Dr. Robbins has recently written an Opinion Editorial on the Listserv of the Southern Headache Society. He has voiced his concerns regarding tackle football before the age of 18. While high school players have strong neck and shoulder muscles that can absorb some of the force, their developing brains remain vulnerable. The following is a portion of Dr.Robbins’ Oped.

We should eliminate tackle football before age 18. (1) I love the game, but as a neurologist and headache specialist, I have seen how football can harm a young person’s brain, and, by extension, life. Many of the millions of young players will live to ripe old ages, and we must protect their only brain.

Concussions are part of football, with the severity ranging from mild (feeling dazed) to severe (out cold). The brain is somewhat like Jell-O, cushioned by fluid. During medium-or high-impact collisions, when the helmet suddenly stops, the brain keeps going through the fluid, banging into the rigid skull. A cascade of events ensues. Billions (millions?) of nerve cells flood the brain with chemicals. Vital blood flow is disrupted. It takes days to months for the brain to revert back to normal (and sometimes it never does). Symptoms include headaches, dizziness, problems with concentration and memory, depression and insomnia. Some symptoms may linger for years. Players with multiple concussions have an increased chance of long-term problems that include chronic headache, lower GPAs, memory and emotional difficulties, dementia, and a host of other problems.

Equally disturbing are repeated knocks to the head that do not produce obvious concussion symptoms. A child who plays football from ages 7-18 will typically sustain thousands of hits to the head during games and practices over the years. High school players occasionally die from football. This may occur due to “second impact syndrome,” from returning too soon after the first concussion. Chronic traumatic encephalopathy (CTE) can result from many head impacts, and leads to death among NFL players and boxers. It recently has been identified in high school and college age players.

Short of banning tackle football, what can we do? Eliminating hitting in practice would help, as the majority of blows occur in practice. John Gagliardi, coach of St. John’s University in Minnesota, and the coach with the most wins in college football history, has not allowed tackling in practice since 1956. Certified trainers are important. Improved helmets help somewhat, but they are better for preventing fractures than concussions; mouth guards protect the teeth and mouth, but help only slightly with football concussions. It is crucial to educate coaches, parents, and kids about proper tackling technique, keeping heads up, and reporting concussions. Young children and adolescents, however, notoriously underreport concussions, so that they can keep playing. At least half of concussions go unreported. A buddy system, in which you are responsible for reporting your teammates’ concussion symptoms is beneficial. “Concussion Rules” listed in current state laws may help a bit, but serious brain damage can occur even without concussions.


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