- Major funding for this program was provided by the Arkansas Department of Education through the Arkansas Ideas Initiative.

[ crowd cheering ] - And it's all started out with the big one itself.

This ought to be a fun ball game.

- And, again, we know the attention about this game has been extremely high, and, I mean, it's no big surprise that we've got a sellout here, a new attendance record, 6,500-plus.

- For 60 minutes, you're guaranteed one shot!

One shot!

Do you understand that?

- Yes, sir!

- Yes, sir!

- You think of all the stuff you went through this summer, the 6 A.M. workouts, these coaches up here pushing you, trying to get you to play your best.

I want you to think about all the sacrifices you've made to wear blue and yellow, all the sacrifices you made!

- [ players clapping ] - You will never, ever forget what's about to take place.

You will come back in 20 years to a class reunion.

You will sit there, and you will talk about every play that's about to made!

- Yes, sir.

- You will remember it - like it's your last moment!

- Sir!

- This is the first rung on the ladder, first rung on the ladder for all of you.

- [ team chattering ] - It's our time!

- [ cheering ] [ music playing ] - Yeah!

Go!

Go, baby!

[ whistle blows ] [ whistle blows ] - Ohh!

- [ whistle blows ] - The brain is the body's equivalent of the deep ocean.

Much of it is largely unexplored.

We don't know how often concussions happen or why they affect some people differently than others.

Are the dementia symptoms you have when you're 60 related to the sports you play when you're young?

It's difficult to know for sure, but we know there are after-effects, and some are devastating.

[ whistle blows ] It's estimated there are up to 3.8 million brain injuries a year in athletics.

- Ohh!

- All right!

- [ whistle blows ] - Good go, Logan.

- Attaboy, Logan.

That's a lick.

Oh, man, that's a lick.

- Some of these injuries aren't preventable, of course, but many are if we're paying attention.

- Let's go!

- [ whistle blows ] - Still stop him.

- Go!

Go!

- Ohh!

- Ooh, gosh.

- [ crying ] - Out of organized team sports, football has the highest percentage of concussions, but it's not alone.

Even limited contact sports like soccer and basketball can carry a high risk.

- Well, the--the brain is-- the brain is pretty special.

[ laughs ] It's a-- It's a very special organ.

It's so complex.

You know, a person talking, just--just us talking, you're involved in so many, uh, sensory patterns, so much integration of your thought processes.

This is what make humans humans, you know, our creativity, our imagination.

That's the thing that allows us to-- to design skyscrapers and--and 747s.

The neurons and so forth, they're imbedded in tissues that allow them to function fairly independently, but connected to literally billions of other neurons.

When you have a concussion, a lot of times, it injures those neurons, and when those neurons are injured, many times, they don't-- they don't recover.

We're not bighorn sheep.

We can't just kind of hit each other.

We're not-- We're not equipped for that.

- Inside the player's brain, 100 billion neurons are sending and receiving messages at lightning speed to make it all happen.

The heart beats, lungs breathe.

Pick up your feet.

Move your arm.

Look at the coach.

Remember the play.

- Set!

Hut!

- The neurons transmit these messages through a long fiber called an axon, which is attached to each neuron.

This information moves down the axon through an orderly chemical process.

When the message gets to the end of the axon, a neurotransmitter transmits the message to the next cell, and so on, and so on.

But certain impacts can disrupt normal brain function, causing blurred vision, dizziness, headaches, or up to 20 other symptoms.

Players describe these symptoms as getting a ding, or getting their bell rung.

Doctors would call it a concussion, a type of traumatic brain injury.

Concussions occur when the brain comes into contact with the inside of the skull, which causes axons to be stretched or sheared.

Message-carrying neurotransmitters move around in chaos, unable to be passed to the next neuron.

Suddenly, the brain can't send or receive messages normally.

- There are certain injuries that are very evident, that anyone can see.

A bone sticking out of your thigh, "Oh, there's a broken bone."

Concussions are anatomically invisible.

- You can put an ankle in an x-ray and look at it, see if it's broken.

There's really nothing to really measure, uh, how severe a head trauma is.

- There are different criteria that you can use to determine if a player has concussion, but there's no one single, if they have a headache, you have a concussion.

- Understanding how-- how that brain injury occurred, Understanding the nature and extent of it, is much more complicated.

- It's tougher with the-- you know, the brain, because it's so, um-- It's your brain.

Jeez.

You know, it's your brain.

You've gotta be-- You can't mess around.

You know what I'm saying?

The difference is that a concussion, you know, can--can end your life and-- you know, like that, and it can change who you are like that.

- Michelle Akers starred on the U.S. Women's National Soccer Team for 15 years, leading the team to two World Cup victories and an Olympic gold medal.

She was characterized by teammates as a warrior, not only due to her aggressive style of play, but also her fierce determination to fight through injuries, including concussions.

- I've had maybe three that put me in the hospital.

Um, you know, broke my face and--on somebody's head.

And, um, there was one, we were playing in China.

The goalkeeper punted the ball, and I was up in the air heading it, and someone, like, undercut me, so I went back, and I hit my head on the--the ground, right?

I was, you know, throwing up.

I was dizzy.

I had, like, everything, massive headache, but I know I've had other times, other games where I know I got my bell rung, and then I--I wasn't right, but I still played.

So I think I've had probably, you know, double digits, you know?

Yeah.

- Monte Coleman is a current college football coach and former NFL Iron Man with three Super Bowl rings.

After 16 seasons in the trenches as a linebacker, he's also had his fair share of hard hits.

- Yeah, I sustained, uh, several concussions, some that when I-- when I finally came to, I thought my neck was broke, and, um, I'll never forget that one.

But sure enough, I went to the sidelines, and they asked me a couple of questions, and I got the ammonia cap, and--and I cleared my head, and I went back in, and I played for the rest of that game.

But I think, i-in my generation, that's--that's what's wrong with some of the guys, uh, that's affected or has been affected by, uh, head trauma.

Does it play an effect on us?

Oh, absolutely, absolutely.

- Professional players aren't the only ones susceptible to concussions.

They can affect every age group and every sport.

[ whistle blows ] - Have you ever had one before?

- Yeah, yeah.

I done had a lot of them.

- Doing what?

- Football and basketball.

- I'm a diver, and I was diving, and I went too far back, and I landed back on the board and hit it.

- I got hit really hard once, and I was real nauseous after that, and I had a really bad headache, but I didn't worry too much about it.

- And what were your symptoms?

- Uh, you know, migraines and a little dizziness at times.

- I couldn't walk.

It hurt so bad just to stand up.

- I was just really tired all the time, and I got nauseous, and I got real bad headaches all the time.

- I think I have a hard time remembering things from school and stuff.

- So how many total would you say you've had?

- Like four or five.

- A lot of 'em, severe.

- Nah, I've had a few.

- I'd say about three or four, probably.

- I've had five.

- We went to see some top researchers to understand just how concerned we should be with this problem facing our youth.

- My name is Dave Halstead.

I'm the Technical Director of this facility, which is Southern Impact Research Center.

I work as a consultant for the National Football League and its players.

I work, uh, as a consultant on several standards-making bodies, including NOCSAE and several others.

- Over his career, Dave Halstead has designed helmets for multiple sports and developed nationally recognized standards to test them.

[ beeping ] He has a deep understanding of head injury that few could rival.

- Concussions, being a brain injury, are a problem at any level.

You know, the oxymoronic term of mild traumatic brain injury is an interesting one.

How can you have a mild injury to your most important organ?

With that said, I think the question you're really asking is do we understand the epidemiology?

Do we truly understand how often they happen?

Do we understand what they mean?

I think we think we understand some of it, but I'm certain we don't truly understand it.

I think we have an inkling.

So with all of those unknowns, yeah, concussions are a problem.

How big of a problem they are, how bad of a problem they are, I'll tell you my personal take.

I have a 14-year-old.

He'd have one concussion, and he wouldn't play again till the next season.

- We know more about head trauma than we did 10 years ago, but the unknowns force us to proceed with caution.

Researchers from around the country are racing to study head impacts in order to better understand their effects on the brain.

Purdue's Neurotrauma Group in Indiana collects data on head impacts through the use of sensors called accelerometers, which record location, magnitude, duration, and direction of the impacts.

- This is our sensor package, and it fits in between the padding in the space here.

- The sensor measures gravitational acceleration, or g-force.

A slap on the head would equal about 10 g's of acceleration, while a car crash could easily reach 100 g's or more.

- I wonder if this is contact with the forehead and then sliding and hitting the shoulder pads.

- They found most players regularly experience impacts greater than 100 g's in both games and practices.

- You can imagine unzipping the helmet in the back and pulling it open and flattening it out.

Blue dots represent small hits.

Yellow and red dots represent big hits.

- But the sheer amount of smaller blows also raise concerns.

- Our lead linemen, so to speak, accumulated over 1,700 blows to 1,800 blows in each of the two seasons, uh, that we studied them.

So for one of our players, he's taken about 3,600 blows over the course of two seasons that exceeded 14.4 g's.

So overall in fewer than 40 sessions, some of these players are accumulating as many as 1,700 hits to the head.

- They also found that many typical starting players had sustained more than 1,000 impacts over the course of a season.

While it still may take many more years to fully understand how these impacts affect our brain, what we know is that risks increase with more head impacts.

- Boxers, professional and amateur, strong and with wobbly legs, eternally fight it out.

- For decades, we've seen the effects of repetitive head trauma in boxers, who have a higher risk of developing long-term degenerative brain diseases later in life.

It was believed that chronic brain damage was only found in boxers, but in 2003, researchers began finding it in football players in the form of a brain disease called chronic traumatic encephalopathy.

This is CTE.

Repetitive hits cause tau, a protein in the brain, to form clusters that deteriorate brain tissue.

Once it begins, it is progressive, meaning it doesn't stop even if the activity that caused it stops.

As time passes, the damaged area gets bigger, and symptoms begin to worsen.

Memory loss, depression, and confusion take hold over time.

- We see it in not just football players, but boxers or anybody that has head trauma on a routine basis.

- So far, CTE has also been found in military veterans, as well as hockey players, soccer players, even baseball players.

Unfortunately, it is unknown how widespread CTE is.

There's no proven method of diagnosing the disease within the living.

The only method of diagnosis is an autopsy.

Dr. Ann McKee at Boston University has studied the brains of nearly 250 athletes, mostly football players, and over 65% of them have had the disease.

The question is why is a sport with helmets having brain trauma like this in the first place?

- I think one of the most important things anybody should focus on here is what the helmets do, because if you played the game, even at the high school level, with the same mindset, but without helmets, you would have dead players on every snap of the ball.

The unintended, incidental head impact at the speeds these guys are going at without a really high-quality helmet, is a death sentence.

We can't forget that.

So with that said, now you say, "Okay, Why don't they work better for concussions?"

I'm gonna give you a couple of analogies.

Imagine you are a chicken farmer, okay?

You raise eggs.

Without them eggs, you ain't feeding anybody.

Those eggs are important to you.

You want to get those eggs to market, but when Mom goes to buy 'em, she opens up that egg carton, and if there's a cracked egg in there, she wants another dozen.

This hurts you bad.

You don't like this, so you go, "I gotta solve that problem."

So you invent the egg carton of all egg cartons.

It's--It's the best thing in the world.

In fact, when you open it to put the eggs in, there's an airlock.

Pssh.

And you put your dozen eggs in there, and you pssh.

And now you throw it at the guy who's come to pick them up, because you're not gonna break the eggs.

He throws 'em in a truck.

He doesn't even care where they are.

He bounces down the road.

He gets to the supermarket.

"Hey, the eggs are here!"

Throws 'em at the produce guy.

The produce guy goes, "Ah, great!"

Drops the watermelon on 'em, no problem.

Throws 'em in the produce bin, right?

Mom goes to buy 'em.

"Well, I want to make sure the eggs are good."

Pssh.

Hey, the eggs are perfect!

Wonderful!

So now Mom closes it up.

Mom goes home.

Grandma's there.

"Oh, the eggs are here.

Let's make-- Let's make a couple over-easy eggs for Dad."

Not possible.

The yolks are scrambled.

You've built this device that allows you to mistreat these eggs any way you can imagine, throwing 'em around.

The shell has been protected.

but inside, the yolk is already scrambled.

That's the problem.

The helmet does a wonderful job of keeping that skull from getting fractured, which, by the way, used to happen.

The helmet does a wonderful job of keeping a direct impact from driving into your head, bending your skull, and causing immediate intercranial damage.

So you got this wonderful egg carton, but the yolk's just getting scrambled.

That's why the helmet's not gonna make this better.

- There most likely will never be a concussion-proof helmet, but we can minimize long-term risks by properly handling concussions when they do occur.

- Go!

Let's go!

Let's go!

[ fans cheering ] - There you go!

Get-- Oh, come on, buddy.

You're all right.

[ whistle blows ] Like the head head?

No neck pain?

No shoulder pain or anything like that?

No numbness, tingling?

All right, just headache?

- Numb where?

- All right, squeeze my hand.

Squeeze hard.

All right.

All right, you know where you're at?

Know what the score is?

- All right, let's take a break for a second.

You okay?

You got dizziness?

Okay, all right.

Let's stand up.

- Let's go, guy.

- You got it?

[ crowd cheering ] - Good job, son!

- You did good, buddy.

- Usually, my--my concussion assessment is three main steps.

You got your balance, or your postural stability, and then there's-- there's self-reported symptoms.

How do you feel?

Do you have a headache, nausea?

Do you have any problems with seeing?

That kind of thing.

- Tell me when you see the doubles.

[ whistle blows ] - And then you got your neurological assessment, or your cognitive function.

You know, that's your can they count, ABCs, you know.

Let's do some cognitive thinking where they have to try.

I want you to count backwards from 15.

- 15, 14, 13, 12, 11... - We go to the patient, and we try to pull out of the patient what's going on, asking him specific things, having him do specific things and testing him.

- Tell 'em back to me.

- I know...something.

- All right, I'm gonna ask you those questions here and again in a second, okay?

Can you read that top left sign underneath Bryant?

- No.

Everett-- - There you go.

What were the words I gave you?

- Blue, bottle, trunk, I think.

- What you do is you refer to the trainer.

You refer to the doctor.

Because the player, what he's gonna say, "Oh, Coach, I feel fine."

- How's your head?

Still got a headache?

All right.

I'll talk to you after the game, okay?

You're out for the rest of the game, though.

- All right.

- Now, the way he feel and, in all actuality, his condition could be two different things.

- Let me go tell Coach real quick he's out.

He's done.

Yeah, he's good.

It's just he's got a headache with it, so we'll look at him next week.

- It's a lot harder to identify and to diagnose.

That's why, with a concussion, the most important thing is when you suspect that you've had some kind of a trauma, just the suspicion of having a concussion, they should not return until evaluated, because that's how serious it is.

- If we can just get somebody to report it, that's number one, 'cause you don't-- you don't see these things.

Rarely is a concussed player knocked out or loss of consciousness.

That's easy, all right?

Yeah, okay, we got that one.

The ones that fall through the cracks are the ones that have the headache and that have difficulty with remembering a play and they don't tell anybody.

Players, most of 'em know something's not right, but they don't want to come out.

- The thing that you didn't want to do, you didn't want to be labeled a--a wimp.

[ chuckles ] So what you did was, you know, to help your football team, you went back in, and you played.

- If I got a headache from it or felt weird or foggy or-- you know, thought something was wrong, but I was functioning, then I just ignored it.

I--I never said anything.

I just never said anything.

- I lit up the hole, and they hit me head to head.

Like, my body froze up, and I fell.

- Your body's numb from neck down, or... - Yeah.

- That kind of scare you?

- Well, I mean, not really, because it happened before, but I kept, like-- I kept playing.

Like, I just kept blocking 'em.

You know, it went away.

- So you've been numb before and just kind of kept playing, and eventually it was fine?

- Yeah.

- Like, keep it to yourself?

- I kind of got used to it, you know, like, 'cause it happened so much.

Like, I really only go to them when, like, I can't function, when it hurts, like, really bad.

I know it's bad, but I mean--I don't know.

- How many concussions would you say you've had?

- I've had three, three or four.

- If you had numbness before and, uh, maybe didn't report it, it's possible you might have had a lot more concussions than four, then.

- Probably so.

- What is it that keeps you doing that?

I mean, what do you-- - It's like I'm letting 'em down.

I just didn't want to let them down, let the team down.

- Because of the difficulty of identifying concussions, we're now looking for ways to identify them without a player reporting symptoms.

Just as Purdue's Neurotrauma Group used helmet sensors to measure impacts for their study, some teams are beginning to use similar devices to track the impacts of their own players.

Most of these devices are designed to alert someone on the sidelines after a large impact, giving the team a chance to evaluate the player who sustained the impact before they return to play.

- So when a helmet reaches a threshold of a single impact or of multiple impacts over time, it'll send a signal to my handheld unit that I carry with me.

When that sensor goes off, it'll alert us.

It'll flash and beep.

It'll tell me where-- what player it is, the name and the jersey number, so I'll go check that player out and do a quick sideline assessment on him.

and, uh, kind of determine whether I believe they have a concussion.

No headache?

- No, sir.

- No nothing?

Blurred vision or anything?

- No, sir.

- Okay.

You still remember the words that I gave you?

- Yes, sir.

- What are they?

- Blue, ball, truck.

- Okay.

If you start getting any kind of headache or anything, you gotta let me know, okay?

In the past, we waited on an obvious sign from a player, either they're unconscious on the field or just complaining of severe headache.

Now I'm doing assessments when I wouldn't be doing those in the past.

Um, going through my protocol a lot more now.

Um, it's helping me identify possible concussions.

- When they work properly, sensors can provide data showing which players have sustained a large impact, but they don't diagnose concussions.

Only trained medical personnel can do that.

- If it sets off the alarm bell and there's no problem, that inconvenient, but it's not a danger.

But if it doesn't go off and the player has a concussion, there's a real risk that someone's gonna go on.

His light's still green, he's fine.

- And now you've returned him to play, because you think he's okay, but he's not, because the sensor's wrong.

That's very frightening to me.

- A protocol is an official procedure or system of rules or, in essence, a detailed plan.

After a concussion is identified, there are strict steps that much be followed, called the Graduated Return to Play Protocol.

The first step after a concussion is complete physical and cognitive rest until symptoms are gone.

- They cannot return to practice or play until they're released by a medical professional.

But once they're released, they're not able to go immediately back to play or practice.

We're not necessarily going to throw 'em right back out there on the field until they gradually return back to full--full speed.

We're just making sure that no signs or symptoms return for those five days before they return to full contact and full practice.

- When an athlete is cleared by their physician, they begin their five-day return to play.

Day one, all you're trying to do is get the athlete's heart rate up and see how they handle the stresses of doing physical activity.

- You're looking at light, general conditioning exercises 15, 20 minutes, the first day, just to see, once you get the heart rate up, if any signs or symptoms come back.

- Maddie, you feeling okay?

- Yes, sir.

- No problems?

- No, sir.

- No symptoms?

- No, sir.

- You're not lying to me?

If any of those signs and symptoms return, you can't progress to the next day.

- Look up.

Bother you at all?

- No, ma'am.

- Do you feel dizzy when you were running?

- Mm-mmm.

Not at all.

- No headache?

- Nope.

- In the second day, you move into moderate conditioning and maybe even some specific skill work for that sport, whether it be shooting some baskets, dribbling the ball, doing some of those activities with soccer.

You know, no spinning, no diving, no quick movements, but just increase that to about 20 to 30 minutes and see if any signs or symptoms return.

In the third day, you're looking at a little heavier conditioning and going up to about 60 minutes to see if the body can do that without any signs or symptoms returning.

You're looking at continuing some skill workout with that individual sport, no contact whatsoever.

- They're a football player, maybe they start running routes, or they start moving in the sled if they're a lineman, things like that, but there's still no contact.

Day four, you can start adding contact.

And so all of a sudden, now they can start hitting dummies.

They can't have any live contact, but they can start having contact with dummies, or they can start having contact with the ground.

- Very light contact, just to see if any signs or symptoms return.

- Everything's been good?

- Mm-hmm.

- You being honest with me?

- Mm-hmm.

- Pinky promise?

- Pinky promise.

- And then the fifth day, participating in a full day, regular practice.

- They go through a full practice, whatever their practice may be, with no limitations.

Continue to monitor 'em.

And on day six, if there's no problems, classroom is in order, home life is in order, they're nonsymptomatic, everything is good, then we're able to return them safely back to sports.

- I've seen a lot of schools have taken 'em and broken 'em down by their individual sports, trying to gradually amp up the exercise and, uh, the movement to make sure that we have no signs or symptoms during that time.

- There's a graduated protocol after a concussion to prevent the player from returning to play before they're fully healed.

When a player resumes activity before the brain is healed, it often makes the injury much worse and could delay the recovery time a number of weeks, months, or even years.

Michelle Akers played through a number of head injuries and didn't fully recover until she retired.

- Especially after games or a tournament, I'd come home, and I was--just like headaches, but--and migraines and, um, just foggy, you know, just that slow, and I've always felt like my head is, like, kind of swollen.

Once I retired, it was like a year later.

I was like, "Wow, this is a lot-- This is a lot different."

- As we know, some athletes never fully heal, and mishandled concussions only increase the number of athletes with degenerative brain diseases later in life.

It's not just former professional athletes that have these diseases either.

Some have been as young as 17 years old.

One of them was Eric Pelly, who played multiple recreational sports over the course of his life, including hockey, football, and rugby.

If he had lived longer, these dark areas of CTE would have continued to spread years after he was done playing his senior season.

- Many times, you have a brain injury, and then you keep playing, and it becomes a pattern for you, and they keep having these low-level injuries.

The brain keeps a real-- and the body itself keeps a real accurate, you know, record of what you've done to it.

- Unfortunately, the worst possible outcome isn't CTE.

The only reason Eric Pelly and others had their brains studied in the first place is because they returned to play too soon, triggering catastrophic brain damage and death.

When death occurs, often the player suffers an initial concussion beforehand, then experiences a second blow to the head before the first one is healed.

One condition, called second impact syndrome, occurs when the second blow causes vessels to dilate uncontrollably, allowing blood to rush into the brain, causing it to swell against the skull, resulting in a catastrophic increase in intracranial pressure.

In other instances, the first concussion can cause a small brain bleed, or subdural hematoma, leaving the brain vulnerable.

The second blow causes the already damaged blood vessels to tear much worse, creating a larger, life-threatening blood clot.

- Better safe than sorry.

So you take the precaution.

Hey, w-what is it gonna hurt?

The guy miss a game, miss two games, miss the rest of the season, opposed to, "Hey, we're going to his funeral."

So better safe than sorry.

The last thing, last thing that we want, me personally, I would never want a young man to--to die on the football field and maybe because he died was because I rushed him back.

That would break my heart, and I'm sure it would with all the other coaches.

We have some breaking news into the Fox 16 newsroom.

Our news partner, KARN, is reporting Star City football player, Zack Towers, has died.

According to the Lincoln County Sheriff's Department, he passed away last night.

The 19-year-old suffered a head injury that put him in a coma.

- He made the tackle, like, on the--like on the left hash, and I guess he came back, got the play, and then was going back, got set up, and then, I guess, just collapsed.

- He just fell down?

- Yes, sir.

- My grandma called and just said, you know, "Zack's hurt.

Z-Zack's hurt."

So then I called my mom, and she was just bawling.

- It's kind of like a boxer when they get hit and they crumple and go down to the canvas.

He kind of went down that way.

And, of course, everybody stood up and yelled, "Injured player."

And about five seconds, I--I kind of looked at Christy.

I said, "You need to get down there.

He's hurt."

- And I really didn't realize what was going on.

I just knew he was foaming at the mouth, and he had-- you know, he couldn't focus.

He was just looking up and just--you know, and-- And I just asked him where he was hurting, and he said, "My head," and I asked if he was gonna be okay.

He didn't-- "I don't know, Mom."

That was the last thing I ever heard him say.

- In what was the last game of his senior season, Zack made a routine tackle and moments later collapsed.

He had a large subdural hematoma, or brain bleed, as well as severe brain swelling.

In the weeks prior to collapsing, he suffered a diagnosed concussion and had lingering symptoms, which doctors believe more than likely played a role.

- You know, about a month before the actual accident, he had started complaining of headaches.

We never thought about a concussion, because he had never told us that he felt like he had gotten a concussion in any of the games or, um, anything, so I started medicating him with sinus medicine.

You know, I'd say, "Well, it is helping?"

"Yeah, it's helping some."

And then he'd go to football practice or something and come home and say, "Well, you know, it's hurting again," or just kind of back and forth like that for probably a couple of weeks.

He'd say, like, if he bent over, he just felt like there was a lot of pressure, and it hurt really bad.

And then finally we decided to take him to Children's, to the ER, just because we figured we could get a CAT scan quicker that way, just to make sure that there was nothing-- you know, nothing going on.

They said the CT scan looked normal.

So they said, you know, it's just-- it's got to be a concussion, just from the--the symptoms that we gave the doctors.

When the doctor said that, then Zack said, "Oh, yeah.

I'm sure it was at that Hamburg game."

You know, "I saw stars whenever I made that hit."

But he never-- it never knocked him out.

You know, he never told us anything about it.

And, I mean, he remembered the specific play and everything.

- One of their star players was about a 225-pound guy, and Zack had made a tackle on him, and he said that that had to have been when he got his concussion.

Apparently, it was a heck of a collision, and-- Yeah, he said he saw stars.

I remember him saying that.

- So he diagnosed him with a concussion there at Children's and said to stay out for a week and then the next week, to start practice if he felt better.

He could start practice on Monday and just take it easy and do a little bit each day, and, "If you start having headaches, to go back to the day before," you know, and don't push himself to do any more.

You know, he stayed out that one week, and then the next week, he started slowly, and, like, on Monday and Tuesday, he was like, "No, yeah, my head's okay.

My head's okay."

He had started contact, I think, on that Wednesday.

Of course, we didn't read it till after the fact, but he had tweeted that, you know, "I'm tired of my head hurting.

I wish my head would quit hurting," something-- - "I'm tired of these headaches."

- "I'm tired of these headaches."

- He tweeted, "I was tired of these headaches."

That was on a Wednesday... - But, of course, he didn't tell-- - Before the game on Thursday.

- Yeah.

He didn't tell us that.

- Despite his symptoms after practicing Wednesday, Zack played in Thursday night's game.

After collapsing, he had emergency brain surgery that night... [ siren blaring ] and was in a coma for nearly five months.

He eventually died in February of the next year.

If protocol was being followed and Zack reported the symptoms he had on Wednesday, he would have stopped activity for 24 hours and moved a day back in the protocol.

It's important to remember, though, that if he began the protocol on Monday, the soonest he could have come back to a game would have been Saturday.

Since the next game was on Thursday, he would have been automatically ruled out, with or without symptoms.

- I know, like Ty, you know, who's the oldest son, plays for Ouachita, he said that their protocol there, you know, if somebody has a concussion, I mean, they don't-- they don't go back.

The trainer basically makes the call.

You know, the coaches don't even have anything to do with it.

You know, it's, like, really serious, and they take it serious.

- One more time.

Look at me.

- Do you think Zack would have benefited from having the protocol that you have at college?

- Oh, yeah.

I mean, he had always said that he was having these major headaches.

And, uh, if you even have a headache, well, then they won't even let you run.

- Somebody's got to intervene on behalf of that student athlete.

Somebody's got to be willing to say, "Hey, we need to make a decision here.

"We're gonna go do further evaluation, further tests, talk to some more people before we make a hasty decision".

If we can just start on that step of education and--and setting up a policy and a procedure of how we're gonna conduct this, appointing somebody.

"You're the responsible person that's gonna help us, be our athletic healthcare provider."

Whether you're an athlete trainer, whether you're a school nurse, if you're a physical therapist, if you're a physician, whatever specialty you've got, let's get 'em in there, plug 'em in, and let's move forward with this.

Probably the most important thing that we do is the clinical evaluation.

- Five times?

- Five times.

- Okay.

- You know, having somebody who's trained with sports medicine, that is familiar, that has certification, has continuing education, is critical.

- You know, sadness?

- What about anxious or nervous?

- Not only are we watching them, but we're able to recognize, "Hey, you know, something's not right here."

- Tell me the month of the year in reverse order.

- All right, you stopped at September.

Think of it?

- Okay.

- So my big question is who's taking care of our kids?

Let's put somebody there so that we can recognize, treat, deal with, manage and institute some programs and policies, and--and that helps me sleep at night, knowing that we have a process in place, "Here's how we're gonna treat this."

- The process of managing concussions is far-reaching and multilayered, continually changing as we learn more about the brain.

When done well, this process begins even before the season begins and not just after a concussion occurs.

One person cannot do it alone.

It requires everyone's attention, and everyone must pull together.

Many are taking a step forward, choosing to work together in implementing some common-sense changes to the way they practice and play the game... - 22 1/2.

- as well as their equipment.

- We need to get a large here.

- Start with a large.

- Making sure that equipment is properly cared for, recertified, uh, is very important, so you know when you-- when you put the helmet on, it's gonna do the best that it can.

Making sure that--that equipment fits is very important.

If a kid's wearing a helmet that's not touching all of his head or it's too tight and it's sitting too high or it's too low and it's not touching on the sides, it's not gonna perform as good as it can.

- You shouldn't be able to twist the helmet around, shouldn't be able to grab the facemask and be able to raise it up off of the forehead.

Chin strap should be buckled and secured tightly so that it is holding the helmet onto your head.

Those things need to be checked before any contest.

One of the things that I've said for years, it's very important for your athletes to be physically fit.

If they're fatigued, their body's weary, it puts them at a greater risk for any type of injury.

- Specifically, studies are also showing that stronger muscles in the neck can reduce the risk of concussions, because they help stabilize the head during an impact.

- We'll have the athletes working all four ways of cervical motion, so they'll do flexion, extension, and lateral flexion.

We'll also have 'em do shoulder shrugs.

Then we also use partner dynamics to where the athlete is turning in to their teammate's hands or arms, so that is something that we've added to our programs across the board, both female and male sports, is really trying to help prevent, do everything we can.

- None of the damage these players are accruing, none of the blows they're accruing, are really a necessary component of participation.

Our particular team has two contact practices per week.

At least 2/3 of the blows experienced by these players are taking place in practice.

So if I have a player who accumulated 1,800 blows and I can knock out 1,200 of those blows over the course of the season, I'm now talking about a player who's really only taking 600 blows to the head over the course of the season.

- When you look at risk management in anything, you're looking at the exposure, how many times are you exposed to that potential injury, and so reducing the number of practices where you have full contact reduces the exposure.

- No pads!

Shorts and helmets only today!

- Every exposure they have, that's one more chance for them to get that concussive blow.

And so the new rules from the NFL to the NCAA, now down to the high school setting, where it's limiting contact, I think that that's absolutely the right thing to do.

- There's lots you can do to prevent, because just in soccer when I get kids and I'm training kids, their technique isn't right 99% of the time.

- So we're gonna start with our header progression, and what we're focusing on here is making contact with the hairline of her head, rather than her forehead or her temple or even her face.

The player doesn't close their eyes and let the ball hit them.

They're attacking the ball.

That's it.

That's wonderful.

So you're still trying to make contact with your hairline, right, but now you're trying to, as you hit it, use your torso and your neck, remember, and we try and snap it sideways.

Very good.

LeeLee, that's it.

Great example.

- Well, the most important and the most effective thing that can be done right now is to teach players how to play the game without getting your head in it.

- First command is feet, squeeze, sink, hands.

If you'll notice, he should have a good 45-degree lean.

He should have a good back angle.

We should have an ability to hit right here with the front of our shoulder pad.

That's where we're trying to deliver the blow.

Used to, we would try to deliver the blow with the front of our facemask.

Too many times, we would have guys bent over, and when they do that, that causes their head to go down, and that causes a point of injury.

So on buzz, I'm gonna ask our players to come through with short, choppy steps, straddling the bag, bringing their body under control.

Ready, buzz.

And that puts them in an under-control situation where they can hit with the proper form.

As they become more advanced, now we can incorporate all these things.

At the last second, we slide our head off to one side and finish the tackle with our rip.

Ready.

Hit!

Good job.

Good tackle.

And, again, what we're trying to do is minimize the amount that our head's involved with the tackle.

Hit!

You know, a lot times, we say you gotta be a tough guy to play football.

Nobody's brain's tough.

There's nothing you can do to toughen up your brain, so that's what we've gotta take care of and that's the focus behind most of what we're trying to do.

- When used together, these changes give athletes the best chance to avoid an injury, but concussions can still happen, and preparation is key.

Baseline testing before the season begins can provide a more clinical method of determining how impaired a player is, which can help aid Return to Play decisions after an injury.

- Whenever we first get there our freshman year, we have to take what they call the--the ImPACT test, and we have to do that before we can even play.

- The baseline tests are critical.

because everybody's an individual, and we--we try to treat somebody to meet their specific needs.

There's no pass-fail.

It doesn't measure how bright you are.

It just measures your score on--on six different things, so now we have something with which to measure by.

- The athlete will take a test, if you will, which might almost be like a game in some cases, and the computer is understanding how quickly the person recognizes things, remembers things, recalls things.

- Then when you suspect a concussion or you've diagnosed a concussion, uh, you can then reassess them.

In theory, you'll see the difference between the before and the after.

- This test can be part of an analysis to go, "He does not remember things as well.

"It took him longer to identify this geometric shape, therefore his brain is not functioning the way it was."

- We will redo their ImPACT testing post-injury.

Then we'll compare the scores.

We'll look for their cognitive ability.

We'll look for any delays in the reaction time, and if their scores are not at baseline or better, we're gonna hold on, and we're gonna send 'em for--for follow-up.

- But we also incorporate a balance test, which is the second thing we use.

So adjust your feet to where you can just stand there with no effort and balance yourself just in a normal stance.

- Hands on your hips, and you're gonna close your eyes and hold that for 20 seconds.

Go.

- And when you're ready, okay, I'll give you the countdown.

3, 2, 1.

Close your eyes.

10 seconds.

Somebody's gotta make a decision that says, "Yeah, they can go back."

If they pass the ImPACT tests and it's back up to where their baseline was, that's a good thing, but we're looking at a lot more than that.

5, 4, 3, 2, 1.

If they pass the balance and the baseline, okay, that's two, but they gotta be able to pass that clinical evaluation.

And so after all three of those have been met, we will return them back on our protocol, day one, day two, day three, day four, and day five.

But there's a better way.

There's a better way to take care of our kids.

We want to make sure that we've got eyes on them and that we're following them during the whole process, that somebody's there watching specifically for them.

I think we're making some huge strides, but we've got some work to do.

[ crowd cheering ] - Until about 10 years ago, we didn't treat concussions at all.

- I don't think even a lot of the--the professionals were educated on taking it in a serious manner.

- Literally, the coach had smelling salts, and if he waved it under your nose and you got up and you looked okay, you were good to go!

I am so glad those days are gone.

- Concussions have always happened, and they're not going to go away.

As long as there is high forces involved with athletics, there will be concussions.

You just have to stress to these guys over and over not to use your head.

Don't lead with your head.

- It's not just a better helmet or a better standard, but changing the way you play the game and understanding the importance of--of telling somebody if you have a concussion.

- You know, somebody has to want to learn and understand this, and the first thing they have to recognize is there is no magic wand, so now I need to spend some time trying to grasp this, and I find very few coaches willing to do that.

I'll volunteer to talk in front of a group.

"Well, we'll give you an hour on Tuesday night."

"Perfect."

I'll have three families show up.

It really isn't that important to parents yet until it happens to their child.

Then it's important.

Then it's too late.

- How do you feel about your other two sons playing football?

- Not really.

I don't like it.

I guess I could stop 'em, but-- but they-- they really want to play, so-- so that's what they do.

But I guarantee you, if they got a concussion, they wouldn't be back out there.

- Because of themselves?

- 'Cause Mama wouldn't let 'em.

I would put my foot down.

- We couldn't make the 21-year-old not play, but we could do everything we could.

- I'd be going to his coach, yeah.

[ music playing ] - Man, that was a lot of fun.

I enjoyed playing football.

I really did.

I enjoyed playing football.

- So for you, it was all worth it?

- Yes, it was.

Yes, it was.

- If I hadn't played sports growing up, I would have, you know, been way down another path.

I've gotten, you know, so many gifts from--from being an athlete.

- There's no better way to build that discipline, that teamwork within a kid, because the--the thing that we want to do as a coach, we want to instill that discipline in them so they can matriculate and they can go out and do the things that's necessary to get a family.

- The principles that I've learned and the confidence, everything, I carry with me now.

There's so much you can get out of being an athlete.

It's just--It's irreplaceable.

- If it wasn't for football, I don't know.

I-I'm curious what my life would be like.

[ music playing ]