Running interference on youth football injuries

Signs observed by parents or coaches Symptoms reported by children and teens

Over the last decade, participation in youth football nationwide has declined about seven percent.

The Sierra Youth Football League—a feeder league for high school teams—has seen similar numbers locally. In 2018, the league had just under 1,200 players, mostly boys and a few girls, ages 5-14. Lately, about 100-150 fewer kids sign up each year.

Why the decrease? Some blame income equality. “Among richer families, youth sports participation is actually rising. Among the poorest households, it’s trending down,” the Atlantic reported in 2018. Some blame video games for taking up too much of kids’ time and attention. (Though sports video games like Backyard Baseball and Madden NFL have been praised for teaching young athletes terminology and techniques, bolstering kids’ understanding of real-life sports.)

Rollins Stallworth, coordinator for the Washoe County School District’s Department of Activities and Athletics, listed some other factors, too. Numbers for youth sports in general have declined, he said, and football has probably lost a few players to soccer, tennis, golf and lacrosse, all of which have become more popular in recent years.

And then there’s the factor that seems to be on everyone’s mind—safety.

Concern over concussions

Stallworth referred to “the concussion epidemic,” among young football players, which CNN defined as “a brain injury epidemic that affects 4.5 million players who are still too young to play in the NFL.”

A concussion is a brain injury usually caused by a blow to the head. It can affect memory, judgment, reflexes, speech, balance and muscle coordination. In the short run, a concussion can cause confusion, dizziness and headaches. Repeated concussions can lead to dementia and brain damage.

A report to Congress from the Centers for Disease Control and Prevention referred to concussions as “the silent epidemic” because symptoms—impaired memory, for example—are often not visible.

Brian McGee is the football director for Sierra Youth Football League. “The league has seen a consistent decline in numbers since the time the concussion movie came out,” he said.

He was referring to the 2015 film Concussion, in which Will Smith plays real-life pathologist Bennet Omalu, who, in 2002, performed an autopsy on former Pittsburgh Steelers center Mike Webster. Webster had suffered mental health problems and committed suicide at age 50. Omalu diagnosed Webster with CTE—chronic traumatic encephalopathy—a condition that can cause debilitating memory loss, depression and sleep disturbances. It’s linked to concussions and other head injuries, both common enough in football that in 2013, the NFL settled a $765 million lawsuit filed by around 4,500 players and their families, who accused the organization of concealing its knowledge of the dangers of such injuries. The film and the lawsuit both led to increased awareness about concussions.

Countless opinion pieces have since argued that kids shouldn’t play tackle football at all—including one in the New York Times by Bennet Omalu, the pathologist played by Will Smith in the movie. There have also been countless opinion pieces—including some by doctors—arguing that kids should keep playing football, and that there’s a lot that adults can do to make it safer.

Making kids football safer

Now that the health risks of football have been in the national spotlight for several years, coaches and administrators have had time to respond with new policies and procedures.

“USA Football, the governing body of youth football across the U.S., has made major changes,” said Stallworth. “Limited contact, new, improved coaching techniques. They’re attacking this issue aggressively.”

In December 2018, Renown held a concussion summit in Reno to teach coaches, parents and athletes how to identify and address concussions.

Stallworth said that protective gear for kids has improved. Designs for mouthpieces, chinstraps and helmets have been tweaked in recent years, which has prevented injuries. And the school district takes an additional measure. “Every helmet has to go through a reconditioning process after every season,” Stallworth said.

He added that coaches and administrators have become more cautious about identifying and monitoring concussions. “We’re keeping a kid out who might have a slight headache, and we’re keeping that kid out for an extended amount of time,” he said. “A kid can be out for 10 days. Even if there’s a symptom of a possible concussion, we go into protocol.”

Brian McGee from Sierra Youth Football League said that, in the past, “We were probably doing things incorrectly. We were throwing safety out the door.” But now, in his league, running full-speed at an opponent from 10 yards apart is not allowed. And his coaches take USA Football’s online safety certification course, which teaches them how to prevent heat exhaustion, identify and respond to concussions and cardiac arrest, and teach safer blocking and tackling techniques.

McGee also said that, once kids are ready to start high school football, the safest thing they can do is to show up prepared. “If you ask any football coach, it’s dangerous to have high schoolers who haven’t played before,” he said. “They need to know how to block properly, how to be tackled properly. … We want to introduce people to tackle football.” His youngest players, 5- and 6-year-olds, have the option of flag football or tackle football.

In many high schools, including local ones, the amount of contact time is limited in the name of safety. “In the younger divisions, I’m opposed to that,” McGee said. It may sound conterintuitive, but he’s thinking about safety. “If we only were allowed to have contact for 20 minutes a week, my concern with that is—we get onto game day, and we’re in a live action situation,” he said. When it comes to younger kids and contact, he reasoned, learning to do it properly is safer than avoiding it. “I could see limiting contact when they’re in high school,” he added.

“All levels of football have worked hard to change the culture,” said McGee.

“Everyone’s being a lot more cautious,” said Stallworth.

Spotting a concussion

Children and teens who show or report one or more of these symptoms may have a concussion or other brain injury.

• Appears dazed or stunned

• Forgets an instruction, is confused about an assignment or is unsure of the game, score or opponent

• Moves clumsily

• Answers questions slowly

• Loses consciousness, even briefly

• Shows mood, behavior or personality changes

• Can’t recall events prior to or after a hit or fall

• Headache or “pressure” in head

• Nausea or vomiting

• Balance problems or dizziness, or double or blurry vision

• Bothered by light or noise

• Feeling sluggish, hazy, foggy or groggy

• Confusion, or concentration or memory problems

• Just not “feeling right” or “feeling down”

SOURCE: Centers for Disease Control fact sheet