Hazards in the Huddle

In the late summer every year, thousands of young men and boys, in the often grueling heat of the afternoon, will suit up and push their bodies to their athletic limit. They will do this every day, sometimes twice a day, until winter. They will put the well-being of the play, the catch, the run, or the tackle sometimes above the well-being of their own bodies. They will exert themselves to the fullest of their capacity for a chance to become faster and stronger than they were the day before. It is football season, and the boys aim to win.

As a sport, football may grant each player the opportunity to win glory for himself and his team, and from time to time, each player will take a knee for a lesson in humility.

Football will see each player grow and learn the way all those who play a team sport grow and learn. While the sport offers these young men and boys invaluable life lessons, it can come at a price. A recent study by the Brain Injury Association of Arizona concluded that more than 62,000 concussions occur each year in high school sports, with football accounting for two of every three.

A study done by the Journal of Athletic Training found that, in the teams they studied, there were about 300 hits to the head during football practice that were in the concussion causing range, and there were 200 practice collisions that experts likened to crashing a car into a concrete wall at 40 miles an hour.

Dr. Troy Glaser, D.O., of Central States Orthopedic Specialists, agrees that football offers players a variety of lessons that will benefit them later in life, but advises that individual families “talk about the risks involved, and determine whether it’s worth it” or not to them.

The injuries that occur most often in football include finger and wrist fractures, ankle sprains, knee injuries, and concussions, said Dr. Glaser. While all of these injuries are potentially debilitating, concussions are the most worrying because the brain of a child under the age of 18 is not fully developed.

Dr. Glaser explained that the undeveloped brain does not “bounce back” after injury as well as the developed brain; therefore, school-aged athletes are the population with the highest risk of Second Impact Syndrome (SIS). SIS is a rapid swelling of the brain from a second concussion that occurs before symptoms of the first concussion have subsided. A player may take a hit and get a concussion without knowing it, and feel well enough to keep playing. When he takes a second hit, the brain herniates catastrophically, and often fatally. Those who survive suffer brain damage.

What’s more, neurologists say that a person is four times more likely to sustain a second concussion if he’s already had one. And, after several concussions, even a fairly light blow can cause head injury.

What Can Parents Do?

“It’s up to the parents to make sure it’s child-geared,” said Laurie, “and that [the kids] are the ones who initiate it. They should not be forced into any of it.”

Jarrett Skaggs, a sixth grader at Jenks, began playing tackle football in the first grade.

“We thought it was insane at first,” said Jeremy Skaggs, his father and assistant coach. “But he loved it.”

The Skaggs family is aware of the injury risks inherent in football, and acknowledges that injuries are likely, especially in high school, but they have taken the necessary precautions. Jarrett’s parents regularly consult his pediatrician to be sure that he isn’t suffering from any lingering effects of injury, and to be sure that continuing football is in his best interests.

When Jarrett’s younger brother Hayden received his second concussion (one on the field, one off), they went directly to their pediatrician for consultation. She advised that Hayden no longer participate in contact sports, and the Skaggs were quick to heed that advice.

After that, they “became a lot more conscious of head injuries,” said Laurie, Jarrett and Hayden’s mother. “We talked to a pediatrician about what helmet does what, and which one would be best for Jarrett.” Now Jarrett wears a special helmet designed to give his developing brain a strong line of defense.

Dan Hedman, a certified Youth Fitness Specialist, certified USA football coach and owner of Faster Athlete Speed Training in Tulsa, said that using a high-quality helmet is one of the main measures players can use to prevent head injuries.

“First, make sure the helmet you are using is properly fitted and adequate for the job,” Coach Hedman said. “Just because a helmet is new doesn’t mean it’s a good helmet. The more money you invest in a helmet, the better head protection you will have.”

Even with good equipment, Dr. Glaser advises against five- and six-year-olds playing tackle football. The brain is young and underdeveloped. They should play flag football “for a few more years to learn the fundamentals. Sixth, seventh, and eighth grade might be a better time to start tackle football. At five and six, a concussion just isn’t worth it,” Dr. Glaser said.

Parents’ attitudes also can have a lot to do with keeping injury to a minimum. When kids walk onto the field, it is important to “go out there with a ‘let’s have fun’ attitude,” Jeremy said.

Children, and their parents, might do well to remember that at the end of the day, they’re playing football for fun. Children should not feel pressured into over-performing.

“It’s up to the parents to make sure it’s child-geared,” said Laurie, “and that [the kids] are the ones who initiate it. They should not be forced into any of it.”

As They Grow

Jarrett, like other boys entering middle school, are at the age where their sport, and expectations of their performance begin to undergo a transformation. As they get closer to their high school years, competitive spirit may push “fun” slightly to the side. The “let’s go out there and have fun” attitude, for many, may be replaced by a more competitive attitude. Along with their skill levels, their strength and speed will increase. These gains in ability often lead to increased intensity of competition, and an increased opportunity for injury.

At the same time that they have to work in a new and more competitive atmosphere, their bodies must support increased weight and load as they grow.

“Everybody wants to see that big hit,” Dr. Glaser said, but no child-player should ever feel pressured to make that hit.

Dan Hedman, whose son Seth played youth football for five years, played at Holland Hall and now plays linebacker for Drake University, said that part of injury prevention is developing strength and agility through training and a proper diet.

“If you are more flexible, you can withstand that awkward bend, if you are more agile, you can avoid the unexpected, if you are faster you can get away from the mass of bodies, if you are stronger, you are less likely to be pushed around,” Coach Hedman said. “The better athlete you are, the more likely you are to be able to overcome and avoid accidental injury.”

Consequences of Concussions

Studies are linking concussions to mental and physical ailments later in life. Stories of college and NFL football players suffering from the consequences of multiple concussions are popping up in news outlets regularly. A study completed by the University of North Carolina confirmed that for student-athletes who had suffered three concussions, the risk of depression was two times that of a player who had never received a concussion. Those who suffered concussions also reported having more problems with memory, concentration, speech impediments and other neurological problems than players who had never had a concussion.

Findings such as these have prompted Ivy League colleges this year to reduce the number of allowable full-contact practices teams can hold. The N.C.A.A. guidelines allow five full-contact practices per week during the season, while the new Ivy League rules allow only two. The rules were implemented because, according to a study in the Journal of Athletic Training, college players sustain more total hits to the head in practices than in games.

New rules such as these can impact youth and high school football as well. Coach Hedman said that, besides the helmet, coaches must make sure that players understand proper tackling techniques.

According to a study done at the University of North Carolina at Chapel Hill, the number of fatal football-related head injuries was at an all-time high in 1965-1974 because blocking and tackling tactics known as “spearing, butt blocking, face to the numbers, and face in the chest” were being taught. A 1976 rule change that prohibited initial contact with the head or face “resulted in a dramatic decrease in both fatal head and cervical spine injuries.”

A University of Pittsburgh study on children ages 7 to 13 participating in community organized baseball, softball, soccer and football found that catastrophic head injuries in high school football players are “dramatically higher” than in college players. The researchers were unclear about the reason behind the discrepancy, but speculated that it was because “an unacceptably high percentage of high school players were playing with residual symptoms from a prior head injury.” The study underscored the value of having coaches, athletic trainers, medical personnel and the athletes themselves educated about head injuries, and the need to keep those players from returning to the field.

“Football is a demanding sport that involves not only speed, strength and size, but physical contact,” Coach Hedman said. “As dramatic as football’s violent collisions look, very few injuries happen in those moments, most are accidents. The athlete has a built-in sense of injury prevention and football coaches mostly teach proper techniques that prevent injuries. [A player] should never use his helmet to make contact. Most coaches teach tackling using these simple reminders: Eyes up, head in front, hit with the shoulder, grab cloth.”

“If he ever decided he wanted to stop, that’d be the end of it,” Laurie said.

Keeping It In Perspective

Jarrett’s parents have turned his love of football into a family affair. They attend the Jenks-Union rivalry games, and TU games. When they travel for games, they visit new schools, and eat at new restaurants. They try the local flavor when they visit a town for a game. The whole family gets involved. “You can really make a day of it,” Laurie said.

For the Skaggs’, football is not about Jarrett putting points on the board, or racking up QB sacks, its about Jarrett having fun. He is under no pressure to suit up and take the field every day. He does so because he loves it. He walks around the house with a football in his hands. He’s taught his younger brother and sister how to throw, and how to catch.

“If he ever decided he wanted to stop, that’d be the end of it,” Laurie said.

Here are some tips from Dr. Glaser and Coach Skaggs to ensure your child enjoys football in the safest way possible:

• In this heat, it’s important to weigh yourself before and after practice to keep track of water loss. For every pound lost, drink 20 oz. of water.

• Consult your pediatrician regularly, and keep an open dialogue. Ask, “Is this safe?”

• Talk about it with your child. Be sure he is doing it for the right reasons, and that he knows both the benefits and risks involved.

• Remember, it’s a game.

• Take concussions seriously. If you think there is even a small chance that your son has received a concussion, pull him from play immediately and see a doctor.

• Your son may be tempted to take dietary supplements like creatine, or protein. Dr. Glaser says that milk is the absolute best supplement for athletes. It has everything the body needs after a workout.