By YASMEEN ABUTALEB
Capital News Service
COLLEGE PARK – Before each football season, 10-year-old Ryan Holt must undergo baseline testing for concussions. Now in his fourth year of tackle football, Holt’s coach limits contact drills in practices each week, and players are reprimanded for unsafe behavior on the field.
Holt’s team, part of the Mid Maryland Youth Football Conference League, is one of many across the country to put in place such safety measures. It’s part of increased efforts in youth football to improve safety and better protect players from head injuries in the wake of publicity over NFL players who suffered degenerative brain disease after years of playing the collision sport.
The NFL came under fire for failing to properly train coaches and players to identify concussions and help prevent them.
Some of the guidelines implemented in youth leagues include limiting contact drills in practice and teaching players safe tackling technique to prevent unnecessary head collisions and injuries.
“It is a concern, but I don’t think it’s unique to football,” said Reggie Holt, Ryan’s father, who said he played football through middle school and high school. “To a certain extent, it’s just a byproduct of being in a sport.”
Steven Rowson, a researcher who studies head impacts in sports at Virginia Tech, said physicians and researchers have seen an increase in reported and diagnosed concussions in the past 10 years, indicating more awareness and understanding of head injuries.
“We’re seeing a reduction in the underreporting rate,” Rowson said. “Statistics say concussions are increasing across sports, but that’s not necessarily true. People are more aware, more likely to report it and get it properly treated.”
STEPS TO A SAFER GAME
The Centers for Disease Control and Prevention reported a 62 percent increase from 2001 to 2009 in the number of visits to hospital emergency departments for sports- and recreation-related concussions and other traumatic brain injuries for those 19 years old and younger. The center noted the increases may be a result of increased participation in sports and more awareness in identifying these injuries early on.
A 2013 NFL-funded report found that the average high school football player is nearly twice as likely to suffer a brain injury as a college player, and the sport remains unsurpassed in its concussion rate at the interscholastic level. High school football players incur head injuries at a rate of 11.2 concussions for every 10,000 games and practices, compared to a rate of 6.3 concussions at the college level, the report found. By comparison, high school boys’ lacrosse, which ranked second among high school sports, had a concussion rate of 6.9 for every 10,000 games and practices, according to the report.
Few studies have analyzed concussion rates in athletes younger than high school age.
Some of the country’s largest youth athletic organizations have enacted rule changes in the past five years to try to make the sport safer. Pop Warner Football, a nonprofit that provides youth football programs across the country, put in place measures similar to those of the Mid Maryland Youth Football Conference League. Pop Warner’s policies include limiting practice contact drills to one-third of practice time and teaching safe tackling techniques.
“This is something we’re learning about very quickly and focusing on,” said Josh Pruce, Pop Warner’s national director for media relations.
Yet most youth leagues don’t have athletic trainers on hand at practices and games. Instead, it is up to coaches and parents to identify concussion symptoms. In contrast, many high schools employ athletic trainers, who are health professionals who receive training in how to spot and treat concussions.
And some activists and physicians say the rules modified in youth play don’t go far enough. Dr. Robert Cantu, clinical professor of neurosurgery at Boston University School of Medicine and director of sports medicine at Emerson Hospital in Concord, Mass., recommends children refrain from playing tackle football until age 14 because young athletes are especially susceptible to concussions. In his book, “Concussions and Our Kids: America’s Leading Expert on How to Protect Young Athletes and Keep Sports Safe,” he points out that children and adolescents don’t have fully myelinated brains, which means they don’t have the coating and insulation of adult brains.
Cantu’s co-author, Mark Hyman, noted that children’s brains are also lighter than an adult’s — so less force can “put a child’s brain into motion more violently” against the skull.
Support for tougher restrictions on youth football is growing. A November 2013 poll from the Robert Morris Polling Institute showed more than 40 percent of Americans support a ban on young athletes playing contact football before high school. Similar polls were not conducted in previous years.
A Wall Street Journal/NBC News poll conducted this year found that 40 percent of parents would encourage their children to play a sport other than football because of the fear of concussions.
Additionally, several studies have recommended that youth football practices should limit contact drills, including Rowson’s research team’s study, published in the Annals of Biomedical Engineering in 2012. A study in the same journal, published in December, stated that head impact exposure in youth football “may be appreciably reduced” by limiting contact drills.
More than 4,000 former NFL players are embroiled in a lawsuit with the league demanding it pay for medical exams, concussion-related compensation, medical research and litigation expenses for brain injuries incurred while playing. Shane Dronett, a former player, committed suicide at age 38, and scientists found evidence of chronic traumatic encephalopathy (CTE) in his brain, a degenerative brain disease caused by repetitive brain trauma and even subconcussive hits to the head. His wife is a plaintiff of the case.
Participation in youth tackle football fell following this scare. USA Football reported a 6.7 percent participation drop in football among 6 to 14 year olds between 2011 and 2013. About 3 million kids under the age of 14 participate in organized football.
“Think about the sport. The point is to knock your opponent silly,” said Hyman. But, he said, “The game is far too popular, with parents and coaches, for it to disappear.”
Maryland’s concussion law, passed in 2011, mandates that students suspected of incurring a concussion during a game or practice be removed from play and only allowed to return after clearance by a licensed medical professional. It also requires the state education department to implement concussion awareness programs for coaches, school faculty, student athletes and parents and guardians. The law is mainly geared toward school-sponsored programs, but also has provisions that pertain to community groups.
Although Reggie Holt said he doesn’t worry often about his son’s safety, he said he would not be opposed to improving safety measures in the games. The Hyattsville, Md., resident said he expects to worry about his son’s safety more when he reaches the high school level, when players are more aggressive and the game is played at a higher speed.
The best way to continue improving concussion prevention is a multi-pronged approach, Rowson said. Many researchers agree that some of the best measures include limiting the number of head impacts through reduced contact drills; teaching players better technique so they don’t tackle in a way that puts themselves and other players at increased risk; and ensuring players have the best protective equipment.
But Reggie Holt said his son’s football practices are significantly safer than his own in middle school and high school. He distinctly remembers a drill, which most coaches no longer use, called “bull in the ring”: One player stands in the middle and a scrum of players surrounds him. The coach then calls out players’ numbers, and “the guy in the middle gets pummeled by people on the outside.
“I think coaches and the game itself now are a lot smarter about what are good exercises and what are not in terms of developing strength,” Holt said. “But I’m fine with some more rules to make it safer.”