MANHATTAN — The fans in the bleachers were noisy after every touchdown as East Harlem Pride defeated Evander Childs Campus 23-0 on a clear, sunny afternoon.

Cristina Mendez was watching nervously as her son Jeffrey Palomino Jr., a 16-year-old tight end, and his Evander Childs teammates leapt into action each time the quarterback called the signals to begin a play. 

It wasn’t the outcome of the city Public Schools Athletic League game that had her worried. Her look of concern mirrored that of other parents and relatives watching at George Washington High School in Upper Manhattan.

“It’s very scary as a mom, super scary as a mother,” Mendez said right after halftime. “I always tell him to be as careful as you possibly can. A lot of stuff that happens here is out of their control.” 

Dr. John Leimert, a pediatrician from Massachusetts who was in the stands with his daughter, the East Harlem Pride athletic director, said if he had a son, he would discourage him from playing football.

“I just personally don’t think football should be played the way it’s played anymore,” he said. “I just think, particularly in my pediatric practice, I try to talk kids out playing when they’re in middle school and high school.” 

Flag football—in which there is no tackling and defensive players instead must pull a flag or belt from an opponent to stop play—is a much better alternative at all levels, Leimert said.

Even small, “less impactful” hits can cause future brain damage, he said.

“Parents just across the country are not feeding these kinds of teams the way they used to,”  Leimert said. “Concussions are a very real risk, hard to completely prevent.”

The risks of playing football have been known for decades. Each NFL season brings new attention to the dangers of concussions, with the repeated 2022 incidents involving Miami Dolphins quarterback Tua Tagovailoa putting traumatic brain injuries back in the spotlight.

Yet the PSAL and other high-school associations continue to sanction tackle football, citing their concussion protocols as sufficient protection for student athletes.

The PSAL takes its cues from the state Concussion Management and Awareness Act as well as the rules of the National Federation of High School Sports Associations. 

“PSAL sports and activities provide a vital outlet for our students and we have robust systems and supports in place to ensure the safety of our young people participating in school-sponsored athletics,” Jenna Lyle, a city Department of Education spokesperson, said in an emailed statement. “For students participating in football, this includes on-site physicians, required medical clearances for participating students and strict requirements regarding protective equipment.”

Still, critics say, the health consequences for young people are too great and that football is just too dangerous to support as a scholastic sport.

Danger at every level

In 1994, then-NFL Commissioner Paul Tagliabue created the Mild Traumatic Brain Injury Committee to study the issue. Still, nearly 30 years later, players are still dealing with serious concussion-related injuries. 

The risks for younger players are even greater.

A Boston University School of Medicine study found that the younger the player gets tackled in games correlates with early symptoms of cognitive and behavioral impairment associated with chronic traumatic encephalopathy, the degenerative brain condition known as CTE. Repetitive head injuries starting in school years increase the risk of CTE, which has been seen in players as young as 17 after their deaths. High schoolers typically tend to show signs of CTE only later in life.

In a recent study, doctors found that symptoms of CTE, which can generally appear around age 42 for pro players, have been detected in men from 25 to 76. CTE can not be diagnosed with certainty until after death.

CTE can appear after repeated head blows, brain injuries and concussions. A protein in the brain called tau is essential in regulating nerve cells. After repeated head blows, tau tangles start to form, causing inflammation, tissue damage and memory loss. Retired players who appear to have CTE show many of the symptoms.

A Boston University CTE study by Dr. Ann McKee and her team diagnosed 177 deceased players with CTE after examining 202 brains donated by families of men who had competed in high school, college or the pros.

In the 111 brains of NFL players that were studied, the researchers found 110 cases of CTE. 

Death in a football family

Patrick Risha as a middle-school player.

Karen Kinzle Zegel of Doylestown, Pennsylvania, lost her son Patrick Risha, who played as a middle schooler and then went on to be a Dartmouth College running back, at age 32. The son of a football coach, he died after suffering the symptoms of CTE. 

His mother started a foundation in his name to educate people about the perils of football.

“I think young men are too dug in…” she said in speaking about her efforts to convince young players to give up the sport. “Knowing what I know now, I would have thrown myself on the field and let them run over me and made a scene” to keep her son away from the game. 

She said she often receives calls from retired players who have lost marriages, jobs and families after the effects of brain injuries emerge. They can find themselves out of money, living in their trucks. 

Zegel believes that young players would second-guess their choice if they could hear how sad and depressed wives and family members become.

Risha played as a running back at Dartmouth College.

“Four million kids a year are playing tackle football, we’re banging up all these kids, and we’re having a mental health crisis, we’re having a suicide crisis, were having a drug-addict crisis,” Zegel said. “All of these things can be tied back to what we’re doing to their brains while they’re young.” 

Back at the game in Upper Manhattan, Cody Tapscott—whose nephew Amir Prince, a 15-year-old sophomore who plays quarterback and middle linebacker for Evander Childs—said he wants to see school leagues take concussion protocols more seriously.

 “It is opening my eyes…” he said. “My boy—even though he is a big kid—watching him get hit is still something to pay attention to.”