When football is a way of life and serious health concern

By the time game day rolls around each week, high school football coach Scott O'Neal has watched so much tape – games, practices, slow motion contact drills – that he can tell his team, the Tantramar Regional High School Titans, exactly what to expect when they run out on the field.

He trains the boys hard, about 40 of them, two hours a day, five days a week, demanding the intensity that he was asked to bring to the field as a varsity athlete. Each week builds toward that moment when the Titans, in red and blue, ready for battle, burst from their locker room door.

Before they do, though, the boys get one last reminder of the team ethos: the words "Never Quit" have been etched into the black paint on the lintel above the black door. It has long been custom for each player to jump up and touch those words as he passes beneath on his way to the gridiron. When the team travels, it even brings markers to recreate the sign on paper.

The Titans plan to complete this ritual once more for the regular season on Saturday, when they are scheduled to play on home turf. A tiny New Brunswick town of just a few thousand people, Sackville is known as an amateur-football powerhouse. It has long-produced varsity-calibre athletes for the local university team, the Mount Allison Mounties. The Titans have won two consecutive provincial championships and have lost just one game since 2015.

But this week, for the first time, Coach O'Neal doesn't know if the opposing team will show up.

"They think I'm a barbarian," Mr. O'Neal said earlier this week, referring to the fallout from a controversial Oct. 13 game. The Titans had a 35-0 lead when the coach of the opposing team, L'Ecole L'Odyssée Olympiens' Marcel Metti, told referees that he was forfeiting because nine of his starting players had concussion-like symptoms. One was so bad he had spent halftime sitting in the dressing room with a towel over his head, throwing up into a bucket. Four of the players were diagnosed with concussions later at hospital. By then, the match had made headlines, and some members of New Brunswick's football community were accusing Mr. O'Neal and his team of excessively rough play.

Mr. Metti's decision was unprecedented in New Brunswick and it has stoked debate about the future of high school football in the province. School officials have lauded the coach for sticking up for his team; parents and players from L'Odyssée Olympiens have sent texts showing their support.

But for Mr. O'Neal, who disagreed with the forfeiture and was not afraid to say so – remember, never quit – the fallout has been frustrating and, at times, even painful. He has found himself defending a highly physical style of play that he has refined for two decades – and relied on to develop a stream of local athletes into national-level players.

Heated debate about the game and whether the play was too rough echoes conversations taking place across Canada and the United States about how to prevent concussions while preserving a beloved sport. Some even question whether it can be played safely at all. Schools in Missouri, Maine and New Jersey have all shuttered football programs in recent years, citing safety concerns. On homecoming weekends, some now feature soccer.

Officials from New Brunswick's Francophone South School District are now reviewing their concussion policies. High school football league officials did not return repeated requests for comment. Mr. O'Neal said he will not be surprised if, in the coming years, some teams in the New Brunswick high school league fold. He has an alternative approach, though, that he thinks could save the game: Give players serious, professional-quality training so they're equipped to handle tough games. In Mr. O'Neal's mind, the answer to football's concussion problem isn't necessarily avoiding contact. It's teaching players how to handle it better.

High-school football is supposed to be fun.

That message is one that the Olympiens' coaching staff has hammered at since the beginning of this season .

Marcel Metti has had minor coaching roles with the team on and off since 2004, when he started as an equipment manager, but this is the first season that he has held the team's top job. From the start, he made it clear that he wanted to set a positive tone with his players. Team practices have a light feel. It's not unusual for Mr. Metti's dog, a mutt named Cooper, to be running around the field. Sometimes Mr. Metti's five-year-old son makes an appearance; the older boys make a fuss over him.

As a coach, he aims to "try to build a decent culture for the future of the program," he told Canadafootballchat.com earlier this fall for the site's high school team preview. He also said what all coaches are supposed to say, that he is gunning for a provincial championship and will work hard despite the odds. But Mr. Metti also outlined a more important long-term goal. "If I can make all my kids believe in a system, whether they're winning or losing, so long as everyone believes in it, then that's success on our end," he said.

For the Acadia Bowl, the annual homecoming matchup between the only francophone schools in the province's 12-man football league, Mr. Metti rented a pair of fog machines, strung up caution tape and allowed players to wear Halloween masks for their rush onto the field at Rocky Stone Memorial Field in Moncton. It was a marked departure from the stone-faced entry encouraged in years past.

Above all of that playfulness, though, there are plenty of signs that Mr. Metti, a paramedic by trade, takes his coaching job – a volunteer position that eats a year's worth of vacation time during the three-month season – seriously. At a meeting with parents of the 50 or so kids on his roster at the outset of the season, Mr. Metti made clear that many should get used to the idea that their kids might not leave the bench. This year's team had more than 20 Grade 10 students at the outset. If the coaches deemed anyone unready to safely face what was awaiting them on the field, Mr. Metti told parents, he would not put the student into the game. In other words, no one's child was going to be put in danger on his watch, period.

Fifty kilometres up the highway, Mr. O'Neal gave his players and their families a similar speech. Those in the room knew his reputation, which is that of a demanding coach with a varsity-style approach that spans the year, rather than limiting itself to the three-month high school football season. He is fanatical about conditioning and even gives players special exercises to strengthen their neck muscles while they are in bed, a precaution against concussions.

Mr. O'Neal spends each night in his home office reviewing tapes – and sending clips with notes for improvement to his players – so he can correct dangerous angles or tendencies ahead of games, where players see far more contact than they do in practice, which is deliberately light on tackling due to a province-wide approach to cut down on concussions.

If more coaches in the high school system operated with this intensity, Mr. O'Neal said, teams would see fewer injuries.

"The concussion epidemic is due to players not being properly prepared for competition," Mr. O'Neal said. "That's the biggest thing everybody is missing. We are not preparing these guys for competition. They've got to know how to do everything right. They've got to be more physical. It's everything to do with proper conditioning," he said, adding: "People who don't understand think you're just going out to hit people. But football is very technical. We're so much better at tackling … because we just do it right."

"If you're a parent, you maybe don't know that. All you're seeing is that we're a bunch of bullies," Mr. O'Neal added.

There is nothing quite like that feeling of running out under the lights on a Friday night, pumped up with adrenalin, bulked up in your gear. When they took to the field at Rocky Stone on Oct. 13, both the Titans and the Olympiens had something to prove.

For the first-place Titans, it was their first game since seeing a long-running win streak that stretched back to 2015, over 23 games, smashed. The Riverview High Royals, had rolled them over by just a point, but it hurt. Tonight was about stepping back into their skin, playing hard, scoring high.

The Olympiens were itching for a victory too. In second place in their pool, they had just come off a big win, a 35-0 contest against their francophone rivals, the Mathieu Martin Matadors. But this matchup with the Titans was the one the boys had been training for since the beginning of the year. "Our goal is to get to the No. 1 spot, to have redemption for last year," Mr. Metti told Canadafootballchat.com in that season preview. "And to do that you've got to beat the best, and that's Tantramar."

All week the Olympiens had run drills at practice designed to prep them for the Titans' highly physical style. And they had home-field advantage. But it took less than a minute of play for things to start going awry for the hometown boys. Shawn Chase, a Grade 10 wide receiver who wears the number 87, was the first to go down after a mid-air clash with a pair of Titans. Officials deemed the play clean. But Chase had hit his head.

"My ears were ringing, everything around me was spinning," Shawn, 15, said in a telephone interview from home this week. "When I went down my head hurt a lot. I got up about 30 seconds after and at the time, I felt fine, honestly. But my head started hurting a little bit more as the game went on."

Shawn said he wanted to continue playing but concussion protocols require that a student who has taken a blow to the head be removed from physical activity. They must be seen by a medical professional and given a note of consent before they are allowed to return to play.

The game continued after Shawn came off. But what transpired over the ensuing 23 minutes of play is the subject of a debate that has divided the province's football community. What we know for certain is that the Titans racked up 35 points; the Olympiens did not score.

When both teams emerged for the second half, Mr. Metti called a technical time out. He told referees and the Titans' coaching staff that he had nine players exhibiting concussion symptoms and could not safely continue. The game was forfeited.

On the field, there was confusion as word of the decision spread.

"At first, we didn't understand," said Shawn, the wide receiver. Neither did parents of the Titan players.

"We played probably one of the least-physical games we have [ever] played in and the outcome just made no sense to me," said Tim Cormier. His son, Lucas, plays for the Titans and his older brother, Dylan, played before him. Mr. Cormier has a long history with the sport and is the president of Sackville Minor Football. "When you watch the film, there's no evidence of any wrongdoing during the game," he said. "This is a physical sport. We prepare our kids for it," he said. "Those kids just weren't taught properly how to take hits."

But parents of the Olympiens see it differently. "There were too many players that got hurt – some people say they were bad hits," said Natalie Chase, Shawn's mother. "I saw it as a good thing. The coach had to put himself in the parents' shoes. I think it's a good thing the coaches are watching out for the kids."

Requests for insights from several New Brunswick coaches and influential members of the football community were not returned this week. For his part, Mr. O'Neal still does not support his opponent's decision. "It's not right to quit," he maintains. "What about the other 45 kids that probably wanted to play? Don't they get a say?"

But Dr. Charles Tator, director of the Canadian Concussion Centre at Toronto Western Hospital, said ending the game was appropriate – and questioned whether the game should even have been played in the first place. "The score was 35-0 by half time? That's a recipe for disaster in my view," he said. "If you allow mismatches in size, speed and weight, you are setting yourself up."

Dr. Tator co-chaired a committee of experts that recently developed the Canadian Guidelines on Concussion in Sport, a national guideline for physicians, parents, coaches, trainers, teachers and athletes to use to diagnose, manage and treat concussions. The guidelines are the result of international work spearheaded by the increasing understanding that the condition is deadly and can have an impact on every athlete, from amateur to elite. They place a strong emphasis on prevention and education and clarify frequent misconceptions, such as the common belief that concussions are only the result of a direct blow to the head or face. In fact, they're also caused by hits to the neck and other spots on the body where force is transmitted to the head.

An evolving body of research shows that the brain is particularly vulnerable during adolescence, Dr. Tator said, and must be protected. "The guiding principle can't be' win at all costs,'" he said. "It has to be fun and done safely."

Dr. Tator said the patchwork of governing bodies that oversee high school sports in Canada "have their work cut out for them" to make the sport safer. If they are serious about preventing concussions, he said, their task list includes figuring out how to avoid dangerous mismatches that occur between teams on the football field.

Football New Brunswick, the governing body for the province's amateur football leagues, does not allow players to match up against one another if they are more than two years apart, said executive director Josh Harris. The aim of age limits such as these, he said, is to limit risk. "It's a 'better safe than sorry' situation and you want to make sure you're protecting your players the best you can," he said.

High-school football, on the other hand, has no age limitations. "A Grade 9 could theoretically be playing against a Grade 12."

A lot of people in Sackville would tell you that football here is "a way of life." A lot of kids start learning the game before they even go to school. On weekends, they watch the Mount A. Mounties in the stands with their parents.

"Little kids here look at the Mount A football players as superstars," said Christine O'Neal, Scott's wife. Football, she says, "just gets into them, and they love it." Nobody knows this better than Mrs. O'Neal does. Three of the couple's four children are boys who play football – coached by their father, whose passion for the sport is so strong he starts introducing kids to the pigskin as early as first grade.

The couple's oldest son, Aidan, was part of the Titans teams that won provincial high school championships in each of the past two years. Aidan now plays varsity football for the Mounties, while his younger brother, Owen, has taken up with the Titans.

The O'Neal children have grown up knowing their dad as a local football hero. But all week, the family has heard that status questioned. In the fallout from the game against the Olympiens, Mr. O'Neal has been called a "classless piece of trash" on social media. One man threatened to assault Mr. O'Neal if he continues his style of coaching and play.

But through it all, he's steadfast in his belief that his approach is the only way to safely teach kids the game. "If I have to change the way I play I'm not doing it," Mr. O'Neal said. "My reputation, because we have a hard-nosed team that plays hard, is that I must be some crazy guy," he said. "On the field I play tough. This is football. You've got to play that way."

All high school football coaches are required to take an annual concussion course provided by the Coaching Association of Canada. Football New Brunswick, which oversees all non-high school football in the province, requires additional concussion training for coaching staff. Mr. O'Neal has done both for years. But he argues that it takes more than concussion courses to teach someone how to train students – who range greatly in age, size and aptitude between Grades 9 and 12 – how to play football correctly and safely.

His practices are designed to drill down on the technical skills he insists players must master if they're going to stay safe in contact football. He gets input regularly from Mount A coaches to improve.

But even when he reviewed tape of the forfeited game, Mr. O'Neal could not pick out the plays that led to nine concussion-like incidents. He said he asked several other coaches he trusts to review the tape, including one employed by the Canadian Football League. None could point out the nine incidents.

"This is why I was really shocked," Mr. O'Neal said. "They've got some good athletes – a couple of scary kids. The week prior they beat another team 35-nothing. I watched the film on that one. That one was a bloodbath."

By the time a player reaches high school in Sackville, he has likely been training in the same brand of highly physical football for years. At all levels, players are expected to stay conditioned all year round. The result is what Mrs. O'Neal calls "a well-oiled machine."

"The high school seasons ends, they go into weight rooms and start working for next season. It's much like a university team in the way they prepare and train," said Wallie Sears, a sports reporter who has been covering football in Sackville for 60 years. "They're strong because they train all year round."

Not all high schools demand the same commitment to the sport or train with such physicality, said Mr. Sears, admitting that a downside is occasional mismatches between teams.

Mr. Cormier said he believes there is another factor at play: Sackville coaches at all levels have deliberately adopted the same approach to training. They teach the same offence, defence, even safe contact techniques that aim to avoid concussions, said Mr. Cormier, the minor-football president. The town's teams dominate, he said, because they are exposed to so much technical consistency as they mature.

"That's the real reason we're winning – we play the sport correctly," he said. "We are known as a physical football program. The reason why we're good is our technique is there. We incorporate all the safe practices and it comes together in a package that is very dominating on the football field," he said.

Sackvillians make a disproportionate number of roster appearances on Football Canada all-star teams compared with larger cities. For the past two years, two players from the squad have been tapped to play for national teams. Mr. O'Neal coached Team New Brunswick at the 2017 Under-16 East Challenge and will serve as offensive assistant at Football Canada's under-16 team during the 2018 International Bowl held in Texas next January.

But fallout over the forfeited game against the Olympiens, Mr. Cormier said, risks casting a shadow on Sackville football's glowing reputation. And that, Mr. Cormier said, is unfair.

"We kind of feel like we're being punished for playing hard within the rules," he said. "Down here in Sackville we love the sport of football."