Touch football at Thanksgiving, college and pro games on TV every Sunday, the Super Bowl — no wonder boys of all ages are inspired to pick up a pigskin. 

There's no question: Football is exciting. And playing any sport is good for kids’ bodies and minds. But are safety concerns about football making it an activity that’s not worth the risks? 

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Risky business or overinflated concerns?

Experts aren’t sure how often kids are being hurt while playing football. Injury rates (determined by number of injuries per exposure; a single practice or game is considered an exposure), are hard to quantify, according to neuropsychologist Elizabeth Pieroth, PsyD, associate director of the sports concussion program at NorthShore University HealthSystem in Glenview, Illinois. 

Concussions are the headline-grabbing concern. While one report found higher concussion rates among young ice hockey players, many others have found tackle football causes the most, Pieroth says.

“The most dangerous activity by total numbers, however, is bicycle riding, because so many kids do it,” says Robert Harbaugh, MD, director of the Penn State Hershey Neuroscience Institute.

It’s still safe to say that football players are at a relatively higher risk of serious injury than most other young athletes, for a variety of possible reasons.

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“Certainly one component is the overuse of the head when tackling,” says Pieroth. Ironically, an uptick in concussions occurred as helmet construction improved and more players began to use their heads as part of the tackle. “They were taught to aim their heads at an opposing player’s jersey number,” she adds. This practice is called "spearing."

Fortunately, says Harbaugh, the risk of neurological dysfunction from playing football is low. “The best available comparative work is from a Mayo Clinic study that looked at high school football players and their classmates in the band and glee club but didn’t find an increased risk of a neurodegenerative disease among the athletes later in life,” he says.”

Besides concussions, tackle football has been associated with paralysis caused by cervical spine injuries. Such injuries have become relatively rare since 1976, when the National Collegiate Athletic Association and the (NFSHSA) changed the rules about spearing. A 2004 report in the Journal of Athletic Training found the no-spearing rule significantly reduced the number of kids with cervical spine injuries. 

Heat stroke is another serious threat, one that takes the lives of high school football players every year. 

Playing it safe

If your boy is determined to suit up, here are some considerations to keep in mind. 

The best age to start. Is it more dangerous for very young kids to play football? “This is the million dollar question right now, but anything you read is strictly based on opinion, not empirical evidence,” stresses Pieroth. Lately, there’s a push to delay tackle football until age 14, which is based on the fact that younger children have heavier heads and less neck strength so they may be more vulnerable to injury.

There also are other physiological differences, such as thinner cranial bones, that may make little kids’ brains more susceptible to concussions.

On the other hand, some experts believe kids who learn how to tackle correctly — not using their heads — at an early age will be safer on the field when they’re bigger and stronger because they’ll be in the habit of using the necessary skills to protect themselves. “Nothing’s definitive, but I think there’s value in both opinions,” says Pieroth.

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The right way to tackle. There also has been a push to teach better (and safer) tackling techniques focused on using shoulders and arms, rather than the head. According to a joint recommendation from the Centers for Disease Control and Prevention and USA Football (the governing body for youth football), players are urged to practice “heads up” football, which means never lowering the head during a hit. Coaches should enforce this, and parents should as well.

A protective helmet.well maintained, properly fitted football helmet is as vital on the gridiron as a bicycle helmet is on a bike path. Coaches should demand wear helmets, but it’s also up to parents to make sure a young football player’s helmet is in good condition and that he wears it — chin strap buckled — at every game and at every practice.

The coach is critical. An experienced, knowledgeable coach can make a big difference in youth football injury rates. A recent study underscores how. The report, published in the Journal of the American Orthopaedic Society for Sports Medicine, found that kids who were taught to restrict contact during play had fewer injuries than those who didn’t receive this instruction. 

“Coaches also should be trained to recognize the signs and symptoms of concussion and encourage players to report them,” states Harbaugh. A player who’s suffered one concussion is at an increased risk of another if he returns to the field before he’s completely well.

Other considerations include the kinds of drills a coach leads and the tone he sets. “A coach who tells a player to ‘tough it out’ or ‘suck it up’ when he gets hurt isn’t creating an atmosphere where kids will feel comfortable coming forward with their injuries,” explains Pieroth.

The decision is personal. There’s strong evidence that playing a sport has many benefits for a child. Given that every activity has risks, if your son is passionate about football and may not be active if he doesn’t play, it’s an important thing to consider. Harbaugh and Pieroth each have sons who played football and hockey. Says Pieroth, “It’s a tough decision to make, but parents should base it on actual science and whether a particular sport is a good fit for the individual child,” says Pieroth. 

Do you let your son play football? Let us know why, or why not, in the comment section below. 

Jennifer Kelly Geddes is a New York City-based writer and editor who specializes in parenting, health and child development. She’s also the mom of two teen girls.