Pressure is mounting for a tightening of safety rules in American football at high-school level, after a series of potentially deadly injuries in the adult game.
The sport has been shocked by a recent spate of so-called "helmet to helmet" clashes between players that have caused horrific injuries, including that to 20-year-old Eric LeGrand of college team the Rutgers Scarlet Knights, who suffered a spinal injury that might leave him paralysed.
The National Football League (NFL) - which staged a showcase game at Wembley, London, last weekend between the Denver Broncos and the San Francisco 49ers - has since instituted a series of fines for those who commit head-clashing tackles in a move designed to stem criticism and concern as the game seeks to broaden its global appeal.
But, in the US, the crisis has served to highlight safety gaps in the lower reaches of the game. The Los Angeles Times investigated high schools in southern California and found a worrying lack of adequate medical attention at many games, even though American football accounts for three times as many injuries among high school pupils as other sports.
The newspaper discovered a patchwork of care. Some private schools had many health professionals on hand for games, while poorer inner cities had just an ambulance on standby or no provision.
The situation in high schools, where the sport is played by more than a million boys, has prompted top pundits to urge the NFL to tighten safety further in the hope it will feed down to lower levels.
There is anger that instead of being suspended, professional players guilty of helmet-clashing tackles are fined sums that make little dent in their lavish wage packets.
"The NFL, in not doing everything possible to prevent head injury, sets an awful example for the high school players who model themselves on the pros," said Gregg Easterbrook, who writes the Tuesday Morning Quarterback column for ESPN.
Other news reports have shown that protective helmets used in high school football have never have been tested formally against the sort of forces that cause concussions. Some public figures have even called for parents to pull their children out of school sports programmes where the safety measures are deemed inadequate.
"If your child's coach cannot provide adequate safety information to your youngster, do not let them play," said Lou Jacobs, a blogger on health issues.
But many long-term observers of the sport feel that critics are facing an uphill struggle against a culture that has always put a huge stress on the physical dangers of the game.
Frank Shorr, director of the Sports Institute at Boston University, said American football made a virtue of the physical extremes to which its athletes went.
Indeed, said Shorr, the trend in recent decades had been towards NFL players becoming more and more dangerous to each other as they became more athletic and heavier. "Tackling is like standing 15ft away from a concrete wall and then running into it. It is amazing people do not get more hurt than they do."
- Observer
NFL: Horror clashes imperil game
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