PHOENIX – Before most players in the National Football League wore a pro jersey, they had to put on a college jersey. Before they wore college colors, they probably donned a high school jersey, and, before that, many wore youth football jerseys.
That unbroken progression has existed for generations, but lifelong players are becoming more of an anomaly than the norm.
Participation in tackle football has declined dramatically over the past 10 years for many reasons, most predominantly player health. With high school participation dropping to its lowest point since 2000 according to the National Federation of State High School Associations, youth tackle football numbers are most concerning to those with a vested interest in the game.
For football to make a comeback and secure its spot at the top of the American sports food chain, experts say it has to adapt by making changes to safety, equipment, legislation and manner of play.
The problem that youth and high school tackle football face is the increased prevalence of head injuries and the multiple unknowns of impact on a youth brain, which will require further research, said Dr. Anikar Chhabra, director of sports medicine at Mayo Clinic Arizona.
“The long-term effects of head injuries and repetitive head injuries starting at a young age are a little bit more unknown than the adult who gets a head injury,” Chhabra said. “The unknown is what happens with repetitive head drama. We know there’s an effect, but we can’t really prove it.”
Muhammad Oliver, 50, spent five years in the NFL playing for five teams, and four years in the Arena Football League playing for the Arizona Rattlers. Oliver still believes football is the ultimate team game and teaches youth skills that translate off the field.
“When you’re in a work environment, you have co-workers that you depend on to get a project done. Well, it’s the same thing in football,” Oliver said. “Our defensive backs have to rely on our linebackers and defensive line. Our receivers rely on our quarterback and offensive line. Everybody relies on each other. And you realize how important it is that everybody does their job, including you in order for the team to be successful.”
Oliver’s son, Isaiah, is a cornerback for the Atlanta Falcons, but Muhammad Oliver said he will not let his younger children play tackle football until they are at least 12 years old.
Oliver said his 5-year-old and 8-year-old ask him all the time if they can play tackle before they turn 12, to which he says, “Yeah, it’s not happening. Nope, not happening.”
He’s not alone.
In September, the NFSHSA witnessed its first decline in high school sports participation in 30 years. The number fell from about 7.98 million to about 7.94 million – a 43,395 difference – with football the biggest contributor to the decline.
According to the NFSHSA, participation in high school football dropped by nearly 31,000 participants to about 1.006 million, which is the lowest mark since the 1.002 million mark in the 1999-2000 school year.
In spite of the drop in participants, the number of schools that carry traditional 11-man football teams rose. For context, the average number of boys on a high school football team was 79 a decade ago. Now, the average is about 70.
From 2006-2017, the number of people of all ages participating in tackle football dropped from 8.4 million to 5.22 million – a 37.8 percent decrease.
The decrease began around the time that head injuries, like concussions and chronic traumatic encephalopathy (CTE), came to the forefront of neurological medicine, specifically relating to tackle football.
In 2005, pathologist Dr. Bennet Omalu published a study about CTE, a degenerative brain disease caused by repeated concussive and subconcussive blows to the head. Omalu battled with football advocates and the National Football League over the validity of the study and CTE. His findings are now internationally recognized.
Omalu’s story became the 2015 movie “Concussion.” The most precipitous drops in football participation came in the years after the movie’s release.
“Now I see a lot of my friends (who played in the NFL) going through a lot of injuries and memory loss and all kinds of stuff like that,” Oliver said.
The increased awareness of head injuries had a significant impact on the game of football. It made parents such as Aneesha Sullivan fear for their children’s safety.
“I think my focus is head injuries, because I know the consequences of head injuries,” Sullivan said. “Minor head injuries can have long-term consequences. So if they’re injuring themselves at a young age while they’re still developing, I think that that makes no sense at all.”
Dr. Javier Cardenas, director of the Barrow Concussion and Brain Injury Center in Phoenix and a member of the NFL head, neck and spine committee, said what is known right now is that it takes adolescents over twice as long to heal from a concussion as it does for an adult.
The average time needed for an adolescent to heal from a concussion is three weeks as opposed to a fully grown and developed person, who takes anywhere from seven to 10 days, Cardenas said.
Parents such as Sullivan, who is a physician’s assistant in family medicine in Tolleson, find themselves in a quandary: let your child play football and assume a greater risk to head injuries, or keep them from a beloved American game.
Not all forms of football are going by the wayside, however. One of tackle football’s biggest competitors is another form of the game: flag football.
From 2014 to 2018, flag football participation at all levels rose by just over 16% – from 5.51 million participants to 6.57 million.
Sullivan’s son sustained a concussion when he was young after a car ran a stop sign and struck him, resulting in years of speech therapy, occupational therapy and physical therapy. Sullivan thinks, at least for now, that flag football is the right path.
“I think flag football gives you a little more because it teaches them discipline and structure, but it doesn’t teach them that same kind of aggression,” Sullivan said. “So it allows them to kind of get to learn the game without getting an injury, and then (if they get injured) not wanting to play the game at a very young age.”
Two years ago, Sullivan enrolled her son in GameDay Sports, one of several flag football leagues in Maricopa County. GameDay was founded three years ago by Reggie Alfonso, who saw a growing market and need for more flag football leagues.
“My vision for the whole thing was to get as many kids involved in sports as possible,” Alfonso said. “We think there are great lessons to be learned, life lessons, when it comes to playing sports, both in leadership, goal setting and overcoming adversity.”
GameDay Sports had 400 participants in its inaugural season at its sole location in Goodyear. This season, it has 1,800 participants and two locations with the addition of Gilbert.
“Not every kid wants to get hit, especially in those early ages, but a lot of people love football,” Alfonso said. “So having the opportunity to still score touchdowns, grab interceptions, stop the run, run the ball. You’re still playing football and you don’t have to worry about the physicality part of it. Still a ton of fun, and any kid can play.”
GameDay is one of 50 leagues in Maricopa County that are NFL Flag certified. NFL Flag has been around since 1996 and “serves as a great entry point to the game of football by developing the fundamental skills and techniques for all youth participants,” according to an NFL Flag press release.
The 50 NFL Flag-certified leagues far outnumber the 10 registered Pop Warner football teams that exist in the Phoenix area.
Many parents such as Oliver say that they will not let their children play tackle football until at least the age of 12. In 2016, a UMass Lowell Center for Public Opinion Research survey found that 78 percent of American adults do not think it is appropriate for children to participate in tackle football before the age of 14.
“I think that there’s an influence of youth football slowing down when it comes to tackle,” Alfonso said. “I think that’ll pick back up with the kids that want to play and are ready to play when you get to high school.”
The uproar over the safety of tackle football has gotten so loud that legislation is being discussed in many states.
Chhabra said he thinks the legislation that has been discussed in these states as well as passed in Canada is a growing trend that will “100 percent” continue.
“A hit to the head is devastating for the future,” Chhabra said. “So, yes, as you get older, your growth and your brain maturity increases. Those are the most vulnerable years between 12 and 13 and 14. And so, do I think that that’s reasonable? Yes, I do.”
However, Alfonso thinks it is unnecessary.
“That’s a choice for every family member and every child to make,” Alfonso said. “I don’t think Congress should make that decision for parents. I think there’s a lot of stats on both sides, and we can look at that with whatever angle and lens you choose to look at it from, but at the end of the day, it’s every family’s decision to make, and they’ll make that based on what’s best for them and their child.”
As the trajectory of flag football rises while tackle football’s falls, the NFL, Pop Warner and USA Football are trying to halt the decline. Denise Mathis, president of the Deer Valley Pop Warner league, believes that football as a whole, but especially youth tackle football, is as safe as it has ever been.
“It’s absolutely safer,” Mathis said. “Just the rule changes alone that we’ve administered like the no punts and no kick returns and no helmet-to-helmet contact and you’re only allowed to tackle inside the shoulders. All those details have changed so much.”
Mathis took over as the DVPW president two years ago, when the league was down to just four teams. She and her husband, Dusty, have built it back up to eight teams and around 280 participants.
In recent years, USA Football has made a concerted effort to make the game safer. Every coach who sets foot on a Pop Warner field is trained through USA Football’s certification process, which involves classes in tackling, concussions, heat exhaustion and conditioning, along with background checks.
The rules of USA Football also mandate that the first 10 hours of practices for all age groups be used purely for conditioning and readiness. No pads or helmets are allowed through those periods.
Other rules changes include elimination of punts and kickoffs for younger kids, elimination of helmet-to-helmet contact and increased emphasis on bringing down and tackling your opponent without your head and neck involved in the tackle, Dusty Mathis said.
“I don’t believe that (parents) should be afraid of tackle football if it’s taught the right way,” Denise Mathis said. “If your coaching staff is taught the proper way to pass that along to the players as to how to tackle properly and how to be safe and how to block and make sure they’re doing contact properly, there’s nothing to be afraid of.”
Oliver also believes that the game of tackle football is safer now.
“I think the way I played football back then, I wouldn’t be allowed to play right now,” he said. “Being that I played football, high school, collegiate and professionally, I now know the ramifications and damage from being hit in the head a lot. I want to minimize as much as possible for my kids.”
Cardenas also said that tackle football is safer now than it has ever been, especially because recognition and identification of a concussion has improved so much. Twenty years ago, you were diagnosed only if you got knocked out, he said. Now, if someone is “acting funny,” the player is pulled out of the game. Teams also follow the mantra “when in doubt, sit them out.”
A major area of emphasis in Pop Warner is making sure that all players have proper, well-fitting pads and helmets. Glenn Beckmann, director of communications at Schutt Sports, a leading football helmet manufacturer, said fit is the most important consideration when it comes to helmets.
“Even if the helmet is two or three years old, if it’s been properly reconditioned and it fits your player the best, that’s the best helmet for them,” Beckmann said.
The increased awareness of head injuries in football and other sports has brought some scrutiny to helmet manufacturers such as Schutt, but the attention is a positive thing because the rate of technological advancements in helmets has increased, Beckmann said.
“It forces us – and when I say ‘us,’ I mean the entire industry including medicine and science – to pay more, pay more attention, pay closer attention, and learn more,” he said.
However, a 2016 UMass public opinion poll found that 63 percent of people polled believe it is either certainly or probably false that tackle football is a safe activity for children before they reach high school.
Despite improved equipment, rules changes and better regulations, Chhabra the dictir understands the risks of allowing children to play tackle football, so Chhabra the dad said when his 12-year-old son gets to high school, he will not be allowed to play tackle football.
“That’s going to be a long conversation that we’re going to have to have for me to buy in for him to play,” Chhabra said. “That’s me talking as a parent and not as a sports fan, because I love the game of football. But, yes, I do think it’s legitimized. I think that more data is coming out that shows the young developing brain can be very harmful in terms of taking repetitive hits to the head.”
Alfonso thinks that football will be fine, that it just has to find that niche of kids who are innately a bit more aggressive than their more passive counterparts.
“I don’t think that when it comes to high school and college and eventually pros, there’ll be a deluge of talent,” he said. “I think that they’ll still get the best kids who are ready for that.”
Information is at a premium, and it is important for children and parents to read and watch as much as they can when it comes to new information surrounding head injuries and football, Alfonso said.
“I think that it’ll start to change back to be more tackle once it’s proven that these new techniques and these new rules are effective and kids are safer,” Oliver said. “Then parents will feel more comfortable with their kids playing tackle football and may start getting into it a little bit earlier.”
However, Cardenas said that even if the participation numbers don’t climb back to their historic highs, the safety improvements in the game are necessary.
“The efforts to make the game safer are to keep everybody who participates now and in the future stay as safe as possible,” he said. “Whether or not that translates into an increase or decrease in numbers, that’s really for families to decide.”