The Concussion Crisis


Every year, thousands of young athletes get concussions. Most recover. Others continue to play, and risk lifelong injuries and even death. One teen is on a crusade to help them.

October 12, 2006 was crisp and clear in Maple Valley, Washington—the perfect sort of day for a football game.

Parents chatted in the stands as two middle school teams faced off on the field. Thirteen-year-old Zackery Lystedt was a star player on his team at Tahoma Junior High. Already that afternoon he had made two clutch tackles, helping to put Tahoma firmly in the lead.

Late in the game’s first half, Zack tackled a runner rushing toward the end zone. As both boys tumbled to the ground, Zack’s head smacked against the turf.

The other player quickly scrambled to his feet.

Zack did not.

He lay on his back, clutching his helmet, writhing in pain. His coach ran to him. His fellow players “took a knee” and waited solemnly for their fallen teammate to get up. Seconds ticked by. But then Zack was back up. His teammates slapped his back as he walked off the field with his coach. Zack sat down on the bench to rest.

The game went on—it was football as usual.

But there was nothing usual about what was happening inside Zack’s head. Zack had sustained a brain injury known as a concussion. When his head hit the turf, his brain shook violently inside his skull. As Zack sat on the bench with his teammates, he looked normal. Inside his brain, however, billions of cells were caught up in a storm of chemicals unleashed by the impact.

Playing Through the Pain

Since the dawn of football in the late 1800s, knocks on the head have been considered just another part of the game. Professional players think nothing of racking up four or five “dings” per season. Tough guys play through the pain, heading back onto the field even with blurred vision, throbbing temples, and stumbling steps.

This attitude—part of what experts call football’s “warrior culture”—has trickled down to even the youngest players. “It all starts with the pros,” says Roger Goodell, commissioner of the National Football League (NFL). “We know that we set the example for the kids playing football.”

Indeed, kids like Zack grew up watching some of their favorite football stars treat their heads like battering rams, colliding with their opponents with ferocious force. Popular video games like Madden NFL showed injured players staggering along the field with obvious head injuries. Sportscasters on ESPN and other channels celebrated the most brutal pro and college football hits of the week with highlight segments like “Jacked Up!’

So it was little wonder that within 15 minutes of his injury, Zack decided that his team needed him, and he should go back into the game. Every year, 300,000 young athletes sustain concussions. Zack, like many others, did not realize he’d suffered a serious brain injury and that by stepping back into the game, he was risking brain damage or even death.

Zack’s coach looked him over. But a concussion is an invisible injury that leaves no outward marks. Without special training, even many doctors can’t detect them. Zack told his coach that he felt fine. And so the coach did what most coaches would have done when a star player says he feels well enough to play: He sent him back onto the field.

Zack played like a champion through the second half. He sprinted, jumped, and made key tackles. Meanwhile, his injured brain was a ticking bomb. With each small hit and jostle, it was being pushed closer to shutting down completely. In the game’s final seconds, Zack crashed into the other team’s running back, forcing a fumble. It was a game-saving play for Zack’s team.

There would be no celebration.

A minute later, Zack collapsed. His brain was bleeding and swelling, pushing against his skull. The pain was blinding. Zack drifted in and out of consciousness, with his frantic parents and coach by his side. He was airlifted to a hospital in Seattle, where surgeons worked feverishly to save his life. They removed large sections of his skull to relieve the pressure. But with each passing hour, his brain became more damaged.

By that night, Zack had lapsed into a coma and was on life support. It would be three months before he opened his eyes, and nine months before he could utter a word. Today, six years after his injury, Zack is in a wheelchair. He talks only with difficulty and maintains a grueling program of daily rehabilitation.

Second-Impact Injuries

It’s shocking to think that a friendly middle school football game could end with a healthy young athlete on the brink of death. Yet every year, 140,000 young football players get concussions. Many consider this the price of playing America’s most popular sport, a game that for many kids helps build discipline and focus—traits that can help them succeed later in life.

Over the past few years, evidence has mounted that there is a major concussion crisis in youth sports, especially football. Concussions can happen to anyone at any age. Most heal if treated properly, with rest. But many young athletes return to sports before their brains have completely healed. In Zack’s case, it was not the first concussion that caused his brain to bleed and swell. It was those second, third, and fourth knocks to his head that happened after he went back into the game.

After going back in, Zack suffered a “second-impact injury.” Over the past decade, these injuries have killed or caused major brain damage in more than 50 young football players. Thousands of other young athletes have suffered postconcussion syndrome, a less severe condition that is life-changing nonetheless. Their untreated brain injuries often leave them with headaches, memory problems, mood swings, and other issues.

Research shows that concussions can lead to serious brain diseases later in life. Indeed, dozens of retired NFL players have been diagnosed with profound brain problems that were caused by impacts sustained during their playing years.

What If . . . ?

As Zack lay on life support, his parents were haunted by “what ifs.” What if they had all understood the dangers and had made Zack sit out after his injury? What if the team had had a trainer on the sidelines whose job was to make sure hurt players sat out?

“The hardest part is knowing that what happened to Zack could have been so easily have been so easily prevented,” Zack’s father, Victor, says.

As the Lystedts focused on helping their son recover, they wanted to prevent other athletes from suffering a similar fate. They helped develop the Zackery Lystedt Law, which is designed to help educate athletes, coaches, and trainers about concussions so they can prevent second-impact injuries. It was passed in Washington State in 2009. Since then, 37 other states have passed the Lystedt Law or similar laws.

Even the NFL, after years of denying the connection between concussions and brain disease, has set tougher rules about concussions in its own league. The NFL has also given millions of dollars to help scientists learn more about athletic injuries to the brain. Most important, just this year, Pop Warner, the nation’s largest youth-football association, implemented new rules for practice and play to prevent concussions. Among the biggest changes: Intentional head-to-head contact is totally banned, and contact time is strictly limited during practice.

Even the makers of Madden NFL have joined the effort: Now the announcers in the game provide information about concussions, and injured players are benched. The helmet-crunching sound effects have been removed.

These are certainly encouraging steps. But most experts agree that the warrior culture persists in football. Concussions are on the rise in all sports; players are getting bigger and faster. As many as 40 percent of high school athletes admit to going back into a game even though they had symptoms of a concussion. This is a problem that Zack and his family are working hard to solve.

Nobody knows how far Zack’s recovery will take him. His doctors and parents marvel at his ongoing progress. “There is nobody tougher than my son,” Victor says.

Indeed, Zack pursues his physical therapy with the same grit that made him a football star. He can now walk from one end of the house to another using only a cane. He’s taking some college courses and continues to spread the word about the dangers of concussions. Everywhere he goes, his message to young athletes is the same: No game is more important than your life.

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