“Football is, after all, a wonderful way to get rid of your aggressions without going to jail for it.” ~ Heywood Hale Brown, sportswriter
The distinctive “pop” of a bracing football hit can bring cheers from the crowd, but can also cause some of the sport’s most tragic injuries. A player’s protective equipment is meant to safely distribute the impact of the forces during a hit, but that doesn’t always happen. The force can be absorbed to the head, and when that impact reaches around 100 g-forces — equivalent to smashing your skull against a wall at 20 mph — a concussion occurs, according to the University of Michigan. And a concussion has the potential to lead to significant brain problems, which local high schools and the medical community are aiming to combat using modern tools.
National concussion attention has cast a doubtful shadow for parents of high school athletes, but local coaches and medical experts are assured there is progress away from Draconian old-school mentalities, and they believe football can be seen as a positive and healthy game. The schools have implemented a series of modern measures to increase safety: from the equipment they use, to thoroughly evaluating kids if they are suspected of being concussed, to changing the culture of concussions.
The growing concussion concerns have added to the challenge of keeping local football programs alive in the small community. North Tahoe High, Truckee High, and Incline High’s football programs are competing to recruit players in a community saturated with every sport possible. North Tahoe even had to cancel their season in 2014 due to lack of players, but are back for 2015.
“Concussions are no longer a ding. This is a brain injury. There’s a chance if we don’t treat it properly that kids won’t be able to develop normally mentally… but there is a gradual changing of the culture around it and we are treating them far more conservatively,” said Dr. Nina Winans, a medical consultant for the Tahoe Institute for Rural Health Research (TIRHR), a program within Truckee’s Tahoe Forest Hospital, that administers a series of safety measures related to head injuries for all students in the Tahoe Truckee Unified School District.
“I understand the seriousness of concussions.” ~ Peyton Manning, 39, NFL Quarterback
The publicity over concussions started in the NFL, where studying the brains of deceased players revealed that Chronic Traumatic Encephalopathy, a progressive degenerative brain disease, was occurring at an alarming rate — in 87 of 91 players by one account — and is linked to concussions. This finding led to an outcry, and it further raised concern for all concussions. In particular is the high school athlete, where concussions occur in greater numbers and can have different effects compared with adults.
Concussions are a minor traumatic brain injury (mTBI), during which rapid acceleration or deceleration of brain tissue within the skull causes brain tissue to change shape, which can stretch and damage brain cells, according to the Massachusetts-based Concussion Legacy Foundation.
High school football players are at the greatest risk, both for sustaining a concussion, and for how that concussion can affect their still-developing brains. A 2009 study by the National Athletic Trainers Association found the impacts that high school players receive during collisions are greater than for college players. The study said that the lesser-developed muscular makeup of high school athletes might explain the discrepancy. Additionally, the American Academy of Pediatrics states that 47 percent of high school sports concussions occur during football.
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There is also an increase in the number of concussions being reported, which can actually be seen as an encouraging change.
“I’m thrilled to hear when concussion rates are going up because that means more people are reporting them, not that there are actually more happening,” said Cliff Robbins, program manager of education and research for the Concussion Legacy Foundation.
Robbins believes this is an indication of change, to where kids feel more confident about telling their coaches about a suspected head injury. “Studies show that how a kid believes the coach will react to them reporting an injury is the single biggest factor in if they speak up,” Robbins said. Currently, only one in six concussions are estimated to be diagnosed nationally, according to Robbins’ foundation.
But some schools and athletes see too much risk. High school football participation has decreased 2.4 percent nationwide over the last five years, according to a September article in the NY Times. The article also reported a growing trend of high schools discontinuing their football programs, citing safety and other reasons.
“You can ignore concussions or take them on. I’ve chosen to say ‘what do we need to do to keep football alive?” ~ Josh Ivens, head football coach, Truckee High
The measures taken to combat concussions in Tahoe/Truckee cover several components of the game. All three high schools participate in the ImPACT program, a computerized neurocognitive assessment tool that every student athlete takes prior to the season. The test takes 25 minutes and tests for aspects of cognitive functioning such as reaction time, working memory, and several other factors. The test gives each student a baseline score, and if a player is suspected of suffering a concussion, they retake the test to meet or beat their baseline score as part of being cleared to play.
Winans oversees the evaluation of the ImPACT program for TTUSD students, but points out letting a player back into competitive play goes far beyond just passing the test. “Balance, motor skills, concussion symptoms, and much more are evaluated on an individual basis and go into making the decision to clear an athlete,” Winans said.
A main factor with concussions is to avoid a second or third concussion before the brain has recovered from the first one, as those impacts create a much greater risk of permanent impact. That is why Winans speaks with parents and athletes before the season about the necessity of reporting suspected concussions when they happen.
Winans says the TIRHR treats an average of one concussion a week from all high school sports. A positive change for football specifically is that she has seen a noticeable reduction in reports of kids suffering from a second impact.
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She and her colleagues are also researching ways to detect concussions quicker by looking at the chemical reactions that happen in the brain during concussions and the changes to the energy of the brain, which will hopefully expedite the recovery and identification process.
Head Football Coach Josh Ivens of Truckee High uses the InSite system by helmet manufacturer Ridell. InSite places a sensor in the helmet that measures the amount of impact to the helmet on a given play, which is relayed instantly to a live-monitored device. If the impact passes a threshold, that player is removed from the game and evaluated. He currently has 24 helmets with the device, with plans to purchase enough for every player next year. He reports that so far this year, 20 impacts have registered, but none strong enough for a concussion.
At Incline High, Head Football Coach Scott Conn has purchased 33 new helmets in the last two years to replace outdated ones. He also places a large emphasis on strength training, especially the neck muscles, which were shown in a recent Stanford University study to have a significant impact on concussions. He purchased a neck weight training machine, which is a mandatory part of the team’s weight lifting program.
Conn also has a doctor and physical trainer that attend every game and are available on-call for consultation at practice if an injury is suspected.
Both Ivens and Conn also teach a completely different tackling technique than when they played.
“When I played [in the ’70s], kids were taught to keep the head up and drive the face mask straight into the opponents numbers,” Conn said. “Now we teach shoulder tackling and to not use the head at all.”
“Football is like life – it requires perseverance, self-denial, hard work, sacrifice, dedication, and respect for authority.” ~ Vince Lombardi, former coach, Green Bay Packers
With head injuries currently synonymous with football, some parents don’t allow their kids to play, and some think football should be shut down entirely. While the inherent danger of the game will never disappear, some believe the valuable life benefits to football aren’t being discussed enough.
“Football throws people together from different backgrounds and forces them to come up with a solution together using the body, brain, environment, and equipment,” Conn said. “It teaches you how working towards something together can make it better, and the physicality helps instill that point.”
Alongside the lessons of hard work, Conn knows there is a limit. For example, Incline High’s starting quarterback got knocked out from an illegal hit early in the season, and was taken on a backboard to Reno. He was checked out, and doctors knew he had suffered a severe concussion.
“He wanted to get back in there and that he felt good, but there’s no way,” Conn said. “He’s done for the year.”
