Nowadays, one cannot watch a contact sport like tackle football and not think about the risk of concussions, and if you are a parent of a child or preteen, let alone a high school student playing football, those thoughts may be even more formidable. Should youth be allowed to play tackle football knowing that the more direct contact, the more opportunities for concussions to occur? Rather than assume we know what parents think about their children playing tackle football, Chrisman et al. (10.1542/peds.2018-2402) decided to collect data on this issue by surveying 1025 parents from across the country in regard to whether there should be age restrictions for tackling in youth football. The authors at the same time also asked parents what they thought the risk of concussion might be if children did participate in the sport. The results showed that most parents surveyed (61%) were in favor of age restrictions and another 24% gave a “maybe” response to this question. In addition, females surveyed had greater odds of supporting age restrictions if they felt there was a greater risk of concussion compared to women who did not. Male parents had greater odds of “maybe” supporting age restrictions if they had a child between 6 and 12 years of age. So, given that most parents are supportive of age restrictions, should those youth football set up age restrictions for tackling?
To discuss this question, we asked Dr. Cynthia LaBella, Chairperson of the AAP’s Council on Sports Medicine and Fitness, (10.1542/peds.2019-0519) to huddle up with us and provide a thought-provoking commentary on this study. Dr. LaBella acknowledges that parents in this study are strongly supportive of age restrictions, but also notes that their perception of concussion risk in youth is much higher than what proven studies have shown to date. She reminds us and in turn parents to not just be implicitly biased by the stories we see on the news of professional football players experiencing neurologic disorders like chronic traumatic encephalopathy attributed to multiple concussions experienced over years of playing football, but to note that the sports medicine literature shows the incidence of concussion in youth football is no different than those experienced in soccer, ice hockey and lacrosse based on studies she references in her commentary. Yet no concussions are better than even small numbers of concussions, and perhaps the best suggestion one can take away from this study and commentary is to continue to touch down with the peer-reviewed studies that are accumulating on the short and long-term risks and benefits of playing a contact sport like youth football. Don’t fumble with parents when they ask you about whether or not their child should play this sport, but instead score points by reading both the article and commentary and making sure the decision a family makes is as evidence-based as possible.