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Despite contrary opinion, playing football causes CTELarry Fedora, the head football coach at the University of North Carolina, had a few interesting things to say last week.

Fedora believes that if football declines in the United States – due to links between playing the game and CTE, a chronic and debilitating brain disease – the country will decline as well.

“There will be the decline of our country, no doubt,” Fedora said at the Atlantic Coast Conference (ACC) football media days. “There’s no doubt in my mind. I think because of the lessons you learn in the game of football relate to everything that’s going to happen in the rest of your life. And if we stop learning those lessons, we’re going to struggle. And I think in some ways we’re struggling more than we ever have. Are we ever going to be a perfect country, no, not by any means, but I do think the game of football has had a major impact on who we are as a country.”


First of all, only a small minority of one gender actually plays football in the United States. Is that small minority responsible for making the country great?

Two, while there definitely can be some positive benefits from playing football (physical fitness, leadership skills, teamwork, dealing with adversity, etc.), all those benefits can be derived from playing other sports, or participating in a variety of other activities for that matter. One doesn’t need to bash one’s head hundreds – and in some cases, thousands – of times a year, as is the case in football, to reap those benefits.

Third, Americans are predominantly sports spectators, not sports participants. Does Fedora believe people can learn important life lessons by simply plopping down on the couch on Saturday or Sunday and watching football games while eating pizza and drinking beer?

Fedora touched on a few other topics that are worth addressing.

For example, he thinks the United States has a strong and powerful military thanks to football. His reasoning is that a general once told him that we are the only football-playing nation in the world (sorry Canada). Powerful military. Only football-playing country. Well, that surely must be a causal relationship, right?

But what about the fact that football has only been America’s major sport for 50 years, at the most? Before that, baseball was the clear national pastime and smart people like historian Jacques Barzun said that to know America you must understand baseball. In addition, the United States has had a tough and strong military during a lot of wars throughout its history, from the Revolutionary War on, and football wasn’t a big part of the culture during most of them.

These comments by Fedora, and others like them, are pretty benign. It’s just a football coach being a football coach. But when Fedora started talking about CTE (chronic traumatic encephalopathy) and football, that’s when things got scary.

Fedora’s not sure football causes CTE. He says there’s no definitive proof.

Well, technically, he’s right. There isn’t any definitive, absolute proof that football causes CTE and all the devastating effects associated with the disease. But there certainly is a giant mound of research suggesting a strong link between football and CTE.

First, CTE is a degenerative brain disease predominantly found in people who’ve experienced repetitive head trauma.

Second, and maybe most importantly, it’s not just concussions that we need to worry about when it comes to CTE and lifetime brain damage. It’s sub-concussive repetitive blows to the head in which the brain pounds into the side of the skull. A perfect example is the repetitive sub-concussive blows to the head that football linemen experience on nearly every play.

Most people associate CTE with the professional football players – specifically retired players.

But CTE is more than a pro football issue. While the Boston University CTE Center has discovered CTE in the brains of 110 of 111 former National Football League players (99 percent), it has also found CTE in the brains of 48 of 53 former college players (91 percent) who didn’t go on to play football in the NFL. Moreover, 21 percent of the 14 brains of former high school football players studied had evidence of CTE. And those players never played a single down of football beyond high school.

Admittedly, those are pretty small sample sizes (brains can only be examined for CTE after death) but the percentages are still quite scary.

A summary of all the studies linking football with brain injuries would be very long. So even without definitive proof that football can cause CTE, should youth and high school athletes be playing football, a game in which repetitive brain trauma is inherent? Especially when the brains of youth, high school and even college football players are still in the developmental stage (the human brain is still developing into the early 20s)?

Consider that Purdue University researchers have compared changes in the brains of high school football players who suffered concussions with the brains of high school football players who were concussion-free and found brain tissue damage in both. That’s scary. That means brain injuries are occurring without players, coaches or parents even being aware of it.

Wake Forest University researchers followed 25 boys ages eight through 13 over a season of tackle football. They placed sensors inside the players’ helmets to measure impacts. Players accumulated between 250 to 580 “crashes” during the season. MRIs of the kids’ brains before and after the season showed that those “who experienced more cumulative head impact exposure had more changes in brain white matter.” The stunning part is not one player had suffered a concussion. Brain damage had occurred without any concussions in the group. And, like the Purdue study, the players and the parents weren’t even aware of it.

“Just the routine hits changed the brain,” says Dr. Robert Stern, a professor of neurology and neurosurgery at Boston University. “That’s what parents need to hear.”

Andrew Lawrence recently wrote a comprehensive feature article in Men’s Health on the dangers of football. He wrote: “After a single injury, the cells’ default response is to clean up toxic proteins and chemicals. But when the head is hit time and again, that recovery sequence becomes overwhelmed. One consequence is a buildup of tau, an abnormal protein that clumps together and creates tangles that eventually choke brain cells to death. It can also spread to other cells and propagate, leading to CTE.”


No, we don’t have all the scientific evidence yet to absolutely state that football causes CTE. But we have enough to believe that playing football is one scary game of Russian roulette.

Fedora did suggest that kids shouldn’t play football until after middle school. That’s good. But due in large part to the fact their brains are still developing, football remains very dangerous for high school and college players.

“There’s something to the play of football that damages the brain,” says Dr. Ann McKee, a Boston University neuropathologist and the world’s preeminent expert on CTE. “That, to me, is irrefutable.”

Football is fun and entertaining. I played the game in my younger days and have long enjoyed watching it. I appreciate that coaches like Fedora – along with millions of fans – are passionate about the game.

But there are some realities that just aren’t fun to face and this is one of them: Football is very dangerous to the human brain.

For the sake of our young people, we can’t continue to avoid that reality.

Ken Reed is sports policy director for League of Fans (, a sports reform project. He is the author of Ego vs. Soul in Sports and How We Can Save Sports.

Despite contrary opinion, playing football causes CTE

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