Millions of kids play sports, and that brings many physical and emotional benefits.

But injuries in youth sports is a very serious issue.

In some ways, reaching epidemic levels will go in depth on the concerns, trends and solutions.

On this edition of In-Studio Youth Sports Injuries, Youth sports has become a big business.

It's opened up more opportunities for kids in sports, but it's also led to some increased risks, especially with injuries.

The most significant issues are in baseball and football, and that will be the primary focus of this show.

We have an outstanding panel of guests to help us navigate and learn about this important topic.

First of all, we are honored to welcome Dr. James Andrews, a world renowned orthopedic surgeon and leading contributor in scientific and clinical research on sports injuries.

He founded some of the leading sports medicine organizations in the country, including the Andrews Institute and close by Gulf Breeze.

Dr. Andrews has treated many of the most famous athletes in the world.

We're very fortunate to have him as a member of our community and as a guest on today's show.

He'll be with us for the full hour.

And also joining us on this first segment, focusing primarily on baseball.

Tim Sweeney, blogger, Pensacola native Pine Forest High grad who made a meteoric rise to Major League Baseball in the early 2000, pitched three seasons in the majors until elbow injuries, a couple of surgeries cut his career short.

And we also have Mike Jeffcoat, the head baseball coach at the University of West Florida, for 18 seasons with a very impressive run of sustained success, including a national championship in 2011.

Gentlemen, thank you so much for being with us.

Thank you.

Dr. Andrews, I'll start with you.

We're going to talk about baseball in this segment, but I want to talk overview.

First of all, you have many of the world's most famous athletes that come to see you in all different sports, but you also have a lot of youth that come to see you as well.

So overall, how big of an issue is it?

How many kids do you see?

How big of a problem is injuries with youth?

Well, you you hit the nail on the head when you said there's an epidemic in youth sports around the table.

This particularly true and we're talking in this segment on baseball.

Since year 2000, we've been researching and keeping up with injuries in baseball.

And what we've seen is a ten fold increase since year 2000 in youth baseball in general.

In baseball in general.

Back then, for example, the Tommy John's ligament injury was primarily for our professional baseball players.

Now, the youth athletes in high school and younger lead the group.

There are more of them coming in with all the collateral ligament injuries than professional baseball players.

So we've got a real problem at the youth level.

You actually have a stat to back you up.

In 2003, there was less than ten recorded.

Tommy John Surgery for people under 21.

Ten total ever.

It started in 1974.

Now 57% of Tommy John surgeries are done on kids between 15 and 19 years old, which is insane.

And they also had another recent study that showed 27% of elite high school pitchers that we're in the study that were at showcase events went on to have Tommy John surgery.

So that shows you how serious it is.

Before we get to the other gentleman, the physiology, what is the physiology at work here on the arm that causes these type of injuries?

And what is the fix with the Tommy John surgery?

Well, we've started in our biomechanics throwing lab, the ability afforded by the Tommy John's ligament, and we wanted to know how strong it was at various ages.

The thing we learned is that it it's baseballs, developmental sport.

And that ligament gets stronger up to about age 26.

The problem in high school is we found out that the Tommy John's ligament, red lines in high school and younger at about 80 miles per hour.

If you get to 85 miles per hour, it's suspect.

If you get to 90, that could tear the leg on every pitch.

And of course, it depends on their genetic makeup.

Some of the kids that can throw 90 in high school, their daddy was a major league pitcher.

And genetics plays a role and they can sometimes get by without injury.

But the big problem in high school is that they're all trying to throw faster with higher velocity.

And that ligament can withstand.

And that's why we're seeing so many injuries in high school and younger.

So you guys are out there like you coach on a college level team.

You know, you play in the majors, but you also work at a baseball travel ball academy was Ford Academy.

So what are you guys seeing out there in terms of how prevalent this is, how much of an issue it is?

It's definitely an issue with me having to Tommy John's.

It kind of hurts my heart to hear that it's getting younger and younger and younger.

But nowadays, the the chase velocity is just greater and greater and greater.

You're told that if you throw harder, you're a great pitcher and you're going to be the guy.

And for young kids who's not developed yet, usually that leads to some problems.

Yeah, and I think as Dr. Andrews alluded to, what you're seeing with the statistics is it's becoming more common for these kids to play a lot more games throughout the year.

I remember reading an article Dr. Andrews wrote several years ago about diversify, buying and playing multiple sports, which is something most of us, you know, that were born in the sixties and all that.

You know, Dad played basketball, football, multiple sports, which everybody talked about.

It gave you greater dexterity and you're a better athlete.

But also specifically for baseball.

What it did is it forced us to rest our arms.

If we're playing basketball and football, we're not throwing a baseball.

And so inevitably, I think it helped us.

And now they're cutting all that out.

You're having fall, spring, summer baseball and baseball tryouts.

And they're seeing, I think, you know, technology and social media and letting the kids have access to seeing kids all around the country and short video clips and them getting a lot of clicks.

Certainly, they want to be a part of that and it drives them to want to get there quicker is something he just talked about.

And there's a process and you I think as coaches, we've got to do a better job.

There's a lot of things in place already with pitch counts and all that.

And I think you're going to get into a little bit about that as we go along.

Yeah, You know, we talked about everyone wants to throw fast, you know, but does it have to be the way everything was in the nineties these days?

But when you look to recruit guys, when you're looking at guys, does it have to be you have to throw fast?

Is that is that always the measuring stick?

Well, for me in college, it's certainly not in Division two level.

It becomes more difficult to sign a bunch of guys.

We just had our scout day and we had 11, 12 guys hit 90 miles an hour.

And now where do those guys pitch at that speed?

Probably not.

A lot of them do.

But you know, you're going to see the higher velocities at the pro level and the higher D ones, obviously.

But, you know, that's not the end all be all.

What you see is those kids end up not being able to pitch and have command.

And then that's the issue with the arm injuries.

Why do you think people have kind of lost sight of this?

Why why have they started to overuse arms playing year round but then also just overusing them in terms of the amount of innings they use?

You know, why do you think it's gotten so bad?

Well, I think a lot of it has to do with the financial aspects of youth sport.

If you think about it, the parents will pay any amount of money to add three miles per hour to the kid's fastball, and the parents have to take some responsive entity for this epidemic.

The thing is that they don't pay any attention to as these quick fix situations where they're throwing weighted baseballs or running into and throwing into the wall, you can get the same amount of increase in your velocity in a safer way by just doing pure baseball exercises and none of that kind of stuff.

And you're not spending all that money.

But that's not what's happening.

And they'll they'll pick up anything that's that says, well, if your kid comes to us will increase his velocity by X amount of miles per hour and it only cost you $100 a session or whatever.

No telling.

Parents are spending an enormous amount of money on their kids in a single sport like that.

And not tell me you see this because you work at West Florida Baseball Academy.

You work with a lot of young people.

They come to you with your expertise.

So kind of what are you seeing and maybe the overzealous beliefs that are out there?

I think for a lot of guys, it's that dream maybe of getting on TV or getting to their favorite college, but they don't realize that it takes many, many years to get to that.

What I feel I've seen more with Travel Ball now is right away at a young age, they want to put them on most in a major league situation.

You know, and that stresses these athletes a ton.

They're playing a ton of games on weekends, multiple, multiple games in one day.

And that's just tough on any sort of arm, especially young arms and young kids.

And then to be honest, you know, with pitchers, if you're a coach, you're usually going to throw the hardest throwing guy.

That's just kind of the obvious answer.

So you're always looking for the harder throwing guy.

You don't want that to be unsafe, but that's the way the team works.

So every kid maybe that wants to pitch now, he needs to be the hardest throwing guy.

And I think Dr. Andrew sit on it for me.

A lot of arm velocity, it's genetics.

You know, every kid's not made to throw 90, 95, 100 miles an hour.

You know, those are almost kind of unicorns.

You can gain a little bit, but you can only gain so much within your body before an injury is inevitable.

Well, people talk about travel ball being a big part of it because they are selling, you know, something out there.

So as a college coach, you've seen a lot of guys that have come through that and some guys that haven't come through that.

You know what?

What's your sense of how much of a problem that is and the people need to play, you know, do that to to succeed, to get to the high levels?

I don't think you need to do as much as you're seeing out there.

It's just like, you know, anything else in life as Dr. Andrew said, it's the parents and the kids that are making the choices of how much and what is excess.

I went through it with my son, and Trent's playing with me now, and he did the travel ball circuit.

But, you know, we laid out a schedule to where it wasn't going to be excess and it wasn't going to be all the way through the fall.

And certainly there's time and and money involved when you're doing that.

And it's great for competition and it's great that you can play against a lot of different kids from a lot of different areas.

Back when we grew up, you know, I played at Warrington Ballpark.

We played it, you know, Dizzy Dean out by the airport and you just knew how good you were in your own town.

You know, you didn't get to play everybody from around the country.

So that that part's cool.

But as we talked about, there's a lot of pitch count things that are in place and put in place for these kids.

And I think the big piece is if they're going to play travel ball week in the weekend, what are they doing in between?

Is there anybody giving them a schedule of a throwing schedule?

And if they're on a travel ball team, they're probably not practicing every day.

If you're in high school or on a college team, we can control that a little bit with a better throwing schedule that keeps them more accountable and safer.

If you're doing just on your own, you know that's a problem.

And then the kid comes in like spoon, he says, and he's got to throw, you know, two games in four days and however many pitches that the coaches decide.

But you don't know how many bullpens he's thrown.

And it is a long toss to do improper arm care.

Things like showcase advanced radar guns.

How much does this contribute to the problems?

Well, I think the radar gun and the coaches may not agree with me, but I think the radar gun should be outlawed in college.

You know, these dads have their own radar guns now.

Well, that's terrible That that's the problem.

Let me just say one thing about some time off.

You mentioned it, Coach.

We try to tell every baseball player and parents that they should take at least two months off each year where they're not throwing a baseball, preferably four months.

And by the way, we did a study on the high school kids.

We did Tommy Johnson.

We went back and looked at their schedule on a yearly basis.

And the only time that group why the majority of that group, the only time they had off was one week between Christmas and New Year's.

And they all had Tommy John, surgery and high sugar.

Of course, spooning.

You have a very interesting story.

You reached the highs and lows within baseball, played it by force.

You got drafted.

Meteoric rise.

I think you were 22 when you reached the majors, played for the Braves and the Marlins pitched.

They pitched you a lot while you're up there.

So what was your journey like in terms of arm injuries you had as you went?

How much you threw?

And then with the way it played out at the end?

I think, you know, looking back now that I've gotten older, when I was younger, I definitely had arm injuries kind of on and off.

I would miss a couple of weeks here and there, but I was, you know, the main pitcher to probably most of my life as I got to professional baseball with the Braves, I was throwing a lot, but the Braves protected me very much.

So I really didn't throw back to back days.

I didn't do a ton.

And really the big change was when I got to the Marlins, I just I wasn't prepared physically to throw as much as I was throwing.

And then that's kind of where the breakdown happened.

You had to Tommy John surgery and he got the first one and there and then but it didn't really take or I guess your body didn't.

Just for whatever reason you know I remember Dr. Andrews you know, when I had the first one, he told us, you know, about 80, 85% of people come back.

That's not everybody.

You know, people see on TV that, you know, a guy has Tommy John, no matter what, 12 months he's back healthy.

And and I don't think that's the case for everybody.

For me, it was a long road.

It was it was tough for a long time.

Yeah.

And that's that's our town.

When you tell somebody they an athlete, they have an 85% chance of coming back.

They by that point, you know what you said you got to tell them around the corner is you got to tell them you understand 50%.

That means 15 of your players that, you know, that had a Tommy John, 15 of them out of 100 are not going to come back.

And that brings them to reality.

But that's the that's the way everything is.

And medicine where we hang on to the optimist stick side when we talk to patients and and we don't emphasize the other side of the coin so it but nothing in medicine is 100%.

Yeah.

So there have been campaigns to change habits.

You've been a big part of that.

There's the pitch Smart program.

So so what have been the things that have been put out there with Pitch Smart and other things that you guys have tried to get the message out there that should be going on?

Well, that started years ago.

I was on the board of little League International.

And by the way, that group that has the best interest in the health of our young athletes of any any youth organization I've ever dealt with.

And we started the pitch count through Little League and got it adopted.

By the way, we didn't know how to do a pitch count.

We just had to pick some number.

I set up, I said a thing out to a budget.

They sold our baseball doctors and I asked them to answer my protocol, answer my questionnaire about how many pitches would you let a pitcher pitch it at the various ages you took all that, put it together, and that's how we came up with the pitch count.

Then we worked with USA Baseball.

I was on their board and they adopted it and then we said, Well, we need to put some teeth into the pitch count role.

Maybe if we can get Major League Baseball, and I tried for years to get them interested, they weren't really interested until I finally figured out if they didn't do something about the injuries in high school and college, they wouldn't have anybody to dry out that hadn't already been operated on.

So they got behind the pitch count and and teamed up with us with with USA Baseball.

They basically adopted the roles that we had in Little League way back.

And you probably know what those roles are when they start, what, a seventh and eighth grader not let me throw a ball and 40 or 50 pitches.

And I worked their way up to a kid 18, 19 years old and as a senior can throw 100 and I think 105.

You know, we have days off that they have to have to have so many days off, depending on how many pitches they pitched on that first day.

By the way, everybody has a way to get around those roles.

And one of the ways is you're supposed to have a five days off.

So if they pitch on Monday night, if they start the first day on at 12:00 that night, they can pitch a day earlier.

Yeah, yeah.

I use the time thing to.

You know.

You can't do that coaches.

While they are doing that and here's the game put.

It up 24 hours.

Are these suggestions or recommendations being listened to?

A recent study in 2021 said that only 43% of coaches correctly answered questions regarding pitch count and rest periods.

And another study said noncompliance with the pitch smart guidelines in tournament settings.

More than 90% of teams were not complying with what was in there.

And almost 50% of pitchers were not complying with what's in there.

So how do we get these coaches to follow these guidelines and listen and do the right things?

Hmm.

Well, you have to take the score off the scoreboard, I.

Guess.

Because, you know, I mean, for us, when they get to our level, obviously, we have, you know, longer periods of time with them.

And I think that's where the parents, again, have to come into play.

It's it's the kids.

If they're under 18, the parents sports ability to look out for their well-being, I believe, and, you know, the coaches want to win, you know, and some of them will go whatever it takes to win.

And Sony knows and I was one of those guys through pitching when I was younger.

That bring you back on Sunday and you were the starter and they bring you back and relief closed championship game and it wasn't just that championship game.

It could be several championship games that year, but I think it falls back on pulling back the reins a little bit, winning at all costs when they're eight, nine, ten, 11, 12.

And literally I talk to parents all the time and they're under the impression if their kid at 11 or 12 years old has enough, you know, perfect game rings, that that's part of getting them a scholarship.

And I'm like, it has nothing to do with that.

And what I see more of is the kids are burned out by the time they're 14.

And I know this because I have a 19 year old son now that along with him and several of the other kids, but he played basketball, football, but a lot of his friends played baseball.

And I got burned out around that age going from eighth grade.

In the ninth grade, they were about done with it.

And you never want to see that.

You don't want want that fall back on your shoulders where you took the love of a sport away from somebody.

If you talk about youth sports in general, you're right.

60 and up to some statistics say 70% of of youth athletes burn out and quit sports by age 13.

And when they do that, they never get Bob involved in athletics or recreation the rest of their life.

They're sitting on a couch, turned off computer, and they're not doing any recreation.

But 70% drop out and age.

They drop out is age 13.

So what's the responsibility of travel ball organizations?

You know, you work for one, a responsible one here with Florida Academy.

But what's the responsibility for how they handle these situations and the advice they give or the people that they take and the advice they give to parents?

And I know for for us at West Florida, we try and go off every rule that kind of Dr. Andrews has sent out.

We have kind of guidelines.

It's nowadays with the way baseball is, you have to basically have every kid on your team able to pitch in.

If if the thought of winning is so great, you don't do that, then your better arms end up like you're saying.

They pitch multiple days on these weekends and it's just really rough for them.

So I think finding ways for more kids to pitch and if we lose a game because another kid got to pitch, then that's kind of the way it is on a Saturday.

That's tough, though, when when you are trying to compete and win.

Now what I run into a lot is, is say, I have a kid come in and he's nine or ten years old, I'll give him advice and I'll say, No, we'll probably going to wait.

I always use the adage, Wait till you can shave to throw breaking ball, right?

Well, I'll tell him that and I'll say, Well, throw in a breaking ball.

Well, you know that I'm in that weird position, man.

If we tell them they can't do it, they're going to kind of go to somebody that's going to tell them they can.

So I think it does come back to that period of really kind of standing up for your kid and knowing guidelines and ages and making sure they're being taken care of for sure.

And I think getting back to the leagues like we used to play Tuesdays and Thursdays and Saturdays and now your kids are playing spaced out.

Now you're asking me to play four and five and six games.

I know I saw my kid play, even if it was Coach pitch, they're still throwing a baseball around three games a day in these tournaments trying to win a Dizzy Dean World Series.

When I grew up, we played, you know, in a league there wasn't any travel volunteer.

You get to the world Series and I think the Tuesday, Thursday, Saturday or the Monday, Wednesday, Friday, how we used to play, you're spacing out that workload and that's where you're having the problems, in my opinion.

The workload of so many games in a condensed period.

And now you're going, what, 2 to 3 weekends in a month to play this travel ball with nothing in between.

So you don't do anything Monday through Thursday and then all of a sudden four straight days of play and then you're off for a week and a half and the kids don't do anything and then they hit it again.

So I think we got to try to figure out a way to get the message across of getting back to more consistent playing instead of bunching it all up and not letting these travel organizations dictate so much to us.

The parents ran the leagues anyway.

It would just be a matter of them stepping up.

And I think hopefully with the way costs of everything is going up and up and up, I think maybe the economics is going to come into play where the parents say enough is enough.

You know, from paying the $10 to park the $20 entry fee.

You know, it's just.

Crazy that you have two young kids that are just also.

So what's you watch?

I'm sure you have a plan, right, for how you're going to what are you going to allow them to do?

And my my plan right now is for them to pick whatever they enjoyed doing this their first year doing baseball.

Honestly, I would love for them to do something else.

They love soccer and this and that, but it has been interesting.

I kind of want both of them to pitch, but it'll kind of be down the down the road.

And it's funny, every time they pick up a baseball, they probably get frustrated with.

They have bad mechanics.

I tell them right away, like you know, close your front shoulder, step to me.

But, you know, I don't know.

They'll kind of choose what they want to do, but hopefully, maybe something a little different.

I know what we touched on this a little bit.

Our people bring this up.

Back in the old days, you know, now pitchers in the big leagues at higher levels, they pitch, you know, six innings, five innings back in the deal, complete games with a door back in the day guys pitch so many more innings but there were so fewer arm injuries.

So when somebody says, well, how does how is that possible?

How is that possible?

Just like pole vaulting, for example, back in the days the world record was 15 eight one, many injuries either.

Now what's the world?

The rotation while Rutgers 20 feet five and a quarter inches so you can't compare those pitchers to the pitchers we see today.

Those pitchers were mainly interested in throwing strikes and place on the baseball and that's what they worked on.

They weren't throwing 100 miles an hour every time they throw a pitch.

So it's an attack.

You can't you can't use that to say that we got soft pitchers today compared to years ago.

It's just a it's a it's a different like apples and oranges.

Yeah.

So, you know, we're kind of going to the end of the segment.

So.

So what's the biggest thing for you guys?

What do you feel like?

You touch on a lot of it, but moving forward, how do we convince the parents that you don't have to do this?

Because that's the pressure.

You you know, we felt that we have kids in the fight, youth sports as well.

You feel that pressure.

You have to do this.

Otherwise you're not going to make it, are you?

Falling behind?

And that's being sold out there.

So what what's the best way to stop that?

You know, I would hope that what we're doing today would have some influence on some emphasis, but we're probably preaching to the choir.

And I keep searching for that magic formula that's why we did the PetSmart program, of course, why we weren't getting any of the like you said, we weren't getting to youth legs to buy into pitch counts.

And if we brought Major League Baseball in and used major league pitchers to help enforce it and emphasize it and during breaks out of and a baseball game on TV, the parents might listen.

I think it has helped.

But we're still got a long ways to go.

I'm telling you how I don't think it's as much of a culture problem as it is a parent's problem thinking.

Yeah, I agree.

I mean, I think you've got to look at the schedule and, you know, as Tony's fixing to go through with his kids, I mean, you know, the coaches are going to say in the travel team, you're playing with us how many tournaments we're playing.

And you can tell them, look, we're only willing to play this many a month or or what have you.

And that's where you have to take control of it.

And like I said, and Dr. Andrew's is even stated the burnout phase in all these games we're playing, Let the kids be kids.

And when you get into high school is when you really you know, if you've developed the basic skills of hitting and pitching and catching and you can do them efficiently, playing 100 games a year is not going to change that and get you any better.

And just because you're not the 66 kid that just happened to sport up, you know, when he was 12, 13 doesn't mean that you're not going to grow.

And I think that process is, as he said, is trying to be sped up so quickly.

Hopefully the NCAA is helping with that recruiting because the parents are doing this for pros and for scholarships.

The NCAA is dialing back the recruiting now to where, you know, you can't even talk to a kid till June 15 prior to his junior year where all these, you know, verbal offers for freshman and sophomores, all that's gone now.

So they're only recruiting a class or two out.

And that's good for all of us.

It lets us be spending more time with our family and so forth.

And these kids and parents aren't forced to make unwise decisions way before they're good enough, you know, early enough to really know what's going on.

And he and we as coaches really don't know.

We're guessing if that kid develops into the guy, we hope he's going to be really we don't know.

So it helps both ends.

And I think if you see that from what were the rule changes are then don't try to push the envelope when they're younger.

Let them let them develop naturally and keep a love for the game.

Yeah.

Remember we play baseball?

Yes.

Play baseball?

Yes, sir.

Really?

Most coaches will tell you the best athletes are ones that played a lot of different sports.

Like built other skills, right?

Yes, absolutely.

I would agree.

Yeah.

Yeah.

And I think you saw in the Last Dance with Jordan, talked about his love was baseball.

He didn't just do basketball his whole life.

You know, I think for for me, they hit on it like, I just wish youth sports would give back to parents just enjoying watching their kid develop and go through some growing pains.

And I just feel like nowadays, man, it's if your kid's not performing and if he's not the best at whatever age, It's almost a lot of parents pressure from the parents for the kid to be better.

And it's not to high school or older to the kid's going to decide, like you said, I can throw and catch at a high level.

I want to do this way more often, you know, And if you do it that much and it's that important at eight and nine years old, usually by 13, they're they're kind of over it.

Yeah.

So we hate seeing that as baseball games.

We want baseball kids to want to play for forever.

You know, we don't want to take that passion away.

Well, we're going to leave out our discussion of baseball, too, there.

So thanks to Tim Sweeney Barker and Mike Jeffcoat for your time and your expertise.

Dr. Andrew is going to hang with us for the next segment.

The focus shifts to football next as we dive into significant injuries worries in our country's most popular sport.

That's coming up.

Concerns about injuries, especially to the brain, have led to a drop in kids playing football.

According to a U.S. News and World Report, high school football participation is down over 12% since 2009, and the decline is steeper for younger kids, down 29% since 2016, for ages six through 12.

Despite this, millions of kids still play football and it remains especially popular here in the South.

Dr. James Andrews, the world renowned orthopedic surgeon, remains with us for this discussion.

And joining our panel for the second half is Taylor North, A primary care sports medicine doctor at the Andrews Institute has a lot of specialization in concussions as well.

And Tony Carter, who was the head football coach at Pine Forest High School, and he had three sons that either play or have played college football.

And one of them, Michael Carter, is now an NFL, NFL running back with the New York Jets.

So, gentlemen, thank you so much for joining us.

Dr. Angelos, I'll start with you.

So what are the biggest concerns from a physical standpoint for youth playing football, the biggest dangers?

Well, the one that's talked about mostly right now are concussions.

But I'm not sure that's the number one injury.

You know, if you if you take, for example, a college football program that most injuries occur in the eye and the foot and ankle and in the hand, believe it or not, you don't hear about them that often.

But the big injury is ACL injuries to the knee and multiple ligament injuries to the knee.

And then, you know, concussions are not that common, but they are.

But they get your attention, let's put it that way.

Force is the most serious, you know, thing that can be out there.

You know, in football, there's always going to be injuries.

It's going to happen.

So, Tony, for you, you know, you've been through you know, for many years as a coach and working with your sons.

What have you seen in terms of the knowledge out there, The amount of injuries is the better?

Is it worse?

Where's it from?

What it was years ago?

I think the awareness is a lot better.

And technology, the equipment that people and people use, is a lot better.

The the coaching strategies are a lot better with the heads up tackling and taking your head out at attack of it is a lot better than you know even there especially even at my practices too.

You know you just push that that aspect of it.

So I think part of that that's concern, I think just awareness is a lot better.

But, you know, of course, the head injuries, the knowledge that's out there right now about the damage to the brain, concussions, CTE, those kind of things.

Doctor, what is the latest kind of recommendations and the way the latest knowledge out there on the brain injuries that football players go through?

Well, as Dr. Andrews said, it's you know, it might not be the most common injury that we see even, you know, in football.

But anytime we're dealing with the brain, it's something that we don't want to take lightly.

So you know, one thing that we do know with concussions is that our real goal is to prevent a second insult.

So with repeat concussions or repeat, you know, brain injuries, which is what a concussion is, a concussion is an insult or mild traumatic brain injury.

So, you know, there's certainly efforts that are being put forth to try to prevent them from happening, such as, you know, tackling techniques and so forth.

But even if one of our athletes sustains a concussion, our goal is physicians is really to try to rehab them and get them back to their normal state prior to returning to play to prevent that second insult.

So a lot of the research and emphasis has really gone on to what can we do once an athlete sustains an injury to, you know, either improve or accelerate their outcome or prevent a second insult from happening.

Know, of course, that, you know, a lot of the biggest news out there is about CTE, CTE, which is the chronic degenerative degeneration of the brain through a history of repeated head trauma.

So so how significant is CTE and how much more are we learning about that?

Well, we're not sure that repeated concussions in athletics or whatever type of athletics is the only thing that causes trauma, like chronic post traumatic encephalopathy.

And another way we know about the prevalence of it is, is that past that was ones that for some reason the family decides to do an autopsy.

So it's not that's not done that often.

So it's probably a lot more common in the general population than we know.

We don't know what it is.

If you took all of the NFL football players that played in the NFL, how many of them, when they pass away, have that problem?

We don't know that because there's not many autopsies that are actually done.

So the answer to your question is try not to have more than one concussion during your athletic career.

Well, good luck with that, right?

Yeah, It's not a specialty in football.

So that's you know, there's been a big push out there for different techniques, especially in football tackling.

So what are the new techniques that they're being taught?

And when they get to the high school level, can you tell, you know, are these being taught in the youth levels or are they not?

Well, like I said, the biggest one right now is like I was saying, the heads up, you know, so so when you one of the biggest techniques you see what you hit for, first of all.

So a lot of people have the problem when you put your head down, you want to dive like a missile, you know, in head first.

That's why that's a penalty in football.

Now there's a personnel file.

It's a big penalty.

So if you see what you hit, you know, a lot of people a lot, of course, you use turkey terms like head, hips, hands or feet, you know, when you strike your opponent, you know, so so if you see what you hit, then you bring your hand.

So you see your hands.

So you can see your hands when you strike, you know, also, you know, sit down in your chair.

So like so you guys had a natural S-curve in your spine so you can absorb the contact properly.

And then in the end, you know, head on the place out of the ball.

So now I'm straight ahead when I see what I hit and I got my head on the place out of the ball.

So now my face smashes at the ball and instead of at my opponent, you know, so.

So and then now I'm driving through the ball with my legs and my shoulders on on the body of the person I'm tackling.

So those techniques like that take my head out of the direct collision, you know, in and save that what could possibly be that that that that trauma that causes that shift in the brain if that's you know that causes that concussion or that that motion that would you know, give me that brain bruise.

And so that's what we focus on, that if you see what you hit, obviously you're going to hit it, right.

So it would be a lot of missed tackles.

I'd love.

But what are you seeing that you know, when they come because you've coached you.

Know, a lot of times a lot of times the youth football that gets lost because you, you know, a lot of people want the big hit and a lot of people want to highlight, you know, And you know, what I would promote is I would read that you have 1010 routine, boring save tackles in a game as one big highlight tackle, you know, And that's what I promote to my players, especially at the high school level.

A college coach would want to see 1010 tackles, short tackles in the backfield as opposed to one big highlight tackle where, you know, you might have made a a wow moment, you know, and made a guy from always opposed.

They tend to short tackle because this guy got ten tackles this game 12 tackles in that game, 15 tackle that game Those are what you call stats you know that's what people want.

That's what recruiting that's what college of policy as opposed to the big hit that you may see on a highlight reel.

And this kind of takes away from like the big hit that you see video of the two of you on YouTube.

Kind of like, you know, kind of like gives kids a misconception of what, say, football is.

So maybe we need to put a safe hit video out there on YouTube.

So so kids can do that, too.

So so what is the dangers what are the possibilities that people need to understand?

Have you if you're not doing the right techniques, you're putting kids in jeopardy and what happens?

Yeah, certainly so.

So, you know, not not only I mean, we're we've been focused on concussions, but, you know, talking about a head down technique, too, is, you know, certainly certainly concussions still in play with with a concussion.

It's it's not always just the direct blow itself.

It's it is an to the brain.

But oftentimes or typically will this will occur from more of a rotational force that's put on the brain.

But if we shift away from concussions, just you know, on the topic of head down, you're certainly putting your cervical spine, your neck at greater risk when you're, you know, going into a defender for a tackle with the crown of your helmet.

Yeah, certainly putting that neck and neck at risk, which, you know, your spinal cord lives is buried there within your cervical spine.

And so, you know, certainly a structure that we want to prevent any injury to.

So keeping that face up again is going to reduce the risk for that.

You know, athletes are getting bigger and faster and stronger.

That kind of compels the problem.

You've worked with NFL teams, obviously, a lot of players, many colleges as well.

Yeah.

What do you see with the way they're trying to address what could be a major problem for them moving forward?

Unless this is we can get a handle on this?

Well, the main thing is you got to see what you're hitting.

You know what they're doing as you put your head down and you're trying to then the player with any athletic ability jumped right over the top of you and keeps going.

So they're trying to teach the right technique.

But you know what?

Natural instinct is to use a top of that helmet.

So it's like a battering and it's like, so you got maybe you can hit him harder.

Yeah.

Particularly if you hit him in the chest with it.

You know what happens to that, don't you?

From number three last year.

Yeah.

So teaching them good techniques is better than making some kind of wow tackle with the top of your helmet and getting thrown out of the game.

So what's the right age?

You know, some kids play as young as five years old, tackle football.

I don't know when you're boys how old they were when they they.

Started at.

Five.

Do you would you still do that today with your knowledge now and is there is there some recommendations in terms of the age kids should start to play tackle football?

For me because, you know, I was fortunate enough to be their coach.

You know, I would you know, just because, you know, and this is because there's other five year olds out there tackling them, you know what I mean?

You know, Lawrence Taylor is not out there tackling my five year old son, you know.

So I was able to kind of I was able to be there, you know, and teach them to safely hit and honestly off of teaching in a safe way to follow.

You know.

So, I mean, there's a thing to that, too, you know, So so I would do I would I would long as you're teaching them the right technique, you know, I would I would I would definitely let my five year old to play football right now.

But there are some issues.

I know some kids that they grow at an earlier age.

They're they're bigger kids and there's some kind of limits and they're not allowing some of those kids to play.

What's the answer there?

Is it what's fair there and what's the answer to to like kids that are bigger, naturally, bigger earlier?

And then, you know, in a sport like football, it's not it's not a fair situation.

Most of the time.

Generally, if there's say, for instance, you got a £45 five year old and then you got £120 five year old and you worried about the £120 five year old hitting this £45, five year old.

Most of the time their body is not developed enough.

That £45 five year olds probably a whole lot faster at under £20 five year old.

So like I've never in my experience I haven't seen that on a £20 five year catch the £45 five year old.

So as a coach, you know, you have to be smart enough to like make sure you that you don't put your child in that situation.

And also most leagues have a rigid right rule rule.

So like the heavier kid can only play on offense or defensive line.

Or as sitting on the bench.

Too.

Yes, there is.

There's so so the smaller kids are probably at a skill position, like a wide receiver or defensive back or quarterback, you know what I mean?

So so if not, these are £220 kids or the bigger kids don't have such a big run in start at at the smaller kids.

It's you know obviously you you knew what you were doing but there's a lot of youth coaches it's not as regulated and they may not know what they're doing.

So I know accreditation is a big thing in youth coaches doctor and just what's kind of the key with accreditation to making sure that coaches are out there in football youth coaches belong to be a deserve to be out there should be out there.

Well youth coaches when you talk about youth coaches, I'm 14 years of age and younger.

Usually parents are and they may have played a little football or baseball or whatever, but they really don't know anything about coaching and they don't know how to recognize injuries.

And they're the you know, in those young age groups, you don't have an athletic trainer out there and those types of younger kids, you know, grammar schools and junior college, junior high schools.

So the coach has got to recognize injuries.

And that's really important is early recognition and treatment.

So what we're trying to do is a mandate that all youth coaches coaching kids in all sports, 14 years of age and younger, have to be accredited in prevention and recognition of of youth sports injuries.

We passed a law in the state of Alabama that they can't coach until they take that that examination, which is an examination that we put together from our foundations in Birmingham and Pensacola.

And it's it's it's it's $25 to take it and it's on the Internet and it teaches them about how to recognize concussions and what to do with different injuries.

So we're trying to get that done in all 50 states.

We're working on that right now in the state of Florida.

As a matter of fact, it looks like we're going to be able to get it passed.

But the coaches need to know that because if they don't have some type of knowledge about injuries, the lawyers are all out there looking for you're making a mistake.

So there's liability on their part.

And the most these young coaches have no idea about the liability of what they're doing.

So at least it gives them some education to hang their hat on in case they do have some catastrophic injury that is not preventable.

As part of the education, limiting the amount of contact in practice, because I think that's kind of changed over the years as well.

You know, how is things change coaching wise in terms of how much you allow them to have contact and what type of contact they have, you know, during practice?

Well, for me personally, you know, I learn a lot from different coaches, you know, especially in college, you know, watching these guys perform at a high level, you know, fundamentals is is is key.

You know, So in my practice that like I try to go over a lot of fundamentals in practice and so so you know, we don't have to practice like we're playing a game every day.

So I mean if you want to get them to the game, you know, so, so limiting contact is key.

So we don't do a whole lot of tackling in practice and not taking it to the ground.

You know, great technique, you know, you know, you can hit without taking to the ground, you know, So we call it third, you know, so so you practice great technique, great intensity.

You still block and still running, still hitting, still wrapping up.

You know what I mean?

So we're practicing those fundamental things instead of the big hit all the time.

So, so so you so you still get the same intensity without without without the risk to injury.

So so so I think that you should limit that I think to the one I think I know to do that I toughest day of practice.

You know, that's the most physical day and that's really it do Friday.

Night that's real smart is there most most most coaches now still say that if we all hit every day prior to the game we can't play on Saturday and we can't play on Friday night.

So you need to speak up and get these other coaches to fall in line because that's what you got to do to prevent injuries in football is to limit your heavy contact in practice.

You can't limit it.

In a contest on Friday night.

You damn sure can limit it in practice.

So what's the key to getting the word out there?

I know you know, you've done a lot of research on this.

Is there a lot of thought given on your end to how you guys can can turn that into making a difference out there by getting getting the word out?

Or how do you guys try to to educate, you know, coaches and the population on what you've learned?

Well, you know, I think as as with many things in medicine and this is certainly one of those topics that's, you know, extremely pertinent, especially in our in our country and society.

Any I think any effort can get can go a long way.

So, you know, something as simple as is this US meeting here together and talking about our different experiences and sharing knowledge that we might have.

You know, Dr. Andrews has done a great job with outreach programs within this and beyond.

And so I think, you know, any effort that we can do to, you know, spread, spread word continue working towards constructing guidelines and so forth, education is is key.

And I don't think there's just one thing.

I think it's it's you know, a a whole a whole mix of these types of different ways of just sharing and sharing knowledge and experiences is probably the key.

And little by little, you hope to make a difference.

You know, I think we really have to decrease the injury rates in football because right now it's got a bad name amongst mothers.

Yeah, and I know my daughters and my wife know more than any of my grandsons to play football.

Of course, they all play in it.

So dad is watching them with the mother is pretty adamant about, oh, you can't you can't listen to my wife.

You got to let them do what they want to do.

If you start preventing them from playing football, coach, if they get hurt, they'll get hurt doing something else.

Right.

But that, as you've said earlier, the number of people playing football across the board in the United States is now, what, 15 to 20%?

Yeah, I.

Know the coaches are worried about it.

Right.

They're not going to have any players coming up through the ranks to learn how to play football.

Not have enough to play in in high school.

Yes.

And that's a problem.

Yes.

Down 12% in high school football since 2009.

And youth football ages 6 to 12 is down 29% since 2016.

Because you hear about these different different things is, you know, football still the most popular sport.

But is it in trouble in some ways in terms of the knowledge is coming out there?

They opened themselves up legally also to to lawsuits.

Okay.

You know, this is permanently damaging people.

So is football in trouble if they don't get a better handle on this?

Well, I think football may be your answer.

There you.

Go.

But it's not really the answer.

I think it is, too.

But but I mean, but there's there's concussions in soccer, you know, with kids heading to football.

You know what I mean?

With bicycle kicks and, you know, so like, there's there's concussions in basketball and there's concussions in cheer.

You know, can you know, so like, there's still a high rate, you know, but football is a collision sport, you know, to me.

So for front of the mind, you know, so that so that that stands out, you know what I mean?

So, I mean, I think that just because, you know I guess football is the violent sport so so so that kind of gets the bad rep, you know.

But I mean but I mean, we just have to promote the safety.

What measures in place like Dr. Andrews has.

I think that concussion certification for all coaches you 14 below needs to have that because we have to have it in high school.

You know, we have to we have to take a test.

We have to do a course and take the test and have a certificate to be qualified, you know, to coach at a high school level.

So so I think all coaches need to recognize those injuries.

And it's mainly for their good.

It is.

It is.

So I mean, so those are good things that I think that these measures need to have in place, you know, so that measures the coaches will willingness to to commit to coaching, if you know what I mean.

So I think it's a good thing I.

Didn't I didn't want it so you know kind of piggybacking off that there there's certainly when we're talking injuries and so forth, this sort of has a, you know, a negative tone to it to some degree.

But I also don't want everyone to forget that there are many positive things that come with playing sports, football included.

So I was having this discussion with one of my colleagues actually just today and talking about the benefits and youth sports.

So there's a, you know, social benefit from it.

There's physical benefit from kids getting out, being active, there's mental benefits and positive things that do come from it.

So, you know, certainly any you know, parents, guardians are going to have their concerns.

But I also don't want that to be, you know, for it to be forgotten that there's many great things that can come from youth participating in sports as well.

And no doubt, I think some of the changes that have happened, you know, trying to protect quarterbacks, trying to protect the head, the old school mentality is all there, making the game soft.

You know, that, you know, this is not football anymore.

So what's your answer to that?

When people say that it's too, too gentle now, the ones that that argue on that side.

I don't I don't think you do.

I mean, football is still tough, you know, still, you know, imposing your will against your opponent's will, you know, and I don't think it's 12.

I just think that I just think that, you know, it's evolved, you know, it's evolving.

And I just think that we just understand that we have to have this 21st century, you know, we don't play with a leather helmet with no facemask on them anymore, you know, for a reason, you know.

So I just think we just have to say this is the 21st century.

You know, we don't use rotary dial phones.

You know, we don't have to jump out of our car and crank it up with the crank in the front, like the old Model T, you know, is it you know, we just have to progress with the time.

How about equipment changes also as an issue?

I guess there's a new helmet right now that they're working on.

So what's what's come some of the technology that can maybe help decrease some of these injuries?

Well, the helmet has come a long ways.

By the way, when I was coming along, you didn't get a facemask until you were a senior in I kept saying the helmet as a as a weapon.

And the saying was, well, if you'll take your helmet off, I'll take my hat off that I didn't go back.

That's here to stay.

The helmet, the modern helmet has really come a long ways.

Now you talk about the that what the guarding Are y'all using that to practice?

What the paddles And we.

Don't have those in.

I know in Alabama all the young all the young kids playing tackle football they've got it on their helmet in practice and in games and then the colleges are using and the pros are using it for practice.

But the thing is, you can't use it for a game, apparently, which is I had the young kids over in Birmingham are using it actually in the games.

Really now is it help prevent a concussion that that's still a debate but the NFL said it does.

So everybody's using it now.

In our area up in Alabama.

We've been talking mostly about head injuries.

Heat stroke is another big concern.

And we've seen a lot of stories out there, unfortunate stories of people getting seriously hurt or dying because of heat stroke.

Doctor, what are some of the things that you've kind of learned about those effects and the proper recommendations there?

Yeah.

So as far as heatstroke goes, you know, from from my standpoint, from a physician's standpoint or a health care provider standpoint, that might be at an event, whether it be a race, whether it be a football practice, a football game, what be it, preparations, the key.

So from, you know, being able to recognize early symptoms and then really just having resources available.

So with heat stroke, your body's essentially exceeding a certain temperature to where it starts to inflict damage onto some of your organs.

And so that's the the key is, you know, it's fairly straightforward.

You try to cool the temperature.

And so, you know, a common thing to have on a football sidelines is an ice tub or a cold tub.

And that's a quick strategy strategy that we can use to try to bring that that temperature down.

But really, I'd say preparation, recognizing symptoms and having access or resources, knowing, knowing how to handle it when you see it.

You know, the thing that you pointed out about the ice to during these hot days we've just gone through, we should have that ice tub on the sideline because if you have a major heat stroke and you have an ice tub, it's 100% preventable if you have to wait and I'll have that on the sidelines.

If you have to call an ambulance and send him to a hospital, by the time they get to the hospital, too late, their organs have been, I'd say the whatever they've been cooked.

So it's it's 100% preventable if you have if you are prepared and and you have that on the sidelines and summer practice around here.

Another other thing is you can't you've got to use a wet bulb and you've got to follow the rules.

And, you know, the state of Florida High School Athletic Association has strict rules about whether you can practice or not, depending on what the wet ball says.

And for those coaches that ignore that the third time they ignore that, then they put on suspension forever.

A law.

How has coaching changed around this at all?

Back in the old days, you know, three hour practices, no water, you know, that was a normal.

But how has that kind of evolved?

How do you guys how to handle that?

Well, I build water brakes into my practice and because I don't like to waste my time, so so I just build water breaks into our practices in and I don't have three hour practice, so we don't have three hour practices.

So I like to be efficient with the time.

So and also, Andrew, just to provide outstanding athletic trainer, you know, for us to be at every single practice that we have.

So so our athletic trainer she you know she has the way to stay home after she she check the wet bulb temperature all the time so I rely on her heavily.

Yeah.

You know, to tell me, you know, if they're lighting in the area, you know, if the temperature you know, we have co we have Kotov at the practice field, we have three of them actually as a matter of fact at at the practice field, you know, we have ice machine at the shade right beside our practice field, you know, so.

And you've got a defibrillator too?

Yes, sir.

So, so you know, so I want to I want to make sure that the safety first, you know, we we we can't I don't I don't want to put too I mean, we're out there to do something good for for the kids and not put them in danger, you know?

So I can't we can't have an effective practice.

We always worried about injury or, you know, I watch the video, you know, and I didn't I took the test, you know, for that save that.

I understand.

You know, So, you know, I I'm not trying to teach the kids accountability and responsibility.

Then I need to be held accountable and I need to be responsible at the same time.

So, you know, football is not just about going out there and calling plays and trying to win ballgames.

Yes, we do that, you know, But at the same time, it's about the lessons.

It's just like, Doc, just explain, you know, the benefits of football.

So we got to be that example to.

You know, if you can't practice without a coach can, you know, through the heart.

The same thing goes, if you shouldn't practice football without an athletic trainer.

Right.

And it's a team like he's talking about.

It's a team situation and you all work together and athletic trainer keeps the players out of trouble and also keeps the coaches out of trouble.

So you never argue with the athletic trainer.

You just made that emphasis.

They they control that wet ball.

I'm sure y'all learn this.

Hey, y'all were practicing at five or 6:00 in the morning.

We practiced at eight in the morning.

Eight?

You're sure you able to do it?

And then?

And then sometimes.

And sometimes when it when it.

When it was too hot, we'd be inside.

You couldn't.

You had to go inside.

We go inside.

We're going to the gym.

Well, we're getting late in the show right now.

What are some other sports, you know, that jump out to you?

There are some significant, you know, injury issues in other sports that people don't talk about as much.

I had three daughters that were cheerleaders and cheerleaders have been neglected all these years.

And so I helped pass some cheerleading prevention injury roles and USA cheerleading.

And we stopped some of this, some of the stocks they were doing.

But you got to realize in cheerleading before all this happened, cheerleaders led the nation in catastrophic injuries, meaning there's spinal cord injuries, etc.. And since which which we instituted those changes, they've come way down.

By the way, cheerleaders in college take up 25% of the college medical budget, whereas football players take up about 56% of the budget.

But they that many more times football players and cheerleaders.

So cheerleaders per cheerleader take up most of the medical monies in college.

Of all the other athletes.

You know what the cheerleaders say Coach?

Was it?

I say that if football was any harder, they'd call it cheerleading.

Well, that's a good place to end it right there.

So thank you guys very much for being here today and sharing your time and your knowledge.

Huge.

Thank you to all our guests, including Tim Sweeney, blogger and Mike Jeffcoat from the first segment.

Hopefully, insights on his broadcast will help keep our kids safe out there and playing the sports that we all love.

Thanks for watching.