Citing the "high prevalence of concussions" among players, two physicians at the University of Minnesota are calling for schools across the country to eliminate their tackle football programs.
The risks and long-term health consequences of concussions are being debated more openly in recent years, in part due to the public struggles of some professional athletes who had head injuries during their careers.
The conversation is trickling down to elementary and high school football programs now, and that's the focus of the editorial by the U of M's Dr. Steven Miles, a bioethics professor, and family medicine specialist Dr. Shailendra Prasad.
Their editorial was posted online by the American Journal of Bioethics, and it will appear in the journal's January 2016 print issue.
Hundreds of hits to the head
The two physicians reviewed studies of football-related concussions, and concluded that up to 20 percent of youth football players between the ages of 9 and 18 experience at least one concussion during a given season, the Star Tribune reports.
"Nine to 12-year-old players experience an average of 240 head impacts per season; high school players average 650 head impacts per season," the editorial said. "School football concussions are often followed by weeks of impaired school academic performance, memory disturbances, headaches and absenteeism."
They also note the potential for long-term brain damage is higher for children than it is for adults.
"Evidence is ... sufficient to show that school football is likely to adversely affect school performance in the short term and may, if the trauma is not stopped, proceed to permanent cognitive dysfunction over the long term," the editorial said.
Their findings on the prevalence of concussions in youth sports are in line with what Minnesota Department of Health researchers concluded last year; that high school football players are more likely to suffer a concussion than their counterparts in other sports.
The MDH study estimated 2,974 sports-related concussions occurred in Minnesota high schools last year, which averages out to about 22 per school. Of those, football players accounted for 42 percent of the total.
If you look at the concussion rate – how often concussions happen compared to how many players participate – both boys and girls hockey have nearly the same concussion rate as football.
But because so many more kids play football than hockey (about five times more in Minnesota), the doctors argue, football should be banned because it causes far more brain injuries.
Miles told the Star Tribune he believes a total ban on youth football is not realistic. But he's making that recommendation and also urging other health professionals to do the same.
Practice is more dangerous than games
Another recent study concludes that high school football players are more likely to be injured in practice than they are during a game, according to NPR.
The study, conducted in the 2012 and 2013 football seasons, found that 42 percent of concussions in high school and college football happened during games, while 58 percent occurred during practices.
That's primarily because the number of players participating in practice is much higher than those that actually play in games, the study's author said.
Returning to play after a concussion
In 2011, the Minnesota Legislature passed a law requiring coaches to remove high school athletes from athletic events if they show symptoms of a concussion. A certified health care provider must provide written permission before the student-athlete can participate again.
The MSHSL concussion protocol says athletes must work their way back to the playing field with a step-by-step process; first no activity, then light aerobic exercises, then sport-specific work, then non-contact followed by full contact before being allowed to play again. A student-athlete must be symptom-free for 24 hours at each step before moving on to the next.