FORT WAYNE – James Keszei still has some sleepless nights.
They usually come when he thinks about the time his two boys started playing organized tackle football for a youth league in Kansas City, Mo., several years ago.
It was a time when the word concussion didnt carry so much dreaded weight, and nobody outside the medical field used words like second-impact syndrome or chronic traumatic encephalopathy.
It was also a time Keszei would tell his boys to take some ibuprofen or aspirin and see how they felt in the morning when they complained of a headache after practice or games.
I go back in my mind, and I sometimes get sick to my stomach, said Keszei, now a coach in Fort Waynes Police Athletic League youth football program and whose sons are 12 and 13.
While concussions have been at the forefront of football in recent years, talk of the dangers that result from such injuries has largely been limited to the fields of the NFL, colleges and high schools.
Now, the issue is trickling down to even younger players, and steps are being taken to ensure that youth coaches can recognize a potential concussion when they see one.
Last week, USA Football, the sports national governing body, announced a new campaign called Heads Up Football geared toward educating coaches, parents and players alike about ways to keep safe while playing the sport.
This year, the citys Metro Youth Sports football league implemented a new policy that requires a child showing signs of a concussion to have written permission from a doctor before he can return to the field.
Its the same policy the Police Athletic League implemented in the past few years thanks to Keszei, who moved to Fort Wayne in 2010 and brought with him a passion to make the sport as safe as possible.
Especially when it involves kids hitting and tackling each other.
There are hundreds of thousands of kids playing youth football, and nobodys been talking about them, Keszei said.
‘Hit me to the core’
At first blush, the tackle looks like a typical one.
One sunny day in 2006, Seattle-area eighth-grader Zack Lystedt chased down a running back and brought him to the ground right before the two tumbled out of bounds.
The play, though, ends with Lystedt holding his head.
In slow motion, you can see Lystedts head snap and strike the ground. He never came out of the game and continued taking multiple hits throughout the afternoon.
He was largely confined to a wheelchair in the aftermath of the game, and it took months for him to regain his speech. He lost many of his motor functions, as well.
Keszei saw a Dan Rather television report on Lystedt – whose injury sparked concussion laws throughout the country – right after moving to Fort Wayne.
The effect on him was immediate.
It hit me to the core, he said.
Keszei played high school football in the 1980s in South Bend – right in the shadow of the Golden Dome and traditionally football-crazed University of Notre Dame.
It was an era when you just shook off headaches and regularly played through pain. Keszei admits he probably suffered a concussion or two during his playing days and stayed on the field despite the injury.
But after viewing the Lystedt video, he immediately went to Police Athletic League coaches – his sons were set to play in the league – and asked how they treat and deal with injuries.
Our thought was, like everybody else, we knew about them, but we didnt know about their emphasis, said Steve Butz, coordinator with the Police Athletic League, which caters to kids ages 9 through 12. It just highlighted that we needed to pay more attention to them.
Once Jim (Keszei) came up here, thats where we first really started to look at that, Butz continued.
Others have described Keszei as a parent on fire. He described himself as a bull in a China shop after watching the Lystedt video.
Keszei started sending out letters to various neurosurgeons and neurologists in the area, asking what could be done to get coaches and parents up to date on the dangers of concussions.
One answered his letters: Dr. Jeffrey Kachmann of the Fort Wayne Neurological Center.
It was not even remotely catching on here, Kachmann said regarding how concussions were viewed in this area. And to be honest, were still far behind. We have a long way to go in Fort Wayne.
When asked whether kids in youth football leagues can hit hard enough to give each other concussions, Butz gives a small chuckle.
Ill tell you this. We had one 12-year-old with a beard one time, and we had another who was 6-2 and 185 pounds, he said.
Jim Winters, the president of Metro Youth Sports, which has players from ages 7 through 12, played high school football in the 1950s in Pittsburgh. He said no one back then even discussed concussions.
Hes been involved in youth sports for 38 years, and hes seen the changes in the game. He believes medical professionals – not coaches – should decide whether kids should get in the game after head injuries.
Coaches not being doctors is one of the major reasons the Metro League has jumped on board with requiring players who show signs of a concussion to see a doctor before returning to play.
Winters said the plan to implement that policy was started three years ago and finally happened this year.
Its a policy that also coincides with high school plans across the state, a policy that state law required high schools to adopt last year.
Along with taking the decision for a player to return to the field out of a coachs hands, Winters said, all coaches carry with them a sheet of symptoms describing a possible concussion.
If any of the players report to coaches such symptoms or coaches see a player moving slowly or clumsily – as if dazed – or a multitude of other signs, that player is removed from the game immediately.
When a person starts playing football, from youth through the college and NFL, a lot of guys may hit their head one season and years down the line have problems, Winters said. Were trying to get in front of that. We want children to enjoy the sport with no problems.
Like the Metro League, Police Athletic League coaches carry clipboards with concussion symptoms written on them. Any time a player shows symptoms of a concussion, that player is pulled from the game or practice.
Coaches in both leagues attend seminars about the head injuries, and a new emphasis has been put on fundamentals, officials said.
Tackling properly has become a priority. Some coaches stress the importance of neck strength to players, with the idea that a stronger neck may reduce the risk of concussions when taking a hit.
A child can fall back on his head or they can hit helmets or they can do some things incorrectly and hit their heads, Winters said about the importance of fundamentals.
But still, the kids have television, and its there where they can pick up bad habits – such as helmet-to-helmet hits or leading with a helmet on a tackle.
They can still watch the NFL, Keszei said.
Sit the player out
After corresponding, Keszei and Kachmann quickly struck up a bond.
They put together a presentation, one they initially gave to Police Athletic League coaches and have since given at the Pro Football Mini Camp put on by NFL punter Jason Baker in Fort Wayne.
The pair plan to give one to a hockey league and possibly a motocross league as well, since concussions are far reaching and not just an occurrence in football alone.
They usually talk about the serious consequences of second-impact syndrome – which occurs when someone with a concussion suffers more head trauma without proper time to heal – as well as symptoms and how to deal with a concussion.
Their main message: When in doubt, sit the player out.
For the most part, thats beginning to reach the coaches and parents, both Keszei and Kachmann said.
When we showed the Zack Lystedt video to the (Police Athletic League) coaches, there wasnt a dry eye in the house, Keszei said. And these were burly football coaches.
But while the message may be reaching the coaches, it may be eluding those it affects the most – the athletes.
Keszei said the competitiveness of a sport like football is going to make it hard for players at any age to speak up when they have injuries. Stories abound about NFL, college and high school players hiding concussions to stay in games.
It isnt that far of a stretch that a 10-, 11- or 12-year-old would do the same. No matter what you tell them, a kid suffering from a concussion might be reluctant to lose his spot by sitting out, Keszei said.
So what do you do? Keszei asks rhetorically. You change the way you coach. You have to for your kids well-being.
That means constant education.
Both Kachmann and Keszei said area middle schools and high schools are getting the picture.
Several schools throughout the area are now using ImPACT testing, which is taken by athletes before a season to provide a baseline reading of their brain, a measure that they must return to if they ever suffer a concussion.
Coaches and administrators at many area schools are taking concussions seriously. They have to nowadays, both Kachmann and Keszei said, if for no other reason than to avoid potential lawsuits that might get filed if a kid gets seriously hurt.
And even with the dangers, Keszei still lets his boys play.
He coaches his youngest in the Police Athletic League. His oldest is now out of his hands, though, and playing at Woodside Middle School – a school with coaches extremely cognizant and attuned to the seriousness of concussions, Keszei said.
The cultures changing, he said. Its definitely changing.
Part of that change is in small part due to a man who played through pain himself, who played in the shadow of Touchdown Jesus and who two years ago never gave concussions a thought.