ALGONQUIN -- On a sunny July evening, Jose Capistran’s face beamed with pride as he paced the sideline at Westfield Elementary School, watching the next generation line up to play the sport that taught him so much.
“This is the fun part,” he said.
Capistran is the president of the Algonquin Argonauts, and grew up loving football in Chicago. He suited up in high school at Prosser Career Academy as a linebacker. He was tough. He played through injuries. He remembers a game as a senior where he dislocated his finger at the knuckle and it bent at a 90-degree angle. He taped it up and kept playing.
But he hopes to see his sons play a safer version of the game. He spent a handful of years coaching his older son, Noah, now a freshman at Jacobs. His 5-year-old Christopher runs through drills during this summer camp, which is set up to stress fundamentals and proper tackling.
Players go through various drill stations, running through cones, hitting tackle sleds and pummeling tackling dummies. They wear no pads, dressed simply in T-shirts, athletic shorts and running shoes, but they practice form.
“You drive, you drive, you release and you tackle,” instructed one coach.
“And get low,” another added. “Get low so you don’t get hurt.”
After one player ignored the directions, lunged forward and used his helmet as a sort of battering ram to knock down the tackling dummy, he was tapped on the shoulder.
“Head up,” warned the instructor.
“It all comes down to form,” Capistran said. “If you teach them the right way, they’re going to get it.”
That’s what he’s banking on. As the Argonauts have watched participation plummet by 55 percent during the last three years, he hopes he’s found a way to ease parents’ concerns through teaching a standardized, safer form of tackling.
Last year, the Argonauts, one of 26 Chicagoland Pop Warner teams, signed up for Heads Up Football, a program sponsored by USA Football, a nonprofit national governing body of amateur football largely funded by the NFL. So, too, have teams from The Chicagoland Youth Football League and the Illini Youth Football League. By this season, more than half of all 5,500 youth football leagues in the United States registered for Heads Up, which was first introduced in 2012.
Pushing the slogan, “a better, safer game,” the program emphasizes concussion awareness, equipment fitting and proper hydration. Its central — and most widely debated — component, Heads Up Tackling, teaches proper tackling to prevent head injuries. It pledges to do so by taking the head out of tackling.
Players are taught to drop into a low position, keep their head up and use their arms to make the tackle as part of a five-step process. Lean with their shoulders, not the head, they’re told.
“It’s creating uniformity in coaching and teaching technique,” said USA Football Medical Director Patrick Kersey, a former team physician for the Indianapolis Colts. “You’re getting a similar message from many people.”
But even though the program has received a number of high-profile endorsements that include the American Medical Society for Sports Medicine and the National Athletic Trainers Association, it’s unclear if it’s been effective in what it claims to do: curb head injuries.
“I don’t know we’ve had enough time to answer that appropriately,” Kersey said. “But we’ve seen an uptick in awareness. Kids are more open to reporting and addressing injures. Over the next one to three years we’ll see the ability to gather data about it. But in my opinion, yeah, it has helped.”
With limited data, at least at this point, Heads Up has prompted skepticism.
“All due respect to the program, I don’t believe in it,” Hall of Fame coach John Madden said on an NFL Network panel last month, adding that the 90-minute certification course designed to teach coaches the Heads Up techniques was insufficient. “I respect coaches. I respect what good coaches do. I know that you don’t learn to be a coach in an hour and a half.”
NFL critic Sean Pamphilon, a filmmaker who directed last year’s documentary, “The United States of Football,” labeled the program a “farce.”
“Football isn't played this way,” he said.
Instead, he argues that the program is primarily a public relations maneuver by the NFL, a response to declining participation and concerns about head injuries.
“You’re dealing with an audience that wants to believe it,” he said. “They’re being told something is safer. It’s to appease them.”
Beyond addition to Heads Up, leagues hope a wide range of newly implemented protocol can ease parents.
Two years ago, Pop Warner cut back on the amount of tackling during practices, limiting it to one-third of the allotted time. Practices were already capped at three days a week, two hours per session. It also banned full-speed, head-on blocking and tackling drills when players are more than 3 yards apart.
“We don’t understand all the aspects of how people get concussions or how they have effects later in life,” said Julian Bailes, the chairman of Pop Warner’s medical advisory board. “But we think, in lieu of having a complete understanding, it would be better to just limit exposure. My analogy is even though I don’t know all the carcinogens in tobacco, if you tell me you don’t want to get lung cancer, I’d say how about just not smoking?”
Pop Warner, the IFYL and the TCYFL, the three primary youth leagues that serve McHenry County, have all put together respective concussion management plans in recent years.
Under the TCYFL plan, it neurological baseline testing, as well as return-to-play policies for players suspected of having a concussion.
All USA Football leagues, which include the three aforementioned ones, also require youth coaches to be “Heads Up” certified and undergo a concussion awareness course.
“They all say we were forced to do this,” TCYFL President Geoff Meyer said. “But there was a reasonable cause and we responded to it.”
Whether leagues can keep their players safe from head injuries, and potential brain trauma, remains unseen, as medical experts lament gaps in the science of concussions.
For one, concussions carry the distinction of being an “invisible injury.” A knee injury or a broken bone can be identified by an MRI. A doctor can see the tear or see the break. A concussion is not as clear cut.
The Boston neurosurgeon and concussion expert Dr. Robert Cantu has called the lack of an MRI-like image test the biggest mystery surrounding concussions in youth athletes. A concussion diagnosis only comes when a player shows signs and symptoms of the injury such as headache, memory less, nausea, dizziness or fatigue, and then fails a neurological examination.
“You can’t see it,” said Jim Thornton, the president of the National Athletic Trainers Association. “It’s invisible. It’s inside the brain, inside the cranium. It’s just one of those things where you just have to go on signs and symptoms.”
Recognizing those signs is often inexact. A trainer can look to spot the symptoms, but they often rely on the player to report a potential injury. And players aren’t always forthcoming.
According to a survey released last month by the nonprofit advocacy group Safe Kids Worldwide, 42 percent of seventh- through 10th-graders reported that they have hidden or downplayed an injury to keep playing. More than half admitted that they had played hurt.
Playing through pain is a fixture in the American sports culture, glorified in movies and gushed over in newspaper articles.
“It’s peer pressure, it’s fitting in,” Meyer said. “If you don’t have a warrior mentality, you’re an outcast. That’s the stigma we have to get past.”
Medical experts also worry whether pee-wee players can even fully understand the symptoms themselves.
To combat reluctance in reporting injuries, or just lack of awareness, the TCYFL and Pop Warner last year hired certified athletic trainers from the Accelerated Rehabilitation Centers in the Chicago area to be present at every league-sanctioned game. So, should a player be suspected of having a concussion, the trainer makes the decision to remove a kid from the game. The player is then unable to return until given permission by medical personnel.
“It’s removed us dads from pushing our kids too hard,” said Eric Ernd, the director of football operations for the Crystal Lake Raiders, a TCYFL team. “It’s the trainer’s call.”
The presence of trainers contrasts to previous years, where that decision on removal from play rested solely on the shoulders of the coach, or a parent with some medical background. And the bias, many say, was to keep the players in, unless they saw an obvious knockout.
“You see a hit, the kid staggers and the coaches says ‘you’re done.’ That’s how dramatic it had to be,” said Steve Drain, the president for the Prairie Ridge Jr. Wolves.
Now, removal and return to play decisions are made by a third party.
“We have no players in the game,” said Tim Rylander, the director of concussion rehabilitation for Accelerated Rehabilitation Centers. “We have no stake in it. We’re just there as an objective observer. So, more importantly, it takes the emotional element out of making that decision.”
But removal from play can be a contentious issue. What happens when a trainer removes a player, only to face an irritated parent?
“It’s one of those gray areas,” Drain said. “The trainer has a job to do. But the parents know the kid better? So who’s right here?”
The IYFL has not followed suit, according to league president Darren Fortin, but he added that the league strives to follow Illinois High School Association return to play rules.
Much of the protocol to curb brain trauma that leagues have put in place is voluntarily. Nobody has mandated it.
In a 2011 ceremony at Soldier Field, Gov. Pat Quinn signed into effect the Protecting Our Student-Athletes Act. The bill requires Illinois student-athletes that exhibit concussion symptoms to receive medical approval before returning to play. The law was based on the Zackery Lystedt Law, named after the Maple Valley, Wash., middle schooler who suffered a brain hemorrhage that nearly killed him after returning to the field too soon.
But Illinois’ version of the Lystedt law does not explicitly apply to middle school and elementary school students that participate in independent, non-school run youth organizations. The bill only mandated that schools put in concussion management plans in conjunction with IHSA bylaws.
As a result, youth leagues are solely responsible for putting protocol into place.
Said Kevin Nygaard, a player safety coach for the Lake in the Hills-Algonquin Jr. Eagles whose 12-year-old son plays, “I think everything is being done that can be done.”