kids should be playing tackle football.”

The overwhelming consensus among experts is that more research needs to be done.  That does not mean, however, that there have not been worrisome findings. An important study in North Carolina documented changes to the brains of a high school football team over the course of a season through brain-imaging scans.

None of the players studied suffered concussions. Certain changes were associated with linear acceleration – the head moving forward or back within a helmet. Other changes were associated with rotational impact.  The study followed earlier studies identifying measurable changes in brain chemistry associated with brain damage from participation in high school football.

The studies have not yet established whether the changes are permanent and, if so, what effects they have on memory, behavior, cognition, etc. Again, there remain more questions than answers on long-term effects, but one of those questions for parents is whether to allow their children to play football until there is proof positive about the danger to their brain health posed by playing football. How much risk is tolerable if it involves compromising your kid’s future?

Last year the Centers for Disease Control decided to undertake a “rigorous evaluation of the risks of tackling in youth football,” and called on experts to submit research proposals to identify what age groups are at most risk of sustaining head injuries. It is possible that better answers to the outstanding questions will be the result. It also is possible that the research could take many years to complete, as players are studied over time.

My guess is that, no matter how much research is done, scientists are never going to come up with a “bright line” test for determining how much head trauma is safe, and how much isn’t. The susceptibility to and recovery from brain injury varies by individual. I would expect the CDC eventually to come up with recommendations for things like routine neuropsychological testing and scans: First to get a baseline on players, and then to determine if changes are taking place. It won’t be cheap, and it may not be reassuring.

In the meantime, what happens?  Attitudes can take a long time to change, even in the digital age. But one’s attitude about allowing a child to play tackle football is different, because it implicates the good parent/bad parent continuum, and therefore is susceptible to powerful emotional forces, including social pressure.

If the idea takes hold that only “bad” parents allow their children to play football the idea will dominate social media, and parents who do allow their children to play football will be unable to escape it. When the accepted wisdom among parents is that allowing children to play tackle football is tantamount to being indifferent to their health, the tipping point will have been reached and it will only be a matter of time before participation in youth football declines even more dramatically.

Some of the factors mitigating against the long-term survival of youth and scholastic football are based on more practical issues: Even if is deemed “safe” for a child to begin playing tackle football at age 14, what parent wants to be placed in the position of trying to persuade his or her child that it is not safe to continue playing it after age 18? Better to never start down the path than to have to convince an 18-year-old, who believes that he is invincible, to give up football before it’s too late.

There also is a major question about the effect of playing flag football at the youth level on the general popularity of the sport, and on the transition to tackle football at the high school level. The two sports are similar, but not identical, and players that flourish at one may not flourish at or even like the other.

I see the arrangement as increasing the exodus from football to the other football, soccer, which has continued to increase in popularity in this country. Ann Coulter aside, soccer no longer is viewed as a “foreign” sport for youngsters who can’t play football.

Finally, there is the issue that is implicated by poll findings showing that college-educated Americans are more likely than their less-educated peers to believe that football is unsafe.  Could football go the way of boxing, which gradually lost acceptance by the educated middle-class as a safe and responsible sport, particularly for children? I think it could. It also is possible that youth and scholastic football could become a regional phenomenon, more likely to survive in the south and southwest than in the northeast and elsewhere.

The initiatives underway to make the game safer for players of all ages are admirable and important, but I believe that they are no more than rear-guard actions that will do little to slow the decline in participation. There is only so much that can be done to change the nature of the game before it no longer is football as we know it and the bottom drops out of its popularity. Will the decline in participation in youth and scholastic football flatten out? I tend to doubt it.

In his story, Esquire’s O’Neil recounts an interview in 2015 by Bryant Gumbel of HBO with legendary NFL player and coach Mike Ditka. I attended graduate school at the University of Pittsburgh, where Ditka played. The son of a welder, he was raised in nearby Aliquippa, a steel town with a population of no more than about 11,000 where two other Pitt and NFL players of some note, Tony Dorsett and Darrelle Revis, also grew up.

Ditka asked Gumbel: “If you had an 8-year-old kid now, would you tell him you want him to play football?” Gumbel said that he wouldn’t, and in turn asked Ditka: “Would you?” “Nope,” Ditka replied. “That’s sad. I wouldn’t. And my whole life was football. I think the risk is worse than the reward. I really do.”

Ditka would never be mistaken for a neuroscientist and is prone to saying things without giving them a lot of thought. On the other hand, he was one of the game’s iconic tough guys and nor would he be confused with a bleeding-heart liberal.

Ditka cut the issue down to its essence: Balancing the risks against the benefits. As more and more players have made similar statements, it has become increasingly clear to those football fans who would prefer to live in a state of denial about a sport they enjoy that the problem is a real one that they may have to confront as parents.

I admit that I also see this issue in another context, which is my lingering feeling that scholastic and especially major collegiate football have outgrown their proper roles. We are the only country in which the feeder programs for the country’s most popular sport are its academic institutions, a relationship that does not entirely make sense and produces inevitable tensions – to describe the football programs at places like Alabama and Ohio State as anything more than revenue-producing adjuncts to their academic programs is disingenuous. Try persuading anyone that the tail doesn’t wag the dog after the Sandusky child sexual abuse scandal at Penn State.

I touched on the role of intercollegiate sports in a piece that I posted last year on Pearl Harbor Day on the Navy’s decision to allow Naval Academy graduate Keenan Reynolds to forego his military obligation to try out with the Baltimore Ravens. I thought that it sent the entirely wrong message about priorities, and the head trauma issue is also about priorities: Is football so important that academic institutions are willing to expose their students to the possibility of mental impairment? It is not only parents who have something to think about.

I’m not sure exactly why I felt strongly enough about this subject to write about it now. Maybe it is because of my general malaise over the current direction of our country and my belief that a lot of our priorities have become misaligned. Or maybe it is because the Pitt Panthers lost another game yesterday and are on their way, yet again, to a disappointing season.

October 8, 2017