I know it's football season when I see the guys walking home from practice still wearing shoulder pads under their jerseys. Last year my local high school team won our state division championship. So when they pass me by I say, "Good luck this year." And one will invariably smile and reply, "No worries, man."

Tell that to the NFL

No worries? Tell that to all the former professional football players and their families who have sued or already settled with the National Football League. The NFL has spent more than a billion dollars trying to rehabilitate retirees with trauma and brain injuries.

Tell it to the family of Junior Seau, the great all-pro linebacker who committed suicide while suffering from a sleep disorder. An autopsy found he had the same type of chronic brain damage that left other pros in wheelchairs or in nursing homes with Alzheimer's.

When you're a high school athlete whose dream is to play in the NFL, you don't think about life after your playing career. A study by the non-profit advocacy group Safe Kids Worldwide shows that more than half of the 1,000 young athletes surveyed, between 7th and 10th grades, admitted they "played hurt."

What's even worse: Both their coaches and parents pushed these children to keep playing even though they sustained a concussion with its after effects, which players call "having your bell rung." The survey shows that the 70 percent who continued to play had told their coach or parent they were hurt.

Pyramid collapse

Jon Butler, the executive director of the Pop Warner Athletic Program, which sponsors football for younger boys and cheerleading for girls, tells a typical story. He was on the other side of the field when a girls' cheerleading pyramid collapsed. The knee of the girl on top hit the neck of the girl on the bottom.

When Butler reached the injured girl, a paramedic was already putting a cervical collar on her neck. But the girl's mother was trying to take it off so that her daughter could continue cheerleading.

And that's not unusual. The Safe Kids study shows that more than half of all coaches are pressured by an athlete or parent to put the player back in the game even if he or she is injured.

Remain in the game

Why this fixation on wanting your child to remain in the game? Part of it is due to a parent's unfulfilled dream of their own shortened athletic career and the chance to live vicariously through the child. My daughter played boys’ little league and girls’ softball. At one game my wife told one boy's father to stop heckling his son from the stands. During another game a father punched a coach.

The prospect of a college scholarship encourages some parents to push their children to hang tough when hurt, play dirty and, in some instances, even trash their own teammates. I saw this happen on my daughter's traveling softball team. Although these girls played together every weekend in different ballparks and should have been friends, most weren't.

More mayhem

Whatever the underlying cause, we are seeing more mayhem in children's sports. In 2013 an astounding 1.24 million youngsters went to the emergency room with sports-related injuries.

One of the biggest problems: Children pick a sport, or one is picked for them, at a much earlier age and play it year-round. This leads to repetitive stress injuries, particularly in tennis and baseball because the same muscles and joints are overused. Coaches should be aware of sports injuries, try to prevent them and, most importantly, take these players out of the game when appropriate.

And with all the publicity generated by the NFL, which now limits tackling in practices, more coaches are paying attention. But the Safe Kids study shows that fewer than half of all coaches at the middle/high school level are actually certified in how to prevent or even recognize sports injuries.

If you have health insurance it will cover treatment for sports injuries, but you’ll have to pay your deductible, and some physical therapists and other specialists could be “out of network.”

Safety suggestions

  • Start a dialogue between coaches, athletes and parents before the season about how best to deal with injuries.
  • Take your child for a physical prior to the beginning of play, even if one isn't required.
  • Find out if your child's team carries insurance. In the Pop Warner League, each team is covered up to $100,000 per accident. Otherwise, a parent could be responsible for the cost of that trip to the emergency room and all subsequent care.
  • Emphasize the need to stretch and warm-up before practice and games.
  • Encourage athletes to play more than one sport to develop overall conditioning.
  • Stress to your child the importance of speaking up when hurt.
  • Urge coaches and trainers to become certified in sports-injury prevention.