Contact sports can cause brain injuries. Should kids still play?

Hindustan Times

18-05-2025

RECENT YEARS have seen a steady drip of troubling studies on head injuries among young players of rugby and American football. Research on schoolboy rugby published in Sports Medicine in 2023, for example, calculated that nearly two concussions result from every 1,000 tackles. As for American football, one in 20 youth players suffers a concussion over the course of a season, per a study in the Journal of Pediatrics. The real risks could be even higher, as many concussions go unreported.
The consequences can be tragic. If a second concussion is sustained before complete recovery, it is more likely to trigger acute brain swelling, which can be fatal. Younger, developing brains appear more susceptible to such 'second-impact syndrome'. Even weaker 'subconcussive' blows to the head are a concern. If repeated for long enough, such hits may damage a brain's white matter, the nerve fibres that transport electrical impulses. A paper published in Brain Communications in 2023 suggests that athletes who were exposed to head impacts from a young age are more likely to experience cognitive decline from subconcussive damage to white matter.
Outright bans on youth contact sport are one option. Another is to focus on protective gear. But in rugby, at least, research has yielded surprising results. Padded 'scrum caps' do protect ears and reduce cuts, but neither scrum caps nor helmets can stop a brain from being pushed into the skull, the cause of concussions. Many players are unaware of this, leading to dangerous false confidence and more aggressive play.
New types of protective headgear are emerging. In 2022 a British startup called Rezon began to sell a special padded headband for rugby and other sports. Known as Halos, it is composed of nine layers which slide over each other when hit at a non-perpendicular angle. The resulting friction, the company claims, reduces by 61% the transmission of rotational forces to the brain.
Rule changes are another solution. Some are hotly contested. Forbidding tackling for minors, for example, may end up increasing injuries when players grow up without having learned the best techniques. The American Academy of Paediatricians, for its part, has declined to endorse a blanket ban. Widespread rules against specific types of impacts including head-first 'spear-tackling', however, have curbed injuries. So have increasingly common policies that limit full contact during practice.
Young players can also be grouped differently. Children enter puberty at different ages, which can lead to glaring mismatches in body size and agility. The injury risk to smaller kids is compounded when teams short on players call up older children too. To avoid such risks, young players are increasingly grouped by physical maturity, not age. This 'bio-banding' appears promising, but research remains regrettably thin.
Parents who are still concerned should consider two final points. First, any impacts that rough-and-tumble sports may have on mental development could be revealed by periodic cognitive tests. Second, a child prevented from playing rugby or tackle football might well find other dangerous hobbies. A paper published in the Medical Journal of Australia in 2019 reviewed 8,857 children taken to emergency rooms for head injuries and found that recreational activities such as horse-riding, biking and skateboarding caused more serious injuries than contact sports.
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