Interview Gregg Easterbrook

A writer and columnist for ESPN, Easterbrook used to play high school football himself and now attends his son's games. "If you want to know where the scandals are in football, they are not in the NFL," he tells FRONTLINE. "They are in high school." This is the edited transcript of an interview conducted on March 11, 2011.

• The helmet has become a weapon
• The spread offense is causing more concussions
• How to improve players' health and safety
• The NFL's impact on today's high school games

Are there more injuries in high school football than other sports?

High school football is the number one source of sports injuries because of the nature of the sport and because a million boys play high school football.

We talk about the NFL, but that's statistically a very minor number of people playing compared to the number who play in high school.

With high school, there's 30,000 to 40,000 concussions per year. Most of them vanish without a trace, and you never hear about what's happening, and you never hear about the aftermath for the boy. And there are lots of good stories in high school football, too; there are lots of wonderful things that happen. But the downside of it is the abuse of boys in practice and injuries and deaths from heatstroke, which just absolutely should never occur.

And the key point is there is no punishment. No one is ever sanctioned or penalized in any way for this. If you want to know where the scandals are in football, they are not in the NFL; they are in high school.

Are we at a point where you're more than ever concerned about this?

Well, to some extent, awareness of concussions is rising. It's coming out of the closet, which is good. But the emphasis on high school football has never been more intense than it is today. Many states are going to year-round high school football practices. Virginia just did; Pennsylvania did it a couple of years ago. I'm from Maryland. I'm afraid that Maryland's about to do it.

It not only means a lot longer exposure to injury form the boys' standpoint, but if high school football becomes a year-round requirement, it means that most boys are going to do poorly in class. They're not going to have extracurricular, and when their high school eligibility is used up -- and 1 in 50 high school football players gets a recruiting boost to college -- so 49 out of 50 players are going to find that they are not qualified for regular admission to college.

A lot of us were introduced to the concussion problem with the NFL during the 2010 season. Do you think the conversation has been too focused on the NFL?

The NFL should be paying more attention to this, in part to try to set a better example for college and high school. They're not setting a particularly good example yet.

But at the high school level, remember, most teams don't have physicians present at practice or even present at games. My kid's high school has a neurologist on the sidelines during games. It's great. Most high schools don't have any access to a neurologist.

A lot of high schools don't even have a certified trainer present at games, let alone at practice. So diagnosis of head injuries especially is often very poor. Most coaches have not taken classes in diagnosing or treating head injury or heatstroke. Most states don't require it; a few states do require it -- Oregon, for example. But most states don't require it.

So in most states you have to have a license to cut somebody's hair, but you can be a high school football coach and insist that people run up hills in 90-degree weather, even when they are vomiting and shaking and trembling, and you don't need a license for that. You don't need to have proven that you know anything about first aid or symptom recognition.

What are your biggest concerns when it comes to injury and safety issues?

In high school football, there will always be bumps and bruises. You can't play football without that, and our society is pretty good at treating orthopedic injuries at this point. The biggest concerns are concussions and heatstroke.

Heatstroke can kill people. It doesn't happen very often, but it should never happen at all. And every year, several boys practicing for high school football die of heatstroke because the adults around them have acted irresponsibly. And there is never any penalty for it, other than the sorrow of the family involved.

Heatstroke is 100 percent preventable. The American Academy of Pediatrics has said that. The professional association of certified athletic trainers [National Athletic Trainers' Association (NATA)] believes that heatstroke is 100 percent preventable. Nobody should ever die of heatstroke, yet it happens.

Why?

Two things. One, coaches aren't required to know the symptoms, do the symptom recognition and initial first aid treatment. I've encountered heatstroke in high school football practices myself, and I knew what to do, because I'd been through a class on heatstroke-symptom recognition. Most coaches have not.

And then you have this macho culture of coaching, where if a kid is screaming and saying, as one boy said to me who was going into heatstroke, "I can't feel my hands; I can't feel my hands" -- that's how I knew he had heatstroke; that's why I called 911 -- many coaches at that point will scream at the kid: "You're a faggot! Get back up and run back up the hill!" They think that's macho, you know. It has to do with the coach's own psychological problems.

But there is no licensing of the coach. There's no formal training in most states -- a few states do have formal training. Often there is no neutral observer at practice to watch to make sure the coach is not abusing his players. And commonly, high school football coaches do things to players who are children -- legally, they are minors -- that would be considered child abuse if a teacher did it; it would land a teacher in jail. But it's fine if a high school coach does it with a minor under his care.

But what are the coach's motivations? I mean, I've known a lot of high school football coaches, and they talk about their players like they are their sons. What is ultimately motivating the coaches?

Coaches want to win, obviously. And many men go into coaching for ego reasons, and there's nothing wrong with that. I've known a lot of high school football coaches that are very conscientious, and I can point you to programs that are run in an extremely conscientious manner. But a lot of them are not, and there's no regulation of the difference between the conscientious ones and the monsters.

If you have a player with concussion symptoms and you send him back into the game and he gets the second concussion, which is always worse than the first, there's no penalty for you as a coach for doing that. If you pull the kid out of the game and take away his helmet and say, "You can't play again until you've been examined by a doctor," and you lose the game, there is a penalty for that.

… And it's most worrisome for neurological injuries. Increasingly, the research shows that it's not just the one big hit where the kid drops unconscious that you worry about. It's the accumulated lifetime effect of lots of little hits, and high school football players are taking lots of little hits. And they're suffering long-term neurological damage that could be anywhere from just mildly annoying to very serious. And with the exception of a couple of states, there is no regulation of this.

So what generally is the regulation situation?

The lack of regulation is partly because public high school systems have limited funds. They're all stressed for money. And what's done in sports is just, "We do it this way because we always do it this way."

It depends on where you are whether the supervising body for high school athletics is state or county. Most don't have the resources to send neutral observers to practice, which would be a huge improvement. If you just had a neutral person watching practice, the coach would get away with a lot less.

The coaches are under intense pressure to win games. It's the only thing that they are judged by in most cases. In some places -- Texas, for example -- the coach in most cases isn't even a school system employee; he's an employee of the booster club. So the only thing the coach in the booster club cares about is winning games, and winning by big margins.

So, absent some form of regulation --- and I'm not talking about a federal department of high school football; I'm talking about county or state sanctioning bodies having strict rules for the licensing of coaches, making sure that they've passed a course in two key things, the symptoms of heatstroke and the symptoms of head injury, making sure they know first aid for both those things, and having some penalty for coaches who mistreat boys and don't look after them properly when they're going into heatstroke or have a head injury.

And that exists either nowhere or in very few places?

There's a few places. Some private schools do it; generally private schools have more money than public schools do. The couple private schools in my area -- I live outside the Washington area -- the two great private programs in that area are [Our Lady of] Good Counsel and DeMatha high schools. Both of them always have a certified trainer present, even when people are just doing conditioning drills. So I don't worry about the health and safety of boys in those programs. Most public schools can't afford that.

Would you say that the high school injuries have been a hidden story?

High school football injuries has sort of always been a hidden story, because unless it's a very well-known player -- and most high school players are not particularly well known -- nobody pays any attention when some poor boy is taken off on a cart or collapses at a practice and later dies.

The reason for the increased [attention] today is that the speed and violence of collisions has gone up so much now that there are more concussions than there used to be.

The National Federation of [State] High School [Associations] make the rules and enforce rules on the field, and they've shown more concern for head injuries over the last five years. But they don't have anything to do with regulating how football is coached or what standards are for coaching or how players are treated in practice. Nobody regulates that except a couple of states. There is no federal or national regulation of it.

And in the rest of the states, there's no organization that's responsible for the health and safety of its players?

Basically no, with a couple of exceptions. Most states set dates for contact practice. In Maryland you can't have contact until Aug. 15. Most states have a rule like that.

Some states regulate the number of practice weeks. Virginia, for example, just increased to 49 the number of weeks of the year a football coach can have mandatory practice. Forty-nine out of 52 weeks of the year, so that comes from the state sanctioning body for Virginia high school sports. But there is no regulation at all for what happens in practice, especially in the summertime, when it's hot.

The professional association for certified athletic trainers two or three years ago promulgated standards for how to handle heat with high school football players. There's no requirement in most states that coaches follow those standards. Coaches can do pretty much whatever they please. And if there is some bad result, even as bad as a boy dying of heatstroke, in most cases there is no punishment of any kind.

Can you compare the lack of regulation and enforcement at the high school level to the college and pro level? What's the difference?

In the pros the program is extremely violent, but the players are represented by a union, and the union has set some fairly strict rules, mainly having to do with off-season contact. And it's also very common at every NFL practice [that] there is either one physician or at least one certified trainer present. There are many neutral observers around at NFL practices. You know, they're tough, they're violent, but if the coach tried to get away with something that was abusive, everyone would see it.

And the same is mainly true with the NCAA [National Collegiate Athletic Association] level, too. There is always a certified trainer present for most programs. NCAA practices are not necessarily open, but there is always going to be somebody who's around, if the coach does something really terrible, it would get out. You saw what happened to Mike Leach at Texas Tech, who did something that would be considered something minor by the standards of high school football. He had a guy stand in a shed because he was angry at him, and he got fired over it.

High school football would get none of this. Generally, there's almost never a physician present, generally not a certified trainer present, although some programs do have them. There's generally not a neutral observer present. And at practices, you have a middle-aged man screaming at 16-year-olds who are quaking in terror of being cut from the team, telling them to do all kinds of things that are irresponsible from the standpoint of how an adult should treat a child, and there is no neutral observer present.

And in many high school environments, the high school coach is a little god who nobody questions, and even with parents -- you know, any ethical coach would say, "I welcome the parents at my practice." And some good, ethical coaches do say that. But a lot of little godlike high school coaches say: "No, parents can't come. Nobody can observe my practice." And schools don't generally do anything about that and see what best practices are, and if you violate the best practices standard you lose your license. Add that to high school football, and there will be a lot less screaming at vomiting boys to get back up and run when it's 95 degrees out. But right now, since there's nothing like that in most states, coaches get away with murder.

The culture of high school football has always been intense, right? But it feels like it's become particularly intense in the past, let's say, three to five years. Can you describe what's contributing to it?

I grew up in Buffalo, N.Y., where high school football was a very major subject. In the last 20 years, the popularity and the intensity of focus has gone way up, partly because football itself is becoming more popular. It's the king of sports. It's everybody's favorite sport. It's my favorite sport. There's just more focus now.

The Internet has allowed an interest in recruiting and high school issues that wasn't possible before. As recently as 15 years ago, I live in Maryland, if you wanted to know what was going on in Arkansas high school football, how did you find out? You didn't even know. Now I can get tape of Arkansas high school football games on the Web anytime I want, and with Rivals and MaxPreps and ESPN now giving a great deal of coverage to high school and ranking players and posting tape of them all over the country, it just raises the interest.

Street agents always were a factor in professional sports. Now they're a factor in high school football, guys trying to warm up to 17- or even 16-year-old boys in hopes that at some point there will be essentially a bribe for them when the boys are recruited. There usually isn't, but a lot of street agents hope that there will be.

So that creates a pressure on boys that hasn't come before. And there is just an extreme amount of exaggeration in high school football culture about your likelihood of being recruited.

I constantly use the numbers 1 in 50. That's your actual likelihood of being recruited from high school. I think in a lot of big-deal high school programs, most of the boys believe that they're going to be recruited, and the coaches do not disabuse them of this. Coaches should take most of their boys aside and say: "You're a great player; I love you. You are not going to get a college scholarship. Make sure your GPA is high so you can get regular admission to college." Coaches don't do that. They do the reverse.

What other factors are amping up the culture of high school football?

... There’ve always been injuries in high school footbal, but they’re on the rise. ... The ramping up of pressure on high school kids, the intensity of high school play, the increase in size, strength and speed, the increase in the severity of injuries, and the increase of media attention on high school football -- my God, in the last 10 years it's become like a little NFL in every sense except that the boys generally don't receive any reward for what they do. ... In the last ten to twenty years, we’ve seen it become amped up and it’s a real concern.

Another thing that changed is that it is on television now. Starting roughly 10 years ago, there was this feeling that the NFL was all about money, and NCAA football is great quality sport but is obviously corrupt, so what is still pure? High school football is still pure; people are just playing for the love of the game.

So television has brought attention to high school football, [but] that unfortunately brings the same flaws that we find in the NFL and NCAA football down to the high school level.

What kind of NFL elements or culture have trickled down to high school playing fields?

Well, boys forcing themselves to gain weight so they physically look like NFL players is a big concern. As recently as 20 years ago, it was pretty rare to find a high school offensive lineman who weighed more than 220, maybe 230. Now a lot of high schools, all their starting offensive linemen weigh more than 300 pounds. They weigh more than NFL linemen used to weigh a generation ago.

And it is possible with modern training and nutrition for a college athlete to be 300 pounds and be 300 healthy pounds. It certainly can be done. But high school boys are generally not like that. They're just forcing themselves to eat to gain weight because the coach tells them, "You want to start for me, you've got to weigh 300 pounds." So boys force themselves to gain unhealthy levels of weight, and since 49 out of 50 of them will never get a college recruiting boost, they're going to be stuck with an unhealthy weight for at least most of their lives.

The research shows that weight gained in youth causes the most long-term health problems, and we're encouraging boys all over the country -- a million boys play high school football; roughly half of them weigh more than they naturally should in order to please their high school coaches so they feel like NFL players when they walk out on the field.

The weight gain at the NFL level is problematic in many ways, but at least those players are supervised by physicians. The weight gain at the high school level is occurring in a totally unsupervised fashion, and it's not good for the majority of players. And it's an arms race. If the teams you're playing have 300-pound linemen, you'd better have 300-pound linemen.

In what other ways are you seeing signs of high school football being an arms race?

Coaches have always encouraged kids to hit hard and play in a vicious fashion. That's not new. What is new is now you have the emphasis on big hits at the NFL level, the big hit where the guy goes flying backward or spins around in the air. Man, a lot of kids want to say, "I did one of those, too."

You know, they see those things on highlight shows on television, and they want to create highlight reel hits, so they're launching themselves into the bodies of other players, which generally isn't safe and should be a penalty, in order to imitate the sort of superviolent hits they see in the NFL. And the NFL said it cracked down on that this year -- not really; there's been some reduction. I've got to say, this year's Super Bowl, which I enjoyed immensely attending except for the snow in Dallas, there were no vicious hits in that game, and it was a fantastic game. This was the Packers-Steelers game. So it shows you can have a fantastic football game without a vicious hit.

But you still see a lot of vicious hits at the high school level, and the switch to the spread offense has increased high-speed, high-energy hits. If you think of what the physics of a high school offense was as recently as 10 years ago, most high schools were playing some version of the Power I offense, where most of the plays are running plays between the tackles. On running plays between the tackles, nobody ever gets up to full speed, so when the guys collide, they're not colliding at maximum speed.

In a spread offense, where you have four receivers on the field and half of them are crossing across the middle, and the safeties are coming from the opposite direction, you're adding lots of high-speed collisions to the game. And that was not the plan for the spread offense; the spread was just a fad that came along. But the effect is to increase the number of high-speed head-to-head collisions, and that's why you see concussion statistics rising in the last five years. Some of it is the dropping of the taboo about it. But the other reason is, I think, we have more concussions than we've had in the past.

Do you have any data on that, or is it just your instinct?

I've looked. I don't think that there is any hard data that proves it, but certainly my impression, and the NFL Players Association [NFLPA] numbers show [over] the last four years a 3 percent-per-year increase in the number of reported concussions. Some of that may be the end of the taboo against reporting the concussions, but it can't all be artifact. Some of it has to be an increase in the concussions themselves. And if you take the Players Association data and project it out over a million high school boys, that's where you get 30,000 to 40,000 concussions per year in high school.

Do you think that the helmet as a weapon is encouraged in high school football?

Oh, absolutely. Many programs have long encouraged the use of helmet as a weapon. I mean, there's some awareness of it rising now. But I have heard with my own ears high school football coaches scream at their players: "I want to see injuries on the other side! I want to see people knocked out! I want to see opposing players carried off the field, and if you guys don't injure some players on the other side, we're going to do punishment drills in the morning." I mean, this is a common thing to hear high school coaches say. And the main way you can try to injure somebody is by launching with your helmet.

How would you respond to a coach saying, "I want you to play so hard that they lose their next game, too"? How would you interpret that?

Well, it's the same basic thing. It's Neanderthal thinking. But a lot of high school coaches think that the measure of success is how many injured players are carried off to the other sideline and how many times an ambulance needs to be called to the game. Some high school coaches reward their players who injure others players. Now, others don't, and many are very conscientious and do a great job. I don't want to give you the wrong impression.

But the coaches who reward players for creating injuries, what's the punishment on the coach? Who regulates that? Who supervises it? Nobody does. And no 16-year-old is ever going to say to his parents or to the media, "Our coach is giving us rewards for causing injuries." It's just not realistic. It would be realistic to ask an NFL player to say that in public. It's not realistic to expect a 16-year-old to say it, because he knows he'll be thrown off the team the next day.

There's talk about reforming the way the game is played, to make helmet-to-helmet contact and contact in general less frequent. Are you optimistic about how the existing culture of high school football will respond to those ideas?

I think there are some things that you could do. I think any deliberate helmet-to-helmet contact should result in ejection from the game, so we need a stronger rule for that. If players were tossed out of games for deliberate helmet-to-helmet contact, it would go down pretty quickly. So you can have stronger enforcement of the rules that already exist.

The arms race to get bigger and to get stronger: I'm not sure where you stop that. I was slight friends with the late NFL coach Bill Walsh, who won a lot of Super Bowls in San Francisco, and his belief was the arms race for weight wouldn't end until somebody lost a long-term lawsuit over health damage in later life. But if you could show that players who bulked up in order to play football damaged their long-term health prospects and weren't adequately warned about it, as has to happen in liability law, that that would end the arms race. Is that in the offing? Not this year.