WHY
I
LET
MY
SON
PLAY
FOOTBALL
Donald
Haas,
MD,
MPH
How
can
you
let
your
son
play
tackle
football?
As
a
physician,
I
hear
this
question
often,
and
for
good
reason.
It
seems
the
media
is
filled
with
one
study
after
another
focusing
youth
sports
injuries,
particularly
head
injuries.
Football
takes
the
brunt
of
the
scrutiny.
I
read
and
hear
these
reports
like
every
other
loving
parent.
I
also
follow
the
medical
literature
on
this
topic.
So
my
decision
to
allow
my
son
to
play
is,
if
nothing
else,
thoughtful.
Without
question,
playing
football
comes
with
the
risk
of
incurring
injuries,
including
concussions.
In
fact,
football
lags
only
behind
womens
soccer
in
terms
of
relative
concussion
risk
among
competitive
youth
sports1
.
The
crucial
question,
however,
is
what
is
the
absolute
risk
of
concussion,
rather
than
the
relative
risk.
Absolute
risk
refers
how
often
an
event
occurs
per
exposure.
Relative
risk
is
a
ratio
comparing
one
outcome
to
another.
For
example,
a
drug
company
may
advertise
that
their
new
product
can
lower
your
heart
attack
risk
by
50%
compared
to
standard
treatment
(relative
risk).
Thats
a
striking
improvement,
but
it
needs
to
be
interpreted
in
the
context
of
the
absolute
risk.
If
your
baseline
risk
of
suffering
a
heart
attack
is
only
1%,
taking
a
drug
to
lower
your
heart
attack
risk
to
0.5%
may
not
be
worthwhile.
On
the
other
hand,
if
your
absolute
risk
of
a
heart
attack
is
60%,
cutting
that
risk
to
30%
with
the
drug
would
be
a
wise
decision.
Its
the
absolute
risk
that
needs
to
be
understood,
more
so
than
the
relative
risk.
Most
of
what
is
reported
in
the
media
regarding
concussions
and
football
describes
the
relative
risk
for
example,
high
school
football
players
are
more
than
twice
as
likely
as
high
school
wrestlers
to
sustain
a
concussion2.
However,
the
relevant
question,
in
my
view,
is
what
is
the
absolute
risk
for
a
concussion
in
playing
football?
Available
data
suggests
that
for
both
high
school
and
youth
football
(ages
8-12)
there
are
about
0.7-1.7
concussions
per
1000
athletic
events,
where
an
athletic
event
is
defined
as
a
practice
or
game
1,2,3.
The
actual
occurrence
rate
of
concussions
in
youth
and
high
school
football
is
considerably
lower
than
the
relative
risk
suggests.
I
am
also
asked,
Even
if
the
absolute
risk
is
low,
why
play
a
sport
where
there
is
even
a
small
increase
in
concussion
risk?
My
answer
is
admittedly
subjective
and
debatable,
but
I
think
there
are
few,
if
any,
team
sports
like
football
arguably
the
ultimate
team
sport.
In
football,
every
player
matters
on
nearly
every
play.
Twenty-two
opponents
line
up
to
compete
individually
and
the
sum
outcome
of
these
unique
contests
determines
the
success
or
failure
of
a
play.
An
entire
team
(coaches
included)
prepares
for
a
week,
focused
on
implementing
a
complex
game
plan
that
requires
all
team
members
to
execute
effectively.
Also,
football
offers
an
opportunity
to
excel
even
for
kids
not
blessed
with
great
hand-eye
coordination
or
speed.
Strength,
along
with
agility
and
quickness
(which
are
different
from
speed),
can
always
be
improved
upon
and
these
are
the
core
elements
needed
to
play
on
the
line.
Football
fosters
toughness
and
perseverancenot
just
physically,
but
mentally.
It
takes
courage
to
line
up
against
someone
a
foot
away
from
you
and
compete
for
four
quarters.
Former
players
speak
of
the
brotherhood
of
football,
and
I
think
it
is
an
accurate
description.
Playing
football
was
an
overwhelmingly
positive
influence
on
my
life,
and
I
hope
my
son
will
have
the
same
experience.
There
are
risks,
but
I
know
I
cannot
protect
my
son
from
everything
in
life.
I
also
let
him
ride
a
bike,
climb
trees,
swim
in
the
ocean,
and
ski
I
dont
think
that
makes
me
a
bad
parent.
I
credit
youth
football
programs
(which
seem
to
be
ahead
of
other
youth
sports)
for
their
efforts
to
educate
coaches,
parents,
and
players
regarding
concussions
(the
WW-P
Wildcats
program
provides
preseason
neurocognitive
testing
in
effort
to
diagnose
concussions
more
effectively).
I
will
continue
to
follow
this
topic
closely
in
the
scientific
literature,
rather
than
the
media.
I
will
be
the
first
to
prohibit
my
son
from
football
if
the
risks
are
unacceptable.
At
this
point,
the
data,
in
my
view,
does
not
support
keeping
him
from
a
game
that
has
been
a
positive
influence
on
boys
and
young
men
for
decades.
(1) Giza
CC,
et
al.
Summary
of
evidence-based
guideline
update:
Evaluation
and
management
of
concussion
in
sports:
Report
of
the
Guideline
Development
Subcommittee
of
the
American
Academy
of
Neurology.
Neurology
2013;80:2250-2257.
(2) Harmon
KG,
et
al.
American
Medical
Society
for
Sports
Medicine
position
statement:
concussion
in
sport.
British
Journal
of
Sports
Medicine
2013;
47:15-26.
(3) Kontos
AP,
et
al.
Incidence
of
sports-related
concussion
among
youth
football
players
aged
8-12
years.
Journal
of
Pediatrics
2013;
163:717-720.
