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Dr. Bailes, on the other hand, pushes for widespread practice limits, already instituted by Pop Warner in 2012, along with taking linemen out of the three-point stance and decreasing head impacts. He believes the velocity and frequency of those impacts among youth players are less than seen at higher levels.

“Overall this is a very safe activity,” he said. “You’ve got to put it in the context of alternative activities.”

Technique before tackling

One of those alternative activities is flag football. In addition to working with athletes of all levels at Mase Training in Sterling, Mr. Mason is commissioner of a local i9 Sports youth flag football league. Turnout more than doubled this fall, from 720 players last season to 1,475. Mr. Mason attributes the growth, in part, to parents concerned about brain injuries in the sport’s contact version.

“There’s no fear of the game,” Mr. Mason said. “They don’t have to worry about getting hit.”

Three players still suffered concussions despite the lack of hits, something he sees as an unavoidable risk of most recreational activities.

Flags, rather than tackles, provide opportunity, in Mr. Mason’s eyes, to develop fundamental skills he finds wanting at every level of football. Mr. Mason didn’t play tackle football until ninth grade. That helped shape the desire to have his son learn how to take a handoff, make cuts and control his body before pads and helmets come out.

Mr. Mason favors a progressive model to train youngsters in the game’s basics with flags, from proper technique to play defensive back to how to enter a tackle in the proper fashion, before moving to soft pads and, finally, full contact in high school in hopes of reducing head injuries and producing technically sound players. Unqualified coaches at youth levels and a culture that values big hits over sound technique worry Mr. Mason. He believes both issues are feeding a stigma among some parents that the game is unsafe.

“The object is to tackle this guy, not try to hit the guy as hard as I can,” Mr. Mason said. “We’re not modern day gladiators. We’re not supposed to be building a bunch of kids bent on, ‘Man, I want to knock this guy out.’”

The decline in football participation, whatever the reason, doesn’t surprise him.

“I think there’s a way we can really head this issue off and bring safety back to the game,” Mr. Mason said. “But it’s just going to take time.”

That means culture. Technique. Mindset. Everything for football to get back up from the latest hit.