U.S. News

10.26.13

Friday Night Lights Out: The Concussion Debate Hits the Texas Youth Leagues

After years of heated debate, the NFL is finally taking concussions seriously. But how are they being handled in football’s lower levels? Pete Freedman reports from football-crazed Texas.

On the evening of Monday, September 23, emergency room doctors determined that 12-year-old Connor Curreri of Dallas had suffered a concussion during a football practice held that afternoon. Five weeks later, the seventh-grader has yet to complete a full day of school.

Given all of the concussion talk that has permeated the mainstream media these days—especially in the wake of this month’s PBS Frontline documentary League of Denial, which takes an in-depth look at the havoc that concussions have wreaked upon National Football League players and the preventative regulations the league has finally put into place—Curreri’s case offers an important reminder: head trauma is a concern at lower levels of competition as well, especially in football-crazed Texas.

Only recently, as League of Denial shows, has the NFL taken concussions seriously. Heeding the advice of outraged neurologists, who, after studying the brains of deceased former NFL players such as Hall of Fame-inductee and Pittsburgh Steelers center Mike Webster, found what they believe to be indisputable connections between football-related head trauma and later-in-life suicidal tendencies, the league finally instituted a slew of new rules heading into the 2013 season. These include the required presence of an independent neurological expert on the sidelines of each game, and the ban of most helmet-to-helmet collisions, with league-issued punishments for such hits now resulting in suspensions as well as substantial fines.

Most agree these rule changes were a long time coming. But, interestingly, many similar rules have already been in place in youth and high school football leagues. Whether they’ve resulted in much change or concussion prevention on those levels is another debate.

It’s tough to say when, exactly, Curreri suffered his head injury. His parents know this: during that September 23 practice, players on Curreri’s seventh- and eighth-grade team at The Parish Episcopal School in Dallas were running the “gauntlet” drill—a controversial practice exercise in which players run through a tackle-simulating contraption before colliding with a coach armed with a pad on the other side.

After multiple runs through the drill and after multiple hits from his adult coaching staff, the five-foot-four-inch, 165-pound Curreri began to feel unwell. He excused himself from practice and retired to a bench. But when he started to feel less dazed, only more trouble came. It took Curreri three tries before he was able to stand.

“We think it was the accumulation [of hits],” says his mother Kristin.

“You just don’t know if he’s going to come out of his room and fall down the stairs. But I wouldn’t say I’m terrified or anything. Terrified might be too strong.”

Regardless, Connor fought through the pain and returned to practice after his stint on the bench, his coaches none the wiser about what had happened. If the coaching staff at Parish Episcopal was concerned about Connor’s health during that Monday practice, their worries mostly surrounded the cast the young lineman wore on his sprained wrist, the result of an injury suffered at a Saturday practice just two days prior. Initially, not even Connor thought much about his head injury. It wasn’t until Kristin dropped Connor’s teammate off at home as part of a post-practice carpool that her quiet son even acknowledged that anything out of the ordinary had taken place that afternoon.

“It was actually the other kid that said something,” Kristin says. “’You should tell your mom what happened,’ he said. So I asked Connor and he told me. He said ‘I don’t feel good. My head hurts. I feel dizzy, and I want to throw up.’”

Those three symptoms, undeniably and almost universally, count among the ones most often associated with concussions. So, after consulting a competitive horse-riding friend who’d herself suffered concussions in the past, Kristin and her husband John took their son to a nearby emergency room.

“When we got to the hospital, he just about fell down out of the car,” John says. “I don’t think he even realized it.”

Emergency room staff wasted no time: It was clear, as soon as Connor saw the attending physician, what was happening with his head. Connor had been concussed.

What was less obvious then—and what remains unclear now—is just how long it might take Connor to properly recover from his injury. Initially, doctors and school officials alike agreed to keep Connor home from school for the rest of that first week, and out of football practice until doctors could determine that no effects lingered in Connor’s reaction times. The following week, though, more troubling signs began to arise.

“We tried to send him back on Monday, Tuesday, and Wednesday [of that next week],” says Kristin. “All three days, he ended up at the nurse’s office with a raging headache. He said he went to the chapel to [relax], and he said he just thought he was going to die.”

Efforts to return Connor to school since haven’t fared much better. On October 15, he made it through all of one period before having to be pulled from class once more.

“He said it was too loud and too bright,” Kristin says. “He just couldn’t handle it.”

Connor also hasn’t scored highly enough on a balance test meant to check his recovery and allow for his return to athletics. Before each football season, Parish Episcopal players are required to take a reaction-time test designed for this exact purpose. Coaches, team trainers, and school doctors then use those initial results as the baseline factor in determining when a player is capable of returning to practice. Now, five weeks out, Connor is still responding to these tests at about half the speed that he did before the season. And since September 30, his mother has been forced to take a sabbatical from her day job so she can take care of her house-ridden son.

“By Sunday the 13th, he should’ve been feeling better [according to doctors],” Kristin says. “He didn’t.”

To help cope with his recurring headaches, heightened light sensitivity and nausea, a school-suggested neurologist prescribed Connor two medications: 100 milligrams of an antidepressant agent called Amantadine intended to “jump-start” Connor’s brain each morning, as well as 10 milligrams of a second drug called Amitriptyline to help him sleep through his headaches at night. After two days of taking those pills and no noticeable improvement in his condition, Connor’s neurologist doubled his dosage to the amount he still takes now.

“[The neurologist said] it’s like the brain is a snowglobe,” Connor’s father John says. “When the brain is shaken up, it’s got all this snow. Until things settle down, it won’t be clear.”

The Curreris say that Parish Episcopal, a pre-K through 12th grade private school that charges students $22,000 in tuition each year, has handled Connor’s situation to their satisfaction, with administrative officials even going so far as to suggest that the family “not worry” about Connor falling behind in his studies during this extended time spent away from school, recovering at home.

But even his parents acknowledge the possibility that Parish Episcopal’s response is simply reactionary. As a private institution, Parish Episcopal’s athletics program—including its football program, which starts at the seventh grade and falls under the supervision of head high school coach Scott Nady, who failed to respond to multiple requests for comment—is exempt from the concussion guidelines that other, public schools in Texas are required by law to follow. Those rules are set forth by the state’s public school athletics governing body, the University Interscholastic League (UIL); Parish Episcopal instead falls under the watch of the Texas Association of Private and Parochial Schools (TAPPS) and its guidelines.

UIL guidelines—as set forth by the 2011 state legislation-passed House Bill 2038, also known as Natasha’s Law—requires that all athletics coaches, assistant coaches, and trainers undergo concussion training sessions each offseason. The law instituted some concussion awareness and reaction policies, too: parents must now read and sign concussion-specific information awareness forms before their children are permitted to participate in high school athletics; athletes suffering from concussions are no longer allowed to return to play until administrators receive a written statement from a physician indicating that it’s safe for the player to return; and each school must now have in place a four-person “concussion oversight team” that includes at least one physician, so concussed students can be assessed from an impartial perspective beyond simply that of the coaching staff and its team trainer.

TAPPS rules are generally less forthright and mostly refer to the NCAA rulebook, which suggests “special attention” be paid to concussion-suffering players, an immediate removal of injured players from action, and the assurance that a player be evaluated by “an appropriate health care professional” responsible for clearing an athlete’s return. Beyond that, the rulebook designates that coaches “develop a game plan,” but notes no training requirements for coaches.

As of this year, 49 states and Washington, D.C. have all green-lit similar measures to Natasha’s Law for public school athletics programs; Mississippi is the only state that has not passed similar concussion legislation.

Kate Hector, media coordinator for the UIL, acknowledges that concussions have been of especial concern to the organization in the wake of all the recent media attention given to brain trauma, with parents and journalists alike making more and more inquiries about the governing body’s guidelines of late.

“More recently, it’s been pretty frequent,” she says. “But it’s not surprising. It’s been in the news.”

Hector notes, however, that concussions were of concern to the UIL even before Natasha’s Law: since 2001, the league has convened a medical advisory committee to review its state guidelines on a twice-annual basis. And, before that legislation even passed, the league put into place specific wait times before concussed players could return to practice or game play. As of April of this year, that medical committee also limited football teams to 90 minutes of practice contact each week.

“We can never say that [players] are safe,” Hector says. “But they are as safe as possible.”

Joey Florence, who has served as the head coach at the Ryan High School in Denton, Texas for the past 14 years and whose staff undergoes both UIL- and Texas High School Coaches Association-sponsored concussion training sessions each offseason, echoes that sentiment.

“You play sports,” he says, “and you’re going to get injured.”

Still, Florence says his school takes its precautionary measures even further: “We do not hit live in practice, and we haven’t [in my programs] for 20 years,” he says. “Those days are over. Player safety is huge to us—and it was before all of [these rule changes].”

Where Florence does say he has an issue with player safety—specifically in football—is with parents and coaches that encourage their children to play the sport all year long.

“I’m very against that,” he says, noting the potential dangers of year-round, full-contact athletics to the brain. “I would not let my kid do that.”

Since the second grade, Connor Curreri has played both fall and spring football. As far as anyone knows, his most recent concussion is his first. Even so, the repercussions of his injury on his athletic career—which not even his Riddell 360 helmet, as expensive a helmet as exists on the market at $350 a pop, could prevent—are potentially major. Already a two-time state champion wrestler at his young age, Connor’s parents are considering sitting Connor out of the upcoming winter wrestling season over concerns that he’ll need to use that time to catch up on his academics—already a concern, given that Connor struggles with a number of learning disabilities. Each patient’s recovery from a concussion is different, doctors say. But Connor’s neurologist believes his learning disabilities may at least be partly responsible for slowing down his recovery.

As a result of his injury, Connor has missed the rest of the Parish Episcopal team’s season, which came to an end this past Thursday night. But the Curreris have yet to rule out any future football play for their son.

“I’m not necessarily scared off of football,” says Connor’s father, John, who estimates that he himself suffered as many as ten concussions as a youth and notes that such injuries are a part of the game. “And I don’t think [Connor] is, either. He may have reservations about going through that [gauntlet] drill again. But I think he’ll still want to play.”

Florence, the coach at Ryan High School, doesn’t think there’s any reason for a player like Connor not to play.

“I don’t know that you can play football for 25 years and think that it’s OK,” Florence says. “You can’t do that as a boxer. But I don’t know that there’s any evidence [to the dangers of youth football]. I wouldn’t be coaching if I didn’t think it was safe. If there was real evidence against it, I would [stop]. There’s no doubt in my mind.”

Even so, Connor’s father concedes that his son’s interest in the sport has waned somewhat in the wake of his concussion—at least for the time being.

“When you’re dealing with a bunch of 12-year-old kids, they sometimes just look for an excuse to not practice,” John says. “But, as much as Connor loves football, he [never] hit a Thursday game day [while recovering] and tried to play. It once took us three weeks to realize he had a broken foot. So for him to act like this, we know it’s real.”

For now, the Curreris are taking things one step at a time. And, though doctors recently estimated that Connor still has at least another week, if not more, of recovery ahead of him, Connor’s parents remain encouraged by their son’s slow, but certain, improved cognition.

It’s taking time, but, each day, his condition does appear to be improving, if only slightly.

“It’s a little nerve-wracking,” John says of his son’s injury and recovery. “You just don’t know if he’s going to come out of his room and fall down the stairs. But I wouldn’t say I’m terrified or anything. Terrified might be too strong.

“I’d say I’m just concerned.”