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Worth the Risk? Players, coaches and parents wonder if football can be saved from dangers of hits to the head

Damiere Shaw had suffered concussions before. But as the doctor’s appointments piled up at a rate outstripping the answers he and his family received, he started to worry.

He’d had headaches before, had sensitivity to noise and light, all the expected symptoms. But when he’d sustained concussions as a standout at Cardinal O’Hara, they usually faded in a matter of weeks.

As spring wound into summer and his redshirt freshman year at Temple beckoned, Shaw didn’t see progress. Instead, the symptoms grew, affecting his sleep, his mood, his life. He spent more time in hospitals than on the field, without yielding conclusions. Was this visit due to dehydration? Was it something with his blood? What is more than physical?

One of 11 kids from Chester, a football family through and through, Shaw wasn’t a stranger to the game’s adversity. But that didn’t diminish his fear.

“We really didn’t have a clue what it was,” Shaw said. “It was challenging, and it was scary.”

That was four years ago, when Shaw undertook the soul-searching his body mandated. Five times in two and a half years, he suffered concussions. His first came in October 2010, in a win over Monsignor Bonner in which Shaw ran for 117 yards and a touchdown. He got dinged in the first half, and even with seven years of hindsight, his motivation in shaking out the cobwebs comes across.

“At halftime, I told two of my teammates that I think I’ve got a concussion,” Shaw said. “And I was like, ‘Don’t tell the coaching staff; I’m not coming out of the game.’”

Shaw clued in the trainer … on Monday, the first of four weeks on the sidelines. He returned for basketball season, but a concussion in practice ended his hoops career.

He suffered another one in the first scrimmage of his All-Delco senior year, missing two weeks. He matriculated to Temple and redshirted, landing on a scout team, where another injury found him in the fall. By the time the fifth concussion rattled his brain in the spring, he knew his past made him more susceptible. He also knew a strong spring would vault him into the starting conversation at cornerback for a program on the rise.

As July 2013 beckoned, Shaw, shuttling in and out of doctors’ offices, grasped the gravity of the situation even before it was spelled out by a physician. I can’t prevent you from playing football, Shaw recalls the doctor telling him, but if you do, there’s a serious risk of severe and permanent damage.

“That one I couldn’t shake,” Shaw said, “and that told me it was probably about time to hang it up.”

Players and parents across the country are faced with similar conundrums, reactively or proactively. Football entails dire physical risks. The decision to suit up entails a risk-reward calculus borne of a multi-billion dollar industry of college scholarships and the elusive professional promised land. The cost of freight is increasingly paid with equity in players’ bodies and, more frighteningly, their brains.

For years, the dangers were either not understood or purposefully obfuscated by those with a vested interest in retaining a veneer of purity. The game remains punishing and the consequences startling, but risks are better understood by the medical and athletic establishments. While much still remains to be learned in diagnosis and prevention of long-term brain injuries, even the most rudimentary efforts are light years ahead of where they stood just a decade ago.

The coaches guiding the next generation are imbued with that history, some moved by its message, some irrevocably scarred by its brutality. They occupy a complex niche in the landscape, testifying to the benefits football offers while marked by the physical price at which those gains were achieved.

As outlets across the country ponder grandiose tracts about the future of football, the question on high school campuses is more granular: How can the players of yesterday — the coaches of today — steward the next generation of players toward a safer and more sustainable future?

***

You can’t swing a dead cat on the Internet without hitting a study or treatise on the horrors of football or prognostications of its demise. Stripped of the American-as-apple-pie nostalgia for a time when players obliviously hurled their bodies into the breach, the facts present a compelling case.

Just this month, Boston University published evidence of chronic traumatic encephalopathy (CTE), a neurodegenerative condition. It revealed plaques of aberrant tau proteins accumulating and causing a host of cognitive disorders and early onset dementia, in 110 out of 111 brains of former NFL players.

The stat blared from the headline obscures a scarier one: Of 202 brains of deceased athletes at all levels — including 14 that played only in high school and 53 only until college — 88 percent presented CTE. The disease, which is not only untreatable but as yet undiagnosable in living tissues, manifested in 91 percent of college players’ brains tested.

READ: Keep Your Head Up: Lindberger, Infante tout benefits of new player safety programs

The anecdotal evidence is no less convincing. Players like San Francisco linebacker Chris Borland and Baltimore lineman John Urschel retired in their early 20s to preserve their faculties. Scores of high-profile players have cast doubt on whether they’d allow their children to take up the game. In a 2013 Washington Post poll, only 46 percent of 500 former NFL players surveyed would “recommend children today to play youth or high school football.” 

The concern has steadily crept downward, and the idea that only 10 years in the NFL causes lasting brain injury is bunk. In 2009, BU’s CTE Center found substantial deposits of tau proteins in an 18-year-old deceased high school player.

The conversation, which many experts note is still in its nascent stages, has shifted from chronic to acute conditions. Second-impact syndrome occurs when a concussed brain (one exhibiting swelling and weakness in the spinal column) receives a secondary impact, which can have deadly and immediate consequences.

Fatalities, fortunately, have slid over the long term, per the National Center for Catastrophic Sports Injury Research (NCCSIR) at the University of North Carolina Chapel Hill. In 2016, 16 football players died as a result of the sport, seven in high school. Two were “direct” injuries, resulting “directly from participation in the fundamental skills of football,” while five were “indirect,” primarily cardiac events. Those tallies have fallen sharply from a peak of 35 deaths in 1968 (26 in high school). Rule changes enacted in 1976 eliminated the head and face as a primary focus of tackling contact, and only one year since (1986) has involved more than 10 direct deaths across the youth, middle and high school, college, semi-pro and pro levels. Indirect deaths hit a 20-year low in 2014 at seven; the 2016 number was nine.

Even that level of risk has culled participation. Rosters for Pop Warner, the nation’s largest youth program, dipped nine percent from 2010-12. Though membership has stabilized in absolute terms, a growing population means the percentage of youths has dropped as players flock to flag football. At the high school level, California saw a seven percent drop from 2009 to 2016.

In Pennsylvania, the high school population topped out at 26,910 athletes at 598 programs in 2008, per the National Federation of State High School Associations (NFHS). By 2015, nearly 1,000 fewer athletes participated, a decline of 3.7 percent. It remains the most popular sport for male athletes in the Commonwealth.

In 2011, Gov. Tom Corbett signed the Safety in Youth Sports Act, which delegates oversight authority to the Departments of Health and Education and stipulates criteria for removal from play in the event of a suspected concussion, clearance by a doctor to return to play and informational resources. The law establishes penalties for failure to adhere to the rules, in terms of suspensions or civil liability, which mirror PIAA statutes. The PIAA also maintains a Sports Medicine Advisory Committee drawing from a variety of specialties and disciplines.

Football has also belatedly acknowledged the existential threat injuries pose and — after numerous trips to the courtroom and the bank vault — sought to mitigate harm. Rule changes encourage touchbacks at the expense of the bone-jarring kick-return collisions, outlaw wedge-blocking, deter certain blocking techniques and harshly penalize targeting defenseless players. At the heart of the rules is an effort to put players first; logical as it seems, that wasn’t always the case.

“As an official, I’ve seen leaps and bounds in 25-plus years,” said Kevin Doverspike, a referee in Clarion County and the Male Parents representative on the PIAA’s Board of Control. “Coaches are much more aware that there are long-term effects to concussions and they’re very amicable when an official pulls a player out of a game. I would be surprised to get any lash back from the coach. Once an official says, ‘Hey, he needs to be out of the game,’ they’re willing to tell the trainer, ‘He needs to be looked at.’”

***

Twenty years removed from an NFL career, Randy Cuthbert strikes an imposing figure that hints at past glory. A standout at Central Bucks West and Duke University, he played two seasons with the Pittsburgh Steelers in the early 1990s.

But as Wissahickon football practice winds down and the subject shifts to his history, the bullhorn coach’s voice fades to a more doleful tone. Cuthbert played 11 games with the Steelers, a career comprising one rush, one reception and one kick return. But that output doesn’t reflect the physical grind he subjected his body to in an era where the prevailing mantra involved getting your head across the ball — or the more primeval “bite the ball” — imparting jarring forces on the head and heck.

Cuthbert estimates 10 to 15 concussions in his career among untold scores of sub-concussive blows. He’s been plagued by migraines since his playing days ended. But at 47, Cuthbert grants that the game he played and the one he coaches vastly differ.

READ: Roman, Defend Your Head aim to be ‘agents of change’ in fight against head injuries

Cuthbert was first baseline tested in 1994, 15 years into his organized football career, in a pilot program launched by Steelers physician Dr. James Bradley, who chaired the NFL’s medical research committee. Now, middle schoolers who may never play a down of varsity football are routinely screened.

Cuthbert’s conception of progress may seem just a product of his age, but it bears out across other epochs. Dan Connor played six seasons and 62 games for three NFL franchises. The Archbishop Carroll coach recalls his first baseline test in his second or third year with the Carolina Panthers in 2009-10 — none at Strath Haven High, none at the elite, pre-scandal Penn State, none through the NFL or its Players Association in advance of its multi-day draft spectacle or its calendar-consuming camp schedule.

Connor, 31, recalls two concussions. The game exacted a greater toll on his musculoskeletal system, with six surgeries, including an ACL tear and a neck injury that hastened the end of his career in 2013. He remains a proponent of football’s benefits. With his playing past, he recognizes his Patriots trying to conceal symptoms that he knows warrant concussion protocols.

“When you’re on the coach’s side, you can see it easier, having seen some of the symptoms of it,” he said. “It’s helped me see when a guy gets dinged because you know the telltale signs of a guy, shaking his head, stumbling, feeling a little sick, headache, sensitive eyes. Having played and gotten them, you learn the signs of it. … You know you don’t mess around with the head stuff.”

The prevailing logic among coaches reduces practice contact and advances teaching methods. The PIAA limits contact to 60 minutes per week. Cuthbert is in the burgeoning congregation of coaches who don’t allow players to tackle to the ground; the furthest they go is a technique called “thud,” full speed to the point of contact with no predetermined winner without finishing the confrontation to the ground.

“Those are all things that make the game much better,” Cuthbert said. “Do I think they should’ve happened a long time ago? Yeah. But it’s the right thing to do and it’s smart and there’s more of an emphasis on player safety.”

Another shift is deference to parents. St. Joseph’s Prep coach Gabe Infante, who travels the country as a master trainer for USA Football’s Heads Up initiative, bluntly declares that, “Mom is the one that holds the future of football in her hands.” He conducts safety clinics geared toward parents, frankly explaining signs and risks of injuries.

Connor and Cuthbert both see parental interaction evolving. The coach no longer wields unassailable power from on high; progress requires dialogue with parents whose children incur physical risk. Connor said that includes relenting to parents’ caution even after a doctor has granted clearance to return. That’s the path Connor sees toward stemming the tide of rampant defections, one he learned from Strath Haven mentor Kevin Clancy, who refers to his contact-light practices as “rehearsals.”

“It’s a shame to lose out and have a sport wither away that’s such a great sport, a character-building sport, having you face fears and make mistakes under pressure and have to overcome them,” Connor said. “There’s so much good in football, you’d hate to see the sport get taken down from that.”

Cuthbert has occupied both sides of the conversation. His eldest son, Ryan, graduated last year from Pennridge. Cuthbert encouraged his three children to pursue multiple sports; his younger son, Kyle, gravitated toward soccer and basketball. But Ryan was drawn to football. With faith in the coaches he entrusted Ryan to, Cuthbert was content that his son could glean the positive lessons sans the collateral damage, even if the cost the game extracted still weighs on Cuthbert’s mind.

“I always loved the game, and that’s what I wanted to do,” Cuthbert said. “I’m just worried about what might happen in the future because there’s no test for CTE while you’re living, which is a concern. I look at the rule changes and I feel a lot better about where it’s going in terms of safety.”

***

GENE WALSH — DIGITAL FIRST MEDIA
Wissahickon head coach Randy Cuthbert, who had a short-lived career with the Pittsburgh Steelers, estimates he suffered 10-15 concussions during his football career in Pittsburgh and at Duke University, and numerous other hits to the head. He says he still suffers symptoms, but thinks the game he coaches is safer than the one he played.

Damiere Shaw is minimally comfortable discussing his past, even when the subject doesn’t dwell on the end of his playing career. Sometimes, retracing the pain seems easiest: The pang of longing at how he and Tavon Young, a cornerback for the Ravens, entered Temple on equal footing; the humility instilled when Temple honored his scholarship as a player assistant under Matt Rhule, transforming Shaw from competing with teammates to filling their water bottles.

Shaw parlayed four seasons at Temple into an offensive quality control job on Rhule’s staff when he took the head coaching job at Baylor. It’s not the path Shaw envisioned at O’Hara, but he’s grown grateful for his unique trajectory.

“It’s been a heck of a journey,” Shaw said. “Every day is something new, but I’m definitely embracing it, loving it. It definitely wasn’t my plan, but it was God’s plan. His plan was to have me coaching and helping young men, showing people that come from situations similar to me how to be great players and how to be great men. I’ve embraced that.”

Shaw doesn’t talk about his injury history with his Baylor pupils, beyond allusions to value every rep lest it be their last. He readily points out dangerous flaws in tackling technique and exudes an appreciation for the game, exhorting similar thankfulness from those strapping on the pads.

Part of his support structure is longtime girlfriend Miah Shockley, with whom he tied the knot in July. A Chichester grad, Shockley has been beside Shaw for the ups and downs football has brought. While Shaw clung to his football career at Temple, the couple discussed what their future could hold and what that choice might one day entail for a son.

For all he’s been through, Shaw can’t deny what football has afforded him. And he hopes to safely avail a son of those values someday.

“It’ll be their choice,” Shaw said. “My wife and I had multiple conversations about that, even before I stopped playing. I would let them decide when they get older.”

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