A Toronto-based sports therapist who has attended to teenaged athletes injured in games during the past 25 years says the number of catastrophic injuries in high school football is low – but he's concerned with the increase in head injuries and fractures.

Jim Panno, owner of Panno Therapeutic Inc., said more emphasis is needed by coaches when it comes to educating athletes – particularly those playing tackle football – on how to avoid serious injury.

"I think the size of kids, the impact and how they make a tackle has resulted in more serious injuries and there needs to be more emphasis on reminding players to think before they make a costly mistake," said Panno.

On Sunday, the issue of neck injuries was put back into the spotlight when Buffalo Bills tight end Kevin Everett suffered what appeared to be a devastating spinal cord injury resulting from a tackle in a game against Denver. After a kickoff, Everett lowered his head into the shoulder of Denver return man Domenik Hixon and was later carried off the field.

It was initally feared Everett would not walk again and the injury and doctors at one point called the injury potentially life threatening. But doctors on Tuesday said Everett was moving his arms and legs, adding he could eventually walk out of the hospital.

Panno, who is contracted by the Toronto Catholic District School Board to have his staff at all home football games, cited an incident last year at Michael Power/St. Joseph High in which a player was suspected of having a serious spinal problem.

The injury turned out to be a fractured spine.

The Ontario Federation of School Athletic Associations confirms that just over 16,000 students in the province play tackle football, making it the second most popular boys' sport next to soccer.

But OFSAA doesn't keep statistics of serious injuries.

The injury issue is a big concern with the Indianapolis-based National Federation of State High School Associations who have 1.5 million students playing high school, junior high school, and non-federation school football throughout the U.S.

"Just the nature of the sport of football spells out risks and we want to do whatever is possible to get the message out about precautions," said Bob Colgate, who is assistant director of the NFSHSA.

Colgate said a report prepared by the National Center for Catastrophic Sport Injury Research at the conclusion of every football season outlines injuries. In 2006, the report states one fatality occurred directly related to a spinal cord injury in football.

With the Greater Toronto Area high school football teams just days away from starting a new season, teachers and coaches are re-emphasizing to their players the proper way to tackle and play the game.

"We tell the guys time and time again to keep their head up when tackling and hope that they listen to what you say," said Frank Trentadue, defensive coordinator for the defending Metro Bowl champion St. Michael's College Kerry Blues.

Al Rover, who is a teacher and football coach at Huron Heights Secondary, said he starts the teaching process from scratch every year – and it doesn't matter if his players are returning athletes.

"I haven't seen a spinal injury at a high school game in my 20 years as a coach and I hope I never do," said Rover. "We make sure every player gets proper instruction on how to tackle. They start from the knees, we practise it at half speed and keep re-emphasizing not to tackle with the top of the head. But kids are kids and they forget."

The Ontario Physical and Health Education Association provides guidelines for school boards to share with teachers and coaches. The guidelines are not mandated by the provincial government.

Rob Pacas, director of the Exceptional Athlete Program at Birchmount Park Collegiate in Toronto, has spent the past year producing a DVD for teachers and coaches to help student athletes in conditioning, concentration and playing.