Evan Hansen was born to play football. A strong, rambunctious kid, he started playing sports year-round as early as he could. "He was very selfless, always willing to sacrifice himself for the betterment of the team," says his father, Chuck Hansen. As a fearless linebacker at Wabash College in Indiana, the young player made 209 tackles in his first three seasons, and was hit far more than that during games and practices. Two days after winning the second game of his senior year, Evan died by suicide.
Searching for an explanation, Chuck Hansen pored through his son's internet search history. One query popped out: "CTE."
CTE stands for chronic traumatic encephalopathy, a neurodegenerative brain disease that causes symptoms like memory loss, depression, and emotional dysregulation. Since 2005, it has been linked to head trauma and to contact sports like football, where brains can get knocked around during tackles and collisions. In 2016, the National Football League acknowledged that the sport was linked to CTE after many retired players were diagnosed posthumously by researchers at the Boston University CTE Center.
[...] This study reveals that young, amateur athletes aren't spared from the brain damage that comes with contact sports, even if they quit before going pro. And studying early-stage CTE in young, otherwise healthy brains, McKee says, "may give us clues as to how the disease is triggered." To her, the takeaway is clear: "We need to reduce the number and the strength of head impacts in contact sports. If we don't, we're going to face consequences like this."
[...] A common misconception is that a one-time impact can lead to neurodegeneration. The real problem is getting hit in the head over and over, for years and years. "A tennis player who had five concussions is not going to get CTE," says Nowinski. "There's something about getting hundreds or thousands of head impacts a year. That's what triggers it, whether you have concussion symptoms or not."
[...] But CTE is preventable. Small changes to practice drills and gameplay could make a huge difference for young athletes, says Nowinski. The playbook for prevention is simple: Reduce the number of hits to the head, and reduce the strength of those hits. Most happen during practice, so by reducing the number of drills involving head impacts and choosing ones that are less likely to cause high-magnitude blows, coaches can spare their players unnecessary danger. "You can't get rid of CTE in tackling sports," adds Nowinski, "but you can get rid of most cases of CTE."
Reducing the length of each game and the number of games per season can minimize the likelihood of head injuries, and banning brain-jostling events, like fighting in hockey or heading in soccer, can make games safer, he continues. Perhaps most importantly, youth sports leagues can raise the age at which kids are first exposed to preventable head impacts. "With tackle football before 14, the risks are not worth the benefits," Nowinski says. "You don't become a better football player from playing young." In one case study reported by the US Centers for Disease Control and Prevention, transitioning from tackle to flag football would reduce a young athlete's median number of head impacts per season from 378 to eight.
But, Nowinski points out, there is no central governing body in charge of youth sports leagues, leaving it largely up to individual coaches to make changes to their practice drills and recruitment strategies. "The opportunity is right in front of our faces," says Nowinski. "I remember being told how much football makes you a leader. But right now, on this issue, there's a black hole of leadership."
McKee doesn't think that parents should take their kids out of sports—far from it. "We just need to change the rules and our thinking about these games, so that CTE isn't a consequence of playing contact sports," McKee says.
And for young athletes concerned about CTE, she urges them to seek help for mental health symptoms, build personal support systems, and keep moving forward with their lives. "Individuals like Evan need to be seen, because in all likelihood, we can treat their symptoms and help them feel less hopeless," she says. "It's not a time to despair. It's a time to come in, be evaluated, and be treated."