In 2016, an NFL executive admitted that they were aware of the connection between CTE (Chronic traumatic encephalopathy) in the brain of their athletes and the repetitive brain trauma related to the sport. This was a turning point in how the league was forced to create the rulebooks, the severity to which they carried out the rules in real-time, a stricter fining and suspension policy, and a revamping of each teams seemingly complicit and negligent medical staff. The game was supposed to change. In 2019, just one Sunday away from Superbowl 53, it’s clear that two things have happened: the game cannot fundamentally become non-collision enough to prevent repetitive brain trauma in their players and that the few rules that do prohibit head-to-head contact are simply whistles and penalties that highlight, in slow-motion replay, the brain rattling high speed collisions that occur between each and every player on any given play.

A six second play involves 22 or 24 players running full speed with the intention of making collisions while leading exclusively with their torso. With three tools to make this contact: two shoulders and one head. This means that instances of repetitive brain trauma, moments when the brain sustains a concussion or a minor-concussion event, are not just inevitable, but the only way the game can work as it currently does.

Football needs to rethink what we can reasonably expect from these athletes. The mentality that is instilled in young football players is of the “hurt don’t mean injured” or “suck it up” variety. An insistence on toughness, walking it off, sticking it out, sacrificing your body for the team and never taking yourself out of the game because the next guy up will take your spot is instilled within young football players. And as they age, the sentiment will ossify and intensify until it eventually breaks them.

Fans play a role as well. Players are paraded in front of the crowd and given value for their ability to play the game well. Playing the game well means running faster and hitting harder. And playing the game means staying in after your bell is rung. It means not telling the truth to the trainers and the doctors. It means failing to inform people when you wake up with intense headaches, when your speech is slurred or when you can’t seem to focus.

The game is hard to change and the passionate culture around football is even harder. It will need to start at the grass-roots level. Coaches and parents need to pay closer attention to their athletes. More information needs to be gathered and more studies need to be conducted with a focus on youth football so that people can stem the effects of concussions and brain related trauma before they become chronic and debilitating. We need to afford our youth athletes the ability to take themselves out of the game without fear of disappointing their team, without being made fun of, and with the understanding that there is a life after the game.