The crunch of protective padding is usually greeted by cheers from Idaho football fans. But when helmet meets helmet, more than a few gasps can be heard from the sidelines. Some parents can only pray that their son isn't the latest victim of a concussion or worse.
"My son got two concussions in eighth grade. He finished the season and hasn't played in the last two years since," said Marc Paul. "As a dad that loves the sport--and I see so many good things about it--I would love to see him play because of how much he loved it before he got hurt."
But Paul is more than a dad. He's also Boise State University's assistant athletic director for sports medicine.
"I love the sport, I really do," said Paul. "I played football in high school and my son absolutely loves it."
But Paul's son decided to stop playing football because of head injuries, a problem Paul sees on high school, collegiate and professional fields with more frequency.
"As a dad, I see the other side of it. We know that it takes less of a hit to have the same affect over time," he said. "Nobody wants that for their kid or anybody else's. And when it's my son, I certainly didn't want that at all, especially doing what I do."
For the thousands of young men who suit up to have their moment under the Friday night lights, they're also experiencing a new glare: a widening spotlight placed on sports-related concussions.
"We had one of our players that had symptoms of a concussion--not a full-blown concussion, but he did show some signs--so he's sitting out next week," said Matt Holtry, head football coach and athletic director at Homedale High School.
That Homedale student athlete sat out a full game because, in March, the Idaho Legislature passed a law meant to protect him from harm. House Bill 632, which passed with only seven "no" votes in the Idaho House and no opposition in the Senate, was signed into law by Gov. C.L. "Butch" Otter April 3.
The new law says that if an athlete younger than 18 years old "has sustained a concussion or head injury and exhibits outward signs or symptoms of such ... then the youth athlete shall be removed from play." The athlete will only be allowed to return to play once he or she is "evaluated and authorized to return by a qualified health care professional who is trained in the evaluation and management of concussions."
"It's all part of the step-by-step," said Holtry, referring to the young man he benched for a full game after taking a hit to the helmet. "He has to pass some tests before he gets back on the field."
Additionally, Idaho school districts are now required by the Idaho Athletic Association to train coaches to recognize the signs of a concussion. Holtry said Homedale High School has an advantage, because unlike many other small Idaho schools, Homedale has a team trainer who ensures that all coaches can double- and even triple-check symptoms of a possible concussion in their players.
Boise State coaches and trainers had been on the lookout for possible concussions long before most Idaho high schools. Bronco coaches and trainers have what they call a "baseline test" process for players. According to Paul, when a student athlete first arrives on campus, he or she is given a series of tests.
"It tests memory and reaction time, visual motor skills and cognitive ability, all kinds of things," said Paul. "When the athletes come onto campus, we give them a baseline test; they haven't been hit yet, no concussions, nothing. And once they start practicing and playing, if they have a concussion, we wait until the athlete reports symptom-free to us."
The university works with a local neuropsychologist to help evaluate those results, but Paul said it's only the beginning of the process.
"If they come out of that test OK and everything is fine, we wait 24 more hours, then we go out and stress test them: running, pushups, etc.," Paul continued. "And then they get back to practice, but it will be a non-contact practice. They eventually progress into full practice. So it's a big process. And at any point if they say their headache comes back, we go right back to the beginning."
Additionally, the National Collegiate Athletic Association's Playing Rules Oversight Panel passed a new rule to protect the athlete from the possibility of a concussion.
"If a player loses his helmet [other than as the result of a foul by the opponent, such as a facemask], it will be treated like an injury," reads the rule. "The player must leave the game and is not allowed to participate for the next play."
Fans of college football have seen the new rule already enforced dozens of times this season. Fans and athletes are split on the topic, but it's something the universities are taking seriously.
"It's something that we knew this past summer and then during practice. Coach [Chris Petersen] went through it with all of us," said Paul. "We practice it with the players so it was something we were prepared for."
The NCAA rule doesn't apply if a football helmet is pulled off by another player, to stop competing teams from using it to their advantage. A player who loses his helmet is also required to stop playing, even if the play is not over.
Paul said he believes the idea is a good one, as long as it can be enforced correctly.
"It's one of those things where a play can happen so fast on the field that the referees have to be able to determine: Was it taken off as a result of a penalty or did it just pop off? And how do you stop a kid from still running when he loses his helmet?"
According to the NCAA, a 2011 study revealed that a player's helmet came off an average of more than twice per game.
But even if the helmet stays on, head-to-head contact is serious business and the process of recovering from a concussion is not a short one.
"This is a long process; you don't just get a concussion on Saturday and then Sunday take a baseline test and compare your scores," said Joe Nickell, sports information director with Boise State. "You have to show you are symptom-free in order to get to that point."
For Holtry and Paul, the process is worth it. Even though both agree significant head injury is rarely obvious in high school or college, severe problems often surface in professional football players who have been hit repeatedly throughout their athletic careers.
"If you do have signs or symptoms, going through the process of recovery and having that appropriate recovery time is key," said Holtry.
When Junior Seau, former linebacker for the San Diego Chargers, killed himself in May, friends and relatives of the NFL star theorized that long-term exposure to concussions was the cause. The 43-year-old was only one of more than a half-dozen ex-NFL stars to take their own lives recently. Andre Waters of the Philadelphia Eagles, Terry Long of the Pittsburgh Steelers, Chicago Bears player Dave Duerson and Ray Easterling of the Atlanta Falcons all committed suicide.
The families of the players, and many of the players themselves, alleged continued concussions had caused long-term damage to the brain. Duerson went as far as "requesting his brain be donated to science so that researchers could study the long-term effects caused by concussion and other repeated brain injuries," reported to Amina Khan of the Los Angeles Times.
While the overwhelming majority of young athletes will never play in the NFL, Holtry still thinks high-profile incidents of concussion may give parents more pause before allowing their children to enter the sport.
"There are both sides: Most of us played through an era when somebody might have had a concussion and they would be back in the next game," said Holtry. "But the good part is the new awareness. And the education part of it is huge. So the coaches all agreed upon the new protections."