By Dev K. Mishra, M.D., President, Sideline Sports Doc
There’s an interesting murmur I hear coming from the mouths of some of the high school athletic directors I work with: is it possible that safer football helmets will embolden young players to become more reckless with their tackles, actually leading to an increase in concussions?
It’s an interesting question, and I doubt an increase in concussions will actually happen with improved helmet safety. But the argument will require some ongoing data to solve the dilemma. Some say that the rate of concussions is higher now than it was “back in the day” in football because “helmets” were simple leather coverings, and players did not propel themselves headfirst into another player due to fear of head injury. It’s impossible to compare concussion rates across eras due to the changed size and strength of the players, rule changes, and concussion awareness, amongst other things. Similarly, a comparison of concussion rates to rugby (where headgear is generally not used) is not possible due to different rules and game objectives.
What I’d like to see are small pilot studies at the least, and some larger clinical trials if possible. It’s an important question that should be answered scientifically.
Making football helmets as safe as possible certainly seems like the right thing to do. We then need to take some practical steps to make sure young players have incentive to play as safe as possible, and I’d suggest these steps at a minimum:
Coaches Need To Coach Heads Up Tackling
We can do this right now and it should make a big difference towards reducing concussion rates.
Youth Sports Rules Need To Be Uniformly Applied
Here’s another one we can effectively emphasize right now- referees should uniformly enforce existing rules designed to improve player safety. This starts with equipment rules and runs through game play.
Coaches Must Recognize a Possible Concussion And Remove Players From Play
This is something I emphasize every time I speak to a coach: you do not need to know how to diagnose a concussion, you only need to know if you think a player might have one. Several resources are available on the Sideline Sports Doc site and others. Remove the player from play, no matter how the game situation will unfold, and seek qualified medical help.
We Need To Foster Innovation
Multiple new technologies are under development for concussion diagnosis, impact-sensing technology, force reduction technology, return to play testing, etc. We need to provide an environment of entrepreneurship that fosters innovation. Big topic that we can cover another time…
We Need To Support Research That Turns Innovation Into Practical Reality
It’s not enough to measure the impact from a single hit or repetitive hits, for example. We need research that allows us to then predict a player’s concussion risk. This is a large, complicated task, and that’s what good research is for.
The culture of youth sports in terms of tolerance for certain injuries as “part of the game” is changing slowly and for the better. I applaud USA Hockey’s new development model in particular, and they have made substantial inroads in age appropriate player development. For football to do the same it will take some courage to accept the changes, but the sport should be better off for the long term.