The Concussion Blog

Yesterday Rich McKay, chairman of the NFL competition committee, made comments regarding player safety and rules.  Of note was McKay stating that kickoff concussions were down from the previous year, he credits the rule change of moving the ball up five yards on the kickoff;

McKay said Monday that concussions on kickoffs dropped by 40 percent during the 2011 season which likely goes hand in hand with the fact that kickoff returns dropped by 53 percent.

Also in the AP story – linked in various places  – McKay released information about concussions being down, for “in-game” situations, versus the previous year;

For all plays, concussions were down 12.5 percent, from 218 in 321 games in 2010 to 190 in 320 games last season. There was no Hall of Fame game last year because of the lockout.

In the end of the year wrap up posted in January you will note not only did we mention the decline in the kickoff concussions, but our data on the past two seasons;

The 200+ concussions should not come as a surprise, as we told you to expect that back in the preseason, the main reason being the better reporting of the issue.  Players seemed to capitulate, slightly, to the injury as the season wore on, yet there is still the stigma present in the game.  […]

There are still issues with the reporting of the injury for what ever reason, as evident with some teams.  For example of the 384 found concussions the past two years Cincinnati has only reported THREE or 0.78% of all concussions, Tampa Bay, Houston and Buffalo are not much better, if the injury was truly random then each team should be reporting about 12 a year.

Our data shows that we have 390 total concussions (2011 practice and post season included) while the NFL has 408 (“in-game” only).  This is a significant issue unto itself, as the NFL has not made a statement about raw numbers until this information from McKay.  The 218 in 2010 far exceeds our 172 of that same year, meaning that there were concussions that occurred that were never listed on the official injury list and did not appear in the media coverage of the teams.

2011 is a bit different as we found 191 “in-game concussions” (with one being the James Harrison injury that the league nor Pittsburgh listed as a concussion but we did).  That being said there were 225 total concussions found in the league last year; meaning that we found 34 or 15% of concussions that occurred in practice or somewhere other than a game (yes we keep track of practice and game injuries, as well as: position, helmet, occurrence, height, weight, years pro, starter/backup, etc.)

If anything this verifies how we are collecting data, at least for 2011, and since our methods were unchanged from the previous year, it begs the question – who has the real list of injuries?  The data from the NFL tells us that those that cover the teams are doing a good job of exposing the injury as they occur.  A worry is the NFL has never even come close to signaling that there were 200+ concussions in a season, heck as recent at 2007 the number was well below 100 – of found concussions.  This makes me wonder.

Problems still remain, but McKay and the NFL are correct in saying the kickoff rule did as it was intended; helped with player safety.

While we are on the subject of rule changes, I would like to endorse the proposed bylaw change that has been floated out there regarding concussions and roster limitations;

6. Allowing one roster exemption per team per week for a player who is inactive with a concussion.

This makes just too much sense when dealing with an injury with an unspecified recovery rate for each individual.  Not to mention that when returning from a concussion that the player needs to progress through a step-wise flow, and if they have a setback then they possibly could miss a game.  This would allow teams more flexibility and possibly not rush a player back.  The only issue I have is that the number should be raised to two, because, a majority of teams (looking at the past data) will have AT LEAST one player recovering from a concussion each week (unless you are Cincinnati, Tampa Bay, Houston or Buffalo).  Maybe they can fine tune that a bit, we all know the NFL can do some serious investigating if they feel you are skirting the rules.

Here are some more suggestions if you are listening;

The NFL is making an effort, although a reactive one, to take this issue seriously if they want to make some serious head way and lessen the cost of concussions to the owners then there are some suggestions I can make;

1. Create a truly independent think tank.  (Perhaps this should be run by the Players Association).  This think tank should be composed of various types of people and ones that are not concerned about what they find or say.  Just like taking a band-aid off, this group would be good at getting the necessary information and providing recommendations no matter how critical or imposing they may seem.  Their information should be transparent and thorough.  I believe this group should be composed of the following 20 people: 4 independent researchers, 2 independent neuropsychologists, 2 independent physicians, 2 psychologists, 1 active NFL athletic trainer, 1 college athletic trainer, 1 high school athletic trainer, 2 media personalities, 2 active NFL players, 2 former NFL players, 1 current NFL Head Neck & Spine Committee member.
2. Compile and publish a concussion database for NFL injuries that includes at the least: total number of career concussions, time missed.  (There may be a HIPAA issue with this, so perhaps again the Players Association should have dual ownership of the official NFL listing).
3. Again look for the proper helmet for the position, let alone get rid of all helmets that are technologically older than 15 years.  This would mean the removal of the old model Riddell, Shutt and Adams.  (The teams and players get by the 10 year “throw out” rule by having the companies manufacture the old style helmets; this is happening less BTW.)
4. Use the league and players to promote the proper management of concussions, including full rest until asymptomatic then a graded stepwise recovery.  This course of action may differ from professional players but make it clear, adolescent brains are different from that of the mature adult.
5. Promote less hitting in practice and proper tackling technique (don’t use James Harrison).  Stop using the top or crown of the helmet as the primary point of contact.
6. Enforce all rules on the books that deal with helmet contact.  Remember that helmets were made for and instituted for protection not for weaponry.  The use of the helmet as a weapon has contributed to an increase of concussions, if players were to use their face mask instead of the crown of the helmet I would hazard a guess that concussions would decrease.
7. (new) The NFLPA should demand that the league put in the HITs system (by Simbex) in the helmets for a trial season.  This will require effort from the league as well, because the NFL will have to convince Riddell to allow the technology in all helmets.  This monitoring would only initially be available to the PA, NFL and the mentioned think tank above.

Simply put the game of football was designed for the human playing in the early 1900’s not the athletic monsters that patrol the sidelines today.  Even with the advancement in technology the player and game have advanced much faster; in my observation this has come at the sacrifice of medical research on the sport – concussions not withstanding.

BIGGER + FASTER + STRONGER = more injuries.