Football's Spotlight Needs to Be on Players' Deaths
Two college football players died last week, each within days of playing a game. This may be a statistical blip, but it’s the sports news we should be talking about this week. Instead, we’re talking about President Donald Trump, who waded unwisely into the controversy over professional players who protest during the national anthem -- and, as it his wont, made things worse.
I’ll leave the anthem ax for others to grind. I want to meditate on the two players who died. Neither death received more than a snippet of coverage, even on the sports pages, probably because neither young man was part of a major program. Robert Grays played at Midwestern State; Clayton Geib played at College of Wooster. Had the players been from, say, Ohio State and Alabama, I suspect that cable networks would have spent hours earnestly debating the future of the sport.
That’s a debate we need.
I love football, both college and professional, and I don’t mean to suggest that the sport is going to begin to die soon (although it could). Certainly I hope it’s around for a long time. But then I remind myself that I turned my back on boxing because of its radical inattention to safety.
In high school football, about a dozen players die every year. Given that over a million teenagers play the game, this number might seem tiny. But according to figures compiled by the University of North Carolina’s National Center for Catastrophic Sports Injury Research, among high school sports where at least five players died in the period from 1982 to 2015, football has by far the highest fatality rate. 1 Football’s rate of serious injuries is topped only by women’s ice hockey and cheerleading. 2
That’s among kids. For college players, matters are just as bad. According to a 2015 report from the Centers for Disease Control, college football players have the highest rate of injury in competition (40 injuries per 1,000 athlete exposures). These are not all minor bruises: “Football accounted for the largest proportions of injuries requiring ≥7 days before return to full participation (26.2%), surgery (40.2%), and emergency transport (31.9%).”
What about deaths? A 2013 study of 20 years of data found the fatality rate among college players to be almost three times the rate among high schoolers. Yes, the absolute number of players who die is quite small. But the data should remind us starkly that the violent sport so many of us enjoy is just that: a violent sport. Trauma to the head and neck is a commonplace. 3
Which brings us to chronic traumatic encephalopathy. By now everybody’s heard of CTE, and every parent whose son wants to play football is scared of it. The syndrome results from multiple traumas to the head -- including mild traumas -- and generally takes several years to manifest. If football dies, fears of CTE will likely be the reason. Nobody knows how common the affliction is. A new study from Boston University’s CTE Center found signs of emotional and cognitive impairments in adults who had played tackle football before age 12. A widely publicized study released by the same center in July found that 110 of 111 brains of deceased NFL players showed CTE. True, the researcher behind the study warned of a “tremendous selection bias,” because the brains were donated by families who thought the players in question had neurological problems, but the results are nevertheless chilling.
One result of CTE fears is a refreshing emphasis on reducing concussions. The NFL has adopted rules to try to reduce blows to the head during the game, and has instituted procedures to allow medical professionals to remove concussed players from the game. All of this is to the good, but a concussion can result from a blow to the neck or even to the spine. (Spinal cord concussions in sports are understudied.)
A concussion-proof helmet would be a much-lauded development, but many researchers doubt that such a thing is possible. Moreover, as the writer Gregg Easterbrook has pointed out, the popularity of the quick-strike offense in both the college and professional ranks increases the number of plays per game by as much as 50 percent -- and every increase in the number of plays is also an increase in the chance of injury. 4
The most dangerous part of football is the kickoff, where each team’s players get a running start as they streak toward the other. That’s when the risk of serious injury is highest. In 2011, the NFL shortened the kickoff distance, in order to create more touchbacks (that is, kicks that go into the end zone and are not returned). A 2015 study in the Journal of Occupational and Environmental Hygiene, found a slight decrease in injuries as a result. But when the authors ignored touchbacks and examined only returned kicks, the new rules had no effect on the injury rate. 5 Further tweaking of the kickoff last year seems to have made little difference.
In recent years, a rising clamor has demanded the elimination of the kickoff. 6 Purists have fiercely resisted. The game, they insist, will take on an entirely different coloration if there are no kickoffs. As a sports purist myself, I’ve long been part of the resistance. But my will is beginning to evaporate. Young men shouldn’t be injuring each other for our entertainment. If kickoff is truly where the risk is greatest, perhaps that’s where we should be willing to consider the most radical reforms.
True, neither of the college players who died last week was hurt during a kickoff. Grays injured his neck while making a tackle. Geib felt unwell after a game, was hospitalized, and died the next day. No part of the sport can be made entirely safe.
But getting rid of the kickoff seems an obvious fix. Although purists like me would groan, we’d get used to it. If the NFL owners want to show solidarity with their players by linking arms on the sidelines to defy criticism from the Oval Office, great. I’m all for it. If they really want to show how much they care, though, they might consider abolishing the most dangerous moment in the game so many of us love.
If you look at the chart on page 14 of the report, men’s gymnastics and ice hockey appear to have higher fatality rates, but the authors caution that only limited significance should be attached to sports with fewer than five deaths during the period studied -- and each had fewer than five.
The serious injury rate among female cheerleaders is about twice that of football players. There are too few injuries among male cheerleaders for accurate calculation. Anecdotally, the highest risk is thought to involve sequences in which female cheerleaders are tossed into the air or climb atop a human pyramid.
Head and neck trauma is also a major risk in international football, that is, soccer.
See page 145 of this fine book.
A much-hyped threefold decrease in the rate of head injuries during kickoffs was not statistically significant.
Some proposals would leave an exception for onside kickoffs. If you don’t know what an onside kickoff is, the chances are you’re not reading the footnotes anyway.
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Stacey Shick at email@example.com