Youth football accounts for nearly one in five sports-related brain injuries, and repeat hits are common

American Academy of Neurology

Nineteen percent. That is the share of all sports-related traumatic brain injuries in children and young adults that come from a single sport: football. Soccer is second at 11%. Basketball is third at 10%. No other activity comes close.

Those numbers come from a preliminary study of more than 72,000 young athletes, set to be presented at the American Academy of Neurology's 78th Annual Meeting in April 2026 in Chicago. The findings add hard data to a debate that has been simmering for years about when and whether children should play tackle football.

The repeat injury problem

The raw count of first-time brain injuries is concerning enough. But the study's findings on repeat injuries may carry more weight for parents and policymakers. Among youth football players who sustained a TBI, 37% went on to experience another one, compared with 32% across all sports studied. That five-percentage-point gap matters because research increasingly suggests that cumulative brain trauma, not just individual hits, drives long-term neurological damage.

The study, led by Dr. Steven Wolf of Boston Children's Health Physicians in Hawthorne, New York, drew from a health records database to identify 72,025 children and young adults aged 25 or younger who had experienced their first sports- or recreation-related TBI. The average age at injury was 14. About 32% of cases occurred in girls.

Sports and activities in the dataset included soccer, basketball, cycling, skiing, snowboarding, running, baseball, hiking, roller skating, skateboarding, wrestling, cheerleading, ice hockey, lacrosse, field hockey, and volleyball, in addition to football.

Headaches, vision loss, and mood disorders

To assess longer-term consequences, researchers matched each athlete with a TBI to an athlete of the same age and sex who had sustained a lower-leg fracture during similar activities but had no history of brain injury. This comparison allowed them to isolate the effects of TBI from general sports injury risk.

Among football players specifically, those with TBI had a 23% higher risk of chronic headaches compared with those without brain injury, along with a 5% higher risk of visual impairment (including double vision and, in rare cases, complete blindness), a 5% higher risk of anxiety, a 3% higher risk of depression, and a 1% higher risk of substance use disorders.

The timing of injury also mattered. Brain injuries sustained at younger ages were associated with developmental and mood disorders, while those occurring in older adolescents were linked to substance use disorders. That age-dependent pattern suggests that the same injury may have different consequences depending on where a child's brain is in its development.

What the data can and cannot tell us

The study has a significant limitation that the authors acknowledge directly: because the data come from clinical records, many TBIs are logged without a documented cause. Researchers had to attribute injuries to specific activities based on available information, which introduces some uncertainty. It is possible that some injuries were misclassified.

The study is also preliminary and has not yet undergone full peer review. It will be presented as a poster or oral session at the AAN meeting, with publication of the complete findings expected to follow.

Still, the sheer size of the dataset, more than 70,000 cases, gives the findings statistical heft. And the consistency of football's outsized role across multiple measures (total TBI count, repeat injury rate, and association with long-term health consequences) makes it difficult to dismiss the pattern.

Delaying tackle football and limiting repeat hits

Wolf frames the findings as a public health priority rather than an indictment of football itself. His recommendations focus on two interventions: delaying the age at which children begin tackle football, and finding better ways to limit repeat injuries once players are participating.

Several major medical organizations have already recommended against tackle football before age 14, though enforcement varies widely. Pop Warner, the largest youth football organization in the United States, has implemented some rule changes to reduce head contact, but participation in tackle football still begins as young as age 5 in many programs.

The question is not whether football carries brain injury risk. The data on that point are now extensive. The question is what level of risk is acceptable for developing brains, and whether the sport can be modified enough to change the equation.