Archive for Dangers of Concussions

DANGERS OF CONCUSSIONS: How State Laws Are Mandating Adult Education on This Important Issue

A New Study on Adult-Education Mandates In State Concussion Laws

By Doug Abrams

 Between 2009 and 2014, amid heightened public awareness about the serious consequences of concussions suffered in youth sports, every state and the District of Columbia enacted laws designed to promote prevention and treatment of these traumatic brain injuries. Such legislative unison is rare in today’s partisan times that divide blue states and red states, but this flurry demonstrates public support for effective measures designed to make life better for the nation’s youngest athletes.

Legislatures enact standards to govern events and circumstances as they occur in the future. Recognizing that legislation is inherently predictive, prudent legislators monitor operation of their enactments to help assure that standards will work as anticipated, and to consider amendments in light of experience. In prominent matters such as youth sports concussions, laws once enacted remain works in progress.

In the December issue of the American Journal of Public Health (AJPH), researchers published a study indicating that the recent state concussion laws are already fulfilling one of their primary missions — educating adults and players about prevention and treatment. After surveying these laws, this column discusses the early signs of the positive effects of this education. The column concludes by discussing the role of concussion education in guiding parents toward an informed decision about a matter not directly raised in the AJPH study, whether to permit their child to play a particular contact or collision sport at all.

State Concussion Laws              

Between 2009 and 2014, every state and the District of Columbia enacted statutes concerning traumatic brain injury in youth competition. By that time, leading voices were calling youth sports concussions “a true health crisis” and a “matter of public health.” Time reported the emerging medical consensus: “Concussions are an alarmingly commonplace injury, particularly among kids and most particularly among active, athletic ones.” With the stakes so high, said CNN chief medical correspondent, neurosurgeon Sanjay Gupta, “we owe it to our . . . kids . . . to make them as safe as we know how to do, and we can do a lot better than we have been doing.”

The various state concussion laws show differences at the outer edges, but the laws share three common directives. First, nearly all these laws require that before each season, state education departments or local boards of education provide parents, coaches, administrators, and players with information and education about the nature and dangers of concussions, about how to recognize symptoms of potential brain trauma, and about how to help insure healthy recovery. Some of the statutes contemplate provision of written educational materials, and others specify face-to-face group presentations.

Second, most of the laws require that coaches immediately remove from a practice session or game any player who is suspected to have suffered a concussion.  Third, most of the laws require that the player may not return to action until a physician or other licensed medical professional clears the player and affirms that return is medically appropriate.

 The Beneficial Effect of Concussion Education

The new AJPH study found a significant nationwide increase in reports of new and recurrent youth sports concussions for the first two and a half years or so after the state laws went into effect. The research team concluded that the immediate increase “may be attributable to greater recognition and reporting of concussions by athletic trainers or athletes following implementation of concussion education requirements of these laws, rather than increased number of injuries.” The research team reasoned that mandatory education has “improved coaches’, athletic trainers’, parents’, and students’ knowledge of concussion signs and symptoms.”

Concussion Education and Parental Prerogatives

The AJPH study focused on the evident effects of parent education in preventing and treating concussions among youth leaguers. But this education may also play a central role in a parent’s decision whether to permit a child to enroll in a particular contact or collision sport in the first place. For example, youth football enrollment rates have fallen noticeably in many localities, while other parents educated about the risks and rewards of participation decide to enroll their children. Either way, parental choice here is a parent’s prerogative.

Quoted in Sports Illustrated this summer, Dr. Bennett Omalu said that no child should play football. “Someday,” he predicted, “there will be a district attorney who will prosecute for child abuse, and it will succeed.” He called youth football “the definition of child abuse.”

Dr. Omalu is trailblazer in raising public awareness and concern about concussions in football and other sports, but I believe he is wrong about child abuse. There is no room for prosecuting parents for allowing their child to enroll in youth-league or school football. The Constitution guarantees parents broad discretion to raise their children, so the law requires a strong showing to defeat parental decision making. Football safety concerns are real and medical experts and safety advocates should continue to speak out to educate parents and players. Parents commit no crime, however, when they decide to allow their child to play the nation’s most popular professional and amateur sport.

A child endangerment prosecution might be appropriate if, for example, parents expose their football player to specific health or safety consequences during play, such as by coaxing him to play with a concussion or other serious injury. But the initial enrollment decision depends on the parents’ informed judgment, backed by the sort of educational outreach mandated by the states’ new concussion laws and by educational commentary and reports widely available in the broadcast and print media.


Sources: Jingzhen Yang et al., New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005-2016, American Journal of Public Health, vol. 107 (Dec. 2017); Douglas E. Abrams, Confronting the Youth Sports Concussions Crisis: A Central Role for Responsible Local Enforcement of Playing Rules,  Mississippi Sports Law Review, vol. 2, p. 75 (2013); Lyle J. Micheli, Foreword, in William Paul Meehan III, Kids, Sports, and Concussion: A Guide for Coaches and Parents xi (2011) (“[a] true health crisis”); Alan Schwartz, High School Players Shrug Off Concussions, Raising Risks, N.Y. Times, Sept. 15, 2007, at A1 (quoting Dr. Robert Sallis, president of the American College of Sports Medicine); Jeffrey Kluger, Headbanger Nation, Time (Feb. 3, 2011); Tackling the Dangers of Concussions, Daily News of L.A., Jan. 26, 2012, at L1 (quoting Dr. Gupta); Scooby Axson, “Concussion” Doctor: Letting Kids Play Football is “Definition of Child Abuse,” Sports Illustrated,  (Aug. 8, 2017); Brooke de Lench, Letting Kids Play Football is Not Child Abuse, (Aug. 14, 2017).


DANGERS OF CONCUSSIONS: New Study Targets Long-Range Effects on 6-12 Year-Olds

This past week, new research out of Boston University revealed that kids under the age of 12 who play tackle football have a tendency in later life to develop  behavioral, cognitive and depression issues.

Now, we have heard endlessly in recent years about the dangers of concussions from playing tackle football. And of course,  there’s the latest headline about Aaron Hernandez and the severe amount of CTE found in his brain. He was only 27 when he committed suicide. Who knows how many hits he suffered to his head starting at an early age? And his behavior was clearly out of control to have done the horrible acts he committed.

Along these lines, this new Boston University study comes forth, and concludes that young kids age 6-12 who play tackle football are lining themselves up for problems later in life.

I’m certainly not suggesting there’s a direct correlation between Aaron Hernandez and the BU study. But then again, it does make you ask questions.

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CONCUSSION PREVENTION: New Protective Catcher Helmet is Finding Support

First, an important disclaimer. Let me just say that this is not a commercial endorsement. does not receive any compensation from Force3 Pro Gear, nor do we have any relationship with the company.

That being said, if your son or daughter plays baseball or softball, and is a catcher, or for that matter, an umpire, you might want to check out the Force3 Defender mask as a marked improvement in protecting them from concussions. The mask has been adopted by pro and amateur several leagues, including the South Atlantic Baseball League and Babe Ruth baseball and Cal Ripken Baseball.

What makes the Force3 Defender mask different from traditional masks is that any blow to the mask, such as from a fouled pitch, is strongly cushioned by strong and resilient coils. It’s worth taking a look. Check out the website at


DANGERS OF CONCUSSIONS: New Study Suggests More Concussions in Girls Soccer than in HS Football

There was a recent study published headlined by a medical professor at Northwestern University who says that girls who play HS soccer suffer a much higher incidence of concussions than boys do – even those boys who play HS football.

As you might imagine, I was somewhat stunned by this. After all, the vast majority of attention in recent years has been paid to the long-term concerns regarding the health of football players. Sure, it’s well known that concussions can occur in any sport, but this new study shifts the focus to girls’ soccer, and that caught my eye.

In the study, which looked at 41,000 injuries to HS athletes in 9 popular sports between 2005-2015,  6,400 concussions were tabulated.

And during that time span, the concussion rate for girls’ soccer was higher than in football – and especially in the years from 2014-2015.

Now, if you’re a sports parent of a daughter who plays soccer, what does this mean? Suddenly, you may be having some of the medical misgivings about soccer as the parents of football players do. Of course, as I have noted over the years, concussions are part of all sports, and accidents do happen. I would daresay that it’s rare to find a kid who hasn’t suffered at least one concussion during their playing career.

But that being said, concussions do come in different degrees, and athletes and parents and coaches have to be careful about the handling of serious concussions. And medical doctors caution about repeated concussions; that is, one hit to the head can be treated, but if the youngster returns to action too soon, and receives another concussion, that’s where long-term concerns come into play.


In any event, I asked my listeners this AM as to what’s causing the spike in female concussions?  Is this due to excessive heading of the ball in soccer? Or heading being done incorrectly?

Should the girls in soccer be wearing more protective headgear? I know some girls wear protective headgear AFTER they suffer a concussion….but should they all be wearing headgear as a precaution as well?

And of course, is there just too much physical contact during the game?

Not surprisingly, the responses ranged from too much heading, and that it’s taught incorrectly at the younger ages when the most damage can be done to a developing brain. Head gear is also now receiving more and more attention as a protective measure. And finally, one caller suggested that the refs have to do a better job in controlling the physical action on the field in order to minimize physical contact. Kids falling to the turf and hitting their heads on the ground is a major source of concussion.


In addition, I know there’s been a lot of talk in recent months about girls lax and girls being told to wear headgear to protect them from concussions.

But from what I can tell, while some schools make such headgear mandatory, this protective trend isn’t really taking off in a big way – even though I can personally tell you from the years of watching my two daughters play lax in HS that there’s no question that getting hit in the head by a stick or errant pass is alarmingly routine in games.

Yet in discussing this issue with my daughters, they both felt strongly that protective headgear in lax would be a mistake – that it’s just not needed, and that it would indeed make the game much more aggressive as players would take more liberties in attacking opponents on the run and using their sticks.

Remember that traditionally, girls lax has been considered a non-contact sport. To me, though, and perhaps you share my views, I have never believed girls lax to be a non-contact sport. And if you have even seen a HS girls lax game recently, I’m sure you feel the same way. It is hardly a non-contact sport, and the fact that the girls do have to wear mouth guards and eye goggles and carry sticks and throw around a heavy hard rubber ball makes it a dangerous activity.

So where do we go from here? For starters, both in girls soccer and lax, more than ever it’s incumbent on parents and coaches to make sure that kids are well taught about how to head a soccer ball, and how to play a competitive game but not doing so in a physical manner. Same goes for lax. Learn how to use the lax stick as a tool, but not as a weapon. Learn how to control the ball and learn how to pass it correctly.

No, sadly, concussions are not going away. But we really do need to adopt protective measures at the youth level to make sure our daughters are protected.

DANGERS OF CONCUSSIONS: Will New Guidelines for Youth Football Make A Difference?

Ken Belson of the NY Times did a wonderful article this past week about a new initiative from U.S.A. Football, the nation’s governing body when it comes to amateur football, to do something to stop the dropping numbers of HS students who are deciding not to play football. Belson reports that since 2009, HS football numbers have declined by as much as 20%.

That’s a significant percentage, and of course, most of it can be attributed to rising concerns about concussions. Despite a tremendous upsurge in research on how to prevent or diagnose concussions, the hard truth is:

o There is still no football helmet on the market today that will prevent a concussion. True, the more advanced helmets can do a lot to soften the blow to the head, but no helmet can claim to prevent concussions from happening.

o And while there are medical protocols in place for a suspected concussion, there is still no definitive method to determine if a football player has suffered a serious hit to the head. Doctors can only determine real damage to one’s brain only in an autopsy.


U.S.A. Football, in an attempt to do what is can to modify and make the sport safer for kids who want to play tackle football between the ages of 6-12, have announced the following changes:

Reduce the number of kids on each team during the game to no more than 6 to 9.

Have the kids play on a smaller field.

No more run backs on kick offs or punt returns.

All players must start each play from a crouch position, not a three-point stance.

Will any of this help? Or more directly, will parents feel more assured about letting their kids plays tackle football? If today’s callers were any indication, the answer is a resounding no.

Most of today’s debate centered on whether kids would be better suited to simply bypass tackle football and opt for flag football instead – at least until they are 13 or 14. By that age, their brain is close to being fully developed, and their head has more strength and support from their neck and shoulder muscles.

Dr. Robert Cantu, the Boston University neurosurgeon,has long advocated this approach, and I must say, I agree. If young football players want to play the sport, they are much better served to play touch football or flag football in elementary and middle school. Then, when they reach high school, not only can they turn to tackling, but more importantly, they can learn the safe and fundamental way of how to execute a tackle properly without risking harm to their head.  At the HS level, there are plenty of well-qualified football coaches who can teach these essential basics to football players.

To me, in light of the reality that we are in this transition phase where we are still waiting for medical science to catch up with more insights on how to prevent concussions, as well as how to treat them, Dr. Cantu’s approach makes a lot of sense. And by the way, for more information, there’s an enlightening article in Bloomberg BusinessWeek  that ran this week about what’s happening regarding the latest research in this area, much of which is being sponsored by the NFL.

Sad to say, the medical experts still say there is no effective way to prevent  a concussion, and even worse, we are still 4-5 years away from having a simple blood test to determine whether a football player has had a concussion. In other words, we are still in the dark.




DANGERS OF CONCUSSIONS: HS Guidelines Should Be Mandatory, Not Just Voluntary

Two Steps Forward, One Step Back:

Michigan’s New Guidelines on Full-Contact High School Football Practices

By Doug Abrams

In an article by Ted Roelofs last week, Bridge Magazine reported about the Michigan High School Athletic Association’s new concussions guidelines concerning the permissible length of football teams’ full-contact drills. The new MHSAA guidelines maximum is 90 minutes per week.

The problem, noted by Mr. Roelofs, is that the guidelines are just that – guidelines. That is, they are voluntary. Remaining in place is the mandatory state rule, which sets a maximum of six hours of full-contact drills per week (an average of more than one hour a day in any week when a team practices daily before Friday night).

The article reports that Michigan remains out-of-step with several other states that mandate 90-minute weekly maximums, and even with a few states that mandate lower weekly maximums. These other states have reputations as high school football hotbeds, but their statewide activities associations doubtlessly recognize that adolescent concussions, and even repeated sub-concussive head hits, can leave student-athletes with irreversible short-term and long-term damage. Last year, a study published in JAMA [Journal of the American Medical Association] Pediatrics found that repetitive head trauma occurs more often in youth football practice sessions than in games.

Coaching Integrity

A MHSAA spokesperson told Mr. Roelofs that he does not foresee problems with the new guidelines because, he says, coaches understand the risks of head trauma and no Michigan high school comes close to conducting six hours of weekly full-contact drills. Writing in USA TODAY, however, Ben Rohrbach asks the obvious question: “When the Michigan High School Athletic Association recommends 90 minutes of full-contact football practice per week, but doesn’t actually restrict coaches from using all six allotted hours of full-contact drills in a week, you can’t help but wonder if teams will actually take their governing body’s suggestion seriously.”

In my years of coaching, I never met a coach who ever wanted to see any of his players suffer injury or ill health. But voluntary full-contact guidelines nonetheless leave the door ajar for coaches who might feel tempted to exceed them. A coach, for example, might feel frustrated during a losing streak, or overzealous in the days before a big game or the playoffs. When word gets around that one or more teams have exceeded the 90-minute guideline, the temptation for other teams also to inch toward excess might not be far behind.

Strength From the Top

In interscholastic sports and youth leagues alike, strength and wisdom must begin at the top, and not at the middle or bottom. In the absence of state legislative action, the “top” here is MHSAA, which could level the playing field with a weekly full-contact maximum of 90 minutes or less, mandatory for all school districts and all football teams in the state.

Player safety should not depend on self-restraint by individual local school boards, principals, athletic directors, or coaches. Nor should player safety depend on individual parents who demand more protective concussion standards for their own children. In a high profile sport such as high school football, taking an individual stand risks arousing the sort of local criticism that can make silence seem the easier path.

Ongoing medical research informs us that the stakes for young athletes are simply too high to forego meaningful safety measures that maintain the essential character of the game. The MomsTEAM Institute of Youth Sports Safety, for example, maintains a web-based Youth Sports Concussion Safety Center that for years has collected a downloadable treasure trove of informative articles and commentary written by leading experts in a variety of disciplines. Accumulated learning means putting the players first.


Concussions damage actions are expensive, and they happen. I also wonder whether, by not joining several other states that have mandated 90-minute weekly maximums (or less), MHSAA unnecessarily weakens its position in any future negligence lawsuit that names the association as a defendant.

What if a concussed football player and his parents allege that the player’s team routinely exceeded the 90-minute voluntary guidelines while remaining within the association’s six-hour mandate? If I were MHSAA’s defense lawyer, I would much rather argue that the statewide association mandated best practices – the nationally emerging 90-minute mandated weekly maximum, or less — and not that the association condoned the team’s exceeding these maximums.

In damage actions, defendants tend to fare better when the judge or jury perceives them as acting within the mainstream. Perceptions help influence settlement negotiations, where most lawsuits terminate short of trial.

Some voices warn that concussion risks in contact and collision youth sports such as football may jeopardize the ability of high school programs and youth leagues to maintain affordable insurance, not only for players, but also for adults who conduct the competition. If the MHSAA spokesperson is right that none of the state’s high school football teams currently approaches the six-hour mandatory maximum, the voluntary guidelines bring jeopardy that seems avoidable and counter-productive – and dangerous.


Sources: Ted Roelofs, Bridge Magazine, June 16, 2016,  Thomas P. Dompier et al., Incidence of Concussion During Practice and Games in Youth, High School, and Collegiate American Football Players, JAMA Pediatrics,  (May 4, 2015); Ben Rohrbach, Michigan Recommends Less Full-Contact Football Practice, But Won’t Require It, USA TODAY High School Sports, June 17, 2016 (emphasis in original); MomsTEAM Institute of Youth Sports Safety, Youth Sports Concussion Safety Center,

DANGERS OF CONCUSSIONS: One HS Player’s Personal Story

The Life of The Concussed: One High School Players Account

By Elijah Rechler

“One Family, One Goal!” That was my high school football team’s motto. We were a tightknit group of brothers, and our goal was to achieve the highest caliber team both on and off the field. Each individual player felt an unwavering loyalty toward the rest of our unit. I did not care how many hits to the head I took or how confusing the play calls became: this was my team, my family and I would not abandon them.

Those were the thoughts that crossed my mind in the huddle right before the play that would end my eleven year football career. Three plays earlier I received the first out of many devastating hits that sent my brain flying into the front of my skull.

I played fullback on offense which meant my job was to block for the quarterback as he dropped back to throw the ball. Our quarterback’s name was Corey Goldglit, and although I gave him trouble for being a year younger than me, he was a member of our team and one of my best friends. As long as I was in that backfield and breathing, no one would touch him.

Corey snapped the ball from the center and dropped back, I was at his left hip and immediately saw a defender coming from the right side, head first, trying to spear my quarterback and possibly injuring him. Since I was on the opposite side of the defender, I would have been too late if I attempted a standard blocking approach, one that would have protected my head. Instead I made the quick decision to dive head first to the defender before he could spear

Corey. I felt a harsh vibration that rattled my helmet. My eyes lost focus and my entire body tensed up. My teeth clenched so hard that my molars bite right through the ends of my mouth piece.

After I landed, I distinctly remember hearing my helmet vibrating even as I lay motionless on the ground. The play was over, and Corey got the throw off. I did my job. One must understand that football players are not dumb. We know when we get hit in the head; we know when we should stop. We just don’t care. The team is more important. I had to keep going.

Play after play I received the same hit from the same defender in order to protect our quarterback. My coach screamed something to me from the sideline. I hear noises but not words.

Right as I came out of the huddle to what could have been a devastating event for my mind and body, I was saved by halftime. I waddled off the field and my coaches immediately noticed something was wrong. At first they thought I was overheating which led them to remove my pads. I then went on to tell them that I felt like I was going to throw up. My coaches and our trainer then understood that I had suffered a head injury. I was done for the day but my experience with brain trauma was just beginning.

As soon as I got home I developed a worsening headache. Within a few hours the presence of any light sent me into hysterics. I knew I had a concussion, but it felt like something much worse. With sunglasses taped over my eyes and my mom walking me hand in hand like an infant, I finally made it to the doctor the next afternoon. He took off my glasses and shined a light in my eye. It felt as if I stared directly into the sun. The doctor told me that I had suffered a serious concussion and should consider giving up football in order to prevent permanent damage.      Give up football for good? Absolutely not, I was going to play the following weekend. He told my mom and me that the more concussions one sustains, the less impact it takes for them to occur and the longer lasting the effects of the brain damage become. I didn’t know it then, but my doctor was describing the signs of Chronic Traumatic Encephalopathy (CTE). Still, I begged him to give me another chance on the field. He eventually relented and told me that if I spend a couple weeks at home he would consider letting me return.

I spent a week at home in complete darkness with no one around me, no TV, no reading, and no exercise. I was losing my mind because I was now feeling absolutely fine! Even though I was supposed to spend another week at home I couldn’t take it anymore. I was going to school on Monday. My first day back I was welcomed by my coach. We had a meeting in which he told me he was hesitant to ever let me play again. As I started to break down, he began comforting me by saying that to get another concussion could permanently alter my intelligence and my ability to be the person I am. Just as I was with my doctor, I wasn’t having it. I didn’t understand the effects that CTE could have on me. I was worried about breaking a leg or tearing my ACL, not about what was going on in my brain because I just couldn’t see it.

Just like every other football player in the world, all that mattered to me in that moment was getting on the field. Once again I was exceedingly persistent. Although my coach would not let me play the next weekend, if my symptoms remained dormant he would let me play in the game a week later. Unfortunately, the happiness did not last long. By the end of first period, I was laying on the floor of my 10 person English class with my backpack over my head, writhing in agony.

It was, of course, too early for me to return to school or football. I spent another week at home wondering how a headache could last so long. What I didn’t know then was that my brain was trying to heal, and every time I betrayed the process by going outside or to school I made the initial damage worse. Fortunately for me, I had people in my life telling me to slow down and let myself recover. Sadly, NFL players tend to have people telling them to do the opposite. When millions of dollars are at stake, football players will play every down no matter how damaged their brains are. The constant hits that they experience with no time for healing is what leads them to contract CTE, a deadly disease that causes aggression, confusion, memory loss, and destroys lives. I, however, am not an NFL player. I was forced to stay home for weeks until the headaches were unquestionably gone. Finally, the day came where I received both my doctor’s and coach’s approval to play in my last ever home game at night under the lights. It was time to rejoin my football family.

I was always nervous before games, but this time I wasn’t only nervous about messing a play or letting my team down. I was worried about the way my brain works, how I work through problems in a way that allows me to excel at my passions. What if another hit took that away from me? Is playing in this last game really worth giving up everything my brain has to offer? I stuffed the thoughts of concussions and CTE deep into the back of my mind. By the time the opening kickoff came around I was hyper focused on only one thing: I needed to win my last home game ever. As the rest of the team captains were injured, I was the last one left to be a designated leader in this game. It was up to me to take charge, to lead by example, and to be the person my coach believed me to be. I started the game on fire by scoring a touchdown, running for a hundred yards, keeping our defense alive and focused, and most importantly making sure my brothers had their heads in the game. Although we were losing, I was confident that we would be able to pull off the win.

Toward the beginning of the third quarter, Corey threw a high pass over the middle to one of our star players, Jalijah Daniels. If you follow football, you know that a high pass in that area of the field is extremely dangerous for a receiver. As Jalijah jumped up to catch the ball he was hit head on in the air by a defender. As Jalijah was slow to get up I turned to Corey and said, “Don’t you dare throw it high over the middle to me like that, you hear?” He gave his nod of consent to me. Unfortunately, things in football do not always work out as planned. About eight minutes later Corey had no choice but to throw me the same type of dangerous pass that had ended the game for Jalijah. As I jumped up in the middle of the field, I knew what was coming. Once again I did not care about the impending impact because I needed to catch this ball for the first down. Smack! I’m lifted by a defender and dropped. I knew it was a big hit because I could hear the home crowd yell in fear. As I got up I did not feel any pain. Yet,I was still horrified. I did not know whether or not I was hit in the head.

I went to the sideline and saw the look on my coach’s face. It was over. I was done. That was the last time I would ever play tackle football again. I started crying on my coach’s shoulder, and he began crying on mine. I was sad and angry but the truth is he saved my life in one way or the other. I never would have stopped if he hadn’t stopped me. That was the end of my story on the field. However, my interest in concussions and CTE has not relented ever since that first hit early in the season. Even today I often wonder if I am mentally slower than I was pre-concussion. I am for sure not slower in any way that is noticeable to the outside world, but only in a way that I only could notice.

Sometimes it is hard for me to remember names or dates. I feel like I can’t recall events or solve problems as quickly as I did in the past. It may just be because I am a busy college student filling my brain with facts and theories. However, there will always be a part of me that wonders if I had permanently hurt my brain for the game that I love. There is another part of me that is forever thankful to the people in my life that did not let me make it any worse.

Elijah Rechler is currently finishing his first year of college. He still loves tackle football, but no longer plays the game.

DANGERS OF CONCUSSIONS: Parents Sue School District So Their Injured Son Can Play in Championship Game

Every so often, something happens in the course of amateur and youth sports that makes one pause….and makes one think about whether we as sports parent really do have our priorities in order.

Let ask you this: if your son, a HS football player, had been diagnosed with a possible concussion, would you allow him to go back and play in next week’s game?

Would it make any difference that the next game was for the state championship? That your son was the star running back on an undefeated team? That your son has assured you repeatedly that he’s absolutely fine?

I want you to think about that dilemma. Because we all know for a lot of parents, especially when it comes to the fuzzy world of concussions, this is a very, very difficult situation to find oneself in.

Now, let me give you more of the details>

Shawn Nieto is a top running back at Cleveland HS in Rio Rancho, NM. He’s a junior there. He’s also 5 foot 5, and weighs 140 pounds. That being said, he rushed for more than 900 yards this season and 18 TD’s.

A couple of weeks ago, in a state semifinal game, he was tackled hard, and there was direct and solid contact from a defensive player to Shawn’s helmet. As the play came to an end, everybody got up except Nieto. The Cleveland HS trainers ran onto the field and Shawn’s parents in the stands held their breath.

The trainers determined that Shawn was unconscious – that he blacked for 20-30 seconds before coming around. He was helped to his feet, and walked off under his own power to the sidelines.

Shawn says he never lost consciousness — that he had simply had the wind knocked out of him, and he was taking his time catching his breath.

On the sidelines, the team trainers administered a memory test, and Shawn correctly recalled two of the three words he was given. He also passed a balance test.  In other words, as far as he was concerned,he was ready to go.

But from the school’s perspective, especially in light of the new state laws regarding athletes and concussions, not only was Shawn prohibited from playing any more that day, but under New Mexico law, he now fell under the state mandated concussion protocol, which meant that he had to sit out for at least seven days before practicing or playing again.

That meant, of course, that Shawn would miss the state championship football game, which was to be played in 7 days.


Shawn was crushed. He insisted he was fine. He insisted that he didn’t suffer a concussion. He pointed out that after the semi-final game, he drove back with the team on a three-hour bus ride home, and then drove his car home from the school. Plus no headaches.

So, what did his parents do?

They of course sued the school district to let their son play in the championship game!

Among other preparations for their day in court, the family had their son see a doctor the very next day, who examined him and said he showed normal cognitive function.  The parents then took that medical evaluation, and got their day in court in front of a state district judge, just a day before the big game.

The judge heard the case, and read the doctor’s evaluation. Plus he could see for himself that Shawn wasn’t outwardly injured. Even more, the school district didn’t bother sending anyone to present their side of the case. That’s to understand why, but I guess as far as they were concerned, they were just following the law of New Mexico.

The judge made his decision. He lifted the ban on the kid playing.

The next day, Shawn Nieto suited up and was ready to play in Cleveland High’s state championship game and to defend their undefeated season.

But in the intervening hours, the physician who examined Shawn that week heard about the case, and she was flabbergasted. She wrote in a letter that the parents had never told her that Shawn had been ruled unconscious the week before. If she had known that crucial fact, the doctor claimed, she would have never cleared him to play!


And now, here’s the curious twist in this case.

Shawn’s coaches who clearly had been watching all of this  – said to Shawn that he hadn’t practiced all week, and as such,  decided not to start him, or for that matter, to play him. He got in the game on one play, a kickoff late in the 4th quarter. It would seem that all of his legal wrangling had really not gotten him to where he wanted to go.

Meanwhile, his team won 48-35. And in addition, Shawn’s replacement ran for 200 yards on the day and scored a touchdown.

Law professor Doug Abrams discussed this case at length on WFAN this morning, and made it clear that this lawsuit, which was decided in favor of the athlete, should not be viewed as a legal precedent for other parents to follow. It was hard to understand why the school district didn’t bother to even defend their actions, and because of that, the judge really didn’t have much but to allow the kid to play.

But Professor Abrams made it clear that it would be difficult to think that other Moms and Dads, eager for their son or daughter to play when told not to, could use this case as legal doctrine.

But more than that, both Doug and I salute the coaching staff at Cleveland HS for having the common sense to realize that yes, kids do get hurt playing sports, and especially with concussions in football, it’s always much smarter to be on the side of caution. Nieto might indeed have been perfectly fine to play in the next game, but the trainers felt he had been knocked cold. That was their professional opinion. And the state law made it clear that an athletes can not play again for another 7 days.

So the coaches can up with the right solution. Yes, Shawn Nieto could suit up for the game, but even though it was a championship game and he was the starting halfback, the coaches made the right call: they kept him out of the game except for one play. After all, just suppose Nieto had been hit again during that game, and had suffered a concussion again. Then, he would be looking at his HS career coming to an end (remember, he’s only a junior).

Bottom line? The coaches should be saluted for having the right approach here, even when the athlete and his parents may have lost their vision as to what’s the right and safe thing to do.

DANGERS OF CONCUSSIONS: A Closer Look at Prevention in Youth Soccer

A New Safety Study Sheds New Light on Heading the Ball in Youth Soccer

By Doug Abrams

In Montreal’s Olympic Stadium and on television, soccer fans winced when United States midfielder Morgan Brian and German forward Alexandra Popp struck heads as each went airborne trying to head the ball in the World Cup semifinals on June 30. The dramatic moment and its aftermath added fuel to a debate that dominates discussion about youth soccer concussions.  At least for players under 14, should youth leagues ban heading (using the head to redirect the ball, sometimes as it travels at significant speeds)?

As Rick Wolff discussed last week, a new study published in the journal JAMA Pediatrics suggests that the question may be more easily asked than answered. The study’s research team examined reported soccer concussions at 100 public and private high schools from 2005 to 2014. Heading the ball figured in about 30% of boys’ concussions and about 25% of girls’ concussions during that nine-year period.

These are hefty percentages, but most of the concussions did not result from head-on-ball contact. Most resulted from contact between the opposing players as each attempted heading. The research team concluded that “[s]occer has been allowed to become a more physical sport over time because more athlete-athlete contact is occurring, without a concurrent increase in the frequency of fouls or sanctions awarded by referees.”

Dr. Dawn Comstock, University of Colorado School of Public Health epidemiologist and the study’s lead researcher, drew a fundamental lesson about player safety. She told the New York Times that soccer concussion rates would fall “if referees, coaches and players would enforce the existing rules” against rough play. “There will always be some athlete-athlete contact while soccer is played,” she explained to the Los Angeles Times, “but a large amount of the athlete-athlete contact . . . is technically against the rules of the game.”

“A Risk Control Measure”

The relationship between rules enforcement and player safety transcends youth soccer. Dr. Comstock also participated in a 2008 study by the Center for Injury Research and Policy at Nationwide Children’s Hospital (citation below), which concerned nine high school sports (boys’ football, soccer, basketball, wrestling and baseball; and girls’ soccer, volleyball, basketball and softball). Researchers estimated that between 2005 and 2007, more than 98,000 injuries in these sports were directly related to an act that a referee or disciplinary committee ruled illegal. Thirty-two percent of these injuries were to the head or face, and 25% were concussions.

The Children’s Hospital study was unequivocal: “Reducing the number of injuries attributable to illegal activity in general among US high school athletes can specifically reduce the number of injuries to the head/face and concussions.”

“Each sport has . . . rules developed to promote fair competition and protect participants from injury,” the Children’s Hospital researchers explained. “[E]nforcing rules and punishing illegal activity is a risk control measure that may reduce injury rates by modifying players’ behavior.”

Rules and Referees

The JAMA Pediatrics study reminds us that a youth sport’s playing rules are merely words on pieces of paper. Achieving the rules’ protective purpose depends on enforcement by parents, coaches, and referees at the local level, but the adults often do not live up to their responsibilities. In prior columns, I have written about how misconduct by parents and coaches during heated games can compromise player safety, regardless of what the rulebook says. ; . In the last few paragraphs here, I will discuss how that misconduct can endanger player safety by weakening rules enforcement by referees and other game officials.

The American Academy of Pediatrics reports agreement among sports medicine professionals that “[o]fficials controlling the physicality of the game . . . can . . . play significant roles in reducing contact injuries.”  Many communities, however, suffer a steady exodus of experienced officials who grow disgusted with the verbal, and sometimes physical, abuse inflicted on them from coaches on the benches and parents in the stands.

Rules enforcement, and thus player safety, suffers when so many veteran officials hang up their whistles before their time. Many replacement officials are inexperienced, unprepared for responsibilities thrust on them, and frequently not ready to control fast-paced games. But for the veteran officials’ premature departures, many replacements would not be on the field.


The new JAMA Pediatrics study deserves the youth soccer community’s careful attention for shedding new light on risks posed by heading the ball. By emphasizing a central role for rules enforcement, the research team poses continuing challenges for soccer parents, coaches and officials who seek a healthy mix of safety and skills development.


Sources:  R. Dawn Comstock et al., An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer, JAMA Pediatrics (July 13, 2015); Gretchen Reynolds, Heading Ban for Youth Soccer Won’t End Head Injuries, Int’l N.Y. Times, July 15, 2015; Sasha Harris-Lovett, Study: Even Without Heading, High School Soccer players Face Concussion Risk, Study Finds, L.A. Times, July 14, 2015; Christy Collins et al., When the Rules of the Game Are Broken: What Proportion of High School Sports-Related Injuries Are Related to Illegal Activity?, Injury Prevention, vol. 14, p. 34 (2008); Chris G. Koutures & Andrew J. M. Gregory, Injuries in Youth Soccer, Pediatrics, vol. 125, pp. 410, 412 (2010).


DANGERS OF CONCUSSIONS: Focusing on The Often Overlooked Concerns During Practice

New Medical Study Spotlights Football Concussion Rates

During Practice Sessions

 By Doug Abrams

In early May, National Public Radio aired a story about a new study on the prevalence of concussions in football. The study, published in JAMA Pediatrics, found that at the high school and collegiate levels, players are more susceptible to concussions in practice sessions than in games.

The JAMA Pediatrics study found that in high schools and colleges, 58% of football concussions occurred in practices and 42% occurred during games. Fifty-eight percent is quite a bulk. A political candidate who wins election by 58%-42% celebrates a landslide, and the study’s 58% finding demonstrates a “concussions landslide.”

The study also found that in youth leagues, 54% of football concussions occurred during games. That number means that a hefty 46% occurred during practices. When a political candidate receives 46% of the vote, the campaign’s message resonated with voters, even without gaining a majority. The study’s hefty 46% “concussions minority” should resonate with parents and coaches who are concerned about youth leaguers’ safety.

Two Strategies for Safer Practices

The JAMA Pediatrics study concerned only one sport and only one type of injury, but the findings should stimulate closer attention to what happens generally in practice sessions – and not just in football. Football holds no monopoly on injury or risk, and the way that coaches plan and conduct practices vitally affects the health and well-being of the athletes and their families. Well-attended games sometimes attract the lion’s share of attention while practice sessions, without onlookers in the stands, escape under the radar.  But an injury is an injury, and the resulting short-term or long-term disability does not depend on whether the damage occurred with the scoreboard running.

Safety in practice sessions is the subject of this column. I am neither a medical researcher nor a physician, but the new JAMA Pediatrics findings do not surprise me. As a high school and collegiate hockey player in the mid-1960s and early 1970s, and as a youth hockey coach since then, I understand why practice sessions can carry higher injury rates than games.  But I also understand that coaches can lower these rates significantly with prudent, commonsense measures that enhance safety without changing the essential character of the game.

The potential for higher injury rates in practice sessions almost stands to reason. A winning hockey goalie who makes 30 saves, for example, is usually the game’s star; but in a practice, the goalie may face 30 shots in one repetitive drill that lasts only a few minutes, and may face a hundred or more shots in an hour-long session. And many teams schedule more practice sessions than games throughout the season. It would not surprise me to learn that goalies get hit in the face with shots more often in practices than in games. More repetitive shots on net in more sessions = more chances of hits to the head.

Two commonsense measures can help coaches reduce the likelihood of practice session injuries: (1) reasonably reducing repetitive risks, and (2) eliminating unreasonably dangerous drills in favor of effective drills that teach skills more safely. Both measures deserve discussion here.

Reducing Repetitive Risks

First, reasonably reducing repetitive risks in practice sessions. . . . Last month, the executive committee of the Georgia High School Association, the state’s governing body for interscholastic sports, voted unanimously to limit full-contact drills in football practices. The new limits, which take effect August 1, apply during both the preseason and the regular season. Georgia becomes the latest state to adopt limits designed to prevent concussions and other traumatic brain injuries in interscholastic football without changing the essential character of the game.

The GHSA says that its new rules resemble existing National Collegiate Athletic Association and National Football League rules, which many Georgia high schools were already following. The Macon Telegraph reports that during the preseason, full-contact drills will now be limited to 135 minutes each week, but not on more than two consecutive days. When a team holds two-a-day practices, contact may take place during only one session.

The newspaper reports that in practice sessions during the season, full contact is now limited to “90 minutes per week, or 30 minutes per practice spread across three practices. Full contact on back-to-back days will be permitted, but three straight full-contact practices will be prohibited.”

Eliminating Unreasonably Dangerous Drills

Now, eliminating unreasonably dangerous drills . . . .  Some years ago, I was watching a hockey practice for young teens in another community. The two coaches had the players do a “Suicide Drill” (their name for it), which featured manufactured mayhem with two pucks. “Team one” of five players skated out of one end of the rink with its puck, while “Team two” of five players skated simultaneously out of the other end, also with a puck. Each team skating full speed passed its puck several times as it avoided the other team through center ice on its way to the opposing net to take a shot.

The Suicide Drill’s purpose was to train players to keep their heads up as they skated through center ice. Heads-up hockey is an important skill at all age levels, but that particular drill should never have found its way into the practice agenda. Within two minutes, a full-speed collision at center ice landed a player in the hospital with a broken jaw.

In any sport, the best drills combine realism with safety. The hockey team’s Suicide Drill failed on both counts because, without simulating real game conditions, the drill carried an unacceptably high risk of injury that should have been apparent as the coaches planned the practice agenda. The team would have been much better off if the coaches had asked themselves a simple question before practice: “If the players do this drill, what might happen?”

When coaches foresee that a drill carries an unacceptable risk of injury, they can usually choose a safer drill that teaches and develops the same skill. Few, if any, skills have only one drill known to the coaching world. Safety is the coach’s primary responsibility to the players, and anticipating unacceptable risk is key to fulfilling the responsibility. Hindsight may indeed be 20/20, but coaches protect their players best when they also rely on 20/20 foresight to anticipate avoidable danger in practice sessions.


Sources: Thomas P. Dompier et al., Incidence of Concussion During Practice and Games in Youth, High School, and Collegiate American Football Players, JAMA Pediatrics, (May 4, 2015); NPR, Concussions Can Be More Likely In Practices Than In Games, May 11, 2015; Ron Seibel, GHSA Votes To Limit Contact In Football Practice, The Telegraph of Macon, Apr. 13, 2015; Assoc. Press, GA Sports Officials Vote To Limit Football Drills, Apr. 14, 2015; Doug Abrams, 20/20 Foresight, USA Hockey Magazine, Sept. 2014.