Sparked by a somewhat vitriolic discussion on a dadgroup I'm in. Would you let your kid play football, if so what restrictions? If not, what other sports are allowed, and with what restrictions?

https://publications.aap.org/pediatrics/article/144/5/e20192180/38225/Concussion-Incidence-and-Trends-in-20-High-School?fbclid=IwAR0EFuaf5EsV5OafmtAAXq3zRGI32dlWadaBM7U18SatYh6txO2v6oaJu-s?autologincheck=redirected?nfToken=00000000-0000-0000-0000-000000000000

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2140075/?fbclid=IwAR18lhXJN3IjhzNwwdd-qfo3g9RBMUtYIDniLxSuH25yFxWZLVGGK_dyLVY

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384815/?fbclid=IwAR1tPWAGlN0NSupBRQMFokLAqlThBt5b0jEE-A_YEem3lWcWm3eKCBIqWXc

https://concussionfoundation.org/news/press-release/breakthrough-study-reveals-repetitive-head-impacts-definitive-cause-CTE

The "dadgroup consensus" seemed to be that football was right out, but that all other mainstream HS sports were fine. My read of the above links is that football is the cause of the week, but that playing MS/HS football is not actually outrageously more dangerous than other mainstream HS sports. A surprisingly high # of people seemed to attack the idea of HS sport as valuable at all, and that kids should only play non-contact sports or no sports b/c the risk is too great.

Sports (specifically) and competitive activities (more generally) are a great way to teach instant and lasting life lessons. How to deal with defeat, the value of hard work, getting along/working with people you like (and those you don't), being a gracious winner, how good it feels to win, building confidence through growing competence and many more. Essentially, sports are life writ small and allow kids to experience previews and learn from those previews in a lower cost environment. Certainly other competitive activities provide many of these lessons (in a saner world people would include progression raiding experience from MMOs on their resumes), but MS/HS sports provide them + the physical activity that growing bodies thrive on. Additionally, many benefits to regular physical activity are well established (and, with the difficulty of becoming physically active later in life, starting young seems a good idea). (To be completely honest, I find the benefits of sports so obvious that the need to include this gasts my flabbers, but given the previous discussion I felt compelled to).

The risk profile seems to be something like: Football, closeish behind other physical sports (soccer most notably), a decent gap, sports with accidental head contact, a decent gap, non-contact sports without much accidental head contact. As it stands football seems more dangerous, but not necessarily wildly more dangerous from a brain injury perspective. If it's only marginally more dangerous then the answer might be to place specific restrictions (stop playing after 1 or 2 concussions, starting in 8th grade vs 6th grade, not playing Pop Warner (starting as low as age 5), limiting position choices to "safer" positions).

Emerging research (shown here by the press release) questions if concussions are the issue, or is it concussions + repeatedly banging your head around, that causes the long term problems? If football is already the highest(ish) risk mainstream sport in terms of brain injury, and we're undercounting the risk because of an undue focus on concussions, then if you account for that risk does it become a category of its own and wildly more dangerous than the other activities?

That's the abstract discussion. The specific question is this: Will you let your kids play football? What restrictions will you place on their participation? If not, can you kid play soccer (specifically Girl's soccer which is (on brain injury) measures potentially as dangerous as football)? Contact sports? Boxing? MMA? Non-Boxing/MMA martial arts? Only non-contact sports? No sports? What do you need to change your mind on this?

Personally, I think I'd let my kids play MS/HS, but probably not Pop Warner and I'd make it clear that they're done for at least a year after 1 concussion. The risks don't seem wildly out of range of the other sports, and while I hope my kids opt into different sports (cough cough fencing), I think the life lessons are too important to pass on. A kid denied their primary sport doesn't necessarily choose a different sport, but might pass on sports altogether. That said, it will of course depend on the kid and if it's their clear preference or a choice among many sports.

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Could I point out that avoiding head injuries might not be the only reason you wouldn't want your children to play football? You might also not want your child to adopt the culture that a lot of high school football teams have (partying, not caring about school, self-centered), which can happen quite easily if they're around football kids 3 hours/day 6 days/week.

Fair enough. Certainly schools have that, other schools have different cultures as well (but I'd guess the average is closer to your thought). Likely a different vibe from track/cross-country and marching band for sure. (Which isn't too say you don't have people that crossover/differences).

Any kind of contact sport is lunacy. Even non-contact sports like track can hurt your joints if you aren't careful. Basketball is bad for your knees, etc. I would tell my kids if they want to exercise: swim or jog on sand. If they want to have fun play video games or have sex (bang in your bedroom at any age). I don't believe in being coercive but I hope my child would trust me enough they wouldn't even consider playing football or heading a soccer ball. 

Our family draws a line between American Football (and Boxing/MMA/etc.) Where the point of the game is to hit your opponent (and, by symmetry, be hit) and other sports where getting hit is accidental. Soccer Headers is a gray area.

While I disagree, I can see why you would make that choice. Personally I stopped doing MAs when I realized I just really didn't like getting hit in the face.

We allowed flag football but not tackle football. In general we believe that concussion and sub-concussive events are bad news, and would avoid high risk of those -- but otherwise are very pro sports. Football is a standout because of all those sub-concussive events especially at the line. 

I would also worry about soccer a bit due to headers, but in practice our kids hated soccer so it's not a concern. Basketball seems fine. 

Martial arts are also fine, though I would not allow boxing or anything that focuses on punching the head. So like, BJJ is fine, competitive MMA is not. 

I've heard a lot of soccer leagues are taking steps to address headers, but afaik, it's a bit of a false lead b/c (and this is weak knowledge) a lot of the concussions are not header related. Happily, your kids didn't want to play it so doesn't matter much.

Boxing is such an odd sport in the modern context. I'd also add that you should be wary of some other MAs like TKD, as depending on the exact ruleset there can be an extreme focus on kicks to the head.

Plan A for my daughter is martial arts; the wife and I quibble a bit about what to look for when the time comes. I am much more tolerant of injury risks, on the grounds that no-contact martial arts doesn't advance the purpose of self defense. I would consider MMA; wife is opposed to MMA chiefly on cultural grounds.

I would also like her to do one of the team competition sports, by which I mean thing like soccer, basketball, and volleyball over track, wrestling, or swimming. The latter set is no different from totally individual competition, because there is nothing to do except well by yourself.

The thing is that I need a way to teach coordination, and individual competition doesn't do that. The critical lessons come from situations where you need to perform with other people; that part of the job is putting other people in a position to succeed, and that you are dependent on others to put you in a position to succeed.

There isn't another reliable way to do this, unless the family undertakes it specifically. School is aggressively, totally useless for the purpose; group projects are common but only serve to emphasize the terrible state of baseline coordination.

I remind myself from time to time that these risks all amount to normality. So all the nuance pays out as "Yes, will let my kid play football."

Seems reasonable. I think the variance MA school to MA school is so incredibly high that it's almost impossible to layout a plan other than "visit schools within a reasonable trip and see".

What is Pop Warner in this context? I have googled it and it sounds like he was one of the founders of modern American football, but I don't understand what it is in contrast to. Is there some other (presumably safer) ruleset?

Pop Warner does football (and cheer) leagues for ages 5 to 16. There are other similar orgs, but it's the biggest. Some areas even have football for 3-4 year olds. Some of the rules are intended to reduce injuries (no kickoffs for example), but the biggest risk increase (for my model) is simple the increase in exposures. If you play football 7th-12th grade it's maybe 500 exposures (game or practice). If you start in 1st grade you're at least doubling the exposures, plus you might be doing other football leagues as well.

Higher exposures, more non-concussion head knocks. Of course the smaller kids don't hit as hard, but some games (afaik) have pretty big weight discrepancies even though the rules try to prevent it.

You might have heard it described as "PeeWee", which means small children. In general, it refers to elementary school aged leagues for otherwise contact or equipment-intensive, like football and hockey. Elementary schools in the United States do not spend money on fields and equipment for these things, not least because they have playgrounds to maintain instead.