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Weighing the health costs of high school football

The debate over the health risks of high school football has escalated since three student players died in a week. PBS NewsHour’s Student Reporting Labs talk to the football team at T.C. Williams High School in Virginia for their response. Then Gwen Ifill sits down with Steven Broglio, director of the NeuroSport Research Laboratory at the University of Michigan to discuss the risks to young athletes.

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    As the fall football season heats up, the Friday night lights dimmed somewhat last week with news that three young players died from injuries sustained on the field.

    Tom Cutinella, a 16-year-old, collapsed following a blocking collision during a game in Elwood, New York; 17-year-old Demario Harris Jr. was pronounced dead three days after collapsing during a game. He's believed to have suffered a brain aneurysm shortly after making a tackle. That same night, 17-year-old Isaiah Langston collapsed during a warmup before playing for Rolesville High School in North Carolina.

    Our Student Reporting Labs train young people in public media journalism. They went to the football team at T.C. Williams High School in Virginia, which happens to include a female kicker, for reaction.


    I like contact. I love hitting.


    I love hitting in football. That's one of the things that makes football great.


    I like the contact. That's what it is.


    When I had that first contact with someone, then like I felt like I had enough power to do what I want.


    When I did kickoff last year, I obviously knew that I could be tackled. And then when it actually happened one time, I was completely shocked, because I didn't know what it was really going to feel like.

  • DENNIS RANDOLPH, Football Coach, T.C. Williams High School:

    Coaches, again, we talk about this in our meetings. We did early. And sometimes we have kind of neglected it in the past, but please make sure that, because of these three deaths related to football — OK, and that's most in a long period of time — with all the safety that is taking place now, we play a game. We want to have fun.

    But we also want to make it safe. We want you to play hard, we want you to hit hard, we want you to go after your opponent, tackle him,, knock him to the ground if you are blocking him, but we want you to be safe about it. We don't want — we're not saying kill the other player, because that's not appropriate.

    Fortunately, I have never have worked with a kid who died. Those kind of things are tragic. And certainly it affects us because I work with kids every day, and I really don't know how I would react to one of my players getting hit and dying from an injury related to the sport that I — has been a part of my life my whole life.


    It will definitely bring awareness to every football team across the nation, because that's something that no team would ever want to have to deal with.


    My mother, she just told me she heard about a kid that died on the field. And she said, like, you know that, when you go out there and you suit up, every time you suit up could be your last time. I say, yes, I know that, but I say, it's not something you think about. And even when you do think about it, you dismiss it because those types of thoughts are going to make you second-guess yourself.


    When you hear about the stories coming out at the pro level, such as the NFL, what you hear a lot of former players say is that, at the same time, we knew what we were getting into when we started to play football. And that's I think one of the things that you have to consider if you want to play football.


    My mom just really, she thinks twice about signing the paper when she has to. So, really signs it because she realized that football helps me keep my grades up, and I wouldn't be doing the wrong things outside of school.


    You can go to a doctor and get cleared from a concussion and walk home and drop dead from a concussion.

    And I know that we have had people who got released and say that we could play, and then they show up here at practice and they're good to go. And, all of a sudden, they're getting headaches and dizziness from — and throwing up two days after they have been cleared to play.

    I wouldn't want to be an athletic trainer. Coaching football is hard enough. Being a trainer is much harder than being a football coach.

  • MARJORIE FRANKE, Athletic Trainer, T.C. Williams High School:

    It's usually pretty clear, to be honest, based off even just their signs and symptoms.

    So, typically, if it's not one of those clear situations, we will still keep them out of activity and we will reevaluate, and of course always make sure the parents are aware of what they're looking for as well, so that we have numerous eyes helping us to determine if it's something we need to be worried about and end up treating as a concussion.


    When I first came, I didn't know how to tackle at all. And so if I was put in that position, I probably wouldn't have known what to do in the first place.

    So, the fact that they take — especially at our school, they take time to show each one of us how to tackle so that we don't injure ourselves, like, heads up, things like that, and so that's definitely something that I think every player should know, even if you're playing peewee or if you are in college. It's something that you should always go over.


    Honestly, I personally would like to see the change of youth football to the full contact starting a bit later, just because of the higher risk of younger kids doing head-related impacts and it showing later on in their life. It's taking a toll on their brain's health in general. And I think we might need to start getting those youth football players working more on technique and skill, as opposed to full contact game situations.


    I think they're going to put a lot of stipulations on the game that's going to make the game a lot less fun for some people. They're going to be very safe their hits.

    And it's like — it's not going to have that freedom that the game once had, even though it did cause injuries and long-term injuries. But while we're in the moment, we're not really thinking about that. And I'm just like, there's a point where you have got to let people live a little bit, because we know what we're doing every time we come out here.

    We signed emergency contact forms. We signed all that. We know what can happen. So, while I'm out here, just let me do what I do.


    For more on the risks to young athletes, we turn to Steven Broglio. He's associate professor and director of the NeuroSport Research Laboratory at the University of Michigan, and a leading voice for the National Athletic Trainers Association about the management of concussions.

    Steven Broglio, when we listen to these students talk, do we know if they are more vulnerable than we have seen with the NFL or the NCAA?

    STEVEN BROGLIO, Director, NeuroSport Research Laboratory, University of Michigan: Thanks for having me on, Gwen.

    The first thing I think we look at is the epidemiology data that shows that the incidence rate for concussion at the NFL, the college and the high school level is all about the same. So the same percentage of athletes will have an injury at all those levels.

    What really differs, though, is the number of athletes that participate in those sports each year. So, at the professional level, we have about 1,500 athletes that play, about 40,000 at the college level, but we have about 1.2 million high school kids that play football each year.


    Well, that's a big difference. And they're obviously a lot younger. They're under someone else's guardianship still, so that is what causes the extra concern.

    How does one lessen the risk to these young people?


    Really, it comes down to good fundamentals, so good coaching techniques, heads-up football, seeing what you hit, as well as educating the athletes on what the signs and symptoms of concussion are.

    You are never going to reduce all concussions or eliminate all concussions from the game, but we can certainly reduce them. But when they happen, we need the athletes to report those to a coach or an athletic trainer if they're available at the practice or the game.


    I have talked to young football players who say, oh, this is just what happens. They speak proudly of being clocked, of having their bell rung.

    Is this just a culture of playing hurt?


    I think it was a culture of playing hurt.

    Certainly, things have started to change. We have seen a time 10, 15 years ago where there was a big emphasis on pushing through it, pushing through the injury, playing while you're injured. But now I think with increased attention both through research and through media awareness, people are starting to understand the injury better.

    Athletes are reporting the injury more often. They're taking it seriously. They're seeking medical attention and they're getting treatment as needed.


    How do we know that the deaths we heard about last week or the incidents we hear about on the field are all related to play, and how much of it are things that can be screened for like cardiac problems in advance, for instance?



    So, I'm not familiar with any of the cases that were talked about. So, there are certain things that can be screened for. There are certain cardiac issues that can be. There are certain brain issues that can be screened for. I believe one case might be related to an aneurysm.

    The question is the cost of those screenings and — vs. the associated risk that might happen. So, aneurysms in — particularly in youth are incredibly rare. And so the idea of screening the entire population may be cost-prohibitive.


    NCAA has a reporting mechanism, a mandatory reporting rule. Do high schools?


    So, every state in the country has a law on concussions, that the athletes should be reporting an injury to an athletic trainer if they're available or a coach or another medical professional if they're available.


    And what do parents do? What do parents say in this situation? We heard the young man say his mother reluctantly signs the paper when he brings it to her. Is there — should parents be thinking, maybe this is a bad idea, football?


    I don't think so. I don't think so.

    I think the benefits that young people get from participating in sports, whether it's football or soccer or anything, far outweigh the risks that they might have or might incur with a concussion. One concussion that's well-managed, we have no evidence that that suggests that there's going to be long-term problems in 20 years or 30 years.

    But yet we know that there are plenty of risks associated with not participating in physical activity, obesity, diabetes, metabolic syndrome and all the things that go along with that. And that's just on the medical side. We know that participation in sports develops work ethic, working as a team. There's huge benefits to physical activity and performance in school. So, I think the benefits of sport participation far outweigh those risks.


    It's definitely a tradeoff on many, many different levels.

    Steven Broglio, the University of Michigan NeuroSport Research Laboratory, thank you for joining us.


    Thank you, Gwen.

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