Imagining A Society That Enforces A "Legal Age" To Play Contact Sports

As physicians, it is our role to educate and inform an adult about the dangers of, for example, smoking... as a society, the question we have to answer is, when we knowingly and willfully allow a child to play high-impact contact sports, are we endangering that child?
— Dr. Bennet Omalu, from "Don't Let Kids Play Football"
 Will Smith plays Dr. Bennet Omalu in the film "Concussion" being released on Christmas Day. Source: https://babajidesalu.files.wordpress.com/2015/09/will_smith-bennet-omalu-jide-salu.jpg

Will Smith plays Dr. Bennet Omalu in the film "Concussion" being released on Christmas Day. Source: https://babajidesalu.files.wordpress.com/2015/09/will_smith-bennet-omalu-jide-salu.jpg

The Nigerian medical pioneer who was first to discover the brain disease Chronic Traumatic Encephalopathy (CTE), which has the NFL "balls deep" in anxiety, is in the headlines again for more than just the upcoming movie about his discovery and his clash with the colossal professional football league. Dr. Bennet Omalu published an opinion piece in the New York Times with a quite provocative title comprising of five uncomplicated words that together bring forth a transparent position: "Don't Let Kids Play Football".

To some, this suggestion is sacrilegious. To others, this suggestion is reasonable. Either way, he has the reader hooked because he wants you to detach - just for a moment - the love affair society has with contact sports, most notably football, and consider the parental instincts that science is now beginning to support. Can you imagine a society enforcing a "legal age" to play contact sports?

Dr. Omalu's Argument Centers Around Brain Development

Dr. Omalu states that the human brain becomes fully developed at about age 18 to 25. That much doctors do know. Doctors also know that repetitive concussions and non-concussion head impact are involved in the brain pathway causing CTE. What doctors do not yet know are the other contributory factors, how much is "too much," and when CTE actually hits. Since there are some unknowns, he emphasizes, "We should at least wait for our children to grow up, be provided with the information and education on the risk of play and let them make their own decisions."

He makes a compelling argument without a doubt. Repetitive blows to the head leave athletes at risk of permanent brain damage because the neurons we are born with cannot be replaced with new ones. So, once neurons are lost, they are lost. That loss is irreversible. That loss can lead to "major depression, memory loss, suicidal thought and actions, loss of intelligence as well as dementia," which are primary symptoms of CTE. We intentionally expose ourselves and, where applicable, our children to this risk that can be avoided 100% by not playing contact sports.

In the opinion piece's closing statement, Dr. Omalu strikes right through to the bone. "We have a legal age for drinking alcohol; for joining the military; for voting; for smoking; for driving; and for consenting to have sex," he writes. "We must have the same when it comes to protecting the organ that defines who we are as human beings."

It is all about protecting the most vulnerable organ in its most vulnerable developmental stages. His argument dissociates the brain from the organ that connects most of us to those contact sports we adore so dearly in the first place.

Whether Colleagues Support or Have A Different Opinion, There IS Discussion...

As one would expect, some in Dr. Omalu's field agree with him while others disagree with his proposition. Dr. Julian Bailes, who was one of Dr. Omalu's colleagues and is played by Alec Baldwin in the film "Concussion," is one who disagrees. This morning on ESPN Radio's the Mike and Mike Show, Dr. Bailes flat out disagreed with what Dr. Omalu wrote in The Times.

From his understanding, youth contact sport is not what we should be worried about. Once children reach high school level of play, i.e., once children reach a more adult-size and play with more adult-power to induce adult-hits, the number of hits increases dramatically. Dr. Bailes stated that there have been six deaths in high school football this season. At the high school level, there is also (hopefully) staff and coaches who are well educated in the seriousness of brain damage risk and can minimize that risk as much as humanly possible.

In his medical opinion, the risk for CTE begins in high school because of the style of play dramatically becoming more aggressive. If that is the case, then one could certainly argue that placing an age restriction would not have the great effect on CTE prevention that Dr. Omalu is pushing for because the people who have the greatest risk are those who play into college and especially those who play into the professional level. There have been no studies on kids who only played youth contact sports or who only played through high school since CTE research can only be done post-mortem. It is possible that having an age restriction (e.g., 19 years old) would not address the real problem - contact sports at the higher amateur and professional playing fields.

... But What Happens If/When We Take That Discussion & Turn It Into Action?

Science does not have to be the end-all, be-all that leagues like the NFL fear it to be. If we take action, we may need to concede that it may not be a permanent solution or that it may not be a big step. We need to reflect back at what contact sports used to be and consider them with the education and knowledge we have before us now. So, even if action is temporary or if it is a small step, shouldn't we take it? Furthermore, what will that step be?

Pause and imagine a society that does not allow children to play football until a certain age, e.g., Dr. Omalu's suggested age of 18 years old. If 18 years old is too drastic, try 13 or "high school age."

As we become more intellectually sophisticated and advanced, with greater and broader access to information and knowledge, we have given up old practices in the name of safety and progress. That is, except when it comes to sports.
— Dr. Bennet Omalu, from "Don't Let Kids Play Football"

If we take Dr. Omalu's proffered solution, it could be a temporary means to an end in a more distant future. An age limit (e.g., you must be 18 years old to play contact sports) could be a viable solution until the science and technology are ready to combat and prevent CTE without age restrictions. Researchers can only look for CTE post-mortem for the time being, though one test to officially diagnose it earlier is in the investigatory stage. Likewise, studies on this type of brain damage in general are in their infancy. CTE was not diagnosed for the first time until 2002. Compare that to the length of time we have studied other brain damaging behaviors such as smoking (about 50 years), drinking during childhood (more than 40 years), and using asbestos (about 40 years), and we are in some cases only learning the magnitude of resulting affects. Given that we have not been able to study brain damage like CTE for very long in retrospect, we must be okay with making whatever decisions we feel is right for ourselves and our children and, moreover, respect each others' decisions.

If we take Dr. Omalu's resolution, we could execute it, but it would not be without discord. The federal government could place an age restriction similar to the minimum drinking age and smoking age. Alternatively, if this is seen within each state's jurisdiction, the state could place an age restriction similar to the age for consentual sex, which varies by state between the ages of 16 and 18. Regardless, an age restriction to play contact sports would get a lot of backlash from a variety of social groups, but it would take a long time to develop such a law anyway. Maybe we can keep our fingers crossed that technology and science catch up more quickly than we think so we will not have to speculate about drastic changes such as this.

Law's purpose, generally speaking, is four-fold: (1) setting forth standards; (2) maintaining order; (3) resolving disputes; and (4) protecting various liberties and rights. On the one hand, an age restriction could provide order consistent with society's guidelines of children's safety. On the other hand, it could arguably violate constitutionally protected rights and liberties, like intruding too much into a parent's right on how to raise his or her child. Sometimes it is the parent who has the idea to enroll the child in a contact sport, and at other times it is the child who begs the parent to play. Both are parental decisions, and the parent has the right to make that decision until current law is overruled and federal law says otherwise.

Dr. Omalu's proposition has the potential to lead to a solution, but most of us do not want to stretch that far. In fact, I believe you can validly argue that sports, especially football, are safer than ever before. Sports cannot be "safe" because there is inherent risk similar to many other activities children participate in. However, we can realistically aim for "safer". Can you think of a less restrictive alternative to contact sports' brain damage dilemma apart from continuing to improve technology, or will the games be forced to change their style of play?

*CTE is a topic close to my heart, which is why I spent a great deal of time researching and writing about it during law school. (You can read my note in the Sports Lawyers Journal- Vol. 20.) If you would like to learn more about CTE and what you can do to contribute to Dr. omalu's paramount mission, check out what his foundation is all about. click here to learn more, donate, and get involved with bringing science into the limelight of sports so we can continue to enjoy them for many years to come.