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When it comes to players and concussions, if in doubt, sit them out

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All-star high school athletes play football at the 4A vs. 5A all-star football game at Alta High School in June.

All-star high school athletes play football at the 4A vs. 5A all-star football game at Alta High School in June.

Matt Gillis, Deseret News

In little more than a month, Friday nights in most cities and towns across the nation will echo with the sounds of high school football: the thuds and whacks of shoulder pads and helmets colliding.

Along with the action and the excitement, however, are serious dangers for the approximately 1.4 million teenagers competing on the fields.

Everyone, especially parents, should be concerned.

Until recently, the major focus had been on injuries that could be seen or touched — broken bones, sprains, muscle strains and torn ligaments. Now, medical professionals and coaches are paying more attention to the concussions high school players sustain during practice and games.

Experts have learned plenty about the debilitating long-term medical risks of concussions for National Football League players, but not much is known about the long-term risks to high school players. What is known, though, is that one of every four players 18 or younger suffers a concussion of some kind, a statistic that is higher than ever. No one has followed high school players systematically for a decade or more, as has been the case with NFL players, to determine the effects of concussions, wrote Kevin Guskiewicz of the University of North Carolina, who is a member of the National Athletic Trainers' Association.

Based on evidence related to NFL players, Guskiewicz wrote: "One would assume a high school player who likewise had three or more (concussions) during his high school years would potentially be predisposed to some of these same long-term neurodegenerative conditions that NFL players are."

A lot of factors are responsible for the increasing number of traumatic head injuries among young players: The number of players greatly increases every year. Players are getting bigger, faster and stronger. As a result, the force and the frequency of blocks and tackles are rising.

At the same time, researchers report, while many coaches encourage their players to hit hard, they are not teaching them the safest ways to protect their heads. When you add the "toughness" factor to the mix, teams wind up with potentially deadly situations. Football players define themselves by their toughness, their willingness to give their all to their teams. They will do almost anything to contribute to victory. They never want to be taken out of a game, and coaches do not want to lose their stars and risk defeat.

A defensive lineman for an Illinois high school told a New York Times reporter: "You've got to sacrifice for the team. The only way I come out is on a stretcher."

Too often, players keep head injuries to themselves. When coaches do not know a player has been dinged, they are left in the dark. One result, according to studies, is that nine out of 10 concussions are not diagnosed. To make matters worse, too many players are routinely sent back into action before they heal.

Most experts agree that better helmets can help reduce the number and seriousness of concussions among high school players. Unfortunately, there has not been a testing program that has produced results researchers can agree on that would most benefit high school players.

What, then, are the best ways to reduce the risk of long-term brain injuries to young players?

Medical professionals and others say that players, coaches and parents need to learn how to recognize the symptoms of concussions and not hesitate to yank players off the field. Players must be kept on the bench until a trusted health professional gives the OK for them to return to competition. Coaches must teach players the safest techniques on offense and defense. And coaches are advised to reduce the number of practices in which players make heavy contact. Evidence shows that where full contact is reduced to one day a week, teams perform just as well.

Yes, football season is nearing, and the excitement is building. Everyone involved in the sport should be mindful of the future health of the children on the field. Concussions should be of particular concern.

When it comes to players and concussions, one old coach said it all: "When in doubt, sit them out."

Bill Maxwell is a columnist for the St. Petersburg Times. E-mail bmaxwell@sptimes.com.