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Chris Nowinski lived the athlete’s dream: playing high school football, then National Collegiate Athletic Association Division I football at Harvard University and then professional wrestling in the WWE.
But at just age 24, after more than a decade of contact sports, Nowinski developed a grueling “three-year headache” and REM (rapid eye movement) sleep behavior disorder—a condition in which people act out their dreams, sometimes dangerously. “I had to be sedated every night so I wouldn’t go chasing shadows, jumping off beds or putting people in headlocks,” recalls Nowinski, now 47.
Nowinski’s experience is extreme. But cognitive dysfunction, mood issues and brain damage can be the cost of repetitive blows to the head— a phenomenon first observed as “punch drunk” syndrome in boxers in 1928. Scientists now call this condition chronic traumatic encephalopathy, or CTE. It is a degenerative brain disease associated with dementia and early death. It’s rare, affecting less than 1 percent of the population; but among athletes playing contact sports, it is alarmingly common.
Nowinski retired from the WWE after a particularly severe concussion. Desperate to fix his pain, he decided to study head trauma, becoming a behavioral neuroscientist at Boston University and directing the Concussion Legacy Foundation.
Data he and his colleagues published last month in the BMJ suggests at least one in four former National Football League (NFL) players who died between 2016 and 2021 had CTE—Nowinski says this is an underestimate. Other analyses suggest about 40 percent of amateur athletes playing contact sports show brain changes that are characteristic of CTE, too.
“CTE is affecting far more people than anyone wants to accept,” Nowinski says. He puts his own odds of having it at 50–50.
Millions of amateur athletes play tackle football each year, and as evidence mounts at the professional level of the dangers of CTE, parents are increasingly worried about their children going into the sport. Some are banning their kids from taking up football; others defend it for building bonds and teaching life skills. Is high school football the new smoking, or are the health concerns overblown?
There isn’t strong evidence that playing at an early age is bad for you, but players need to be “developmentally ready,” says Jeffrey Strelzik, an assistant professor of child neurology at Children’s National Hospital in Washington, D.C. “Why would we have a small, wobbly five-year-old with poor neck strength tackle?”
“Any risk needs to be weighed against the benefits of playing team sports,” he adds.
Getting My “Bell Rung”
Garrit, a 33-year-old former college linebacker, who asked to be identified by his first name for privacy reasons, started playing tackle football at 10. He remembers getting his “bell rung” over the years. “You’d hit someone, and your vision would go fuzzy, and you’d hear this high-pitch noise,” he recalls. Later in his career, he slammed his head on the ground and couldn’t remember the plays for the rest of the game.
“It was on you to self-report, and there was incentive not to because you didn’t want to miss playing time,” Garrit says. “I knew if I said something, that was probably the end of my career.”
Players often downplay symptoms to stay on the field—and many signs of brain trauma, such as headaches, memory problems and fatigue, are easy to hide. CTE appears driven not by concussions but by countless small impacts that jostle the brain: say, a header in soccer or a punch in boxing.
For every diagnosed concussion, college football players sustain about340 hits harder than the median concussive impact. And in a single season, a high school or college football player absorbs an estimated 600 to 1,000 subconcussive blows.
These micro injuries don’t always announce themselves: the brain has no pain receptors, says Michael Buckland, a neuropathologist at the University of Sydney, who founded the Australian Sports Brain Bank. “If you twist your ankle, it bloody hurts. You don’t get that feedback from the brain,” he says. The exception is when the damage compromises basic functioning so much that you lose consciousness or have a seizure.
It’s the cumulative g-force to the head over years that puts people at highest risk, says Daniel Daneshvar, a neuroscientist and chair of physical medicine and rehabilitation at Mass General Brigham and Harvard University. Daneshvar co-authored the study that found that one in four NFL players had CTE with Nowinski and others, and he also played football through college.
“I learned a lot from football, and I want people to continue playing, but I want them to do it in a way that’s safer for their brains,” he says.
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