Jovan Belcher, and Aaron Hernandez. A recent study of 111 deceased former NFL player’s brains
by the CTE Center at Boston University found that 110 of those players had CTE.
With a critical lens on CTE in the NFL, naturally, there has been an increased focus on the
effects of repeated head impacts in youth football as well. Research has shown that two of the key
indicators of CTE are: (1) the length of time over which a person has been exposed to repeated
sub-concussive head impacts, and (2) the age at which the person’s exposure to these head impacts
began. Athletes who are exposed to head impacts at a young age are more susceptible to CTE, and
those who experience head impacts before age twelve have worse outcomes than those whose
exposure began after age twelve.
At the youth level, depending on age, a child playing tackle football will experience 200-
500 sub-concussive head impacts per season. This number increases as the child ages, with the
average high school football player experiencing 600 sub-concussive impacts per season. At the
collegiate level, the average increases to around 1,000. These impacts are especially harmful to
younger children, as research has shown that the impacts suffered in youth level are comparable
to those suffered by collegiate football players, in terms of the level of force put on the brain during
impact. Children are also more susceptible to traumatic impact in many ways. Young brains under
age 12 have not fully developed myelin, or white matter, which protects the axons of the brain.
Without this myelin, axons can be destroyed by impacts, resulting in slower communication across
the brain. Furthermore, as important brain structures are not fully developed until the early teenage
years and blood-flow to the brain is lower in children, repeated brain trauma from head impacts
can impede these important development milestones. Recently, the New York Times reported on
the impacts a collegiate football player experienced in a single game, finding that the average g-forces exerted on his skull during these impacts was the equivalent of the player crashing his car
into a wall at 30 miles per hour. The player experienced sixty-two of these impacts during the
single game observed.
While it is the sub-concussive head impacts that are the primary cause of CTE, the data on
concussions alone in youth sports are cause for concern. Young children are the most susceptible
age group to concussions. Sports-related concussions are the cause of more than half of all
emergency room visits for children ages 8 to 13. A child that has had a concussion is one-and-a-half times more likely to sustain a second concussion, and a child that has suffered two concussions
is three times as likely to sustain a third. On top of this, young people who play football are unlikely
to report symptoms of a concussion, fifty-percent of high school athletes and seventy-percent of
college athletes have failed to report experiencing concussion symptoms.
II. THE PROPOSED BILLS
The four bills introduced thus far are relatively identical. Each begins with a statement of
purpose that largely speaks to protecting young children from the dangers of CTE caused by
repeated head impacts in contact sports. The bills differ slightly in their reach, with some explicitly
targeting tackle football, and others expansively covering numerous sports. Maryland’s bill
explicitly covers five sports—football, ice hockey, field hockey, soccer, and rugby—and has a
catchall provision for any non-enumerated physical activity with a high-risk of head injury. The