Ten-year-old Robbie Soucy broke his right arm playing in the last football game of his season. He got his first ride in an ambulance to Maine Medical Center in Portland. He got attention and maybe a little extra care in the hospital emergency room.

Who can resist a 10-year-old blond boy in uniform, especially when he finally relaxes enough to grin? Soon, he was asking Mom and Dad if they were OK. They were better than that. They were relieved.

“I did say to someone ‘I’d rather he have a break than a concussion,’ ” said his mother, Trish Soucy of Raymond. “Don’t want to mess with the brain.”

This has been the summer and fall when talk of using one’s head to play a game has taken on a different and darker meaning.

The death of former National Football League linebacker Junior Seau in May made people inside the sport at all levels look more closely at the long-term effects of repeated concussions. The medical community has raised its own alarms. But despite the increased attention to the problem, an estimated 3 million children ages 5 to 15 played youth football last year.

Youth football programs have taken a number of precautions aimed at reducing the number of concussions suffered by players, and ensuring that those who are concussed get the proper treatment and don’t return to the playing field prematurely.

Some in the sport and in the medical community say these precautions are addressing the problem. Others say they don’t go far enough.

Studies on the frequency of concussions in youth football and the health problems they pose are lacking and the extent of the problem in youth sports isn’t clear.

And while some parents have educated themselves on the risk of concussion when 10-, 11- and 12-year-olds start tackling one another, others apparently have not, doctors say.

‘EASIER TO TALK ABOUT CONCUSSIONS’

Youth football leagues have taken a number of steps, including telling volunteer coaches to use fewer contact drills in practice or eliminate them entirely. Qualified trainers at the games search for signs of concussions and they, not the coaches, have the last word on whether to allow a potentially concussed player to continue playing.

But the risks once again gained attention in October during a Pop Warner football game in Massachusetts. Five players on a losing team from the Worcester area suffered concussions during the lopsided 52-0 game. Both coaches were suspended and the referees have been banned. And tackle football played by boys in the same age group as Robbie Soucy came under new scrutiny.

Concussions are traumatic brain injuries caused by a blow to the head or the neck snapping in such a way that it shakes the brain.

Doctors affiliated with sports medicine programs in Maine are more vigilant than in the past when it comes to looking for signs of concussions among young players.

Dr. John Hatzenbuehler, associate director of Maine Medical Center’s Sports Medicine Program in Falmouth, has treated about 10 concussions this season among 10-, 11- and 12-year-old players. Ten concussions in a season is about average, he says, and not necessarily alarming.

The real danger comes when a concussed athlete returns to play too soon, before his brain has healed.

“There really is no data for this age group,” Hatzenbuehler says. Not enough studies have been done.

A 10-year-old may know his head aches after a youth football game but doesn’t always know to tell his parents. No one knows how many concussions go unreported, especially in this age group.

For Hatzenbuehler, the increased awareness among coaches and league administrators at the youth level is the big positive. “No question, all the new publicity has trickled down from the effort the NFL is making (to protect its players). That’s only been happening in the last three years. It’s so much easier to talk about concussions today.”

NFL PLAYERS RAISE AWARENESS

Seau played in the NFL for 20 years with the San Diego Chargers, Miami Dolphins and New England Patriots. He was just 43 when he took his life. His name was added to a growing list of former NFL players who have died prematurely and sometimes by their own hand. Many believe repeated concussions are behind these deaths.

Repeated concussions can cause Chronic Traumatic Encephalopathy, a progressive degenerative disease of the brain often found in athletes. Memory loss and confusion can occur as well as the more serious problems of aggression, depression and dementia.

Seau played much of his career when “seeing stars” after a tackle or block was considered part of the game. He may have suffered hundreds of concussions, a former teammate said.

Retired NFL players are the visible victims, especially those who had lengthy careers, such as Seau. Less visible are active players at all levels of football. Players may be so eager to play, they ignore the symptoms of confusion, headaches, nausea, blurred vision or memory problems associated with concussions.

After Seau’s death, Kurt Warner, the former quarterback who led the St. Louis Rams and Arizona Cardinals to the Super Bowl, said he wouldn’t permit his youngsters to play contact football. Bart Scott, a linebacker with the New York Jets, echoed Warner. Others joined the chorus.

BOBBLEHEAD-DOLL EFFECT

Dr. Robert Cantu, co-director of the Center for the Study of Traumatic Encephalopathy at the Boston University School of Medicine, sets age 14 as the youngest for playing tackle football. He believes heading in soccer and full-body checking in hockey should also be prohibited until that age. The brain of a younger athlete is too vulnerable, he said.

“The young brain is housed in a disproportionately big head on a very weak neck,” Cantu told The Washington Post recently. “It’s a bobblehead-doll effect that increases the injury. We’re not calling for sports to not be played, but to be played with those restrictions.”

Friday, Cantu was in Zurich, Switzerland, for an international conference on concussions in sports. “I am not anti-football — I just want them to play flag football until the age of 14. I think, over time, it will happen,” he told The Associated Press.

Cantu did single out Pop Warner football, which organizes football up to age 16, for “marvelous” progress in acting this year to restrict full contact playing time in practices.

University of Maine football coach Jack Cosgrove this summer agreed that there’s no need for a player to play tackle football before he’s 14.

Matt Mulligan, a former player at UMaine, is an example. He didn’t play football until he attended Husson University before transferring to Maine. He’s now a tight end for the St. Louis Rams after three seasons with the New York Jets.

DISCUSSING THE RISKS

Americans live in a football-mad culture. Trish Soucy is a Spanish teacher at Windham High and this year, a senior class adviser. Robbie Soucy grew up watching Jack Mallis, one of his mom’s students, lead Windham to the state championship in 2009 and win the Fitzpatrick Award, which goes to the state’s best high school football player. “I actually call Robbie ‘little Jack Mallis’,” Trish Soucy said.

Robbie Soucy plays on the Windham team in the Maine Sportsmanship League. Last month, during a drive from their home in Raymond to their son’s game in Saco, Trish and her husband discussed whether their son might be at risk playing football. The week before, they watched an ambulance take a player from the Old Orchard Beach team to the hospital to be checked for a neck injury.

Should their son be playing football? Had they done the right thing in permitting him to tackle and be tackled? Sure, he wore a helmet to protect a brain that is still developing, and shoulder and thigh and knee pads for his growing body. But was he truly safe?

By the time they reached the field next to the C.K. Burns elementary school in Saco, the Soucys felt less anxious, but agreed they need to be vigilant. Rich Soucy, a hockey player in his youth, recalls when his older brother took a hard hit to the head in a hockey game. In the oft-used phrase, his brother got his bell rung.

“He didn’t recognize our father when Dad walked into the bedroom to check on him. My brother kept saying ‘I’m fine. I’m fine. But when’s Dad coming home?’ I’ve never forgotten that.”

BUT NOT WANTING TO OVERPROTECT

The Soucys also trust their son’s coaches and league rules that limit contact in practice where more concussions happen, according to the few studies done.

“We don’t want to overprotect our son,” Rich Soucy said. “We believe involvement in any sport is great for them. Anything. If he wanted to play the flute, we would have been just as happy.”

Some parents talk about their concerns. Others don’t. At Kennebec Pediatrics in Augusta, Dr. Kieran Kammerer said that not one parent has questioned him on the risks associated with 10-, 11-, and 12-year-olds playing contact football. Kennebec Pediatrics patients play in the youth leagues in Augusta, Gardiner, Winthrop and others in the Augusta area.

“We have 12,000 patients and I’ve been here 20 years,” Kammerer said. “We have seven providers. I asked some of them if they’ve had more parents asking questions this year. They haven’t.”

During a typical physical or a physical that clears youngsters to play sports, Kammerer will ask about any symptoms that might indicate concussions. By doing so, he hopes he increases the awareness among patients and parents.

“I tell them we’re real good at fixing arms and legs but we stink at fixing heads,” he said. Many pediatricians refer patients with concussion symptoms to sports medicine doctors who specialize in providing treatment.

Kammerer is a good listener. He’s ready for questions from parents seeking advice to help them decide if their son or daughter should play contact sports. This season, he’s still waiting for his first one.

THE BASELINE-TESTING ARGUMENT

Hatzenbuehler in Falmouth cautions that better equipment and the advent of baseline testing — in which an athlete’s balance and brain function are measured before an injury so there is a standard for comparison should they become injured — are not solutions.

“Better helmets don’t prevent concussions. Better padding doesn’t do it. The only way to lose the risk is modification of the rules,” Hatzenbuehler said.

He said the only way to avoid concussions is to prohibit tackling until age 14. Baseline testing, which can cost parents hundreds of dollars for the initial exam, can be a useful tool, Hatzenbuehler said, but again, there is little available data for this age group, and he doesn’t recommend the test.

In August, an ESPN report raised questions about ImPACT baseline testing, named after the company that devised the tests. Some doctors believe the test produces too many false positives and false negatives. The false negatives can be dangerous if a concussed athlete is released too soon to return to his sport.

The tests are now used extensively by professional leagues and colleges and many high schools, but are not required in either the Portland or Saco youth leagues, for instance. Parents are free to have their child tested but anecdotally, it appears few have done so.

‘WE HAVE TRAINERS WHO KNOW THE SIGNS’

David Pelletier, president of the Portland Youth League, says the numbers of youths registering to play this past season held steady and actually increased a bit over last year to more than 250 players. He advocates for changes in the culture of youth football to reduce the incidence of concussions.

“If you came to one of our practices, you wouldn’t recognize it from 20 years ago,” he said. “There’s no contact … We go over everything in slow motion. Our coaches are taught the signs of a concussion. At games we have trainers who know the signs.

“Whenever a kid goes down, a trainer is there. If the trainer thinks he sees the signs, the kid’s done for the game. It’s not the coach’s call. My son is a quarterback. He’s 12 years old and he’s had one concussion this year. If he got a second, he was done for the year. I told him that.”

Before he can play again, the concussed youth football player must be cleared by his doctor, in writing. This protocol is almost universal.

Paul Remmes, president of the Maine Sportsmanship League, echoed Pelletier. He didn’t see fewer boys registering to play this season, and he is aware of heightened concerns over concussions in the 10-, 11-, 12-year-old age group.

Pelletier was angry after hearing of the five concussions in the game in Massachusetts. A former president of the Maine Youth Football League, an organization comprising many youth leagues in Cumberland County, he’s worked to change the culture of thoughtless contact and to educate coaches and parents. In his mind, the Massachusetts game was an aberration. It was coaches and referees caught up in the emotions of the moment and ignoring their training.

Two weeks ago, Trish Soucy didn’t know what she and her husband would say if their son wanted to continue playing football. Certainly they would discuss the pros and cons again. Mom also knows that her son enjoys running. She was thinking he might try cross country. That was then.

“I will say that now that the shock of the break is over and the cool bright pink cast is on,” she wrote in an email Friday, “we’re all a bit more at ease and ready to hit the fields again next season hoping Robbie will be QB again.”

Staff Writer Steve Solloway can be contacted at 791-6412 or at:

ssolloway@pressherald.com

Twitter: SteveSolloway