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concussions in high school sports can football be saved

Concussions in High School Sports – Can Football be Saved?

by Clinton Boone, PT, DPT, CMTPT/DN2 Comments

The Chicago Tribune recently reported that high school football participation in Illinois has reached a 26-year low. For the first time since 1993, fewer than 40,000 high school students in Illinois will be participating in football.1 Furthermore, the National Federation of State High School Associations states the number of high school students playing football has dropped 8 percent since 2007, more than any other sport. However, this is small compared to Illinois’ 25 percent drop in the same timeframe.1

Declining numbers have forced some schools to resort to 8-man football or drop the sport entirely from their school. When it comes to the conversation of safe sports in high school, football always seems to be singled-out, which leads us to the question: Can football be saved?

Although small, there is the risk of developing chronic traumatic encephalopathy (CTE), even in high school. CTE was found in 110 of 111 brains of NFL players examined after death (CTE can only be discovered by examining one’s brain after death during an autopsy).2 Some studies argue that even just one season of high school football can cause brain damage.3 Side effects of CTE vary but can include memory loss, aggression, depression and anxiety.

A few universities teamed up with Riddell to track the impact and frequency of hits to the head during their NCAA Football games. Although it varies by position, it was determined that the average football player receives six hits to the head during practice and approximately 14 hits to the head during games.4

But football still has its’ positives: from character-building and life lessons, there is still a lot football can offer. Ask any former high school football player, and most will agree that the game has taught and instilled values of teamwork, discipline and toughness – both physical and mental. The camaraderie of a football team can also produce friendships and connections from both coaches and players that can last a lifetime. Additionally, for many kids, the game – along with all the practices, weight lifting, and off-season conditioning – can promote more physical activity, improve overall health and develop healthy habits that can last for years to come.

An eleven-year study showed that there is a risk of concussion in any high school sport, and girls’ sports had concussion rates equal to or higher than their male counterparts.5 Moreover, an article from Coach & A.D. suggested that football and basketball have nearly identical injury rates, and that no sport is completely injury-free.6 From bowling to baseball, the risk of injury is present in all high school sports.

Now, more than ever, the focus must come down to proper technique and safety. An article by the Children’s Hospital of Orange County (CHOC) argues that football can still be an integral part of a student’s active lifestyle, as long as they are taught proper form and technique.7 Moreover, physicians at CHOC infer that a focus on non-contact football at an earlier age, as well as a deeper focus on off-season condition – particularly neck and core strengthening, can mitigate the risks of playing football.7

The American Academy of Pediatrics (AAP) recently refused to support a ban on tackling in football, saying it could not confidently support such a fundamental change in the game.8 Most coaches agree that students should be taught the “heads up” tackling technique and have properly fitted equipment to provide optimal protection.

In 2018, the Illinois Legislative Assembly introduced a bill (HB4341 – CTE Prevention Act) that would prohibit children under the age of 12 from playing organized tackle football,9 thus promoting more emphasis on the fundamentals of non-tackle football until the age of 12 (the bill is currently session sine die as of October 2019, meaning that there is currently not a day assigned to have a further meeting or hearing).9 Moreover, physicians at Children’s Hospital of Orange County (CHOC) suggest that parents have their child undergo a preliminary ImPACT test prior to football season, and repeat the test at the end of the season or at any time a concussion is suspected.8 Certain Athletico locations and clinicians offer ImPACT testing (click here to see a list of ImPACT certified clinicians and locations).

In the end, as with any sport, there are benefits and risks with playing football. Many physicians will agree that it is up to the parents to decide if the benefits of the game – with proper coaching, technique, and equipment – outweigh the risks. For many, the game is a sacred tradition that molds young players into the adults they will become.

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The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.


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Clinton Boone is a physical therapist who enjoys treating various orthopedic conditions and vestibular disorders. Clint enjoys spending time with family, lifting weights, and running in his spare time – having just completed the Chicago Marathon in 2022. Clint works and lives in Manhattan, IL, and loves treating members of his local community. He can be reached at if you have any questions or comments.


  1. Erik Krol, ORT/L

    This was a well researched and written article, thank you for your work. I agree that emphasis on “heads up” technique and core strengthening especially during off-season and fall camp practices with and without contact are beneficial. From experience, players are able to develop good carry over into game speed performance even when practiced without contact, too. The decline in participation is an interesting phenomenon, and football at the youth and university level is something I hope healthcare professionals can help to preserve.

  2. David Kim

    Concussions are common when exercising, but people should always be careful not to concuss as much as possible while exercising. The association also studies what situations sports players usually concuss in. You should know which position causes the most brain injuries. It also recommends learning new tackles to minimize concussion. As much as sports become popular and many people enjoy themselves, it’s safe to avoid damaging the brain, which is the most important thing in the human body.

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