Youth Football Safety: Navigating Concussions and Head Injuries

0:00:09 - Shane Smith
Hey, Shane here from Shane Smith Law. We're here today at Mind Matters: Navigating Head Injuries and Concussions. I'm here with Thomas from the Concussion and Brain Injury Group here at Shane Smith Law, and we're going to be talking about youth sports safety. Basically, if you heard on one of our prior podcasts, we talked about the NFL concussion safety protocol. Now we're going to be talking about how it sort of trickles down into youth sports.

0:00:31 - Thomas Ozbolt
Yeah, thanks for having me, Shane. It's really important to keep having these conversations, especially when we're talking about concussions and youth sports.

0:00:38 - Shane Smith
And I know, that's become a bigger thing over-- and you know repeatedly it becomes a bigger thing. I think we're just-- I don't think they're more frequent. I think it's just more aware of it.

0:00:45 - Thomas Ozbolt
Absolutely, and today, you know, we're focusing on concussions. It's a increasingly concerning issue as our young athletes get bigger, faster and stronger.

0:00:55 - Shane Smith
I was gonna say, I think, I think that is documented that the athlete, the kids, are bigger and stronger nowadays, or, or maybe training's better, or nutrition is better, I mean all of that, but they're, they're hitting harder than they used to right?

0:01:05 - Thomas Ozbolt
Definitely. Definitely. I think we're seeing that charted out in lots of different ways all across society. I think one of the biggest issues when we're looking at youth sports and concussions is the second impact syndrome.

0:1:17 - Shane Smith
What is that? And why do we need to worry about it?

0:1:20 - Thomas Ozbolt
So sudden impact syndrome occurs when an athlete suffers a second concussion before the first one that they had has fully healed. This can lead to catastrophic outcomes, including cerebral swelling or even death. It can be pretty rare, but when it does happen, the mortality rate is about 90%. Terrifyng.

0:01:40 - Shane Smith
Holy cow. So that's awful for our kids. And unfortunately it's not like there's a red light, green light, right, that says you're totally healed and now you're not. I mean, that statistic is scary as can be. I mean it's hard to really, I mean even think about that, I mean because all the kids in sports. But it's not just numbers, I mean these are real kids, real people. I think there was Chad Stover's case out in Missouri this year. What happened there?

0:02:02 - Thomas Ozbolt
Yeah, Chad Stover. He was a high school football player who sustained a brain injury during a playoff game. He was hospitalized and tragically passed away two weeks later. And that kind of started to underscore the dire need for immediate and cautious handling of any head injury that happens on the field.

0:02:20 - Shane Smith
And obviously, we know, big game. I'm sure he had pressure, wanted to play. I'm sure his family wanted him to play, coach, I mean, obviously nobody wanted this to happen. But he's not the only one that happened this year, right? I mean, didn't someone get injured in Arizona as well?

0:02:34 - Thomas Ozbolt
Yeah, there was a young man, Charles Youvella, from Arizona. Another heartbreaking story. He was tackled and his head hit the back of the the ground really hard. He stayed in the game for two more plays, but then collapsed and passed away three days later. Just another poignant reminder of why athletes need to be removed from play immediately after a head injury.

0:02:56 - Shane Smith
Which is why the whole NFL concussion protocol came up, right?

0:02:59 - Thomas Ozbolt
Right, exactly. Just looking at these tragedies and trying to find a way to prevent them from happening, because it's a tough thing to know when one of these things has happened sometimes.

0:03:11 - Shane Smith
I know the kids just like professional athletes that want to play. I mean, nobody wants to sit on the bench and rarely does somebody want to, I mean, even for medical reasons, everybody wants to play, right?

0:03:19 - Thomas Ozbolt
Yeah, you just feel like you've done something wrong if you're not out there with the team.

0:03:23 - Shane Smith
And I know you were telling me before too there was another child. Another one. What was it? Damon Janes?

0:03:27 - Thomas Ozbolt
Yeah, Damon Janes. He lost consciousness after a helmet-to-helmet collision. You know, one of those big things you always see when you're watching on TV oh, helmet-to-helmet, immediate flag. People are like, oh, that wasn't that bad. But here, you know, Damom, helmet-to-helmet collision, got rushed to the hospital and died a few days later. And you look at that, you look at the protocols that have come into place, you know, his tragic death shows the need for strict protocols and immediate action after a suspected concussion.

0:03:54 - Shane Smith
And in all of these cases did everybody know they'd had the prior concussion?

0:04:01 - Thomas Ozbolt
In Charles' case, where he hit the back of his head on the ground and suffered a concussion, you know, played in two other plays, and, you know, he had suffered the concussion on the first hit and then essentially got dinged up again on the second one and that was what took him.

0:04:13 - Shane Smith
So the biggest issue is not so much I had a concussion on Monday, I think I'm okay, I'm going to go play a week or two weeks later. It's when they have a super hard hit where a concussion is likely and they're not pulled off the field or evaluated for the concussion. It's just sort of the, "you doing okay, you're okay," kind of deal, back into play, is that?

0:04:33 - Thomas Ozbolt
Yeah, it's, you know, having the, the wherewithal, the spotters on the field, a staff that's identified to see the signs of a concussion, to get someone off the field. Because this can happen like that. It's, it's not like the concern is weeks or days down the road. The concern is immediately after this game. Yeah, this game, this 10-minute chunk of life.

0:04:54 - Shane Smith
When we don't deal with these, we see the tragic consequences you know, which is I mean these kids' lives are cut super short. What are the assessments? I know the NFL has done their, they have their concussion protocols. What are, what have we got in youth sports?

0:05:06 - Thomas Ozbolt
Yeah, there's several measures that have been put in place or several things that we can do at the youth sports level to prevent tragedies like this. First, an obvious answer is education, you know, it's your education awareness, but coaches, players, parents being informed about the signs of concussions and the risks of returning to play too soon. So it's not something that's brushed under the rug or thought to be insignificant. So that's kind of the first step. From there you think about access to medical professionals like athletic trainers or neurologists at games and practices. That can make a significant difference in immediate concussion assessment and management.

0:05:41 - Shane Smith
I think the key, like you talked about, is coaches, right? I mean coaches and assistant coaches or somebody on the team paying attention. And like in the Army, on a range, you can, anybody can call a safety issue and get everybody stopped. Now it doesn't happen often, but something out on the field, I guess, to say, hey, let's slow down and pay attention, this kid got hit really hard. How do we balance this out right? I mean, obviously sports has tremendous benefits to children, to youth, you know their development and responsibility and all those things. How do we balance that versus, you know, the risks of injury?

0:06:14 - Thomas Ozbolt
It's one of those hard decisions that I think every family has to make because, you know, with every increase in safety you have, you know, an increase in, you know, I guess you could say freedom, you know, in people's ability to participate in different things that they want to participate in, because nothing can be completely safe, right? So you know, it's one of these things where, if we have responsible participation by the different individuals who have a stake in all this, then you can assess things as they go and start to, if there's responsible management of the process and responsible look and education about what the significance of concussion for a young athlete can do. It would mean maybe some more expense, maybe some more care taken, but I think that's a way that you can start to balance it, because I mean, you could put everybody in bubble wrap and everything would be really safe, but then everybody would be wearing bubble wrap.

0:07:11 - Shane Smith
And I know from the youth perspective usually they're very resistant to any new stuff. And I can remember when bicycle helmets became new and thinking I didn't need a bicycle helmet when I was a kid, I mean we jumped, we did all kinds of stuff with no helmets and then it shifted over. But I even remember that was seatbelts. Yeah, I mean there was all this resistance to seatbelts. So I'm aware of the balancing aspect and we don't want to coddle our kids, but we also don't want to put them at unnecessary risk. For me it seems like, like you say, some kind of culture of awareness out on the field. And I don't know who should play that role.

0:07:46 - Thomas Ozbolt
The NFL has kind of led the way to an extent with its visibility in terms of improving their protocols. You know, which we talked about before with the sideline neurologists, in-game monitoring. On the other hand, with youth sports, you know you don't always have a large governing body, you know that's responsible for all, you know, travel teams, recreational sports, school sports. You don't really have that kind of governing body that you have with the NFL that measures, you know, the biggest game in the world.

0:08:13 - Shane Smith
And you don't have the money either, right? I mean, I know a lot of rural programs or small schools, they don't have any budget to do it. So I mean it's like how do you do this, right?

0:08:23 - Thomas Ozbolt
It's hard enough to get equipment to play football. I mean, you have pads, you have helmets, you have-- there's a lot of things that, you know, soccer, all you need is a ball. You don't even need shoes. It's a much more expensive sport. So youth sports, particularly with football, they're lacking these comprehensive measures and that leaves decisions like this in the hands of non-medical personnel like coaches, which can be problematic. I mean, we've probably, I've had a coach in the past, "Oh yeah, you just got your bell rung. Get back out there."

0:08:50 - Shane Smith
Get back in there. Well, certainly if you have a coach who's been around a long time, that was sort of the prevailing model, right? If you can get up and run and you say you're good to go, you're good to go, right? I mean, that's sort of how we grew up. I mean I'm thinking about even in martial arts and all of that. I mean, kick to the head, it's, you good? You're back out on the field, which is what they were doing, they do here. Has the government done anything? Have they come up with any programs to encourage the safety and awareness out throughout the high schools? I know the CDC some stuff.

0:09:19 - Thomas Ozbolt
Yeah. So there's been some, some frameworks, both legally and policy wise, that have been established at state and national levels. When we talk about clear, enforceable guidelines, those can support coaches and organizations in making the right decisions for their athletes' health. In terms of specific programs, we've got the CDC's Heads Up Concussion and Youth Sports Initiative and also USA Football's Heads Up Football Program.

0:09:46 - Shane Smith
How are these helping, I guess, coaches at the high school level, or even younger?

0:09:50 - Thomas Ozbolt
Yeah, so this is an example of a government entity taking the initiative to educate coaches, parents and athletes about concussions and use sports comprehensive sort of vision with it. For the CDC, it's something that provides resources to help recognize, respond to and minimize the risk of concussions. One of the key components there is educating the different stakeholders on the signs and symptoms of concussions, and part of that is ensuring that anyone with a suspected concussion is immediately removed from play.

0:10:20 - Shane Smith
And I know that's-- like we've talked about, that's super tough for a coach. I mean, your star player, you know, takes a hard hit. I know you want to err on the side of caution, nobody wants anybody to get hurt, but you also want to win. I mean, so are these programs, are they pushing out, hey, these are all the signs and symptoms of a concussion. This is everything you need to be looking for to sort of make it simple or I don't want to say dumb it down, but I mean simplify the process. So I'm like, oh, you got some warning signs.

0:10:47 - Thomas Ozbolt
It's putting some of what we know and what the NFL has implemented out there in terms of having resources for people and getting it out there and raising awareness about it. One of the biggest challenges implementing these guidelines at a grassroots level is, like you said, there's rural areas. There's, you know, all these counties all over the country that have different levels of, you know, of programs, right.

0:11:10 - Shane Smith
Yeah, programs. Some have a coach and that's it. Sometimes the coach is a volunteer, even. Yeah, I mean, so they're not getting paid anything, so they don't have any money. So I mean making it easy for them to identify and say, okay, hold on, we need to slow down, is really what's needed out there right?

0:11:27 - Thomas Ozbolt
Yeah. And then you talk about awareness. Yeah, awareness is great, but if you don't have any action, I mean, what's awareness worth? It's like, oh, I know about it, but what am I going to actually do about it? We have that awareness. We have to make sure that awareness is getting translated into action, like having a proper medical evaluation or adherence to those return to play protocols. And that's a hurdle.

0:11:36 - Shane Smith
And you know, just sitting here and thinking about it, I mean it seems like the referee bodies would be a good area to push it down to, because they're supposed to be neutral, right? I mean, and I hate to say it, but it seems like everybody hits the ref anyway, at least when they make calls against your team. It seems like that might be an opportunity. You know, another area instead of just the coaches who have a vested interest in their team playing, you know, maybe the refs have the ability to, I don't know, do a medical hold or something on it. I don't know if that's something anybody's looked at or not.

0:12:12 - Thomas Ozbolt
Yeah, maybe put another one on the field like a independent, similar to what they have in the NFL with an independent evaluator. But let's put a ref on the field who's in there, close to the huddle, like some of the other ones are, just keeping an eye on things. That could certainly be something that you would think would be effective.

0:12:31 - Shane Smith
And hopefully fairly cheap. That's what I was thinking about, for, you know, poor coaches. Now we talked a little bit about some of the other programs. I know USA Football's got a Heads Up Football Program. What's that about?

0:12:41 - Thomas Ozbolt
Yeah, it's-- this program by USA football focuses specifically on the sport of football. And it aims to make the game safer by educating coaches on proper tackling techniques, equipment fitting and, of course, concussion recognition and response protocols. This is a more targeted approach and it includes certification for coaches and it emphasizes safer play through education and practice. And it's a partnership with the NFL, so that gives it more visibility and resources. But, like the CDC initiative that we talked about, it focuses heavily on awareness and education without having these clear, actionable tools for actually putting these things into practice. So you have a gap there again between knowledge and action.

0:13:24 - Shane Smith
And it sounds like some of the focus on this is on prevention of concussions by teaching better and safer tackle protocols, right? Yeah. And it's funny, I was actually talking to one of my kids and they were talking about they had an old school football coach who had done wrestling, so they taught them to tackle differently than one of the other coaches had done, which, after talking to him, is actually a safer way, which sounds like I mean, I don't want to give him credit for it, I don't want to do, but it sounds exactly like what this program is trying to teach the coaches to do.

0:13:56 - Thomas Ozbolt
Yeah, I think you can even see it in the name of it too. You know the Heads Up, you know, you don't want to attack with your head down. That's where you see a lot of the injuries happen. It's like leading with your head, you know, keeping your head up, kind of leading with your shoulder, and you know, when you talk about that it's a--

0:14:10 - Shane Smith
It's a good, I don't want to say it's a good, easy way, but it takes away the, I'm going to make the call, does he have a concussion? Let me pull him out because we're teaching safer fundamentals to still do the sport everybody loves.

0:14:23 - Thomas Ozbolt
Exactly yeah, starting at the ground level, it's building up those practices the right way.

0:14:33 - Shane Smith
We talked about targeted education and practice. That seems like the key things to this program and any other program as implementation. Have they been successful? Do we have any data on that?

0:14:41 - Thomas Ozbolt
Well, so, there's evidence to suggest that education and proper tackling techniques can reduce the risk of concussions. But again, the success of these heavily depends on consistent and universal adoption across teams and leagues, and, you know, I don't know that we have a lot of data on that. We have all these leagues and then actually having it implemented and then report it back to a data collecting, for instance.

0:15:07 - Shane Smith
And it's hard to disprove a negative right? You didn't have a concussion, so everything went well. But it's also, it would seem like then, if we push out all this education on how to identify concussions, you know, the rate of concussions is going to spike in all the games, but not because it's any worse, but just because we're identifying it and responding to it appropriately. So disencourages anybody to do it, because now suddenly we're in an unsafe or it's dangerous. responding to it appropriately.

0:15:30 - Thomas Ozbolt
Yeah, it almost creates a false perception of what's going on. It's like you hear with the news people are like, oh, there's so many tornadoes, there's so much all this bad stuff going on all over the world. It's like, well, we have 50 different news channels, right, nothing changed, we're just reporting it more. Same with the concussions. Yeah, everybody has a news camera in their hand now and yeah, of course there's going to be more, because we have more visibility of it.

0:15:53 - Shane Smith
Right. So all right. So we, we know they are pushing these programs out. We know USA Football has got the Heads Up program. You know it seems like the only way for it to work is, like you say, adoption throughout all the leagues, consistency, pushing this over and over. But we don't know how we're gonna get any data, basically. I mean, or we don't really know how it's gonna be effective or not, other than, I guess, less of these tragic deaths. Is that right?

0:16:15 - Thomas Ozbolt
Yeah, it's you know, go ask where we see in those those gaps between the concussions being managed and having prevention. And one of the things you can see with all that is like, even if we had the data all the way across the board in terms of it being reported, what are we going to do about having immediate on-field medical response? There's not the resources. You think, at youth level, every high school game across the country, to have medical professionals there at games, and not just games but at practices.

0:16:44 - Shane Smith
Yeah, I was going to say practice is a whole other can of worms, right? Because even at a game you say you've got to have an ambulance or something which I've seen at some games. Are you gonna make an ambulance be at every practice? I mean that-- pretty soon it seems like some of these less, less wealthy counties and they just have to close down the program.

0:17:03 - Thomas Ozbolt
Yeah, you don't have the resources, so it's, well, we've got, you don't want to choke out the goodness of the game and the goodness of sport by having too many regulations, but at the same time, it's so, well, how do we figure out something like a compromise? How do we bridge this gap? We just need more objective tools in terms of perhaps just having people screen on the sidelines or on the team to have these sideline concussion evaluations that can support those without medical training.

0:17:30 - Shane Smith
Right. So at least it would be like check, check, check looks like you're good to go. At least there's some assessment, some evaluation by somebody to encourage you to slow down a little bit I guess. Yeah. Key takeaways you would give to coaches, parents around this area. What would you say?

0:17:48 - Thomas Ozbolt
Yeah, I think, just the importance of education, proper training and having clear, actionable protocols in place and creating a culture of safety where the well-being of the athlete is paramount. Not, hey, you know, winning some Pop Warner, you know, quarterfinal game. It's, let's think about, you know, little Timmy 5, 10, 15 years from now, and the person he's going to be and the life he's going to have. And everyone who's involved in youth sports, whether it's coaches, parents, leagues and the athletes themselves. They all play a role in making it safer. But advocating for the resources and policies that best support the best practices of concussion management and prevention, that's crucial. It's just getting everybody to buy in, getting everybody to realize the issue and just go with it.

0:18:37 - Shane Smith
And you know, obviously we're highly concerned about concussions and brain injuries because that's what we see every day and we talk to people who have suffered, you know, serious concussions and brain injuries. So we talk to them or their families and they've got personality changes and the long-term impacts. And that's one of the reasons why I think you know you're so passionate about, hey, parents need to take at least take a look at this and understand a little bit. Nobody wants to get rid of football. We just want the kids to be safe, right?

0:19:03 - Thomas Ozbolt
Yeah, you see people's lives transformed. They're one person one day and then the next there's somebody who nobody even recognizes, not even themselves. I don't know the person who I've become, but I know it happened because of this brain injury I sustained, and you think about the tragedy of that happening to a child.

0:19:16 - Shane Smith
I know, Thomas, we're super passionate about it because we spend all day looking at concussions and brain injuries and we talk to families of people who've had brain injuries. And one of the things they say is that personalities change and all that. What do your clients say about that?

0:19:31 - Thomas Ozbolt
Yeah, when you think about what happens to someone when they have a brain injury and they talk about everyone around me, they think I'm a different person. And I even think I'm a different person in terms of you know who I am before this happened and who I am after the brain injury. Seeing that transformation and seeing the devastation that it does to the life of the person it affects and everyone around them. And then you think about that happening to a young boy or a young girl, you know Timmy or you know Josie, whoever it may be and think about what was taken from them and what could have been prevented with just a little bit more care and a little bit more attention to the lives of the most innocent among us. And so that's what I'm passionate about. It's like making sure that things that are tragic and life-changing if we have a way to prevent them and keep them from happening, that we do everything we can to do that. I think that's one of the duties that we have.

0:20:21 - Shane Smith
Without taking away from the joy of the sport, right? I mean, it's like, helmets didn't destroy bicycles, right? Right. I mean, or having to wear a helmet while you ride a motorcycle doesn't make it not fun. And they still do all the kind of things on regular bicycles that they used to do, I think, and they're just safer and they wear a helmet and have less deaths.

0:20:42 - Thomas Ozbolt
We don't have to regulate sports to death. We don't have to become overly, you know, hands-on control-freaks, but all it takes is a little bit in terms of, yeah, ounce of prevention is worth, you know, 10 pounds of cure. In this instance, it's just taking a little bit more time focusing on what's important, and that's the lives of our children. That's all we need.

0:21:05 - Shane Smith
So, Thomas, thanks for being on the show today. I know we talked about youth football today and I think in another episode we're gonna be talking about how it impacts other sports, particularly soccer, I know, is on the list. For anybody out there, this is Mind Matters: Navigating Head Injuries and Concussions. If you enjoyed this, hit like and subscribe and hit the bell down below for notifications and remember you're in pain, Call Shane 980-999-9999.