Wake Forest High is a force in football, but also tops in concussions

Few athletic programs in North Carolina can boast success on the gridiron like Wake Forest High School. In three of the past four seasons, the school has won the state championship. They’ve had double-digit winning seasons for most of the past dozen years.

But Wake Forest’s football program is far and away the leader among Wake County public schools in something else — concussions. The program had 22 concussions in the 2018-19 academic year when its varsity team won a third consecutive championship, according to data obtained by The News & Observer.

No other Wake County high school sport came close to that number. The next highest was East Wake, with its football program reporting 10 concussions.

Wake Forest’s concussion total for football is also far higher than any other among five of the state’s largest school districts that have tracked and reported concussions by sport. The next highest is East Mecklenburg High School in Charlotte, which reported 14 concussions in its football program in the 2013-2014 academic year.

Wake Forest’s reported concussions didn’t seem to trigger an alarm from Deran Coe, the district’s athletic director, or Rebecca Jones, the trainer who pulled the football players from the team. They contend the high number results from a combination of three things: Wake Forest’s higher-than-average roster of 145 football players for the varsity and junior varsity teams, pulling athletes out of the game or practice if they exhibit any sign of a concussion, and a playoff schedule that added five weeks and four games to the varsity team’s season.

“I don’t have any major concerns around it,” said Coe of the 22 concussions. He was Wake Forest’s athletic director for nearly three years before taking the district position in 2013.

The school Wake Forest played against for the state championship, Vance High School in Charlotte, reported seven concussions for all sports in 2018-19.

For Coe and Jones, there was plenty they didn’t appear to know. Jones said she did not realize the team had that many concussions until she was asked to compile the data. She said she didn’t know how many suspected concussions were later ruled out by a doctor. She didn’t know how many involved junior varsity versus varsity athletes, or if any athletes suffered more than one concussion.

The school had only one other sport reporting more than two concussions — boys soccer with three. That’s one less than Apex, which had the highest in the district with four, and tied with four other Wake schools.

Were the 22 concussions in football an anomaly that year? Coe and Jones declined to provide that information.

State law requires schools to log each concussion in a report that they are required to keep. However, Coe said, “We don’t have a plan to go back and collect data from the past at this point in time.”

Jay Allred, an advocate for college athletes whose efforts for health and safety protections helped foster a special study commission and legislation in the N.C. General Assembly, said Wake officials should review that information.

“This shows a reason to do a further investigation,” said Allred, who lives near Winston-Salem. “Stuff like this shouldn’t necessarily be about punishing anyone. It should be about what we can do better to protect athletes. It’s an outlier.”

Tracy Braswell said she is well aware of the concussion risks in football, which her son Justin played starting with Pop Warner and ending at Enloe High School. But the data is important to her for another reason: Her son suffered a whiplash concussion at a wrestling match two years ago when he was thrown to the mat.

“When it comes to all sports you should have that knowledge,” she said. “I went to that wrestling (season) introduction and nobody said anything to me about head trauma or anything like that.”

While the data shows football with the most concussions overall, seven schools each reported three concussions in wrestling during one season.

There is another possibility with the Wake Forest numbers — that other schools, including those in Wake County, could be underreporting concussions. Coe said all of his trainers, like Jones, err on the side of caution in pulling athletes who may be concussed.

Incomplete data

There are caveats with the concussion information The News & Observer and The Charlotte Observer obtained from school districts through public records requests. First, while schools are required under state law to fill out a report when an athlete is concussed, they are not required to track the number of sports-related concussions. New Hanover hasn’t, and Guilford did not respond to repeated requests for the information.

Second, the lack of a requirement means those districts tallying up sport-related concussions report the information publicly in different ways.

The Charlotte-Mecklenburg school district, for example, had been tracking concussions by school for each sport since 2014. But two years ago, it switched to providing data showing the total number of concussions by month per school, as well as how many returned to play. As a result, the public can’t see how many of those concussions happened in football or other sports.

Renee McCoy, a spokeswoman for the district, said officials there would not provide concussion numbers along with the monthly totals out of a fear that individual athletes would be identified, triggering violations of federal medical and student privacy laws.

“I have been advised that the sport by sport break down along with the return to play data, puts the district, ‘too close for comfort’, in light of federal student privacy and sharing of student medical information,” McCoy said in an email message. “The data released together would provide a reasonable person an opportunity to conclude which student has suffered injury by comparison of return to play data.”

Some of these concussions happen in front of hundreds of spectators at games that are open to the public, and they sometimes make news.

CMS school officials say Vance has limited the number of concussions by shortening practices and the amount of hitting in them, making sure helmets are in good condition and correcting players when they use dangerous tackling techniques.

“CMS does not play with concussions,” said Carlos Richardson, Vance’s athletic director. “Our trainers, they hold kids out if they think they’ve got any type of symptom.”

While Vance also had an extended playoff season, the program had 103 athletes playing JV and varsity that year, or 42 fewer than Wake Forest.

CTE concerns

Wake had not been tracking concussions until the N&O requested concussion injury reports from Triangle area local districts and Charlotte-Mecklenburg in early 2018. The N&O did not seek student names and other identifying information, and asked that it be redacted from the reports.

Those concussion reports are required under the Gfeller-Waller Concussion Awareness Act of 2011. The law is named after two high school football players — Matthew Gfeller of Forsyth County and Jaquan Waller of Pitt County — who died after suffering head injuries on the field.

The law was among a wave of changes to address the dangers of concussions, particularly in football. Some districts in North Carolina now have athletic trainers available to quickly identify concussed athletes. Coaches also are trying to reduce head injuries by teaching football players tackling techniques that limit helmet-to-helmet contact.

Wake is among them, and its policies go beyond the state law. Athletic trainers are at all schools and must attend all home football games and practices; and trainers also attend practices for most other sports. According to officials, the district was the first in the state and second in the nation to adopt the USA Football Heads Up program, which instructs coaches in concussion awareness, proper equipment fitting, tackling techniques and heat and hydration preparedness.

One Wake high school, Apex Friendship, has gone even further, eliminating tackling in practices last season to reduce the number of head injuries. But the school district would not allow the school to release concussion numbers, and also told team officials to stop talking to an N&O reporter.

Recent research into head injuries, particularly in football, has created more worry. Brain studies have identified chronic traumatic encephalopathy in football players who exhibited growing mental instability. Better known as CTE, it is a progressive degenerative disease of the brain caused by repeated trauma. Researchers have found it in the brains of teen-aged football players who had died.

The news about potential long-term brain damage from concussions and lesser hits to the head has had a big impact on high school football, with some schools canceling seasons and others struggling to maintain enough numbers to field a team.

N.C. High School Athletic Association Commissioner Que Tucker said she has genuine concern for the future of football in her state.

“Football’s been around so long,” she said. “It’s just been a staple in most athletic programs across not only our state but across the country and if it goes away, I think that would be a sad day, because it’s gone away, but also sad because it would mean we haven’t been able to conquer the safety concerns and figure that thing out so concussions and other catastrophic injuries won’t happen as often.

“I think man is pretty smart, and the good Lord blessed us with all kinds of knowledge and wisdom, and if we can’t figure this out, it would be sad.”

The NCHSAA does not track concussions.

In Wake County, the district paid a $45,000 settlement to the family of Isaiah Langston, 17, a Rolesville High School student who died in 2014 from a stroke that the state medical examiner’s office found was caused by a head injury during football practice. The district admitted no responsibility for the death.

Difficult to diagnose

The Gfeller-Waller law requires schools to fill out a paper report each time an athlete shows signs of a concussion. That athlete can’t return to school or back to playing until a medical professional signs off on other paper forms.

Those records can show how many concussions had happened in each sport, when they happened and how many of those diagnosed were later cleared to play.

Eric Laber, an NC State University statistics professor, said that’s valuable data that could help schools identify concussion risks and take action to try to reduce them.

“There’s lots of questions that you could look at that may shed light on what makes sports safe and unsafe,” he said.

The data would identify schools reporting the most concussions, which could help identify possible causes such as poor equipment or dangerous tackling techniques. Schools with low numbers may be under-reporting, which could pose a danger to athletes.

The timing of the injuries is also important. If a team experiences them late in the season, fatigue may be a factor. If they are happening early, there may be a need to make sure athletes are getting proper training before full contact.

Not surprisingly, the data the N&O collected showed football with the highest numbers of concussions. But other sports had surprising jumps in concussions from year to year.

Holly Springs’ women’s lacrosse program, for example, had nine concussions in the spring 2019 season. William Amos Hough High School’s cheerleading program in northern Mecklenburg County had eight concussions in the 2014-15 academic year.

Vernon Aldridge leads athletics at Cumberland County Schools as its Student Activities Director. When he took the job four years ago, he wanted to know how many concussions were happening among the district’s sports teams. That information, he said, gave him a baseline to do better.

He worked with athletic directors and coaches to focus on ways to limit concussions such as tackling techniques. The district’s data for the past two years showed a 25 percent decrease, from 64 concussions in the 2017-18 school year to 48 in 2018-19. Football concussions dropped from 24 to 19.

“The numbers decreased pretty well, especially in the area of football,” said Aldridge, a former assistant football coach. “That’s one of the things I was looking at — is what we’re doing making a difference?”

He said the Gfeller-Waller law provided the opportunity to collect and analyze concussion data, and he saw the potential if school districts across the state gathered it as he has.

“If I saw somebody had better numbers than us, I would definitely be reaching out and saying, ‘Hey, what are you guys doing?’” Aldridge said. “Because your number one priority is the safety of the kids.”

Coe, Wake’s athletic director, agreed that the concussion data could be useful. But he said he first wants to make sure the data his athletic trainers are reporting is consistent across the district’s high schools.

“This is our first year collecting this data, and I’m going to take this year and maybe clean up the way that it is reported, so we can differentiate better in the future,” he said. “But right now all we really have is some athletic trainers may have reported every single head injury as a concussion, some may have only reported concussions, and I can’t tell you with certainty because of the manner of the way the information was collected.”

It can be a challenge to diagnose a concussion. Athletes do not have to be knocked unconscious to suffer one. At the same time, symptoms such as nausea or fatigue might be attributable to something else. There is nothing as simple as a blood test to identify whether someone was concussed, said Dr. Joel Morgenlander, a Duke University neurology professor and director of its sports neurology clinic.

“Sometimes you are not exactly sure,” he said. “When I see them in the clinic, I diagnose them as having a definite, probably or possible concussion.”

Informed decisions

Chad Hillman expects to play quarterback for Wake Forest next season if the novel coronavirus pandemic doesn’t shut down football and other high contact sports. His brother, Seth, played quarterback for the team in 2018 and is now playing for Concord University in Athens, West Virginia. Their mom, Melinda, is a big supporter and Wake Forest teacher.

Neither Chad nor Melinda knew the program had reported 22 concussions. They both said Jones, the athletic trainer, and the rest of the staff give the highest priority to the students’ health and safety.

They diverged on the importance of publicly reporting the number of concussions.

Melinda wasn’t sure. “For me it doesn’t make a difference, but for some people it might make a difference,” she said.

Chad, a rising senior, said it’s information students should have so they can make an informed decision.

“It’s just like you signing up for a class in school,” he said. “You’re not just going to sign up blindly.”

This story was originally published June 25, 2020 at 6:00 AM.

Dan Kane

The News & Observer

919-829-4861

Dan Kane began working for The News & Observer in 1997. He covered local government, higher education and the state legislature before joining the investigative team in 2009.