How NFL changes are reshaping high school sports
Because of news stories, documentaries and movies, when people think of concussions, they think of football first. But players of other sports are at risk for concussions, too.
According to the National Federation of State High School Associations, 173,283 Virginia students participated in high school sports during the 2014-15 school year; just under 70,000 played basketball, football, soccer or lacrosse, the sports with the highest incidence of concussion.
Yet despite the risks, athletes often do not report potential head injuries. A 2014 study by Harvard University and Boston University found that only 1 in 27 college football players with concussions actually reported them.
The NFL is working to change that “culture of resistance” by creating a range of concussion safety protocols they hope will not only increase public awareness of the risks of concussions, but also how contact sports are played in the future.
“When it comes to sports safety, the NFL looks at itself as the leader. I think they take that responsibility seriously,” says Anthony Casolaro, team physician for the Washington Redskins. Dr. Casolaro, who is also an internist at Virginia Hospital Center, has been working with the Redskins for 18 years. In that time he has seen a big change in how seriously the team and the players take concussions.
Just a decade ago, getting a player off the field for a concussion check was a challenge. Dr. Casolaro recalls one player, whom he declined to name, who had written the answers to the concussion screening on the inside of his wrist before the game—just in case he took a hit. “That’s changed,” says Dr. Casolaro, who credits the high-profile media cases about repeated brain injuries with raising awareness of the importance of concussion screening. “Now coaches, referees and the players will come to me and ask me to check on people.”
The NFL is undertaking several measures to mitigate the risks. It has revised its return-to-play protocols, which include independent neurologists on the sidelines to evaluate players who have taken a severe hit. Most significantly, the NFL is changing the rules of the game. Kickoffs have been moved forward 5 yards, reducing the opportunities for high-speed collisions. “Fewer kickoff returns mirrors a drop in concussion,” explains Dr. Casolaro. Referees enforce new prohibitions on helmet-to-helmet contact with a 15-yard penalty. Dr. Casolaro thinks the 15-yard penalty will change how players engage on the field: “That [penalty] can make all the difference in the world in between winning and losing.”
Dr. Casolaro serves on the NFL injury and safety panel. He also works with the Pentagon to develop safety protocols for soldiers experiencing brain injury. He thinks the NFL is on the right track with the recent array of policy and play changes to reduce the risk of concussion to players and care for players who have taken a hit.
The NFL is also funding research into helmet safety and techniques to speed recovery from concussions. During games, an athletic trainer keeps an eye on players from the press box. If a player takes a hit, the physicians on the sidelines get real-time information about potential injuries.
“This year that eye-in-the-sky can call a medical timeout, the idea being to remove the [potentially injured] player from game,” explains Dr. Casolaro. “We don’t want to risk further injury.”
High schools are adopting similar policies. Fairfax County Public Schools was the first school system in the country to adopt the NFL-endorsed Heads Up Football program. Coaches enrolled in Heads Up complete an online certification in concussion safety and awareness. The program also includes a protocol for tackling that reduces helmet contact. Each high school then designates a coach to monitor the program’s implementation and train other coaches, parents and players. In the two years since Fairfax adopted the program, the districtwide rate of concussions has dropped 28 percent for football. The program is now being extended to other sports. So far, the concussion rate is down more than 30 percent for boys and girls lacrosse.
Other area schools are adopting different approaches with similar goals in mind. At T.C. Williams High School in Alexandria, coach Marc Mattie, a former linebacker for Chantilly High School and the College of William and Mary, teaches players to use the rugby-style tackle favored by the Seattle Seahawks. The so-called Hawk tackle drives the shoulders—rather than the head—into the opponent’s chest or thighs.
Assistant coach Jeff Sejour, who played strong safety at Lafayette College, explains that this is a huge shift from what he learned as a player in the 1990s. Back then, players were taught to aim for the opposing player’s jersey number with the facemask. “Until five years ago, that was the predominant way to think of tackling.”
“There’s no question the game is changing,” Mattie says. Yet Sejour thinks there is still work to be done, especially when it comes to educating players and parents about concussions. He still gets pushback from parents who want to get their kids back in the game. Many of those parents grew up in an era when a concussion was dismissed as a ding or getting your bell rung.
Area coaches now rely on a combination of baseline neuropsychological testing, sideline protocols and the judgment of physicians and licensed athletic trainers to make the call on when a player is safe to return to play. “Some of the hardest conversations you have to have are with the kid who has had a couple of concussions, and you have to tell them they can’t come back [to play],” Sejour explains.
Dr. Casolaro hopes that as the next generation of players grows up using the new concussion protocols and play techniques, the game will grow safer over time. He points out the efforts have already reduced the NFL’s concussion rate by 36 percent since 2012.
“It’s an educational process,” he says. The next step, he says, is making sure everyone learns the lesson.
( February 2016 )
