Football-related head injuries cause concern among Arizona parents

Concern about traumatic brain injuries has contributed to a drop in youth soccer participation. (Photo by Tim Clayton/Corbis via Getty Images)

PHOENIX – For more than two decades, contact soccer has been plagued by a concussion crisis.

Once considered an occupational hazard, collision sport has steadily gained the attention of the sports world, more specifically from parents of younger athletes, not because of standout touchdowns, but because of the rise in head injuries.

As awareness of sports-related concussions and brain injuries rises, parents in Arizona harbor feelings of apprehension about allowing their children to play contact soccer, according to a study published by the Barrow Neurological Institute in Phoenix. In 2016, 68% of parents allowed their children to play soccer. That number has dropped each year to a low of 47 percent in 2020.

High school football remains king among popular sports, but concerns about traumatic brain injuries have apparently resulted in a drop in overall participation. And as experts learn more, there remains the unanswered question of whether playing contact soccer is the best thing for a teenager.

“The biggest unanswered question is, ‘How long after a concussion?’” said Dr. Jonathan Lifshitz, director of the Translational Neurotrauma Research Program at Phoenix Children’s Hospital.

“How far are we from injury? How far are we from recovery? How much longer do we have to go? You can put it in the context of COVID. Someone tests positive for COVID. They don’t know yet if they’re going to have mild or severe symptoms, and they don’t know how long those symptoms will last. And if they lose their sense of smell, that amount of time without knowing it is very challenging.”

The Centers for Disease Control and Prevention (CDC) define concussions as “a type of traumatic brain injury caused by a blow, blow, or jolt to the head that causes the head and the brain move quickly back and forth.

In Arizona, the response to access to more information about concussions has resulted in parents seeking alternatives to contact soccer. Flag football is currently the most viable option.

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In 2021, the CDC conducted a study that compared the number of head impacts in youth football versus flag football. The study revealed that athletes who played contact soccer between the ages of 6 and 14 suffered 15 times more head injuries than flag football athletes and 23 times more major head impacts. The research also revealed that young football athletes experience an average of 378 head impacts per athlete during the season. In contrast, flag football athletes experience an average of eight head impacts per year.

Kerry DeSpain, senior commissioner for the Gridiron Flag Football league, says she is aware of the decreased participation in contact soccer among high school students and is well equipped to offer a safer route for athletes.

Many parents are turning their children to flag football for fear of head injuries. From 2014 to 2018, flag football participation at all levels increased by just over 16%. (Photo by Cassidy McCauley/Cronkite News)

“So we saw an increase in enrollment because of concerns about the (football) tackle and concussions and all of that,” DeSpain said. “Since 2016, we have been working to adjust to the new volume so that we can accommodate everyone accordingly.”

Youth sports provide an opportunity for children and teens to learn character development, responsibility, teamwork, and handling adversity. It is imperative to keep adolescents safe and make the necessary changes to prevent traumatic brain injuries that can result in long-term psychological complications. Replacing contact football with flag football does just that.

“It’s growing,” DeSpain said. “Over the last two years, we have seen more high schools start their flag football teams. They haven’t arrived yet, but it’s growing.”

In areas where flag football is not a viable solution to curb head injuries, advanced tools are being deployed to measure the effects of concussions on the brain and estimate a safe timetable for recovery. ImPACT tests, also known as baseline tests, are given at the Arizona middle and high school levels after an apparent concussion to measure an athlete’s impairment. The ImPACT test will check IQ, memory, and reaction time.

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“It’s one of the things (done) all over the country, and it’s used in concussion research all the time,” said Dr. Christina Stough of OneAccord Physical Therapy. “It’s not the best concussion tool, but it will at least give you a prediction of what your function was before the concussion.

“So a lot of high school programs, like in Arizona specifically, Banner has a lot of high schools that do impact testing, so if their athletes have a concussion, they’re going to do impact testing and once you hit your impact score , you are technically cleared to play”.

It is important to note that the perception of concussions has changed dramatically over the years. In 1994, NFL Commissioner Paul Tagliabue created the Mild Traumatic Brain Injury Committee. Tagliabue named Dr. Elliot J. Pellman of the New York Jets team as president.

“Concussions are part of the profession, an occupational hazard,” Dr. Pellman said in an interview with Sports Illustrated.

While injuries may be inherent to football in nature, the increased awareness of different forms of brain injuries has raised concerns about the overall safety of the sport, with Arizona parents most concerned about the link between concussions and chronic traumatic encephalopathy (CTE).

ImPACT tests, also known as baseline tests, are given at the Arizona middle and high school levels after an apparent concussion to measure an athlete’s disability. (File photo by Cassidy McCauley/Cronkite News)

The Boston University CTE Research Center linked CTE to repetitive brain trauma, such as concussions, and subconcussions in one study. The Boston University study also concluded that for every 2.6 years of playing contact soccer, an athlete’s risk of developing CTE doubles.

“So concussion research right now is trying to figure out if that CTE is related to concussion and the impact on chronic concussions, or is it just normal people who play football?” Dr. Stough said.

“These football players are hitting their heads too many times, they’re freaking out, they’re killing their wives, they’re taking their own lives and things like that. So concussion rap has gotten really bad. So that urge to let their kids play has gotten extremely big.”

The future of contact football is cloudy at the moment, with strong opinions on both sides of the argument about the sport’s longevity. Replacing contact football with flag football is the most pragmatic solution to the concussion problem, but whether or not flag football will be accepted as a conventional alternative remains to be seen.

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