Eight schoolchildren died in the past month while participating in football, including three deaths from suspected brain injuries. Recent research suggests repeated blows to the head, even those that don’t cause concussions, can lead to the degenerative brain disease chronic traumatic encephalopathy (CTE). A Truveta analysis of 25,000 hospital visits for football-related injuries showed that high school boys suffered the highest rate of traumatic brain injuries among age groups.

For most players, there is no way to avoid suffering repeated blows to the head while playing tackle football. Some experts recommend that parents prohibit children from playing tackle football before they are 14-years old.

Considering the risks, should parents consider not allowing their children to play tackle football at all?

“That’s a tough question,” said Dr. Thor D. Stein, a neuropathologist at the Boston University CTE Center. “I think it’s something every parent needs to think about. I’ve got two boys. I grew up in the Midwest. I played football. My dad played football. There is a lot of growth and benefits with the sport.

“But I will say that my position has evolved over the years. We know more and more about the risks. I’ve become more cautious and more circumspect about whether football is the best choice for a sport. If you do play, make sure you take head injuries seriously. Do everything you can to minimize the risk of concussions and non-concussive blows.”

The recent deaths of eight schoolchildren have rekindled questions about the safety of tackle football.

According to data collected by the National Center for Catastrophic Sport Injury Research, 11 young football players have died since July 1. The deaths include two college-aged players, eight high school students and one middle school student. The suspected causes of death include heat stroke (four cases), brain injury (three), sudden cardiac arrest (three) and sickle-cell rhabdomyolysis (one).

Cohen Craddock, 13, was the youngest of the recent victims. His father, Ryan Craddock, said Cohen collided with another boy during practice and hit his head as he fell to the ground. The injury caused Cohen’s brain to swell, Ryan Craddock said. Cohen died from his injuries the next day.

In the aftermath of his son’s death, Craddock has pushed for legislation to make Guardian caps mandatory for high school football players in West Virginia. The cap affixes to the top of helmets and is designed to soften blows to the head.

“I’m not trying to change the game,” Craddock said. “I just want to make it safer for these kids.”

A 2020 study of youth football players published in the CNS Neurosurgery Journal showed that the combination of Guardian caps and safe tackling techniques could contribute to fewer head impacts and injuries. The NFL reported a reduction in concussions among players who wore Guardian caps during practices.

072822 Flowery Branch, Ga.: A Guardian cap is shown on an Atlanta Falcons helmet during Falcons training camp at the Falcons Practice Facility Thursday, July 28, 2022, in Flowery Branch, Ga. The NFL ‘Guardian Cap’ is being worn by the Atlanta Falcons and other NFL teams during training camp. (Jason Getz / Jason.Getz@ajc.com)

Credit: Jason Getz / Jason.Getz@ajc.com

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Credit: Jason Getz / Jason.Getz@ajc.com

However, a 2023 study in the Annals of Biomedical Engineering concluded that the cap doesn’t offer much protection against blows that are typically experienced by players during practices and games.

“We still don’t have a good sense of if that is going to help or not,” said Stein of the BU CTE Center. “I definitely think it’s worth trying.”

There can be severe brain health consequences from taking repeated hits to the head. CTE is associated with cognitive problems and impulsive behaviors. Boston University researchers discovered that the risk of developing the disease is related to the number of years football is played rather than the number of concussions suffered.

The study found that the risk of CTE increases by 30% each year, doubling for every 2.6 years of playing football. The Concussion Legacy Foundation, affiliated with the BU CTE Center, strongly recommends that parents not allow children to play tackle football until they are 14-years old. Its “Flag Football Under 14″ education program includes a “Tackle Can Wait” PSA that encourages flag football as an alternative.

“Any future high school, college or NFL player who starts tackle football at age five will have 10 times the odds of developing CTE than if he had started at 14,” the Legacy Foundation said.

Dr. Greg Myer of the Falcons-affiliated Emory Sports Performance and Research Center said the NFL and NCAA have made progress with reducing head trauma over the past decade. Those practices eventually will “trickle down” to lower levels of football, Myer said. He argued that advances in the identification and treatment of acute head trauma has made athletes in collision sports “safer than ever before.”

“While we must acknowledge there are risks inherent to involvement with youth sports, the health and psychological benefits outweigh the risks,” Myer said in a statement.

Per the Society of Health and Physical Educators, all 50 states now have return-to-play laws regarding sports-related concussions. There hasn’t been the same progress with legislation mandating standards for practicing and playing in extreme heat.

According to the Korey Stringer Institute only 14 states, including Georgia, require ice tubs at practices and games. Experts say that people who are experiencing heat illness have a 100% survival rate with aggressive and immediate cooling.

Martin McNair said it’s not enough to have ice tubs and other cooling methods available. His son, Jordan McNair, died of a heatstroke after he collapsed during a workout with the Maryland football team in 2018. He was 19.

“‘UMD had an emergency action plan, of course,” McNair said. “However, they never practiced it. No one knew how to recognize the signs when Jordan was in distress and it was, ‘Let’s move him around instead of cooling him down.’”

In a September 16, 2016, file image lineman Jordan McNair of McDonogh High School. Now with the University of Maryland, he died on Wednesday, June 13, 2018, two weeks after collapsing during a team workout. (Barbara Haddock Taylor/Baltimore Sun/TNS)

Credit: Barbara Haddock Taylor

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Credit: Barbara Haddock Taylor

A.J. Duffy III, president of the National Athletic Trainers’ Association, said parents who enroll their children in football should make sure that the coaches and medical personnel rehearsed emergency plans frequently. Panic can set in when a player is in distress, but if emergency procedures are practiced enough then they become like “second nature,” Duffy said.

Duffy said if parents decide to enroll their children in football, then it’s important for them to ask questions about the team’s emergency action plan.

“Where is the ambulance coming from?” Duffy said. “Who will call it? If it’s heat-related, is there a cold plunge available? It’s important to know if there is an (automated external defibrillator) nearby. How easily accessible is that AED?

“Are there individuals trained in hand-only CPR? What training is there for coaches? What are the polices when it comes to heat illness and return-to-play if someone has a concussion?”

Parents also must consider the bigger question about whether they should allow their kids to play tackle football at all. Stein said he understands the dilemma that parents can face. Football is important culturally, with polls showing that it’s the most popular sport in America by far. However, parents also are confronted with growing evidence about the risks for kids who play football.

It’s nearly impossible for children in tackle football to avoid the head impacts that don’t cause concussions but can lead to long-term damage to the brain.

“That’s the issue,” Stein said. “Many of the sports have taken concussions seriously. We recognize we’ve got to treat it and minimize risk. But it’s not just those recognized concussions, but the blows that occur over time. ... It’s hard to protect against that. We do want to try to limit it.”

Football deaths this month

The following is a list of the eight schoolchildren died in the past month while participating in football.

Name/Age/Date of injury/State

Chance Gainer/18/Sept. 6/Florida

Cohen Craddock/13/Aug. 23/West Virginia

Christopher Garcia/16/Aug. 23/ California

Caden Tellier/16/Aug. 23/Alabama

Jayvion Taylor/15/Aug. 15/Virginia

Leslie Noble/16/Aug. 14/Maryland

Ovet Gomez Regalado/15/Aug. 14/Missouri

Semaj Wilkins/14/Aug. 13/Alabama

Source: Media reports