That’s a good question. You may have asked it yourself after reading the September 29, 2014, Time Magazine cover story, “He Died Playing This Game: Is Football Worth it?”

The article described the tragic death of a 16 year-old boy who died after suffering a traumatic brain injury while playing football last year. The story also cited the recent NFL court filing in which it was predicted that nearly one third of former players will develop dementia, Alzheimer’s disease or other debilitating neurologic disorders. Combine that with the violent criminal behavior exhibited by some professional athletes of late, and the NFL’s woeful response and you’re left with the same question. Is football worth it?

The Risk/Benefit Ratio
Full disclosure: My 14-year old son is playing freshman football this year. I have mixed emotions about it. In medicine, we are taught to weigh the risks versus the benefits of any intervention. What if we applied the same risk/benefit ratio to football? When I do this, here’s how I see it:

First, the risks: Minor injuries, major injuries, interfering with school work, time commitment, permanent disability, death

Now the benefits: Physical fitness, team work, overcoming adversity, discipline, social group, supporting school work to remain eligible, thrill of victory, learning from the tragedy of defeat, good sportsmanship

Okay, so what if we applied this risk benefit assessment to proposals for making football safer?

  • Baseline testing. This tool can help identify when subtle injuries may have occurred.
    • Risks: Cost associated with testing; time required for testing; expertise needed to interpret the results
    • Benefits: Better ability to identify and treat certain traumatic brain injuries such as concussions; reduces the incidence of catastrophic second impact syndrome; reduces the long term effects of traumatic head injuries; costs can be as low as a few dollars per athlete a year
  • Reduced full contact practices. The NFL allows essentially one full contact practice a week during the season. Several university programs have reduced full contact time as well.
      • Risks: Players do not master the physical skill sets needed to play
      • Benefits: Many injuries occur during practice. If you have fewer live drills, you will have fewer injuries. Also, reducing full contact practices does not interfere with conditioning.
  • Changing youth football to flag football until 12 years of age.
    • Risks: Perception that it is not “real football”; delaying the teaching of some of the physical skills needed in full contact football.
    • Benefits: Reducing the rate of head and neck injuries, both minor and catastrophic.
  • Better helmets
    • Risks: Expensive, as they start in the $300 range and many cannot afford the new technology
    • Benefits: Better helmet design can reduce head injuries. It must be noted that reduction is a benefit, but better helmets do NOT eliminate all head injuries.
  • Changing the rules to penalize leading with the head.
    • Risks: It may change the integrity of the game (Ok, this is a stretch).
    • Benefits: Reduces the incidence of catastrophic head and neck injuries.
  • Better skill sets such as “heads up” blocking and tackling program. To be honest, I don’t see a ratio here because I don’t see any risks. But I do see huge benefits. The only obstacle is the problem of how this is implemented.

As parents, we each have to establish our own criteria for the risk/benefit ratio involving our children and football. Working that equation out starts with the same single question each of us must ask: Is football worth it?

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