Football has always been a physical game ... some might even say a man's man game.

Playing hurt, fighting through the aches, pains--even injuries--were always part of what it meant to be a football player in the mind of 2011 Staples grad Chris Coyne.

So when Coyne, who was planning to play football at Yale, slammed his head during a wrestling match his senior year in high school, he never said anything. It turned out it wasn't just a head slam, it was his fifth concussion.

One thing led to another.

He never played a down of football at Yale.

"There's always been a culture of football about playing through injury," Coyne said earlier this summer at a concussion awareness night in Westport. "It doesn't seem like a real injury, like an ACL tear, so it doesn't seem important."

Across the board, only a few years after Coyne last played a down, attitudes toward concussions and how they pertain to the sport of football have changed, if not revolutionized.

From the NFL, where deceased players' brains from the late Junior Seau and Dave Duerson have been sent to be studied by researchers, right on down to the youth level, how concussions are dealt with on the gridiron is in the midst of a sea change.

In mid-June, Pop Warner, the largest governing body in the country for youth football with roughly 285,000 participants ages 5-15, changed its rules and mandated that practices could only devote one-third of their time to full-contact drills. Beyond that, any drills that featured full-speed, head-on blocking and tackling drills of more than 3 yards were banned outright by the organization. The rules were all made to try to limit the amount of potential situations where young athletes could be exposed to concussions.

"I don't think anyone has gone to the steps Pop Warner has gone to," said Trevor Scofield, president of Stratford Pop Warner. "This was revolutionary and needed to be done. This gets rid of the Neanderthal coaches who'd bang heads for two hours. This shouldn't change anything for good coaches. There is no reason to bang heads for two hours all night. There's a lot of good coaches whom this new rule will not affect at all. It's going to teach a lot of guys how to really coach."

GETTING THE WORD OUT

Walk into the Fairfield Pop Warner offices at Sullivan Field and it's hard to miss the large poster hanging near the equipment room--not far from the rows of shiny new black helmets the league recently purchased.

It's simply titled "Concussion: A must read for youth athletes."

The poster lists facts, symptoms, why a kid should report his symptoms and, perhaps most importantly, tells young athletes what they should do if they think they have a concussion. The poster stresses not to hide the symptoms and report them to a coach.

"We really didn't know anything," Coyne said. "I don't even think I knew what a concussion was until the eighth grade. People are now understanding them and getting educated."

It's a far cry from the days when the bulk of the current Pop Warner staff started playing and learning the game, when toughness was valued above all else by "old-school" coaches, who never thought twice about hours upon hours of helmet-on-helmet drills in sweltering mid-August heat. If players got their "bell rung," so be it, chalk it up to being part of the game.

"When we were kids, I don't think our parents knew what a concussion was, unless you came home and were dizzy for three days and went to a doctor," said David Hulme, in his fourth year as president of Milford Pop Warner. Hulme said his organization has had fewer than five concussions during his time there.

Nowadays youth football coaches are not only required to take mandatory concussion awareness certification by the state of Connecticut, but some even go as far as to carry a quick diagnostic test on their clipboards. Part of the training includes something as simple as a series of questions a coach can ask a player on the field to help determine if he's just received a hard hit or something that could be much more serious. During games, the on-site EMT, in most cases, has the final word if it's safe for a kid to return to action that day.

"Without sounding corny, the coaching here is awesome," said Elizabeth Stern, a parent whose son Connor, 8, plays for the Fairfield Giants. "Everyone here is so educated and trained and then they educate us, so we put our trust in them that they're teaching them the right way. But of course, there's always that uncertainty."

The Fairfield Giants and many other Pop Warner programs throughout the region have their own hired medical personnel not only for game days, but to try to educate both players and parents alike. The Giants have used Richard Bercik, a Yale assistant professor, for years, and every August he'll attend practices to help allay parents' fears and pass along crucial concussion identification awareness to parents.

Bercik's quick advice to all parties: "When it doubt, take them out."

Another common refrain is how it isn't the first concussion that's a problem, it's the concussion that goes undiagnosed. Like any other injury, a concussion can be treated if it's properly diagnosed.

"We have an educational meeting before contact drills start and we've noticed that once we talked, parents are much more aware about concussions than in the past," Bercik said. "Parents are concerned. As we go through the process with them, we tell them that concussions can occur, but they are manageable if you treat them in a safe manner."

THE INJURY

A concussion, by definition, is a traumatic brain injury that occurs when the head makes contact with something or something hits it, causing the brain to make impact with the inside of the skull. Symptoms can include headaches, memory loss and nausea.

The likelihood of a player being exposed to something that would cause a concussion is enhanced on the football field, yet in a slight twist of irony, football isn't the sport in which most concussions occur. Earlier this year, USA Today reported that a Centers of Disease Control study from 2001-2009 showed that bicycling had more head-trauma injuries than any other sport, although football was second. By comparison, a sport most won't consider unsafe--girls soccer--reports an alarmingly high number of concussions.

With the increased awareness about concussions at all levels of the game, youth coaches are more apt to err on the side of caution rather than imploring a kid to "toughen up" and get back into the game. In most cases, too, it's out of the coaches' hands, and the decision whether a player can return to action comes down to medical personnel.

"Our philosophy is safety first," said Lee Battista, executive secretary of Fairfield Pop Warner. "Any hint, any inclination ... you suspect anything and the kid is off the field."

Battista, involved with Pop Warner for eight years, has seen a change in recent years, like most others.

"One of the lines I like to use is, `Long after the lights on the scoreboard go off, you want the kid to be healthy,'" he said. "If that means he has to sit out a practice or a game, his safety is more important than anything else."

Teaching proper technique at an early age and ingraining that in players is perhaps the best way to prevent the potential for head injuries, but it's not a fool-proof plan.

"If you tackle properly, it's tough to get a concussion, but it doesn't eliminate it," Battista said.

From a parental standpoint, most realize in a contact sport that there is the potential for concussions for their sons.

Lori Vasquez's eldest son, Shane, now a freshman at Fairfield Ludlowe, suffered a concussion during Pop Warner practice last year. He was taken out of the practice and later diagnosed by a doctor, returning to action three weeks later.

"We all understand football is a rough sport," Lori Vasquez said. "If I thought something was seriously wrong, he would not have been back. It's safety first. Even though the doctors cleared him, the coaches took it lightly on him. They weren't like, `Get back in there.'"

NO GUARANTEES

For all the changes Pop Warner and other youth football leagues have enacted to try to prevent concussions, there is still the potential for head injuries. A Virginia Tech study in 2011 found that although rarer than in college football or the NFL, youth football players still generate enough force for significant head injuries to occur.

Is the potential risk for brain trauma--both long- and short-term--enough to cause more and more parents to follow the lead of retired Super Bowl-winning quarterback Kurt Warner, who barred his two school-age children from playing football, calling it a "scary thing"? Are the concerns of former Steeler legend Terry Bradshaw, who openly wondered if football would be surpassed by soccer in popularity because of the head injury concerns during an appearance on "The Tonight Show," going to grow louder and louder?

Or are these alarmist statements, only highlighted because of the prevalence of lawsuits against the NFL by former players with head injuries and something all parents should take to heart?

"The risk of concussions for young football players is real," said Chris Nowinski, a Harvard-educated former professional wrestler and now one of the foremost voices in concussion research in sports. "Although it might look like the hits are pillow fights, sensors in helmets have shown they have the ability to hit as hard as adults."

Nowinski, the author of "Head Games: Football's Concussion Problem," is part of the research team studying the brains of deceased professional football players and other professional athletes in contact sports at the Sports Legacy Institute in Boston. Their goal is to learn more about chronic traumatic encephalopathy, a degenerative brain disease which can bring about dementia and only be diagnosed post-mortem.

Nowinski says the changes by Pop Warner to limit hitting drills in practice is a good step, but won't eliminate concussions entirely.

"The way we were playing in the past, a few years ago, I wouldn't expose any child to where you're hitting three, four days a week, drills that never should be done with coaches who aren't trained for concussions. That was the Wild West," he said. "Now if we truly commit to attacking all the risk factors, which does include assessment and management, then it remains to be seen if it's safe enough. Then it becomes a personal decision for the parents to make."

AN ALTERNATIVE?

Pop Warner is synonymous with youth football and is by far its largest organization in America.

The Fairfield County Football League is an alternative league with teams in Darien, Fairfield, New Canaan, Norwalk, Wilton, Ridgefield and Westport. The major difference in this league is that unlike Pop Warner, which determines its teams by weight, teams in the FCFL are grouped by age and grade.

The FCFL has taken some more radical approaches to minimize the potential for concussions. For one, the league doesn't have kickoffs, nor does it have live punts until players are in seventh grade in an attempt to limit high-speed collisions.

Carm Roda, president of the Westport-PAL in the FCFL, says his group has been proactive in trying to reduce concussions. In 2007, he said his group had reported 30 concussions, and that number dropped to five in 2011.

"That's a significant drop, and that's from education," Roda said.

"If you don't deal with cancer, it's going to grow. If we don't deal with concussions, they're going to grow. We're not afraid to deal with it."

Roda, like others, readily admits there is no way to police concussions entirely out of the game of football, meaning awareness across the board should be mandatory.

"You can't be afraid of something, it's going to happen, so you have to ask how you can minimize it," he said.

As with any type of sports injury, no matter how many precautions are taken, concussions are still going to happen. Trying its best to prevent them, Pop Warner leagues around the region have invested in newer, safer helmets. The new helmets are more expensive and a big outlay for leagues, yet most say they're more than worth it.

"The most important piece of equipment is the helmet," Scofield said. "You have to think, is that where you want to save money? The higher the rating, the more expensive it is. The kid only has one brain."

Some leagues, too, have begun using baseline testing for concussions, although medical professionals are dubious of these baseline tests when kids take them before they're at least in the early teens.

Yet no matter how many safeguards Pop Warner leagues take, there will always be a stigma that football is a violent sport and prone to concussions.

"Because it's a contact sport, it's being identified as more dangerous than anything else," said Jen Spies, whose son Max, 8, plays on the Fairfield Giants. "But we had a child last year who got a concussion not because he was on the football field, but because he was jumping on a trampoline. ... They've identified football as the leading factor when it's really not. These kids are totally padded up. They go through rigorous conditioning to learn how to tackle, to how to be tackled, so these (concussions) don't happen."

mcardillo@ctpost.com; @CTPostCardillo