From Trauma to Drama: A Perspective on Head Injuries in Football

The game of football is being highly scrutinized and rightfully so. Wait, what? Yes, I think that there should be a national conversation about football and all other activities that could lead to concussions or other traumatic brain injuries (TBIs).

No, I do not think that high schools should eliminate football from their program offerings. And yes, I would let my child play football when I think it's appropriate.

Since the NFL concussion scandal broke a few years ago, the majority of the public knows that there are inherent risks associated with playing the sport of football, concussions included.

The NCAA has seen its share of lawsuits and inquiries related to concussions. Now, the NCAA is trying to settle a major lawsuit around concussions for $75 million. On the high school level, a legal battle is underway over concussion protocols and management between a former Illinois high school football player via a class action lawsuit against the Illinois High School Association.

As a result, questions about the prevalence of concussions in college, high school and youth football are being asked. But the issue is larger than just one sport.

U.S. emergency rooms treat as many as 173,285 "sports and recreation-related TBIs" a year for "children and adolescents" under 19 years of age, according to data from the Centers for Disease Control. Both football and girl's soccer account for the highest number of incidences.

In a 2013 study, the National Athletic Trainers Association found that high school football players had a higher incident rate of concussion (11.2 per 10,000 athletic exposures) as compared to college football players (6.3 per 10,000 athletic exposures). Other sports - bicycling, basketball, soccer - and playground activities also contribute to the high number of TBIs.

Research has shown that younger athletes are at a higher risk of concussions because their brains and bodies are still developing.

Keeping our children safe should be everyone's priority, however, we should be rational in our approach.

Football is a collision sport, whereas soccer and basketball are contact sports. In the case of high school athletes, the choice of whether to participate is a family decision based on risk tolerance. We all assume a certain amount of risk everyday in everything that we do.

The NFL, NCAA and high schools have a duty to educate parents, coaches and student-athletes about unsafe practices that are specific to a sport and the potential for injury. By withholding information from its players, the NFL took away the players' ability to weigh the inherent risks associated with playing.

I believe that kids should not be allowed to hit and tackle prior to high school. It is more important to develop the fundamental playing skills (i.e. running routes, throwing the ball, catching the ball and learning plays) rather than to hit and tackle.

Another way to decrease the number of head injuries is to teach our student-athletes a different way of playing through teaching proper technique and also teaching them how to protect themselves on the playing field.

At Francis Parker School, we pride ourselves on educating our student-athletes, parents and coaches on the risks associated with playing football. We've also invested in taking steps to minimize the risk.

Parker is one of the few schools in county with two athletic trainers on staff. They attend all of our football contests, both home and away.

The school also invested in helmets with impact sensor technology that alerts trainers on the sidelines when one a player experiences a high impact collision. During practices all Parker student-athletes wear guardian pads over their helmets to absorb more of the impact.

For the last nine years, Parker players in all contact sports have under gone mandatory baseline testing of their normal cognitive function, during the pre-season. This information gives our athletic trainers better indications of when there may be an injury or impairment based on symptom scores.

Our student-athletes are also active in "Athletes Saving Athletes" campaign that encourages student-athletes to communicate with coaches and athletic trainers about concussion symptoms. The school also adheres to the California Interscholastic Federation's (CIF) mandated concussion training for coaches and the concussion management protocol.

We support rule changes to protect players, such as mandatory concussion training. But some rule changes have negative unintended consequences.

CIF's new rule limiting practice to 18 hours per week is a case in point. Under this rule, sports practice is limited to no more than two hours per day during the offseason. Saturday practices are allowed to go on for four hours and Sunday practices will not be allowed. Sounds good so far, right?

The problem lies in what is defined as "practice." The rule defines practice to include "any school or team or individual activity organized by the coach that is intended to maintain or improve a student-athlete's skill proficiency in a sport; and/or any school team or individual activity that includes skill drills, game situation drills, intersquad scrimmages or games, weight training, chalk talks, film review, meetings outside of school time."

While this rule is good for the majority of sports, I argue that it is not good for football. Limiting the amount of time spent teaching high school football athletes proper techniques and fundamentals does not help prevent concussions.

On the contrary, because of the increased risk of injury inherent in playing football more time should be spent educating and developing players both on and off the playing field. It takes time to teach student-athletes, especially those playing football for the first time, how to play and protect themselves and others from injury.

Coaches and athletic administrators are charged with improving player safety. As written, these time limits restrict them from meeting their legal duty to teach skills and build athletic conditioning that will allow them to play safely and be better prepared for the rigors of the game.

There are other concussion prevention measures that don't sacrifice the ability to teach and prepare the student-athletes.

The rule could be improved by requiring mandatory time during practice to teach proper tackling and hitting techniques to prevent concussions.

Moving forward, my hope is that as a nation we continue the dialogue around concussions in sports and come up with data driven solutions to protect our student-athletes and the game that many of us have grown to love.