Football is exciting to watch on TV.  However, those who play are risking damage to their brain.  How can the invincible youth be convinced that it is “ultimately important” not to play football.  This article provides a glimpse at the research evidence associated with head injuries.

Head Injuries

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Parents are reminded of their tough love responsibilities, requiring their permission for sport participation .  Any sport, with potential head injury, should be carefully assessed from a risk/reward basis. These include football, rugby, soccer, boxing, bull riding, etc. What are sport head injuries?  The two most prominent injuries are Concussions and Chronic Traumatic Encephalopathy (CTE).  However, the real answer is any impact to the brain that causes a response from its immune system to send microglia cells to a damage area, whether realized consciously or not (such as a boxer getting a blow to the head), are dangerous.  Such adverse events become cumulative over time.  Often enough, such occurrences, lead to later life problems, such as CTE, depression, suicide, dementia, etc.


image1-17Chronic Traumatic Encephalopathy (CTE) (Figure 1) is a neurodegenerative disease   found in people who have suffered repeated blows to the head.  (Figure 1. Left = normal – Right = advanced CTE).  In the largest autopsy study to date 87% of the brain of (177/202) former American football players,                              Figure 1 – CTE                   who had donated their brainsfor research showed evidence of CTE, as well as tau depositions, which are found in Alzheimer’s disease.  In the study, 110 of 111 ex-players in the National Football League had CTE.  The disease came with mood, behavior, and cognitive problems, as well as in severe cases, dementia.  The study, from Ann McKee and colleagues at Boston University School of Medicine, appeared in the July 25, 2017 issue of The Journal of the American Medical Association.  Co-morbidities were common: 91 percent of cases with the most severe stage IV CTE also had amyloid (possibly Alzheimer’s disease) and 43 percent had α-synuclein (possible Parkinson’s and Lewy Body Dementia).


Concussion, also known as mild traumatic brain injury (mTBI) is the most common type of  traumatic brain injury (TBI).  TBI is typically defined as a head injury with a temporary loss of brain function.

Research has shown that sports-related head injuries lead to future amyloid and tau pathology, as well as a higher risk of dementia and neuropsychiatric symptoms.  However, the link between TBI and these ensuing problems is unclear.  Could inflammation play a role?

Martin Pomper, Professor in Johns Hopkins Medicine Department of Radiology, in Baltimore, reported that NFL players’ brains are filled with activated glial cells (a response to inflammation) even without obvious neuropsychiatric problems.  This finding suggests that neuroinflammation could indicate future problems and, adds to the accumulating evidence that microglia activation is an early response to the repetitive head trauma that occurs during football play.


Evidence strongly suggests avoidance of sports in which head injuries are probable.  For gifted young athletes and their parents it possibly becomes a risk/reward decision.  Unfortunately, the reward is near term and the risk is potentially down the road.  The decision point comes early in life when a “high school football hero” is popular, builds self-ego, and has the potential for “free college schooling”.  However, nothing in life is free.  Evidence is indicating that the college football player’s  trade-off is risking damage to his brain that may not show for years, for current tuition.  Then there is Professional football and mega-dollars.  Is it worth it?  There are many examples that relate to this question, such as Junior Seau, Mohammad Ali, Jim Plunkett, and many more.


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