When I played football in high school, I was taught to be tough, play through pain, and not let my team down. But when it comes to concussions, that tough mindset is doing real damage to high school players.
Concussions are not just “a part of the game,” they are a serious public health issue. Every year in the United States, an estimated 1.6 to 3.8 million sports-related concussions occur (Centers for Disease Control and Prevention [CDC], 2023). Football ranks among the highest-risk sports because of the number of head impacts. Concussions aren’t rare injuries. They happen in high school stadiums, at Friday night games, and during practice. The scariest part is that many concussions go unreported.
Courtesy: goalnation.com
But what exactly is a concussion? A concussion is a mild traumatic brain injury caused by a sudden hit that makes the brain move inside the skull. That movement disrupts normal brain function. Symptoms include headaches, dizziness, confusion, memory problems, and sensitivity to light. Even after symptoms fade, the brain continues to heal (Patel et al., 2024). Returning to play too soon increases the risk of another concussion, and athletes who have had a concussion are 4 to 6 times more likely to have another (Fong, 2024).
But why don’t players speak up? A lot of it is pressure. I remember never wanting to let the team down, from coaches to players. Everyone has to do their part, and one person going down can mess up the rhythm for the whole team. Athletes also worry about losing their spot, which means giving up all the work they put in to get there. Many do not want to be labeled “soft” or “weak.” Research has shown that these pressures often lead athletes to hide concussion symptoms (Wallace et al., 2017).
A matter of responsibility. It is important to know that sitting out one or two games is not a weakness; it’s healing and a matter of responsibility. Today, the tools to lower concussions exist. Cutting down on full-contact practices reduces the number of hits players take across a season (McCrea et al., 2021). Simple protective measures such as the guardian cap have also been linked to large drops in practice concussions. Equipment and practice policy have been shown to make a difference.
Courtesy Northwestern University
So what can people involved in football do? There is a good alternative to just signing a waiver or being required to watch a concussions-are-dangerous video. Every season, players, coaches, and parents should participate in a concussion training program that includes information about concussion symptoms, shares real stories about impacts, and provides players with guidance on what to say and do if and when they need help.
Education matters. Research shows that when athletes, coaches, and parents actually learn to spot symptoms and normalize reporting, concussions drop (Wallace et al., 2017). Providing the training/athletic staff with the tools to recognize warning signs ensures that students can get help even if they don’t self-report, and athletes with trained staff are more likely to self-report their concussions (Wallace et al., 2017). Recognizing that full-contact practices do more harm than good, districts can limit them while still encouraging coaches to teach technique.
Lastly, the message needs to be changed. We need to praise leadership. When a player reports a concussion, call that courage. Making sitting out a demonstration of good sense. Football is worth preserving, and protecting young brains need not get in the way of the game. Indeed, the best ability is availability.
The first step? If you’re a parent, coach, or player, ask your school what their concussion protocol actually looks like. Make sure it’s the right answer.
___________________
Centers for Disease Control and Prevention. (2023). Traumatic brain injury & concussion. https://www.cdc.gov/traumaticbraininjury
Fong, A. (2024, June 28). Football concussions: Prevention, diagnosis & recovery. Cognitive FX. https://www.cognitivefxusa.com/blog/football-concussion-prevention-and-recovery
McCrea, M. A., Shah, A., Duma, S., et al. (2021). Opportunities for prevention of concussion and repetitive head impact exposure in college football players: A CARE Consortium study. JAMA Neurology, 78(3), 346–350. https://doi.org/10.1001/jamaneurol.2020.5193
Patel, H., Polam, S., & Joseph, R. (2024). Concussions: A review of physiological changes and long-term sequelae. Cureus, 16(2), e54375. https://doi.org/10.7759/cureus.54375
Wallace, J., Covassin, T., Nogle, S., Gould, D., & Kovan, J. (2017). Knowledge of Concussion and Reporting Behaviors in High School Athletes With or Without Access to an Athletic Trainer. Journal of Athletic Training, 52(3), 228–235. https://doi.org/10.4085/1062-6050-52.1.07
