Headed for Trouble

BU scientists are renowned for their research on concussions suffered by NFL veterans. Now their studies are raising alarming questions about the true dangers of high school football.

Here in Massachusetts, that middle is very large. There are currently more than 20,000 high school football players in the state. According to experts, 5 to 10 percent of them will suffer concussions this season. Many will go undiagnosed because, much like the professionals, kids steeped in football’s warrior ethic often try to play through the pain. More than 40 percent of concussed high schoolers return to games too soon, according to a recent study by the Nationwide Children’s Hospital in Columbus, Ohio. And because young athletes’ brains are still developing, the dangers for them are elevated: According to one study, the brain trauma caused by a concussion can be three times more harmful for a child than it is for an adult.

The most serious risk is second-impact syndrome, an extremely rare but potentially fatal condition. If a concussed player returns to play too soon, a second hit to the head — even a light one — may cause death. Every year, a handful of kids die from second-impact syndrome nationwide, though there have been no recent fatalities in Massachusetts.

Much more common is post-concussive syndrome. Ordinarily, a concussion takes up to three weeks to clear. If, however, a second concussion follows the first too closely, recovery can take months. Post-concussive syndrome also exacerbates ADD, ADHD, and depression, says Robert Cantu, an SLI cofounder and neurosurgeon at BU’s CSTE center. The condition is especially problematic for students, as mental rest is vital to recovering from a concussion. Even reading can set back the healing.

Take the case of Eric Budden, a senior at BC High. At 5-foot-11, 268 pounds, he’s the football team’s starting center. He suffered his first concussion in a preseason practice during his sophomore year, experiencing nausea and sensitivity to light and noise for about two weeks. When he suffered another in September of his junior year, his recovery took the same amount of time. But when he crashed his head into a teammate’s facemask during practice about a month later — his doctors had declared him recovered — his symptoms lasted more than a month. “My grades kind of dipped a little bit,” Budden says, noting that he had trouble focusing. “There was nothing I could do about it.”

In a sense, Budden was lucky. If he had jumped back in sooner and been concussed again, his recovery could have taken most of the school year. This is something that Chris Nowinski is acutely aware of. “When we talk to the athletes and the coaches, we talk about fighting two fights,” he says. The first is making sure students don’t derail their academic career by going back in the game too soon and suffering post-concussive syndrome. “If you have to miss a semester and your grades drop, it’s going to change what college you go to,” Nowinski says. “It’s going to change everything about your future.”

The other fight is CTE, he says. Unlike post-concussive syndrome, which is the result of a specific incident, CTE represents the accumulation of hits to the head, whether concussive or not. The condition can lead to depression, mood swings, impulsive behavior, loss of memory, and general loss of brain function later in life. “The beginnings of CTE can start quite early,” BU’s McKee says. She’s seen its early stages thus far in two young brains. The first belonged to an 18-year-old football player who died in an incident unrelated to the sport. The second is the brain she slid under the microscope after Hilgenberg’s and Creekmur’s. It belonged to Owen Thomas.