Princeton, New Jersey Makes Peculiar Move

7 Aug

In a very unusual move by a school board the Princeton Regional School District – servicing one high school, one middle school and four elementary schools – has made it mandatory to wear head-gear in sports not known for head-gear.  In a proactive move the board has voted to make this a must in their school district;

The requirement, one that is not used teamwide for those sports anywhere else in New Jersey, will be mandatory initially for the sixth grade only, officials said. For children in grades seven to 12, the headgear is optional, although parents or guardians will have to sign a form saying they have declined to have their children wear it.

Still, officials were clear this week that with each year, the headgear would become mandatory one subsequent grade level at a time, so that all athletes in those sports eventually will have to wear it if they want to play.

This move strikes me as both good and forward thinking and as a waste of money as well.  Let us examine, first with the not-so-good ideas/thoughts.

First, the premise for this move was in part due to concussions (although they did also state it is for facial and oral injury protection as well) and the thinking on this is wrong in my humble opinion.  Many researchers, doctors, athletic trainers agree that helmets do not prevent concussions.  Sure there is disagreement on whether they protect – for focal-direct-linear forces they do have validity in this premise (as you will see below) – but the general consensus on concussion attenuation is exposure limitation.

Secondly, the addition of head-gear in soccer makes almost no sense to me.  Products like the Full-90 and other head band looking devices began their marketing by saying they can protect from concussion but that is extremely flawed, not only in my opinion but by pure Physic’s.  A soccer ball is designed to be headed by the athlete, and when anticipating the maneuver and doing it correctly there is no overt and sudden harm to the brain.  That is the only time one would be expecting to use their head, unlike football where your head is actually part of the game.  In soccer the vast majority of concussions reported are due to the head striking the ground, a pole, or an opponent.  Often these injuries are unanticipated and few incidents begin with strikes to the head, rather the body.  Head gear in soccer will not protect the brain from the angular, rotational and sudden deceleration of the head; which causes the injury of concussion in most soccer cases.  Add to the fact that players with the head-gear may play with a false sense of security and participate in much more risky behavior on the pitch.  For those reasons I am not in agreement with the soccer portion of this idea (cost is also a factor).

However, there has been some decent moves here and I think should be mimicked.

In field hockey, although body contact is not allowed, the sticks are hard and the ball is also very hard.  This combination leads to the possibility of a high-velocity, direct, linear and focal impact on the head.  Exactly what a helmet can protect against.  Granted I have never heard of a skull fracture or subdural hematoma in girls field hockey, this is a small addition that will protect the player in the rare chance this will happen.

In girls lacrosse I have been opining for years that the simple eye shield they wear was never enough.  There are some in the concussion realm that think adding helmets to the girls’ version will make them much more aggressive and take higher risks.  This point should definitely be honored and observed once this goes into effect, after all it is one of my reasons for exclusion in soccer.  I get that like HS boys lacrosse there should be no body checking and “stick-work” that is violent, but it does happen.  My main reason for inclusion of this sport is similar to that of field hockey.  The sticks being at head level, along with the high density ball traveling at high speeds can cause the focal damage that is concerning.

Finally, implementation of this rule over time is a good idea; starting with the youngest group of kids – 6th grade.  As the players get older they will be accustomed to the addition and be able to perform at their potential level.  I do not see a competitive disadvantage for the Princeton schools as this plays out and if they are going to make it mandatory it is good that the schools will provide this for the athletes.

In summation, I don’t think this gets a standing ovation, rather a nice warm clap; for being thoughtful and proactive, but a bit overzealous with the inclusion of soccer.

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8 Responses to “Princeton, New Jersey Makes Peculiar Move”

  1. joe bloggs August 7, 2013 at 07:54 #

    Unfortunately, a knee jerk reaction without supporting data.

    Helmets may be appropriate in some sports and not others. Boxers wear that silly head gear not because that there is any evidence it reduces head injuries; it was assumed padding would protect the pugilist. There is no evidence it works. If fact, it may increase the number of head injuries. Much like the NFL thigh pads it is designed to display concern not necessarily increase safety. As you have pointed out, the use new safety products backed by bogus data produced by ethically malleable scientists such as the concussion reducing Riddell Revolution helmet may have promoted more dangerous behaviors as players are/were instructed that a product would offer them protection.

    Don’t expect and clarifications from the government. The NFL and its marketing partner the CDC is running around promoting a recycled form tackling program from the 1960s that had no effect then as Heads Up will have no effect now. Rather than conducting research, NFL lawyers and lobbyists simply bought the CDC. Dr. Thomas Frieden must be very proud that he has removed science from the CDC and replaced it with manufactured, I guess virtual, science (lawyers and lobbyists are well known for their scientific understanding).

    • G. Malcolm Brown August 7, 2013 at 11:28 #

      Yes,, Joe…Sad picture all around this issue …

      Helmets transfer forces just after the pads inside have been compressed during the deceleration of the head…

      The peak G forces leading to the high number of football concussions are mostly a result of a secondary , and faster acceleration of heads —- caused by the recoil of the plastic hard shells..

      — With the padding no longer soft ,and players brain already slightly displaced.. the head is taken for a quick change of direction…!

      And yes … “Five Star” helmets hit as hard as three star helmets…!

      Thanks for your work,

      G. Malcolm Brown

  2. Kids SRC Doc August 7, 2013 at 12:23 #

    I am going to make my comments only in the context of girls lacrosse (and somewhat field hockey). When the data behind the mechanism of injury for concussion in girls LAX is examined, the majority is from incidental stick-to-head and ball-to-head contact. A helmet can help deflect that type of contact and may/will likely reduce the number of concussions (see stick to head concussions in ice hockey? not many). What drives me crazy is the fire that I will receive for this comment– “It will change the game”, “makes the girls game more contact like the boys”, “makes the players more aggressive”.

    To me, those are all bad excuses. If US Lacrosse continues to teach/coach the girl’s game the same and the officials call the girl’s game the same — then how on earth will this change the game? A player gets too aggressive or initiates contact? She gets penalized. She gets sat by the coach. Coach get suspended for having too many athletes with penalties, etc. They will quickly learn to play within the rules.

    If “helmeting” girls lacrosse does change the game – then shame on US Lacrosse and the organizing leagues for not being able to adequately control, discipline and educate their coaches and officials.

    • jbloggs13 August 7, 2013 at 15:30 #

      Sounds like an excellent case for a hard shell helmet and face mask based on evidence and common sense.

    • Dustin Fink August 9, 2013 at 07:43 #

      This comment is spot on Kids SRC Doc… If the game is officiated and coached the same why the concern?

  3. Jodi Murphy August 8, 2013 at 11:43 #

    “Add to the fact that players with the head-gear may play with a false sense of security and participate in much more risky behavior on the pitch. ”

    That’s a good point. When players think they are invincible they might not be as aware or as cautious on the field and that could actually lead to more injuries, not just concussions. A little fear is good because it keeps your aware of your surroundings.

  4. womber August 9, 2013 at 14:35 #

    Girls lacrosse concussions are mostly from stic to head contact. Having a helmet will probably help. Girls are basically carrying a weapon and when used improperly or carelessly they can cause a world of hurt

  5. Dorothy Bedford August 16, 2013 at 21:12 #

    I’ve waited a while to post this response, so I could see what others have been saying. I am a former member of the Princeton Board, and am still in close contact with my colleagues.

    While to some readers the announced helmet policy may appear to be a knee-jerk reaction, it is useful to remember that Princeton NJ is one of the most concussion-forward school districts in the nation. “No return to play on the same day” as a blow to the head has been in effect for years, and is enforced over parental objections. There has long been a full-time athletic trainer on staff, to whom the administration has granted final say over doctor’s notes on return to play. (This to fight off “doctor shopping”). Baseline ImPACT is mandatory for all student athletes from 6th through 12 grades, and is offered free to all coaches. The guidance staff is diligent in observing return-to-learn protocols for concussed students. This district was the first in NJ (and so far only) to restrict full contact practices for the football team, now in its third year. Our football coaches run many non-helmet practices to reinforce proper technique. Because we are in NJ, thanks to legislation pushed by Dr. Rosemarie Moser, PhD and others, all students and coaches receive concussion education, and both students and parents must sign the mandatory NJ concussion awareness statement annually, (or students are not allowed to begin practices). The Board encourages and expects parents and fellow athletes to be alert for the signs of delayed onset concussion symptoms, and to report them to the trainer, coaches and doctors.

    Other protocols are being considered, such as :
    -reinforcing proper technique instruction in ALL contact sports;
    -reducing full contact practices in ALL contact sports ( perhaps following the new Maryland guidelines); and,
    - reminding our field officials that we expect them to enforce safe play by calling all appropriate penalties

    The board and staff also keep an eye on the latest medical and neuropsych research from UNC Chapel Hill, University of Pittsburgh, University of Michigan, as well as other concussion –related advances around the country, to order to round out its concussion program knowledge base (with thanks to TheConcussionBlog in this regard). The Princeton board will continue to monitor the national discussion going forward, in the interests of improving student safety – protecting their life-long learning abilities; and also as a matter of good governance – protecting the district itself. This what most districts could accomplish with both a collective goal of decreasing head injuries, and a focused collaboration among the board, administrators, athletic staff, teachers, parents, and student athletes. If there is some parental pushback, well, the Princeton educators take their cue from the primacy of the educational mission and protecting all students’ ability to learn.

    Having said all that, the concept of putting helmets on women’s lacrosse players is not new. None other than Dr. Robert Cantu is on one side – pro; Dr Margot Putukian (now of Princeton University and the Ivy League, formerly of the Big Ten) on the other, con. The Princeton Public Schools decided to split the difference and go with soft helmets to protect heads from wayward sticks and balls. (Update: as of 8/14 the move has been approved by NJ field hockey and lacrosse officials). Soccer is a different story. Headgear in that sport is much more controversial, and the science of soccer headgear is in its infancy. Nevertheless, the facts are that, in the Princeton school district, boys and girls soccer were producing more concussions than any other teams, so the board felt that trying out the headgear approach as part of its long-standing, comprehensive program was an experiment worth carrying out. As of earlier today, NJ soccer officials have met on the subject of the Princeton proposal, but not yet given their blessing. If the proposal is adopted for soccer and any benefits accrue, the board will gladly share that information with all of you, readers of TheConcussionBlog.

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