Study reveals alarming prevalence of CTE in younger athletes, urging early intervention

A new BMJ analysis shows that chronic traumatic encephalopathy is widespread among former NFL players and increasingly detected in younger athletes, prompting calls to limit head impacts early in children’s sports.

A new BMJ analysis has intensified concern about chronic traumatic encephalopathy, or CTE, in former NFL players, but the larger lesson may sit further down the sports pipeline. According to the study, 235 brains from former NFL players who died between 2008 and 2021 were examined, and 93.5% showed signs of the degenerative disease, which has been linked to repeated head impacts and a higher risk of dementia. That does not mean every former player developed CTE, but it does suggest the problem is more widespread than many families may realise.

The study’s findings are unsettling because CTE is not a condition confined to elite professionals. Research cited by The BMJ has repeatedly found the disease in college, high school and amateur athletes, while a National Institutes of Health study reported CTE in 41% of 152 deceased contact-sport athletes under 30. Those results point to a pattern that begins long before the NFL, when children and teenagers are first exposed to repetitive contact.

That is why experts who argue for change at the youth level say concussion protocols alone are not enough. Chris Nowinski, co-founder and chief executive of the Concussion & CTE Foundation, has said such measures are designed to spot injuries after they happen, not to stop the repeated blows that can accumulate over years. He argues that many damaging hits never trigger an obvious concussion, meaning players can absorb harm without anyone realising it.

Nowinski also dismisses helmets and padded helmet covers as a complete answer. They may blunt some impact, but there is no evidence they prevent CTE, and reassurance based on equipment alone may encourage riskier play. His preferred solution is straightforward: remove repeated head contact from children’s sports wherever possible, with flag football rather than tackle football as the clearest example. He says the same logic applies to hockey, rugby, wrestling, boxing and soccer, and that children should not head the ball until at least age 14.

There are signs that concern about the disease is spreading beyond medical journals. A separate BMJ survey found that about a third of former American football players believe they may have CTE, reflecting growing anxiety about the long-term effects of the game. Yet Nowinski says no major youth football or other contact-sports organisation in the United States has fully acknowledged the risk in the way the NFL and college football have. For parents, his message is blunt: the first and best chance to prevent CTE is to reduce head impacts before children ever reach the professional game.