But the repercussions of sports-related brain injuries are not limited to professional sports. There are an estimated 136,000 sports-related concussions in the United States each year among high school athletes, according to a recent study by researchers at the Sports Concussion Clinic at Children's Hospital in Boston and the Center for Injury Research.
New Mexico Sen. Tom Udall asked the Consumer Product Safety Commission to investigate the regulatory standards of football helmets worn by high school students and younger athletes.
The request came three days after a Belen football player was knocked unconscious and suffered a concussion during a play against Aztec in the state semifinals.
"Being active and participating in sports is important for young people, but we should be taking a serious look at how best to protect our most vulnerable athletes from severe head injuries like concussions," Udall said in a statement. "We need to make sure we are looking for every opportunity to improve helmet safety standards for all football players."
Locally, the Farmington and Piedra Vista varsity football teams had three concussions each related to football this season.
But football isn't the only sport that puts young athletes at risk. Three Shiprock basketball players received concussions before games started this year. The American Academy of Neurology and the National Brain Injury estimates that as many as 20 percent of high school football players suffer at least a minor concussion in a season, most of which are not diagnosed.
Most concussions will not show up on any X-Ray or CT scan and are diagnosed from reported symptoms, said Dr. Tibor Boco, a Farmington neurosurgeon. Despite the common belief that a concussion is a bruise on the brain, Boco said concussions occur when a heavy blow causes neurons to send irregular signals to different parts of the brain, which can result in anything from headaches to memory loss.
Although a concussion can be managed and a person can make a complete recovery, physicians are urging coaches to be leery of playing someone who has had a concussion, especially a teenager or younger, because suffering a concussion before a previous one heals can cause brain swelling, permanent damage or death, said Jonathan Redwing, a physician assistant at Orthopedic Associates.
"Years ago we used to say He got his bell rung,' but we're trying to move away from that because what we're all worried about is second-impact syndrome," Redwing said. "That is what can cause death or paralysis."
Second-impact syndrome is a life-threatening condition that happens when a person suffers a head injury before a previous one heals.
David Quail, the Belen player injured against Aztec, stayed home from school for two days to recover from the head injury, and the athletic trainer is making him wait at least two weeks before he can attend wrestling practice, said his mother, Cindy Quail.
"I kept him home for a couple days because I didn't want him to be alone," she said. "He was more lethargic, sleepy, I guess you could say he was more out of it. He wasn't up to being in a classroom setting."
David Quail was wearing a special-ordered helmet to protect against concussions the Saturday he was injured.
"There isn't a helmet made that is going to prevent concussions. That's fantasy," said Dr. Deborah Waters, a physician who works closely with the Shiprock athletic program.
But if players aren't fitted correctly in the proper equipment and are not trained to play football, the consequences can be even more severe, she said.
In 2005, an undersized Shiprock Chieftain football team found itself playing against bigger, stronger athletes in class 4-A football. The team didn't have a designed strength training program and many players were using old equipment that didn't fit correctly, Waters said.
The result: 27 concussions in 10 games.
The next year the team members suffered 10 concussion in four games before the school forfeited the rest of the season.
"Some of the equipment was over 10 years old," Waters said. "After that we did an investigation into what we can do to decrease the risk."
Since then, the concussions consistently have dropped. There was not a single diagnosed concussion on the team this year, Waters said.
Helmets used by young football players almost always comply with voluntary safety standards created in 1973. In his letter to the safety commission, Udall suggests that those standards should be revisited.
To comply with the 1973 standards, helmets must protect against severe blows to the top of the helmet, but recent studies suggest many concussions are caused when players' heads jolt back and forth, he said.
Though Cindy Quail commended a possible investigation into youth helmet safety, she and Piedra Vista football coach Jared Howell believe the biggest danger of football is the roughness, not a lack of state-of-the-art equipment.
"I think when the players on another team are playing that rough, and I know football is a rough game, I think the refs should say, you're playing too rough,'" Cindy Quail said. "I think this play was totally too rough."
Howell said it is only a matter time before the flags thrown for helmet-to-helmet contact in the NFL and NCAA trickle down to the high school level.
"I think it's going to end up be something we have to address," he said. "It's unavoidable for all the right reasons."
Ryan Boetel: firstname.lastname@example.org