A new study from the Mayo Clinic shows that playing varsity-level high school football does not carry an increased risk of neurodegenerative diseases compared with other varsity-level sports.
Sports medicine experts welcome the research — and say there’s still a lot of work to be done when it comes to understanding brain injuries.
Researchers analyzed the long-term health of people who played high school sports between 1956 and 1970. In all, 486 former student athletes were studied — 296 had played football, and 190 had competed in other sports.
While cases of head trauma, mild cognitive impairment, parkinsonism, and dementia were observed in both groups, playing football did not appear to carry a significantly higher risk.
For instance, while the percentage of former student athletes who experienced head trauma was slightly higher among those who had played football (11 percent vs. 7 percent), student athletes who had not played football showed slightly higher rates of both mild cognitive impairment and parkinsonism.
Different game, different eras, different levels
The study’s finding, published in Mayo Clinic Proceedings, seems to be in opposition to recent revelations that many former pro football players suffer from chronic traumatic encephalopathy (CTE), a degenerative brain disease associated with repeated head trauma.
“It’s somewhat reassuring,” Dr. Gregory Landry, a pediatric and adolescent primary care physician from the University of Wisconsin School of Medicine and Public Health, told Healthline. “But it’s a relatively small sample size and the game has changed since the 50s and 60s.”
Researchers from the Mayo Clinic study acknowledged that their findings shouldn’t be interpreted as proving that football is harmless, stating, “There may be a gradient of risk, with low potential in high school football players that played in the study period.”
Landry echoes this sentiment, pointing out, “There’s no question that as you get older in the sport of football, the rate of injury goes up. Study after study has shown that.”
Rule changes, diagnosis helps minimize risk
Concussion testing protocol has been introduced across contact sports, at all levels, in recent years as awareness of head injuries has grown.
Dr. Gregory Stewart, co-director of Tulane University’s Sports Medicine Program, says head injuries need to be treated differently than other injuries.
“I tell my athletes when they come in, ‘If this was an ankle sprain, I’d tell you to suck it up and go back and play. But this is your brain. If you’re having headaches and other symptoms, you need to stop what you’re doing and rest, and get back to the point where you can do the things you need to do,’” he told Healthline.
Landry says this is a marked contrast to the way concussions were treated in the past.
“I don’t think we recognized that some of these relatively mild head injuries were indeed concussions and that when that happened, a player shouldn’t be in the game,” he said. “I think that players, coaches, and parents are recognizing concussions much more readily. Any impairment in mental function after a head bonk is a concussion, and athletes should not be practicing or playing if they’re impaired in any way.”
Rule changes are also crucial when it comes to preventing injury.
“I think one of the biggest things that’s happened is USA Football has decided that it’s critical that coaches teach good tackling technique,” said Landry. “I think you can see that at every level now — that there are fewer of the dangerous hits and that’s imperative.”
Dr. Patrick Kersey, medical director of USA Football, outlined some of the ways the organization has worked to reduce risk.
He told Healthline, “There’s been a concerted emphasis on equipment fitting. There have also been significant educational steps taken with coaches as well as all participants in the understanding of head injuries.”
Research still in its infancy
While attitudes and awareness surrounding head injuries in football have changed significantly, there’s still a major gap when it comes to fully understanding these injuries.
“As we continue to evaluate and study this injury, we continue to learn more about its ability to be treated as well as prevented,” said Kersey.
“The way we manage concussions today compared with the way that we managed concussions even 10 years ago is significantly different,” said Stewart. “And because of that, this pendulum has swung — and with the pendulum swinging like that, we’re not going to know if what we’re doing today is right or not for probably another 10 or 15 years.”
Stewart is hopeful that with continued research, the medical community will find further ways to minimize risk in the future.
“I think if we continue to manage it right, we’ll be OK,” he says. “And then as we move forward with a lot of the research that’s going on and continue to move forward, I think we’ll get to a point where we have some of the answers. I think at some point we’ll be able to have a battery of tests where we can say, ‘You’re at a significantly higher risk of developing CTE, therefore you should not participate in this sport.’”