How changing this one play may reduce football head injuries

By Jen Christensen, CNN

(CNN) — From the very first play this season, NFL football has looked a lot different. The league has dramatically changed its kickoff rules in an effort to reduce injuries.

A kickoff starts each half and takes place after a touchdown or field goal. Under the old rules, the kicking team starts at their 35-yard line and tries to kick the ball as far downfield as possible to get their defense a better chance of stopping the offense far from the end zone, while the receiving team tries to move the ball as far as they can up the field. With two teams running at each other at top speed, collisions between players can be devastating.

The new version includes players lining up closer to each other and waiting to move until the ball hits the ground or is touched by a returner inside the 20-yard line.

Time will tell whether it will remain one of the most dangerous plays in football, but some younger athletes think the pros should take a page out of their playbook instead: At Riverdale Country School in the Bronx, they’ve eliminated the kickoff altogether.

“The kickoff isn’t as important as it seems to outside viewers,” said Tristan Cornell, varsity team captain and junior tight end and middle linebacker, who has never once played in a game with a kickoff. “The fact that we don’t have that probably allows us to keep healthy and play throughout the entire season.”

The decision to eliminate the traditional kickoff at Riverdale Country School came after a 2018 season in which the Falcons had so many injuries, the school had to cancel its last game because of a lack of healthy players.

“It was for safety. It was for the best,” Riverdale Director of Athletics John Pizzi said.

Concussions from plays like kickoffs aren’t just a problem for players in the immediate term: Repeated blows to the head can become a much bigger problem later in life, leading to chronic traumatic encephalopathy or CTE, a progressive and fatal degenerative disease.

High school football participation in the US has been slightly increasing in the past two years, according to the National Federation of State High School Associations’ 2023-24 participation survey, but it had been trending downward for nearly a decade as stories emerged about problems with the safety of the game.

Pizzi said school officials are always thinking about how to keep students safe. The team also has four athletic trainers on staff who regularly meet with Pizzi. But even regular strategy sessions weren’t enough to keep the players injury-free, and when the season finally ended in 2018, he decided they had to take a different approach.

Pizzi called the experts at the Concussion Legacy Foundation, an organization created to help protect athletes’ brain health and make sports safer.

Pizzi and the foundation worked with data experts to look at numbers on injuries not just in their division but also among the pros and college athletes. The research showed that kickoffs account for a disproportionate number of concussions.

A 2018 study on data from the 2015 Ivy League football season found that while the kickoff accounted for 6% of the plays, it accounted for 21% of the reported concussions.

In the NFL, kickoffs were four times more likely to cause a concussion than a play that involved running or passing.

Spurred on by Pizzi, Riverdale and teams in the Metropolitan Independent Football League decided to jettison the kickoff to help reduce injuries. It’s the first known high school sports league in the US to do this.

At the start of each half and after scoring, players don’t run at each other at a high rate of speed from opposite ends of the field. Instead, the teams line up at the offense’s 35-yard line. Kids who play safety start on the 20-yard line.

Schools in the league have also restricted full-contact practice to six total hours in preseason and 15 minutes a week during the regular season. They restricted the onside kick, which is an important play that teams can use to keep possession of the football after scoring. Teams also are required to have a doctor and EMT/ambulance at all games.

Admittedly, not everyone was excited about the new changes at first.

“I think we had a hard time convincing some of our parents and some of our more traditional football coaches that this was going to work,” Pizzi said.

But the changes worked. Across the league, they reduced injuries overall, including concussions, Pizzi said.

Between 2019 and 2021, he said, the Metropolitan Independent Football League saw its number of concussions fall 33%.

Cornell, the junior at Riverdale, thought the changes were a great idea. Injuries are something he worries about constantly, even in the offseason.

“I just need to be healthy throughout the season,” he said. “If I’m out for the season, it lets my team down.”

Pizzi says the changes have also made parents more comfortable with letting their kids play. As soon as the new rules went into effect, some juniors and seniors came to try out for the team for the first time.

Participation in football has gone up 18% across the league between 2019 and 2021. And because teams no longer have to spend time rehearsing kickoffs at practice, coaches can work more one-on-one with less experienced and younger players who were typically on those kickoff teams.

With so many good results to show, Pizzi said, skeptical coaches and parents have come around on the changes – even while they understand that injuries can still happen.

“We’re never going to stop concussions in sport,” he said. “Unfortunately, it’s just a part of football.”

When Pizzi called the Concussion Legacy Foundation, he made a joke about wanting to change football in America, he said, and that’s what seems to be happening – at least in his corner of the world. He hopes that when people see how much the changes helped his team, others will follow.

“Student athlete safety, I think, is probably one of the most important things we do,” Pizzi said.

The future of the NFL kickoff

The NFL’s rules have changed over the years, but Rich McKay, co-chair of the league’s Competition Committee, said the kickoff in high school is different from what happens in the pros. High school players can’t kick the ball all the way to the end zone like the pros can.

“With the skilled players we have, we can make this play safe,” he said.

NFL Chief Medical Officer Dr. Allen Sills says he finds the elimination of the kickoff in high school football games to be a “fascinating approach” that the leagueplans to study, along with the effects of its new kickoff rules.

“All options are on the table,” Sills said.

“Certainly, eliminating the play is one of those options, but I believe there are potentially other solutions, and that’s what we’re trying to find. Is there a way to keep the play in the game and keep that part of the excitement of the game?”

CNN’s Amanda Sealy contributed to this report.

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