Disturbing Game. Painful Lesson.

An online video shows a boy collapsed on the ground after being struck in the genital area.

Bob Segall/13 Investigates

Dylan, a 13-year-old honor student from Johnson County, does not want you to know his real name.

He's terribly embarrassed about what happened to him at school.

But Dylan does want you to know his painful story, and he recently came to WTHR studios to share it.

"This boy, he just walked up to me and just hit me," Dylan said. "I fell to the floor. I was crying it hurt so bad because he actually punched me."

It's where Dylan was punched that might surprise you.

It's a topic many school officials don't want to talk about.

Most parents have no idea it's happening.

And the images are painful to watch.

Because some students are being severely injured, 13 Investigates is tackling this sensitive issue to help warn both students and parents about a disturbing game taking place in many area schools.

"Happening all the time"

The game involves hitting or kicking male students in the groin - often very hard - and school officials say it has a name.

"The boys call it ‘ball tapping,' explains Bev Richardson, a school nurse at North Putnam Middle School. "I see it and I can't believe what they do to each other sometimes."

Richardson knows all about this problem. She says not long ago, ball tapping at her school was out of control.

"The boys were saying it is happening all the time... [being] hit in the testicles. I was seeing at least four students a week with this happening," Richardson said. "The pain gets so bad, they just can't stand it, so that's when they come for medical attention."

At times, she admits, that medical attention is more than a school nurse can provide.

"I remember one boy, he was in agony when he came to me," Richardson recalls. "When he mentioned blood in the urine, I knew there was something really going on because that's not a typical thing I would be told by a student."

That student was taken to a hospital where doctors diagnosed him with a severe injury. Medical experts say the problem is very real.

Devastating injuries

"We've actually had a child here at Riley Hospital that required surgical excision of the testicle after that happened," said Martin Kaefer, a pediatric urologist at Indiana's largest children's hospital. "The cases we generally will see are the kids in which they've taken a big hit from another child snapping their wrist, hitting the genital area of the male. Those are pretty big injuries."

Kaefer sees the impact of ball tapping, and he says the name is very misleading.

"The term ‘tapping' makes it sound very benign, as if it's just a little tap and that's far from the truth," Kaefer said. "If you fracture the testicle and literally rupture it, that results in pretty significant short-term and long-term problems, and we've seen this at Riley Hospital. It's really quite devastating."

The doctor says even minor injuries associated with ball tapping include terrible pain, which may subside after ten to twenty minutes. Continued pain, difficulty urinating or blood in the urine can be warning signs of a much more serious injury involving not just the testicles, but also damage to the urethra. Kaefer says those injuries require very complicated surgery -- something he's had to perform even on a kindergarten student victimized at school.

"That's for a five-year-old, and that can affect fertility and passage of urine - let alone the physical impact of a child having that part of their body operated on as such a young age," the doctor explained. "I would say it's a pretty bullying action to hurt a child in that fashion."

Caught on video

While ball tapping often is intended as a form of bullying and intimidation, that is not how it's characterized on the internet, where videotaped ball tapping incidents are publicly posted and often glorified.

Dozens of videos on YouTube show youngsters being ambushed with unsuspecting victims falling to the ground in agony while perpetrators and bystanders laugh in the background. Other videos show groups of boys engaged in a ball tapping game, where the goal is to hit opponents in the groin before they hit you. In online discussions, kids refer to the videos as "cool" and "hilarious."

Victims like Dylan see it differently.

"It's not just like horseplay or playing around," he said with tears in his eyes. "It's serious."

Richardson agrees.

"When they come to me, they're doubled over and crying," she said. "It takes a while before that pain goes away enough that they can go back to class ... and there's really nothing I can do for them. I've tried ice packs, but it doesn't really help."

Boys being boys?

Terry Tippin believes ball tapping cannot be ignored.

When he became principal at North Putnam Middle School three years ago, Tippin was shocked to learn just how much ball tapping was taking place. The first time he saw it, the principal decided to call in police.

"They treated it as an assault case. The prosecutor interviewed the parents and the students, and once that word got out, I really haven't had any trouble since," Tippin said. "I just won't tolerate somebody putting their hands on somebody else."

But that doesn't happen in all schools.

Dylan, who was ball tapped earlier this year in a locker room after his sixth-grade gym class, says the classmate who hit him in the groin received no punishment.

"The school waited two days before they even called me and told me about it," said his mother. "They told me it happens a lot and it's just boys being boys, but it's really assault on a student. If that boy hit my son in the mouth, he would have gotten an out-of-school suspension. I don't know why this is any different."

Keeping quiet

Dylan's story is not isolated.

For this report, 13 Investigates talked with students from eight metro-area middle and high schools. Students at six of those schools said they had personally witnessed ball tapping during school hours. They also said most of the incidents go unreported by students.

Richardson says that's concerning, but not surprising.

"A lot of times they're embarrassed by it because it hurts and they can't help but cry, and then they're crying in front of all their classmates," she said. "They need to tell someone that this happening to them ... and most parents don't know it's happening."

How do you find out if it's happening?

Simply ask your kids.

Yes, it might seem like a difficult topic of conversation, but Richardson says it doesn't have to be.

Time to talk

"Ask your child: 'Has this ever happened to you?' or 'Have you seen it happen?' or maybe a little more generic 'Do you know anything about this?'" she suggests. "If it's going on at school, they're pretty willing to talk about it - once someone else brings it up."

Kaefer recommends parents begin the dialogue early.

"Repetition and starting early is important because, especially the younger ones, they don't always understand the impact of what they're doing," he said.

The doctor says it's a conversation he's started with his own five children.

"I tell them 'hitting in the genital region in particular is completely inappropriate' and also explain to them in the same breath 'the same is true about your back and kidneys.' Don't simply focus on that one area so it's not an uncomfortable conversation for the parent. Say 'these are the areas that can really get damaged and if they do, it's not just that it hurts right away. You can hurt another child forever."