Ray Easterling and Dave Duerson are recognizable names because of their storied careers as NFL players. Besides the game, these men have something else in common. Each suffered brain injuries, and each eventually committed suicide.
Their families, along with more than 5,000 other former players and family representatives, are plaintiffs in federal lawsuits against the league - accusing it of negligence for downplaying the effects of concussions. Last week, the NFL asked a judge to toss those claims calling them "labor disputes" that can be settled outside of court.
Although the sheer number of NFL players coming forward with claims of concussions may not be a surprise, it is no doubt a wake-up call to the risks of contact sports. According to the Centers for Disease Control and Prevention, emergency department visits for Traumatic Brain Injuries, including concussions, among children and teens increased 60 percent. But, states across the country have taken notice and are making concussion prevention in youth sports a priority.
10News Investigates looked into those efforts in Tennessee to see if a competitive culture has changed for local student athletes. Doctors believe the nationwide uptick of concussion diagnoses is not cause for panic. In fact, experts say it's a sign that coaches and parents are finally taking youth head injuries seriously. That's exactly what's happening in our area.
Gatlinburg-Pittman freshman Clay Coghlan knows it's important to be ready instead of reckless on the field.
"As long as we do what we're supposed to do, we shouldn't get concussions, you know, with the head-to-head contact," Coughlan said.
"I'm a firm believer in teaching shoulder tackling, and trying to keep your head our of contact as much as possible," said Gatlinburg-Pittman Head Coach Benny Hammonds.
Hammonds has led teams for more than 40 years. He's also seen the culture of the game evolve.
"When I played high school ball back in the late 50s, early 60s, it was just a matter if you're able to go back in the game," Hammonds said.
Now, Hammonds puts head injury prevention in his program front and center. He says more and more pro players speaking out about brain injuries has helped remove some of the stigma.
"We're going to do everything within our power in the dressing room, with our trainer, with the pre-test, on the things they should do the right way before the injury occurs," Hammonds said.
Players, like Coghlan, take the imPACT test off the turf. Scott Byrd, sports medicine coordinator for LeConte Medical Center and Sevier County Schools, brought the imPACT test to the district last year. Now, every student athlete takes the assessment.
"We'll test them in their freshman year, when they're incoming in high school, and then again in their junior year," Byrd said.
imPACT provides a baseline blueprint of the athlete's healthy brain through a series of reaction exercises. Diagnoses of concussions at Gatlinburg-Pittman are steady since impact testing started. During both the 2010-2011 and 2011-2012 school years, three athletes suffered concussions in either football or soccer. Trainers expect that number to go up with more awareness and as more students take the test.
It's a different story among high school athletes in Knox County, where concussion cases have gone up since they started using the imPACT test four years ago; 1,714 students have taken it so far.
As a result, head injury diagnoses in East Tennessee's largest district are up by more than 250 percent. In the 2008-2009 school year, there were 42 head injuries among all schools and sports. In the 2011-2012 school year, Knox County student athletes suffered 148 head injuries in all sports. Of those 148 injuries, football accounted for 66 percent, followed by basketball at 16 percent and soccer at 9 percent.
That's consistent with data from the CDC where, nationally, rates are highest in football and girl's soccer.
Katie Phillips, 14, from Williamson County has been sidelined with a concussion for weeks after heading a soccer ball kicked by a college player. Dr. Alex Diamond oversees her recovery at Vanderbilt University Medical Center in Nashville.
"Not only are they more prone to suffer a concussion, but their symptoms are more likely to last longer," Dr. Diamond said.
Dr. Diamond is one of eight doctors at Vanderbilt's Sports Concussion Center. It does some of the nation's leading research on the subject.
"There's no data right now that shows there's any way to prevent a concussion," Dr. Diamond said. "There's no such thing as a concussion-proof helmet.
He has also diagnosed more concussions in kids like Phillips. But he says that process can be challenging. When they are doing exams, they are ruling things out but are never able to prove someone has suffered a concussion.
"It's not a structural injury, it's a functional injury. It's not something you can see," Dr. Diamond said.
Some symptoms resemble teenage growing pains, but any hit to the head is potentially serious. Some symptoms include balance problems, headaches, vision changes and mood swings. The CDC offers a full list of symptoms.
After weeks of rest, and a passing a series of exercises with Dr. Diamond, Katie Phillips takes the imPACT test to further assess her progress. In the past year, the Sports Concussion Center has administered it to more than 9,000 professional and student athletes in Middle Tennessee.
"It's one more tool in our tool chest to be able to provide some objective information," Dr. Diamond said,
He also cleared Phillips to return to the game through a two-year old concussion policy implemented by the TSSAA. That's the body that governs youth sports in Tennessee. Every student athlete showing signs of a concussion during play must stop the activity and get a medical evaluation. A doctor must sign a release for players to return.
"It's better to miss one game than have a lifetime of complications," Dr. Diamond.
"I think it's a good rule that they can't re-enter the game until the doctor gives them permission," Coach Hammonds said.
Even though Tennessee is one of 12 states in the country without concussion legislation on the books, coaches such as Hammond are happy with the TSSAA policy, the imPACT test, and the effects of prevention education. And players, like Clay Coghlan, have peace of mind so they keep their heads in the game.