Hard knocks: head injuries among football players are rising and the after-effects are more serious than previously thought. Is football just too dangerous?

• Author: Schwarz, Alan
• Position: Cover story

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Owen Thomas started playing football when he was 9 years old. From the beginning, he enjoyed the rough-and-tumble of the game.

"He loved to go into practice and hit really hard," recalls his mother, Kathy Brearley.

Over time, those hits added up and appear to have taken a terrible toll. In April, Thomas--a junior at the University of Pennsylvania and a lineman on its football team--took his own life. The autopsy showed that his brain was in the early stages of chronic traumatic encephalopathy, more commonly known as C.T.E.

C.T.E. is a head-trauma-induced disease linked to depression, impulse-control problems, memory loss, and dementia. More than 20 deceased N.EL. players have been found to have had C.T.E.

But its discovery in a 21-year-old who had never even been diagnosed with a concussion raises big questions about the dangers of football, especially for the 1.4 million high school students and 3 million younger kids who play.

If this debilitating brain disease can be caused by repeated hits to the head that don't rise to the level of a concussion--an intrinsic part of football at every level--is it even possible to make the game safe?

In general, there's an increasing awareness about the dangers of concussions-especially for younger players whose brains are still developing.

In September, an 11-year-old football player from Muskego, Wisconsin, died suddenly. He had sustained a concussion in a game and then, several days later, collapsed after accidentally hitting his head during recess. Doctors call it second-impact syndrome. Particularly among young people, sustaining another blow to the head---even a seemingly harmless one--before a first has healed can be fatal.

At least 32 high school and youth football players were killed by or suffered permanent brain damage from head injuries from 2006 through 2009, according to the National Center for Catastrophic Sport Injury Research at the University of North Carolina. That's almost twice the total from the previous four-year period. (In October, a collision during a game left a Rutgers University player paralyzed from the neck down.)

Alarmed by these incidents, many states have adopted or are considering strict rules about how and when public school players can be cleared to return to play after a concussion, as well as requiring concussion awareness programs for players, coaches, and parents. Congress has been holding hearings and considering similar national...