DeMatha Catholic High School and St. John’s College High School go head to head in Washington, DC.

Toni L. Sandys/ The Washington Post via Getty Images

Friday Night Lights Out?

Participation in high school football is declining amid growing concern over the long-term effects of concussions. What does that mean for the future of America’s most popular sport?

When Clayton Cohen collided with his teammate helmet-to-helmet during high school football practice last fall, his first instinct was to get right back up and keep playing. Though he felt dizzy and had a large bump on the back of his head, Clayton didn’t want to risk being seen as weak and potentially lose his position as starting linebacker.

“That was always my mind-set,” says Clayton, now a 17-year-old senior at Briar Woods High School in Ashburn, Virginia. “When you would hit someone and saw stars and you felt dizzy after the play, that was seen as a good thing, a good hit. Nobody was telling me about how bad concussions were.”

But the next day, Clayton realized that something might be seriously wrong. As he walked through the halls of his high school, he couldn’t recognize a single face—not even those of students he’d known for years. Sitting in class later, his head started spinning. He felt nauseated, confused, and “out of body.”

Though the symptoms mostly went away after a few weeks, they returned this summer, while Clayton was going through hitting drills at a football camp. So before the start of school, he decided to quit the sport he’d been playing since he was 6 years old.

When Clayton Cohen collided with his teammate helmet-to-helmet during high school football practice last fall, his first instinct was to get right back up and keep playing. He felt dizzy and had a large bump on the back of his head. But Clayton didn’t want to risk being seen as weak and potentially lose his position as starting linebacker.

“That was always my mind-set,” says Clayton, now a 17-year-old senior at Briar Woods High School in Ashburn, Virginia. “When you would hit someone and saw stars and you felt dizzy after the play, that was seen as a good thing, a good hit. Nobody was telling me about how bad concussions were.”

But the next day, Clayton realized that something might be seriously wrong. As he walked through the halls of his high school, he couldn’t recognize a single face. Even the students he’d known for years looked like strangers. Sitting in class later, his head started spinning. He felt nauseated, confused, and “out of body.”

The symptoms mostly went away after a few weeks. Then they returned this summer, while Clayton was going through hitting drills at a football camp. So before the start of school, he decided to quit the sport he’d been playing since he was 6 years old.

“It was one of the hardest decisions I’ve ever made,” Clayton says. “But I’m very glad I did it. I’m not going to let one year of high school football determine the way the rest of my life goes.”

Clayton is far from the only high school football player who has recently decided to hang up his cleats over concerns about concussions. As new evidence reveals more about the long-term effects of repeated blows to the head, participation in high school football is declining—down by about 7 percent nationwide from 10 years ago. And a growing chorus of people, including some scientists, former players, and lawmakers, are convinced that playing tackle football is a bad idea—and that young people shouldn’t do it.

“We don’t have any more excuses; the proof is out there,” says Orin Starn, an anthropology professor at Duke University and an expert on American sports culture. “Football is a destructive and barbaric game that has long-term health consequences for players—but we love it.”

“It was one of the hardest decisions I’ve ever made,” Clayton says. “But I’m very glad I did it. I’m not going to let one year of high school football determine the way the rest of my life goes.”

Clayton is far from the only high school football player who has recently decided to hang up his cleats over concerns about concussions. As new evidence reveals more about the long-term effects of repeated blows to the head, participation in high school football is declining. In fact, it’s down by about 7 percent nationwide from 10 years ago. And a growing chorus of people are convinced that playing tackle football is a bad idea—and that young people shouldn’t do it. That includes some scientists, former players, and lawmakers.

“We don’t have any more excuses; the proof is out there,” says Orin Starn, an anthropology professor at Duke University and an expert on American sports culture. “Football is a destructive and barbaric game that has long-term health consequences for players—but we love it.”

Noah Willman (Left); Courtesy Clayton Cohen (Right) 

Clayton chases after an opponent during a game in 2017.

“[Quitting football] was one of the hardest decisions I’ve ever made.” —Clayton Cohen, 17

Memory Loss, Dementia, and Depression

Though it’s not the only sport in which concussions frequently occur (see “Heads Up,” below), football has been under heightened scrutiny since 2005. That’s when scientists at the University of Pittsburgh revealed that they had discovered a brain disease called chronic traumatic encephalopathy (C.T.E.) in the brains of former National Football League (N.F.L.) players. C.T.E. is caused by repeated hits to the head, and its symptoms include confusion, memory loss, dementia, depression, and suicidal thoughts. (C.T.E. can be definitively diagnosed only after death, though it may be suspected in a living patient.)

The findings forced the N.F.L. in 2009 to acknowledge publicly that football-related concussions can lead to long-term negative health effects. A rash of suicides of former players, including Hall of Famer Junior Seau in 2012, called increased attention to the issue. An autopsy on Seau’s brain revealed he had severe C.T.E.

The N.F.L. has since stated that it expects nearly a third of retired players to develop permanent brain impairments, such as Alzheimer’s disease or other forms of dementia. And a study released last year by researchers at Boston University and the VA Boston Healthcare System painted an even starker picture: It examined the brains of 111 former N.F.L. players, and all but one had C.T.E.

It’s not only N.F.L. players who are at risk of brain damage. The study showed that 76 percent of the 67 former high school and college football players’ brains examined had C.T.E. too.  

High school players are particularly vulnerable to damage from blows to the head, especially if they’ve had concussions before (see “Inside a Concussion,” below). A teenage brain can begin to show C.T.E.-related symptoms if another blow to the head is sustained soon after a concussion, according to a 2018 Boston University study.

There can also be a more immediate consequence to these hits. Last month, a 16-year-old high school football player in Georgia died two days after sustaining a head injury in a game. A 17-year-old high school football player in Washington State died in 2015 after a routine collision following a concussion. And a 16-year-old player in Oklahoma died in 2015 shortly after sustaining a head injury while making a tackle.

“A teenager’s brain is still developing,” says Martha Shenton, director of the neuroimaging lab at Harvard Medical School. “Even a moderate hit to the head following a concussion can be fatal because the brain hasn’t healed from the previous blow.”

Football isn’t the only sport in which concussions frequently occur (see “Heads Up,” below). But it’s been under heightened scrutiny since 2005. That’s when scientists at the University of Pittsburgh revealed that they had discovered a brain disease called chronic traumatic encephalopathy (C.T.E.) in the brains of former National Football League (N.F.L.) players. C.T.E. is caused by repeated hits to the head. Its symptoms include confusion, memory loss, dementia, depression, and suicidal thoughts. C.T.E. can be definitively diagnosed only after death, though it may be suspected in a living patient.

The findings forced the N.F.L. in 2009 to acknowledge publicly that football-related concussions can lead to long-term negative health effects. A rash of suicides of former players called increased attention to the issue. That includes the suicide of Hall of Famer Junior Seau in 2012. An autopsy on Seau’s brain revealed he had severe C.T.E.

The N.F.L. has since stated that it expects nearly a third of retired players to develop permanent brain impairments. These conditions include Alzheimer’s disease or other forms of dementia. And a study released last year by researchers at Boston University and the VA Boston Healthcare System painted an even starker picture. It examined the brains of 111 former N.F.L. players. All but one had C.T.E.

It’s not only N.F.L. players who are at risk of brain damage. The study showed that 76 percent of the 67 former high school and college football players’ brains examined had C.T.E. too.

High school players are particularly vulnerable to damage from blows to the head. Their risk is increased if they’ve had concussions before (see “Inside a Concussion,” below). A teenage brain can begin to show C.T.E.-related symptoms if another blow to the head is sustained soon after a concussion, according to a 2018 Boston University study.

There can also be a more immediate consequence to these hits. Last month, a 16-year-old high school football player in Georgia died two days after sustaining a head injury in a game. A 17-year-old high school football player in Washington State died in 2015 after a routine collision following a concussion. And a 16-year-old player in Oklahoma died in 2015 shortly after sustaining a head injury while making a tackle.

“A teenager’s brain is still developing,” says Martha Shenton, director of the neuroimaging lab at Harvard Medical School. “Even a moderate hit to the head following a concussion can be fatal because the brain hasn’t healed from the previous blow.”

Greg Nelson/Sports Illustrated/Getty Images

Is football losing fans? You wouldn’t know it from watching a game at Allen High School’s $60 million stadium outside Dallas.

Protecting the Players

As concern over concussions has filtered down from the N.F.L. to youth leagues, many parents have become fearful of allowing their kids to play. Some high schools have even had to cancel their varsity football seasons this year because they couldn’t attract enough players. Bishop Noll Institute, in Hammond, Indiana, is one of them.

“Everybody is afraid of the head injuries,” says the school’s football coach, Wayne Racine. “Football has become the bogeyman.”

Many football supporters believe there are benefits to playing the sport. For example, it builds discipline, focus, and teamwork—skills that can help teens be successful later in life. They also say the sport is becoming safer. The N.F.L., for example, now has a neurologist on the sidelines for every game to evaluate players after hits to the head to determine if they’re able to play. The league has also poured millions into researching new anti-concussion helmet technology. 

Concern over concussions has filtered down from the N.F.L. to youth leagues. In turn, many parents have become fearful of allowing their kids to play. Some high schools have even had to cancel their varsity football seasons this year because they couldn’t attract enough players. Bishop Noll Institute, in Hammond, Indiana, is one of them.

“Everybody is afraid of the head injuries,” says the school’s football coach, Wayne Racine. “Football has become the bogeyman.”

Many football supporters believe there are benefits to playing the sport. For example, it builds discipline, focus, and teamwork. Those skills can help teens be successful later in life. They also say the sport is becoming safer. The N.F.L., for example, now has a neurologist on the sidelines for every game to check players after hits to the head to determine if they’re able to play. The league has also poured millions into researching new anti-concussion helmet technology. 

Ron Lewis/ZumaPress.com/Newscom

Not just football: Girls’ soccer also has high concussion rates.

All 50 states and Washington, D.C., have passed laws mandating how youth players with head injuries are treated. And many high school leagues now require the immediate removal of anyone suspected of having sustained a concussion and clearance from a qualified medical professional before the player can return to the field.

Racine, the coach at Bishop Noll, says a lot of high school coaches are limiting contact in practice and placing more of an emphasis on proper tackling technique. 

“When I was playing football in high school, we were told to put your face in the guy’s numbers,” he says. “So your head was taking the blow. But now, your head is nowhere near the blow.”

But many people say these new safety measures don’t go far enough. They argue that tackle football is inherently unsafe and that the only way to fully protect young people is by not letting them play in the first place—at least, not until they’re older. Lawmakers in New Jersey, New York, Illinois, and California recently proposed bills to ban tackle football before age 12, but none have been passed. 

It isn’t just politicians and parents turning away from the game. Hall of Famer Brett Favre, considered one of the all-time great quarterbacks, has endorsed efforts to ban tackle football before the age of 12. Several other former star players, including Bo Jackson, have publicly said they wouldn’t allow their kids to play tackle football.

“There’s no way I would ever allow my kids to play football today,” Jackson told USA Today, adding, “If I knew back then what I know now, I would have never played football.”

All 50 states and Washington, D.C., have passed laws mandating how youth players with head injuries are treated. And many high school leagues now require the immediate removal of anyone suspected of having sustained a concussion. Players must also get clearance from a qualified medical professional before they can return to the field.

Racine, the coach at Bishop Noll, says a lot of high school coaches are limiting contact in practice. They’re also placing more of an emphasis on proper tackling technique. 

“When I was playing football in high school, we were told to put your face in the guy’s numbers,” he says. “So your head was taking the blow. But now, your head is nowhere near the blow.”

But many people say these new safety measures don’t go far enough. They argue that tackle football is inherently unsafe and that the only way to fully protect young people is by not letting them play in the first place. That is, at least, not until they’re older. Lawmakers in New Jersey, New York, Illinois, and California recently proposed bills to ban tackle football before age 12. But none have been passed. 

It isn’t just politicians and parents turning away from the game. Hall of Famer Brett Favre, considered one of the all-time great quarterbacks, has endorsed efforts to ban tackle football before the age of 12. Several other former star players, including Bo Jackson, have publicly said they wouldn’t allow their kids to play tackle football.

“There’s no way I would ever allow my kids to play football today,” Jackson told USA Today, adding, “If I knew back then what I know now, I would have never played football.”

Bringing in Millions

But the love of the sport still runs deep in many places across the country. Consider a Friday night game at Allen High School, just outside Dallas. The Allen Eagles, who won the Texas state championship last year, play under the lights of a stadium that cost $60 million to build and seats 18,000 fans.

Eagles senior wide receiver Kylon Willie, who has earned a scholarship to play at Houston Baptist University next year and hopes to make the N.F.L., says even though he knows about the dangers of concussions, he tries not to think about them.

“I love the sport,” he says. “And it’s also a way to get me to the next level of education.”

But the love of the sport still runs deep in many places across the country. Consider a Friday night game at Allen High School, just outside Dallas. The Allen Eagles won the Texas state championship last year. Now, they play under the lights of a stadium that cost $60 million to build and seats 18,000 fans.

Eagles senior wide receiver Kylon Willie has earned a scholarship to play at Houston Baptist University next year. He hopes to make the N.F.L. one day. Even though he knows about the dangers of concussions, Kylon says he tries not to think about them. 

“I love the sport,” he says. “And it’s also a way to get me to the next level of education.”

Can football be made safer, or is the game inherently unsafe?

Indeed, despite what we now know about the effects of concussions, football remains America’s most popular sport, based on fan attendance for pro sports leagues. And big-time college football programs still bring in tens of millions of dollars for their schools each year. Some see that as a sign that the sport isn’t likely to die out anytime soon.

As for Clayton, the high school player who quit football after having a concussion, he still loves watching the game. But he thinks more people should consider the risks of playing it. 

“Part of the problem is, when you’re playing, you don’t want to know about [concussions],” he says. “We like to hide ourselves from the truth.”

Indeed, football remains America’s most popular sport, based on fan attendance for pro sports leagues. And big-time college football programs still bring in tens of millions of dollars for their schools each year. This is despite what we now know about the effects of concussions. Some see these trends as signs that the sport isn’t likely to die out anytime soon.

As for Clayton, the high school player who quit football after having a concussion, he still loves watching the game. But he thinks more people should consider the risks of playing it.

“Part of the problem is, when you’re playing, you don’t want to know about [concussions],” he says. “We like to hide ourselves from the truth.”

Inside A Concussion

A hit to the head is the most common cause of a concussion. Here’s what it does to the brain.

Illustration by Kate Francis

1. A sudden impact jolts the head in a particular direction.

2. The force of the impact slams the brain against the inside of the skull. Then the brain bounces back against the opposite side. 

3. Some hits also twist and stretch the brain as it bounces around.

4. Severe concussions can make the brain swell. This puts pressure on the brain stem, which controls things like breathing and swallowing. 

Heads up

High school sports with the highest rates of head injuries

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