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.

McKee says she hasn’t seen enough brains yet to determine for sure the long-term impact of high school football on its players’ minds. But the Owen Thomas case — which sparked national headlines — seems ominous. Thomas was a University of Pennsylvania junior lineman when he hanged himself in his apartment in April. Though Thomas’s family said that they never knew him to have suffered a concussion, BU researchers found the early stages of CTE in his brain, suggesting that it may have played a role in his suicide. The most likely explanations are that Thomas either played through concussions without telling anyone or, perhaps more disturbingly, that all the run-of-the-mill hits to the head he absorbed between Pop Warner and Penn added up to CTE.

Nowinski draws his own conclusions. “I don’t think the jury’s out at all on whether high school exposure’s enough for CTE,” he says. “We’ve seen it in a kid who’s just 18. We just haven’t looked at a lot of 40- and 50-year-olds who just played high school football. If it starts in your teen years and it just progresses, some percentage of kids are walking out of high school football with CTE already in their brain. And probably the earlier they started, the higher their risk. If you played from 6 to 16, that’s probably just as bad as someone who plays in the NFL [and plays from ages] 14 to 24. Maybe worse, because the young brain is, again, more sensitive.”

MCKEE AND NOWINSKI AGREE that the most important thing for high school athletes is to not play while concussed. But even in Massachusetts — where all this groundbreaking brain research is taking place — that has proven difficult.

For one, concussions are hard to diagnose. “Perhaps as high as 70 to 80 percent of mild concussions are missed in football because athletes can play through,” says BU’s Cantu. Contrary to popular belief, few concussions result in a player being knocked out. “I believe that the majority of physicians who are in practice today would not be qualified to manage athletic concussions,” he says.

Special training is needed, notes Thomas Dodge, the president-elect of Athletic Trainers of Massachusetts. The standard checklist of concussion symptoms is 25 items long.

Many specialists believe athletic trainers are the key to handling concussions. But Dodge estimates that less than half the high schools in Massachusetts have them. In the city, and farther out into the state’s rural areas, schools become less likely to employ trainers. Though Boston Public Schools has roughly 17,500 students enrolled across more than 30 high schools, for instance, the district employs just one athletic trainer for all of its facilities.

The issue in Boston, of course, is money. Through partnerships with BU and other medical providers, BPS is able to staff a doctor and emergency team at each district football game. But they don’t know the kids as well as a trainer would, and aren’t around the rest of the week. “I’m not saying that sports or a student’s health aren’t very important, but money is what it is,” says Kenneth Still, the athletic director for BPS. “You can only spread it so far.”