The question
My son wants to join the high school football team, but with all the news about concussions, I am too worried about his safety and I told him no. Was this the right move?
The answer
If your son is really motivated to play football, I would encourage you to focus on all the positives, which for me, outweigh the risks.
Things to immediately consider: Has he ever played football before? How experienced is he? How big is your son compared to his peers? Has he ever had a concussion?
If it were me, and my son had some experience that was comparable to or even better than his teammates – and had never had a concussion – I'd let him play.
That said, I understand your fears, given all the news the past year about concussions. In the 24 years that I have been a pediatrician, I have never seen as many experts weigh in on this one topic.
In most articles on concussions, there are no definitive answers. Frequently, experts have conflicting opinions about the investigation, management and prevention of concussions. The best they can do currently is to meet and discuss the available evidence as strong, weak or none at all.
We will never know exactly how severely an acutely concussed brain was damaged. It is enclosed behind the skull and hard to study directly. The damage is determined by subjective symptoms - headache, dizziness subsiding in a week, for example, all the way to permanent cognitive impairment (according to the Canadian Pediatric Society's position paper on concussions).
There is insufficient data to predict exactly how likely long-term damage is to ensue after repeated concussions. Anecdotally, some retired NFL players have a higher incidence of dementia and Alzheimer's disease.
The decision is ultimately yours - if you are worried about your son's safety in sport, then prohibiting him from playing might be an option. If, though, your worry stems from media reports on concussions alone, I'd reconsider your decision.
Perhaps you can rethink your choice after you do more research. These resources are very helpful: www.thinkfirst.ca and www.casm-acms.org.
Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com.