There’s a common strain of thought out there that football is dying. And that thought is based on one assumption: Following the (horrifying) stories of former NFL players shooting themselves in the chest to preserve their brain for posthumous study, and subsequent studies that find signs of CTE in 110 of 111 former NFL brains, the game will collapse in on itself from the ground floor up, beginning with middle- and upper-class parents no longer allowing their sons to participate.
And while possibility should not be dismissed, it shouldn’t be taken as gospel, either. One person who doesn’t believe football is as dangerous as some fear — and who has the knowledge to know better — is Dr. Peter Cummings. Described as a “board certified in anatomic pathology, neuropathology and forensic pathology” on his Boston University bio page, Cummings posted an essay explaining why he allowed his 11-year-old son to play football in an essay for Yahoo Sports.
Cummings’s opinion is based on the data, or, really the lack of concrete data regarding CTE and football players. He writes:
The study population in the most recent CTE paper represents a biased sample, as stated by the authors themselves. This means only the brains of self-selecting people who displayed neurological symptoms while living were studied. This is important because this sample was not a reflection of the general football population. The study was based on 202 brains out of the millions of people who’ve played football – 111 of which are former NFL players.
So, when you hear “99 percent of football players had CTE,” that doesn’t mean that almost every football player will get CTE, and it doesn’t mean your child has a 99-percent chance of developing CTE if he or she plays football. It means 99 percent of a specifically selected study sample had some degree of CTE; not 99 percent of the general football population. This is an important distinction.
Because of this sampling bias, we cannot estimate the prevalence or incidence of CTE (meaning the total number of cases and the number of new cases expected each year in football players); nor can we establish risk or a cause-effect relationship between head injury and development of CTE. To do that you need a randomly selected population comprised of people with the disease and people without the disease.
In other words, we do not have a complete picture of what causes CTE, how common CTE is, or what the chance of getting CTE may be for anyone, or even what symptoms, if any, CTE causes.
Cummings cited one study that found the rate of suicide for players who played at least five players in the NFL from 1959-88 was “significantly less” than the rate of the general population, and another that found the rate of cognitive or emotional defects among 1950s high school football players to be in line with those that never played the game. Another study found that age of first exposure to tackle football did not significantly increase risks of head trauma later on in line.
To be clear, Cummings is not saying that CTE does not exist, or that it’s not a concern. He’s simply stating that what we know about football and brain injuries pales in comparison to what we don’t know, and what we do know does not begin to form a definitive conclusion.
“I made the decision to allow my son to play football after long deliberation over all the facts,” he writes. “To suggest this decision is child abuse is preposterous. I am a forensic pathologist, a neuropathologist, and a dad, and I let my son play football. That should speak volumes.”