HEWETT, W.Va. (AP) — Ryan Craddock had seen his share of tragedy during two decades as a coal miner and firefighter.

Then came the toughest heartbreak of all: his own.

Craddock and his family are mourning the loss of his 13-year-old son, Cohen, who died from brain trauma last month after making a tackle during football practice at his middle school.

Cohen's death, and the death of a 16-year-old Alabama high school player from a brain injury on the same day, have sparked renewed debate about whether the safety risks of youths playing football outweigh the benefits that the sport brings to a community.

“I don’t think we need to do away with football,” Craddock said. “A lot of people enjoy football, including myself. I just think we need to maybe put more safety measures out there to protect our kids.”

Craddock is among those who believe that some concrete actions need to be taken to prevent more deaths.

Proposals in individual states to ban tackle football for younger children during a critical period of their brain development have gotten little traction. At the same time, youth participation in tackle football has been declining for years, and efforts to steer young boys into flag football are growing.

In 2023, three young football players died of head injuries and 10 players died of other causes, such as heat stroke, according to the National Center for Catastrophic Sports Injury Research at the University of North Carolina at Chapel Hill. Dr. Robert Cantu, medical director of the organization, which has been tracking football-related deaths for more than 40 years, calls that a “typical” year.

“So I would not be particularly alarmed about two deaths in a week,” he said. “But I would be very alarmed if we had two deaths per week for four or five weeks in a row. Because we’ve never had that before.”

Cantu also subscribes to another philosophy: "No hits to the head are good,” he says.

In the past, Cantu has recommended that for kids under 14 there be no tackling in football, no heading in soccer and no full-body-checking in hockey.

In football practices, at least, most helmet-to-helmet contact can be eliminated by using noncollision methods such as tackling dummies, said Cantu, who is also co-founder of the Boston-based Concussion Legacy Foundation, which supports patients and families struggling with brain-trauma symptoms. He suggests children play flag football until they enter high school.

Flag football is already wildly popular among girls and is sanctioned as an Olympic sport for men and women at the 2028 Los Angeles Games. About 500,000 girls ages 6 to 17 played flag football in 2023, according to the National Federation of State High School Associations.

Whether that popularity transfers to boys remains to be seen. The Concussion Legacy Foundation has a “Flag Football under 14” initiative and has compiled a list of Pro Football Hall of Famers who waited until high school to play tackle football, including Tom Brady, Jerry Rice, Jim Brown and Walter Payton.

“I suggest age 12 would be a good place to start the conversation,” said Dr. Chris Nowinski, the foundation’s CEO and a former WWE wrestler who retired due to a concussion. “But any minimum age requirement that takes into consideration brain health for children would be welcome.”

Nowinski said even the NFL has limited full-contact practices during the regular season and recently changed kickoff rules aimed at preventing concussions and chronic traumatic encephalopathy, a degenerative brain disease that medical studies have linked to the head trauma of NFL players.

“Yet middle and high school football has made neither change,” he said.

Efforts to ban tackling in youth football have met strong resistance. A New York lawmaker fought unsuccessfully for 10 years to enact such a rule. In January, California Gov. Gavin Newsom said he would not sign a similar bill if it were to reach his desk.

There has been some progress, however. For instance, all 50 states have some form of sports-related concussion laws, mostly requiring athletes to leave a game or practice if a concussion is suspected and be cleared by a medical professional before they can return.

An increase in reported concussions from 2005-06 through 2017-18 was likely due to that additional education and awareness, said Christy Collins, president of the Indianapolis-based Datalys Center for Sports Injury Research and Prevention. The center uses a sampling of high schools nationwide to calculate injury rates involving football practices and games combined.

"Athletes (and their parents) may have been more likely to recognize symptoms of concussion and report those symptoms to medical professionals,” Collins said.

Loren Montgomery, who has won nine Oklahoma state championships in 14 seasons as the head coach at Bixby High School, believes football is “safer than ever.” He cites efforts to minimize injury risk such as penalizing helmet-to-helmet contact and certain types of blocks, along with technology including cognitive tests for concussion assessment and protective soft-shell helmet covers known as Guardian caps.

“Obviously there is inherent risk in all contact sports, but the values of teamwork, hard work and overcoming adversity far outweigh the risk involved,” Montgomery said. He allowed his son to play football starting in the fourth grade, “and I believe it has made him a more well-rounded young man.”

Guardian caps are used from the NFL on down to the youth level. One cap made by Guardian Sports sells on Amazon for $75. But the caps have only a six-month limited warranty from the date of purchase, meaning they could be pricey for a school district to have to replace every season.

Guardian Sports also warns on its website that no helmet, helmet pad or practice apparatus prevents or eliminates the risk of concussions or other serious head injuries while playing sports.

Still, Craddock has vowed to look into the caps' use at Madison Middle School in Cohen's memory.

On Wednesday, several days before his son was to be laid to rest, Craddock found the strength to speak with Cohen's teammates.

“I told them that this was a bad accident, to move forward," he said. “I didn’t want them to have the weight of my son on their shoulders. But I wanted them to play for him. I wanted them to play ‘Cohen strong.’”

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Riddle reported from Montgomery, Alabama.

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