On a recent episode of The Dr. David Geier Show, I discussed the hotly-debated idea that many former NFL players would not let their kids play football. I received a tremendous amount of feedback by email or on Twitter and Facebook, and I have shared some of those opinions. I wanted to follow up that discussion with the thoughts of people whose opinions I feel hold a lot of value. The following post is a collection of opinions I received from prominent sports medicine orthopaedic surgeons, sports neurologists, pediatricians, and writers and bloggers very popular in the sports and sports injury world.

Wendy Sue Swanson, MD, MBE, Pediatrician and author of the popular blog Seattle Mama Doc – “A mom, a pediatrician, and her insights about keeping your kids healthy.” Follow her on Twitter (@SeattleMamaDoc). Her post, “If It Were My Child: No Football For Now,” largely inspired me to start this discussion. Click here to read her entire post, but these are her opening remarks:

This is a position post where I take a stand that represents no one other than myself as a mom and a pediatrician. The reason I clarify this, is that my position is a strong one. No one wants to go up against someone like the NFL, it seems. But let me say this very clearly: It if it were my child, I’d never let them play football. No way. For my boys, the risks are too large, the sentiments too cruel, and the gains simply not worth it. There are plenty of other sports teams out there to grow, exercise, form friendships, and excel. I never want my children to be a part of any institution that houses intent to harm another human being. Although direct harm may not be a tenet in pee wee football, we all know that young sports teams are built to emulate the pros. If the NFL is the inspiration, for now, count my boys out.

Brooke de Lench, Author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (Harper Collins) and Founder/Publisher of MomsTEAM.com – “The Trusted Source for Sports Parents.” Follow MomsTeam on Twitter (@momsTEAM).
My triplet sons played soccer, from the time they were five all the way through high school. In the seventh grade one of my sons switched to football and played linebacker until concussions took him out of the game in 2000, his sophomore year, and ever since that moment I have been deep in the trenches teaching parents what they need to know to keep their athletic kids in the game-especially their football players, many of whom vitally need the sport. There is no reason to eliminate football and every reason to teach risk reduction of getting multiple concussions. Many boys, not only want to play football but they absolutely need to play sports like football. In fact, my soccer playing sons received more concussions than my football son. It is my belief that playing many sports such as; soccer, bike riding, cheer sports, surfing, skiing are equally, if not more dangerous than football where (and if) proper risk reduction is incorporated into the program.

Football player lands on helmet

Steve A. Mora, MD, Orthopaedic sports medicine surgeon in Orange County, California; Read his blog or follow him on Twitter (@myorthodoc).

In regards to football and my own children. Playing football certainly increases the chances of extremity injuries as well as concussions. I’ve seen so many football injuries in my career that it really does make me think twice about letting my kids play. At the same time my viewpoint is skewed because I only see the injuries. Overall most kids on a football team remain injury free.

So Yes, if my children were passionate about football, I would allow them to play as long as they were not getting repeatedly injured. I would not allow my children to play if they suffered a single concussion. I would also shut them down if they endorsed signs of cumulative trauma. Albeit I would not encourage them to play unless they were really passionate.

Now soccer is a different story. I love the sport, so I would certainly encourage it. I actually did encourage my girls to play “futbol” but unfortunately my 10 year old sustained an ACL tear.

Denise A. Somsak, MD, Pediatrician and author of the popular Pensive Pediatrician blog. Follow her on Twitter (@Dr_som).
It’s easy for me to say I would not let my children play football because I have two daughters and a cognitively disabled son who could never learn to play. I wonder why when children are born with normal, beautiful brains, parents risk head injury. But parents also let their children ride bikes, drive cars, operate ATVs, go snowboarding, play hockey, skateboard, & ski….it all comes with risk. Football is like religion for some families with deep tradition and expectation. I do wish coaches and parents could be less serious about it especially in grade school kids where size differences and ability among players can be significant. I wish there were more options for organized touch football or at least less competitive leagues. Wrestling and football are the major sports that prohibit women/girls. I do think that produces a more macho/aggressive game. Heck girls at my college played in a women’s hockey league but never football.
Bottom line…I think football is ok if the risks are understood and the child is not pushed beyond his limit.

Don't let an athlete return to the game after a concussion

Ford Vox, MD, a physician and journalist living in Boston. A brain injury specialist, he is the Medical Director and attending physician for the acute inpatient acquired brain injury program at New England Rehabilitation Hospital, and a Clinical Assistant Professor at Tufts University School of Medicine. He will be joining the brain injury program at the Shepherd Center in Atlanta this summer. Follow him on Twitter (@fordvox).

If I had a son, I would steer him towards other sports. The key issue is whether children can really give “informed consent” for sport. I don’t think they can, so parental judgment will have to supplement the child’s preferences. Once a kid is mature enough to take on responsibilities like driving and voting, if they remained passionate about football, I’d make sure they know the apparent risk, but they’d receive my support in their choice. While the prefrontal cortex continues to develop well past 18, societal norms recognize our maturity before that point and I think as a parent you are somewhat obligated to parent according to the standards of your community. Parenting is pragmatic.

Andrew Blecher, MD, Primary Care Sports Medicine, Southern California Orthopaedic Institute. He wrote a recent column in the Los Angeles Times offering his opinion on this subject. Follow him on Twitter (@the_jockdoc).

I have a 4 year old son, so this is a relevant question for me.

Qualified yes. Football has much to offer but also comes with significant risks. When he is old enough and mature enough to understand these risks and make an educated decision then I would let him play. However, I truly believe that the long term cognitive decline consequences of playing football are not due to a few concussions but rather due to the repetitive sub-concussive hits to the head that occur on a daily basis. Therefore, I would STRONGLY recommend that he not play lineman, linebacker or running back.

Laurie Golden, who describes herself as “Sports mom turned blogger with winning ideas for sports parents. I’ve got minivan miles and dirty sports laundry cred up the wazoo.” Read her blog Trophy Mom: Winning ideas for sports parents or follow her on Twitter (@TheTrophyMom).

Hockey hit
As a mom, I still shudder involuntarily when I see my kid, or any other player, take a hard hit. And then I hold my breath until I know they are ok. Every sport is potentially dangerous, but playing contact sports like football and hockey are inherently more dangerous, ripe for concussions and spinal injuries. My three kids have played around 33 combined years of hockey, while suffering only one concussion, and although injuries are always a concern, good coaching and a focus on safety can mitigate a lot of the dangers and put a mom’s worries to rest.

Your child’s coach should be teaching the players how to protect themselves: how to take a hit or a check, learn where the danger zones are on the ice, learn how to skate at an angle into the boards instead of straight on, etc. A good coach will also teach a player how to deliver a hit to minimize the risk of injury to himself and the opponent: hands down, not blind, not in the back. One of our coaches stressed that a hit was meant to separate the player from the puck, not the player from his head.

Also, I think your attitude as a parent has a lot of influence about how your kids play. Do you get caught up in the macho? Are you praising the skill and effort, or are you going on and on about “blowing that kid up” and the big hits? Are your providing proper equipment, like a protective helmet that fits well, or do you hope that he’ll grow into the one his older brother wore four seasons ago?

There are ways to reduce the risks of contact sports but you can’t make it completely safe, which is true of everything. If your program isn’t teaching safety and stressing safe play, then don’t allow your player to suit up. It’s a family decision.

Christopher Geary, MD, Orthopaedic surgeon, Chief of Sports Medicine at Tufts Medical Center in Boston. Follow him on Twitter (@ChrisGearyOrtho).

My son is 16 months old, so I’m sure a lot more data will come out before I am confronted by this decision, and hopefully effective new safety measures will be instituted. Right now, though, I would say that I would not intentionally steer him to football but I would not specifically prohibit him from playing. Not that I wouldn’t be nervous every time he took the field to some degree, but if he came to me and wanted to play I would let him.

Ironically, having played rugby for 10 years, I think I would prefer if he play that. Despite my badly arthritic shoulders…

Rugby scrum

Finally, Jonathan Edwards, MD, Professor and Chief of Neurology at the Medical University of South Carolina and Director of the MUSC Sports Neurosciences Program. His expert opinions are featured in my “The Hidden Dangers of Concussions” and “Colts’ Collie should serve as a warning to all athletes” columns for The Post and Courier.

The short answer is no.

I enjoy watching football, but I think the current state of the game is that hard hitting, hard tackles, head injuries, and other chronic residual ailments are so commonplace that I would steer them to other sport options.

There has been some progress in terms of equipment, changes in rules, shifts in focus in coaching, but for my own kids, I would prefer other ways for them to get exercise and learn teamwork.

If their choices were between football or being an obese couch potato, that would be different. However, they have so many great sports and activities to choose from.

I must also say that I have an easy out in saying that, since my kids are really interested in other sports – and aren’t really interested in playing football, so it’s easier for me – I don’t have to say no.

If their heart were truly set on football, I don’t know. It is always hard to know what you “would” allow if it were truly important to them, especially if it were your own kids rather than a theoretical question. My wife and I would do what we could to encourage other sports though.