Lionel Macklin, head football coach of Bowie High School in Bowie, Md., admits he can get overly caught up in games as he coaches from the sidelines.
The strategy, the intensity, the emotion--all wrapped up into three hours.
In 15 years at Bowie High School, including the last two as head coach, Macklin has learned to take a step back during games so that he is more aware of the health of his student-athletes.
Specifically, Macklin has had to be more cognizant of concussions.
Concussions are an ever-growing concern in football, from Pop Warner leagues to high school to the NFL.
"As coaches, we need to know the symptoms of a concussion," Macklin said. "Identifying a concussion in a player is our biggest challenge. As coaches, we're all caught up in the game. Sometimes a kid will take a big hit and they'll tell you they're all right, but you have to look at them closely to see that they're not right."
Macklin was among 170 high school football coaches from the Washington, D.C., region at Redskins Park on Saturday for a Concussion Awareness and Education Forum.
The Redskins hosted the forum, in conjunction with USA Football, on the second day of the team's mini-camp. The high school coaches were invited to watch the Redskins practice after the 90-minute forum.
"There is so much information about concussions from so many great resources that we wanted to share it with high school coaches," Redskins general manager Bruce Allen said. "There has been so much advancement in medical science that allows us to understand concussions better."
For decades, football players would continue to play through practice or a game after suffering a concussion, or brain injury.
Recent research indicates that concussions--and especially repeat concussions--can have a long-lasting impact on health, including impaired cognition, memory loss and depression.
The NFL acknowledged the seriousness of the issue in 2009 with more stringent rules on players that have suffered a concussion.
Players who show any significant sign of a concussion must be removed from a game or practice and be barred from returning to action the same day.
"The league's policy changed as we learn more and more about head injuries," Allen said. "The new rules are very important, and they're important for high school and college, too."
It's estimated that 43-67,000 concussions occur in high school football players each year.
Peter G. Gonzalez, M.D., assistant professor in the Department of Physical Medicine and Rehabilitation at Easter Virginia Medical School, was the guest speaker at Saturday's concussion forum.
Gonzalez, who established the Eastern Virginia Sports Concussion Program, said high school student-athletes should wait 7-10 days before resuming practice or returning to a game.
"Once you have a concussion, you are more susceptible to have a second concussion and that continues to go up," Gonzalez said. "Something has changed in their brain that has decreased their propensity to withstand concussions."
It's common for second concussions to occur within 10 days after suffering the first one, he said.
"Don't allow a student-athlete to return to a game while they are still symptomatic of a concussion," Gonzalez told coaches. "We can't prevent the first concussion, but we can prevent that player going back into a game."
Macklin, who had a brief NFL stint with the Seattle Seahawks in 1980 and played with former Redskins coaches Jim Zorn and Sherman Smith, said the 7-10 day waiting period was critical information.
"Sometimes after two or three days, kids think they're good to go, but really they're not," Macklin said. "I thought that was big."
Ken Lane, head coach at North Point High School in Waldorf, Md., said that coaches need to pay close attention to the mental state of their players during practice and games.
"I had a special teams player, and he had played the first play of the game and that's it," Lane said. "There wasn't any big play or big hit that was noticeable on the field. It just so happened that he walked up to me during the game and I noticed he wasn't quite right. It turned out he had a concussion."
Lane, who previously coached with the father of Redskins running back Larry Johnson, said he feels a degree of comfort knowing that he has an athletic trainer available during practice and games.
"We haven't had an athletic trainer the last two years and now it's nice to have a professional on the sidelines with me," Lane said.
John Bowles, head coach at Abingdon High School in Abingdon, Va., is not as fortunate. His school was forced to cut the position due to budgetary constraints.
"It's tough," he admitted.
For Bowles, Saturday's forum was especially valuable since he and his assistant coaches must be able to identify concussion symptoms from the sidelines.
Among the symptoms: confusion, headaches, nausea, balance problems, sensitivity to light and noise and memory loss.
Coaches were also advised to instruct players not to lead with their head when tackling.
It's all part of establishing an action plan for handling concussions and providing coaches with the latest and best safety measures, Allen said.
"The safety of the player is very important," Allen said. "Some of these coaches serve as the athletic trainers, too, and that's why this forum is so helpful. They serve as the head trainer, the assistant trainer and the head coach. It's really about educating people about head injury and how to treat it."