Former San Diego Chargers linebacker and icon Junior Seau’s suicide in 2012 shocked the San Diego and National Football League community.
What really sent a shockwave through the community, though, was a study of Seau’s brain that revealed he was dealing with Chronic Traumatic Encephalopathy, a degenerative brain disease caused by repeated head trauma with symptoms such as depression, aggression, confusion and memory loss.
Seau’s death and subsequent cases of former NFL players with CTE have sparked a new wave of concussion awareness for players of all ages.
For high school football coaches, concussion prevention and awareness has become just as much apart of their job description as game planning for opponents or putting together a roster.
A Boston University study published in 2015 found CTE in 87 of the 91 brains donated by deceased NFL players for the study.
Locally, a former La Jolla High football player is suing the San Diego Unified School District for “traumatic and catastrophic brain injuries” stemming from a game on Oct. 16, 2014 in which he claimed that assistant coach Steven Wachs neglected the severity his head injury.
Coaches like Grossmont High’s Tom Karlo have responded to the heightened awareness and prevention by changing the way they run their team, especially in schools like his where no full-time trainer is on staff.
“It’s a huge problem. I can tell one of my kids to ice an ankle or to tape something up, but when he goes home I don’t know if they’re actually going to do it,” Karlo said. “With a full-time trainer, they treat the player and that is that.”
Not every coach has as much on their plate because some schools have the financial flexibility to hire full-time trainers to monitor and diagnose injuries.
Mt Carmel High football head coach John Anderson heavily relies on the school’s full-time athletic trainer Diane Lawrance in helping monitor his players for head injuries.
MULTIMEDIA: Mt. Carmel is one of a select amount of high schools in San Diego County to have a full-time trainer on staff. This takes a lot of pressure off coaches in practice because they’re able to rely on a professional trainer and not themselves to follow the many new protocols for head injuries.
Lawrance said that concussions will not go away because of the nature of the game, but having a trainer can help diagnose them and educate players on the dangers.
“(Lawrance) has taken a lot off my plate, there’s no guess work for me when it comes to head injuries,” Anderson said. “If a player has any degree of head pain, they have to see the trainer. If she wasn’t here, I’d have to do all the monitoring on my own.”
Doing all the monitoring on his own is a reality for Karlo and many other coaches in San Diego County.
“Head injuries weigh on my mind the most; it worries me more than anything else,” Karlo said.
Karlo has 26 coaches on his staff to monitor all 175 kids in the Grossmont football program, between freshmen, junior varsity and varsity.
Without a full-time trainer, his staff has the sole responsibility of making sure that players aren’t playing with head injuries.
“We’ve had to start shying away from contact in practices,” he said. “A player got a head injury during a scrimmage last fall and we had to cut it short because our coaching staff had to take care of him.”
Karlo uses his observations during practice to monitor his players and if he, or one of his assistant coaches, suspect any problems, they tell the player they need to get cleared by a medical professional before stepping back onto the field.
Although there’s no trainer on site for practices at Grossmont High, Grossmont Junior College head athletic trainer Chris Ray is hired part-time to attend the high school’s games to monitor and tend to injuries.
That’s not enough for Karlo, though, as he pays for an athletic trainer out of pocket to watch the team’s practice on Mondays and Tuesdays.
Karlo believes that knowing the kids and seeing them on a regular basis is the best way to detect any suspicious behavior stemming from a head injury.
“You need to build relationships with the kids and know who they are, otherwise you’re not going to know if they are acting different,” Karlo said.
Trainers have more power to keep players safe
With the increase in concussion awareness in high school football, the power over whether a player can play or not has shifted in the favor of athletic trainers.
The California Interscholastic Federation has begun to put rules in place that intend to limit injuries and give trainers more power to protect players.
It mandated in 2013 that high school football teams are not allowed more than two full-contact practices a week, and can practice for no longer than three hours a day.
Helix High athletic trainer Kathryn Welch says that the reduced practice time has helped prevent injuries in general, but especially concussions.
“We have the law on our side now,” she said. “We’re all trying to fight the battle of keeping kids safe when it comes to head injuries.”
CIF has also mandated that all high school athletes go through a “Return to Play” checklist after suffering a head injury, which is a seven-day process athletes must pass before they’re allowed to play again after being diagnosed with a concussion by a medical professional.
“There’s always going to be kids who try and push through injuries, even with all the information that shows them how dangerous it can be,” Lawrance said.
Lawrance said she doesn’t have to worry about butting heads with Anderson on whether a player should play or not.
“He realizes how serious the problem is,” she said. “It’s not like that at all schools. I know athletic trainers in San Diego where the head coach will still try to avoid the new protocols, that’s when our job becomes more difficult.”
Schools without enough room in their budget to hire a trainer don’t get the opportunity for someone to check the power of the coach.
“In theory, it would be perfect to have a full-time athletic trainer at every school, but that’s not possible because of money restrictions,” Welch said. “Some schools are struggling to keep its math teachers, nonetheless an athletic trainer.”
San Diego resident Benjamin Beiber, now 21, wishes he had the luxury of a full-time athletic trainer giving him guidance while he played offensive line at Temecula Valley High.
Beiber believes he suffered three different concussions during his career, and each time the pressure to fight through it got greater and greater.
“As football players we’re taught to be tough and that if you want to be a good player you must be able to withstand pain,” he said. “When you have a trainer telling your coach that you shouldn’t go back in, it takes the stress of the player.”
Beiber said he doesn’t feel any of the symptoms of CTE, but worries that he and fellow football players may suffer from the disease later in life.
Coaches feeling the pressure
Even with a full-time athletic trainer on staff, football coaches are under a lot more pressure than in the past when dealing with head injuries.
All California high school football coaches must watch a video made by CIF that demonstrates safe tackling methods and procedures when they suspect a concussion. They must also pass an exam with questions related to the video before they are allowed to coach.
Anderson has been coaching at Mt. Carmel since 1998 and said that players are monitored closer than ever.
“Back then, the spotlight wasn’t as bright, the severity of concussions wasn’t laid out in front of us like it is today,” he said. “It feels like we’re under the microscope a little bit, if you make the wrong call or don’t follow the protocol to the tee you can lose your job.”
But Anderson is concerned about more than just losing his job.
“You don’t want a kid to have a lesser quality of life because of something that happened while playing high school football,” he said.
Some long-term effects for high school players who get a concussion is a higher risk to develop CTE and Mild Cognitive Impairment, according to the Sports Concussion Institute.
Even referees have shouldered some pressure when it comes to monitoring head injuries.
Darren Alcalay, a referee in the San Diego County Football Officials Association, has the task of watching for players with signs of concussions, because if a referee believes a player is not fit to play, they trump the coach.
“It just adds to the things you have to watch for,” Alcalay said. “It’s nice to be able to have say over the coaches for head injuries, but you also don’t want to make the wrong call. We’re not doctors.”
For schools like Grossmont, though, football coaches are forced to play doctor without a full-time trainer at their disposal.
“I’ve never had to place more faith in my coaches than I have these past couple years, and it has nothing to do with football,” Karlo said. “It’s fully on us to make sure that these kids are healthy enough to play, while also trying to go out and perform at the highest level.”