Maybe football shouldn't be played at all

Thomson Reuters

The 2016 NFL season kicks off with a hell of a game on the night of September 8: The Carolina Panthers take on the Denver Broncos in a rematch of last season's Super Bowl, which the Broncos won 24-10, largely because of their hard-hitting defense.

But along with the return of the pro and college seasons, with Saturdays and Sundays spent tailgating and tallying fantasy points come the stories of what's happening to players whose brains have been repeatedly battered.

This year one of the high-profile cases is that of Tre Mason, a 23-year-old running back for the Los Angeles Rams. Mason has yet to report to training camp after a troubled offseason that included multiple encounters with police. A stun gun was used on him in one encounter. He was checked into the hospital for strange behavior. His mother, Tina, has said that head injuries have given him the mindset of a 10-year-old.

If we find that brain damage is inevitable, should the sport be played at all?

"As much as he's accomplished, as hard as he's worked, as much as he's built his character, in record-breaking time it's going downhill because of what's going on," she said, according to audio obtained by TMZ. "He doesn't even know. He's not conscious enough."

If Mason's story was one isolated incident, it could be treated as an outlier, but clearly it's not. Look at The New York Times story from last year profiling former UNC lineman Ryan Hoffman, whose mental decline left him homeless, struggling with depression, substance abuse, and memory problems. Hoffman died last December after riding his bike the wrong way into traffic at night. And that's before beginning to list now deceased NFL players such as Junior Seau, Mike Webster, or Dave Duerson, diagnosed after their deaths with a condition that causes a breakdown in the brain known as chronic traumatic encephalopathy, or CTE.

"Until you live this every day and really hear the horror stories of what happens to families when things go wrong," it's hard to understand these stories, says Chris Nowinski, cofounder and executive director of the Concussion Legacy Institute, author of "Head Games: The Global Concussion Crisis," and cofounder of the Boston University CTE Center, largely responsible for demonstrating the connection between football and degenerative brain disease.

"Until the last 10 years these stories haven't been told," Nowinski tells Business Insider.

Thomson Reuters

These stories are not even necessarily about concussions, despite the fact that it's those bell-ringing hits that leave someone unable to focus, control emotional reactions and balance, and properly process what's happening around them that get the most attention. The bigger, still wide-open question is about the impact of the hundreds or thousands of smaller hits to the head that people — ranging from kids to adults — take while playing football and other sports all the time.

We're now in a weird situation. We know more about CTE than we ever have before. At this point, NFL officials say they understand there's a link between the game and the degenerative disease.

But even though there are theories, scientists don't know exactly how people develop CTE. Is it 750 mild hits to the head? A few thousand hits to the head? A couple of concussions and a few hundred other hits? We can't ethically test these things, and they would vary for each individual anyway.

We don't know the point at which we cross the line to inevitable brain damage. It's urgent that we support the research that can try to answer that question. But in the meantime, how do we decide the right approach to sports like football?

The question goes beyond football too — concerns have been raised about heading the ball in soccer and of course about contact sports like hockey or rugby. But football is the arena where we have to confront this question most directly, as it's perhaps the most linked to these injuries and it's the most popular sport in the US.

First, perhaps, we have to decide whether it's right to encourage kids to play. But if kids don't play, eventually, adults won't either. And that leaves us in an awkward spot: If we determine that brain damage is inevitable, should the sport be played at all?

More and more fans wince now when they see a player go down and not get back up. That's when the specter of brain damage starts to shine through. Professional sports are entertainment, and there'd be no reason to play without an audience that's worth billions. So should we stop watching? Writing as a conflicted fan, there's no easy answer.

As Sports Illustrated recently suggested, football could very well die. Can it be saved? Should it?

Thomson Reuters

Can the game be made safer?

Even bringing this conversation up tends to bring out two different groups — those who think it's obvious that games like football are stupid and those who think it isn't manly to suggest that there's anything wrong with the state of affairs.

"People talk about this at the edges," says Nowinski. "It's either 'every man for himself' or it's a 'nanny state with everyone in bubbles.'" We have to get beyond that to have a productive conversation.

Nowinski knows head injuries. After playing defensive tackle for the Harvard football team, he became a professional wrestler. One particular mismanaged concussion ended that career, but he also experienced repeated blows to the head throughout that time, something that we now know is far more dangerous than we once thought.

Most people don't want to eliminate contact sports entirely, as there are clear psychological and physical benefits to playing. But for Nowinski at least, the state of affairs is untenable.

"There's never a reason to hit a child in the head before high school" — at the very least, he says. "It's an unnecessary activity."

And while that position goes further than many others advocate, there are movements in that direction.

There's never a reason to hit a child in the head. It's an unnecessary activity.

This year, the Pop Warner football organization, the largest youth program in the country, eliminated kickoffs for their youngest divisions.

"It seemed to make sense to us, particularly on the advice of our medical advisory committee," says Jon Butler, the executive director for Pop Warner.

Butler says that other decisions that they've made to limit contact, including rules drastically reducing hits in practice and regulations requiring medical professionals to clear kids to return to play after a head injury, have sharply reduced concussions among its players.

Thomson Reuters

"If we find that there is a reduction in injuries and the overall feedback is positive, we would gradually move this [elimination of kickoffs] up through our other divisions of play," he says, pointing out that by moving moving the kickoff line forward, the NFL essentially eliminated the chances of hard hits occurring on kickoffs for pros, since most now result in a touchback.

When we talk about whether "we" should play football, there's of course a big distinction between kids who play for glory, acceptance, and fun, and adults, who, if they still play, probably do so for money. But of course any changes to the game for kids are going to affect adults eventually too, as these are the kids who will or won't play the game in the future. If you are going to talk about the college and pro level of the game, you have to talk about kids too.

Some think that changes to the game will make a huge difference. In 2015, Chad Asplund, medical director of athletics sports medicine at Georgia Southern University, coauthored a provocative editorial in the medical journal BMJ, asking "if brain damage is an inevitable consequence or an avoidable risk in American football."

Asplund tells Business Insider that he thinks both rule changes and proper medical care can be transformative.

"A lot of the reason why these prominent players from the 70s and 80s got CTE is they sustained a concussion and didn't inform anybody, they didn't stop playing," he says. Now, "people are realizing that concussions are serious, they should stay out."

Treating head injuries carefully, teaching people safer techniques, all of these things can definitely reduce the number of injuries, he says.

Clearly, the game can be made safer, as Butler and Asplund say.

Whether that'll be enough is unknown.

Is it worth it?

Nowinski isn't sure. It's hard to figure out the level of "acceptable risk," especially for kids.

"It's an ethical question, what is our culture comfortable with," he asks. "Is government underwriting brain damage for children through school sports? What is fair to do to a child? Adult sports can be dangerous, especially if they have informed consent and a union looking out for them, but children don't have those opportunities."

Thomson Reuters

He does say that the pursuit of a middle ground is a good goal — advocating for rule changes, like those that have occurred at the Pop Warner level. That's something that most people who stop and think about the sport agree with.

"If you look back at the history of the game ... the game evolved and it continues to evolve," says Butler. "It's going to have to, we know so much about the science now and it'd be foolish not to change it."

At the same time, Nowinski and others are pushing for more research, especially studies into CTE. Many, like Asplund, say we still have a lot to learn about CTE, and perhaps the specific brains that we've studied make it seem like football is riskier than it is. We still have a lot to learn.

But it's possible that that research will confirm something that deep down, we all know is a possibility. Maybe there's no safe way to get hit in the head repeatedly.

Maybe there's no safe way to get hit in the head repeatedly.

If so, should we play football at all? Should we watch?

When Nowinski gives talks, he likes to ask the audience how many times they've been hit in the head in the past year. A few people might raise their hands. Then he asks how many have been hit in the head more than 10 times. The hands go down.

"No adults expose themselves to brain trauma unless they are being paid for it," he says. "The only people who get hit in the head thousands of times are kids." In his opinion, the fair number of hits might be the number that naturally would happen without the culture created in sports like football — there would probably be a few serious knocks to head, as happens to a large percentage of the population, but the overall number would drastically decrease.

Maybe the game can be made safer. As a fan, I love that idea. But I don't know if it's possible. Maybe not.

Nowinski argues that sometimes you can make changes to something that make it safer, but that doesn't mean that thing is a good idea. He uses adding filters to cigarettes as an analogy.

"You could argue that cigarettes today have never been safer, but they are still going to cause lung cancer," he says. "I would argue that football is in that position ... Once you start hitting kids in the head hundreds of times, maybe you're doing something wrong."

NOW WATCH: A high school football star turned down 6 college scholarships after seeing ‘Concussion'