Commentary by Munro Cullum, Ph.D.

Headline-grabbing media coverage about the serious effects of concussions on professional football players has made some parents hesitant to let their kids play football or other sports.

Nationwide, the number of teenagers playing high school football has declined about 5 percent since 2008, according to a study published this year in JAMA Pediatrics. And even in Texas, home to Friday Night Lights, we have seen a falloff in participation.  

As both a researcher who studies brain injuries and as a parent, I believe these fears have become somewhat overblown. While every head injury must be taken seriously, most concussions result in short-term symptoms that typically go away within a couple of weeks. And the benefits from participating in team sports as a teenager outweighs the costs of leading a sedentary life, even considering the risks of concussion or other injuries.

Unfortunately, heartbreaking stories of pro football players who showed signs of a degenerative brain disease known as chronic traumatic encephalopathy (CTE) in post-mortem examinations have heightened public fears that playing contact sports will potentially bring on this devastating disease.

This is a misperception. Not everyone who hits their head ends up with a concussion, and the vast majority of concussions do not result in CTE. While we are learning more about the brain every day, we cannot yet identify who is at higher risk for prolonged recovery from concussions. While one person might suffer only short-term symptoms, another’s symptoms may linger. 

Public concern has been growing as the NFL has gradually adjusted its rules to try to make the game safer. In the latest change, players this season will be penalized if they lead with the helmet on any tackle.

On the scientific side, a study released last year led to widespread misunderstandings about the connection between football and CTE, which has been linked to repetitive head trauma. The article, published in JAMA, reported that CTE had been found in the brains of 110 of 111 former NFL players – or 99 percent – that had been donated for analysis.

While informative, this study has limitations that most news reports ignore. It covered only a highly select group of cases – namely players who had reportedly shown signs of mental decline before their deaths – and is not representative of all pro football players. Yet some media reports inferred that CTE is a common disorder. The truth is that less than 200 cases have been confirmed worldwide since the condition was first identified in boxers in the 1920s.

Currently, CTE can only be diagnosed at autopsy by measuring the level of tau protein in certain parts of the brain, and researchers even disagree on the amount needed to indicate the presence of the disease. Furthermore, a buildup of tau in the brain has been linked to more than 20 other conditions, including normal aging.

To be clear, I fully support increased awareness to the risks of concussions, and applaud the attention that the issue has received at all levels of football. That’s why I helped to establish the ConTex concussion registry at UT Southwestern Medical Center, in partnership with the state’s University Interscholastic League, to gather data on concussions suffered by student-athletes from middle schools and high schools in Texas. And it’s why we conduct educational workshops with high school coaches and trainers to provide the latest information on concussion diagnosis and treatment.

Dr. Munro Cullum

But we can’t Bubble Wrap our kids and sometimes they are going to get injured. My son played soccer from childhood through high school and college, and suffered several concussions. While I was concerned as a parent, he fortunately recovered quickly each time after receiving appropriate treatment and has had no lingering effects.

If you’re weighing this decision as another school year begins, my advice is to let your kids play sports as long as they are physically and mentally prepared and you’re confident in the ability of their coaches and athletic trainers to identify and handle injuries. If your son or daughter gets hit in the head and shows signs of concussion, make them sit out. In most cases, they’ll recover after a brief period of rest.

Dr. Munro Cullum is a neuropsychologist at UT Southwestern Medical Center’s Peter O’Donnell Jr. Brain Institute in Dallas. This column was published by The Dallas Morning News, Fort Worth Star-Telegram, Houston Chronicle, Amarillo Globe-News, Waco Tribune-Herald and D CEO Healthcare.

Commentary was originally published on August 24, 2018.