High Schools Seek Solutions to Head Injuries

The father of the 5-foot-9 linebacker waited for the sound that makes him wince.

"You can hear it from here," said Alfredo Lira, sitting at the far side of the bleachers at Ventura's Buena High School. His eyes widened as he imagined the pop of a helmet colliding with a shoulder pad, a knee or another helmet.

"As I hear it, I feel it," said the truck driver. "I feel like a lump in my throat."

Raising his binoculars, he pointed at his son jogging on the field with a kick return team. The 17-year-old loves football. Alfredo does not want him to stop playing and thinks the sport provides motivation.

He still worries.

"I saw three guys on him earlier, and they were bigger than him," he said, eyes wide again. "He got up like nothing. He was fine."

The anxiety is part of high school football, driven by National Football League controversies and rule changes, research linking head injuries to brain damage and the 2015 movie that's on Alfredo Lira's must-see list, "Concussion."

Coaches teach players to keep their heads up and tackle with their arms. Officials call penalties to protect punt returners unaware of the Mack truck charging down the field. Players from at least one Ventura County high school wear helmet sensors that register the impact of every block and tackle.

The precautions have brought greater control and reduced the amount of potentially dangerous collisions, according to coaches, officials and trainers. Injuries still happen.

"We're playing a contact sport," said Jack Willard, head coach at Camarillo High School. "The game is so reactionary and so fast, it's impossible to control every single block and tackling situation."

At Westlake High School where about 130 players compete on freshman, junior varsity and varsity teams, 15 to 18 players have been involved in hits this season that triggered concerns about possible concussions, with many of them turning out to be false alarms.

A similar number of players suffered possible concussions at Royal High School in Simi Valley. Six to 10 Buena players were involved in hits that generated concerns.

The significance of the numbers is camouflaged by a better-safe-than-sorry mentality that means a player who reports a headache after a game or practice is often placed on a concussion protocol. Other sports generate concussion fears, too — soccer, Lacrosse, water polo and sideline activities in which team members are catapulted into the air.

"We probably get three or four cheerleaders a year who have a suspected concussion," said Scott Blatt, Westlake High School trainer and founder of the nonprofit Conejo Concussion Institute.

One concussion is too many, said Blatt, assessing the 10 to 15 possible injuries sustained by football programs across Ventura County.

"It's too much," he said.

When he started as a trainer at Westlake High in the early 1990s, Blatt would conduct an assessment on a player involved in a hard collision. The player could return to the game in 15 minutes if no symptoms emerged.

Now, the player is held out of activity until being cleared by a doctor. If there's been a concussion, the youth can miss several games and must sit out at least seven days.

"I'm willing to bet there were twice as many (concussions) as there are now," Blatt said.

When a teen's bell is rung

Think of a woodpecker repeatedly driving its head into a tree trunk.

Research has shown the birds are protected by a strong beak, a brain with relatively little fluid and a striking motion that always follows a straight line, never curving.

Football players and other teenage athletes are different, said Dr. William Goldie, a pediatric neurologist at Ventura County Medical Center. When they're hit, the collision not only pushes their brain straight back, but also twists and rotates in a motion that can increase the damage.

Unlike woodpeckers, their brains are more diverse and include solid and liquid.

"Some areas will rip and tear," said Goldie, adding that the risk of damage rises with sports where contact to the head happens repeatedly. "I think we have to be very, very cautious, especially with the very young kids."

The men wearing black-and-white striped shirts and, in a nod to breast cancer awareness, pink wristbands preached caution, too.

The football officials gathered in a cluttered locker room office an hour before kickoff and reviewed their plan for a high school game between Buena and Oxnard. They agreed that if a player receiving a kick tilts his head skyward and doesn't see tacklers racing toward him, the play will be blown dead.

Saving the sport

If a cornerback or linebacker continuously lowers his head and drives his body forward, a flag will be thrown. The player will be reminded of the rules. So will the coach.

Referee Tim Drew, a cabinet maker who has been working football games for 23 years, explained the kind of collision the officials are trying to eliminate.

"You know it when you hear it," he said as others detailed the hollow pop of one helmet hitting another, a sound that almost always triggers an echo.

"You hear that one in the stands — 'Ooooh!'" said back judge Mike Dobes.

A series of rule changes that began more than a decade ago mean officials don't hear the noise as often as they once did. They issued illegal hit penalties maybe five times a game several years ago when targeting rules for above-the-shoulders hits were introduced, said Dobes, onetime high school tight end and current president of the Channel Coast Football Officials Association.

Now, they often go an entire game without throwing a flag for illegal use of helmet or targeting. It shows coaches, like the officials, have adjusted.

"We're trying to save the sport," Dobes said. "The sport, in general, has gotten so much publicity because of the NFL. It's filtering down. If we don't fix this safety issue at this stage, parents are going to say, 'I'm not going to sign up my kids.'"

Data released in August from the California Interscholastic Federation shows participation in 11-player high school football dropped from 107,900 players statewide in 2006 to 94,300 players in 2017. Some schools in and around Ventura County that once fielded freshman, junior varsity and varsity teams now field only two squads.

The slide has been particularly dramatic in youth football leagues aimed at players 14 years and younger.

"It's been a steady decline probably over the last two or three years," said Tony Calfo, president of the Pacific Youth Football League, linking the dip in part to fears triggered by the film, "Concussion." He thinks the key to building the numbers back up involves making sure head coaches and assistant coaches all teach the same tackling techniques.

"No one is going to be successful until every coach is committed," he said.

Keeping the helmet out of a tackle

When Jason Klein was a 5-foot-6, 160-pound linebacker in the 1990s, he was taught to bring his helmet across the ball carrier's body. He was told to strike the ball with his face mask to knock it free.

It was a different world then, said Klein, now the assistant athletic director and head football coach at Newbury Park High School. He tells his players to get their shoulders into the offensive players hips and wrap with their arms.

"Try to get the head out of tackling completely," said Klein, who also counsels players to make sure they hit another player between the shoulder pads and the thigh pads. No higher. No lower.

Royal High School Coach Matt Lewis tells players to keep their heads up and to drive forward into tackles with the shoulder and foot nearest to the offensive player. They learn the technique in live-contact practices that are limited by design and by a 2014 state law aimed at reducing injuries. Most of the teaching comes in drills involving padded tackling dummies.

About 40 players at Royal use Riddell helmets equipped with sensors that measure the impact of each collision. If a tackle or block exceeds a force threshold set by Riddell, the sensor sends an alert to the monitor held by training staff member Yousef Jalala.

"Where are you at?" Jalala asked junior varsity linebacker Ryan Abril after a hit in practice, asking him to repeat the months of the year backward, recite a string of numbers and to remember four words: "royal," "apple," "saddle" and "bubble."

If a player can't answer or experiences other symptoms like a headache, blurred vision or nausea, he enters the concussion protocol.

Lewis took the initiative to purchase the sensors two years ago, figuring he could hurdle financial barriers by fundraising. Now the burden — about $150 per sensor plus maintenance costs — is shared by parents and the Simi Valley Unified School District.

"I think it helps us detect many things we most definitely would have missed," he said. "It's hard for any trainer or two trainers to watch all 11 players and (know) exactly what they're doing on the field."

A Riddell official said 130 Southern California high schools use the technology. But of the three Ventura County schools on Riddell's list, only Royal currently uses the helmets. Coaches and trainers at some schools cite limited budgets.

Buena High School Coach Ryan Bolland wants tools some area schools already have, like paid trainers to work practices and games. He wants tests of cognitive abilities performed for all the players, creating baseline assessments that can be used to measure the impact of head injuries.

"All of that stuff to me is far more important than something in the helmet that says you got hit really hard," he said.

Perils of CTE

Dr. Lorne Label flipped through a stack of papers heaped 8 inches high. The documents come from assessments of 80 NFL retired players conducted in the neurologist's Thousand Oaks office as part of a head injury lawsuit that triggered a settlement worth an estimated $1 billion.

The pages reveal math problems, puzzles and other quizzes performed by players, all of whom suffered repeat concussions. In one, a player was asked to draw the arms of a clock showing the time 11:10. He drew 10:10 a.m.

Almost every test reflected memory issues and other impairment. Some of the players suffered dementia.

"Many of them had trouble putting sentences together, their thoughts together," Label said, adding that he asked all of their players if they would let their children play tackle football

"I was surprised how many said, 'No, I want my kids to have a different life than I had,'" he said.

Affiliated with UCLA Health, Label sometimes treats high school athletes who suffer concussions from football, soccer, Lacrosse and hockey. He acknowledged the risks have decreased because of new rules and equipment changes.

Label also conceded his exposure to the NFL players has skewed his views. His two children are both girls and now adults. But if he had a child who wanted to play high school football, his answer would be immediate.

"Absolutely not," he said.

The rules

Illegal helmet contact is an act of initiating contact with the helmet against an opponent.

Spearing is an act by any player who initiates contact against an opponent at the shoulders or below with the crown of his helmet.

Targeting is an act by any player who takes aim and initiates contact against an opponent above the shoulders with the helmet, forearm, hand, fist, elbow or shoulders.

A defenseless player is a player who, because of his physical position and focus of concentration, is especially vulnerable to injury. A player who initiates contact against a defenseless player is responsible for making legal contact

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