The Concussion Blog

If you have noticed the sports news cycle you certainly have heard about John Mara and his comments regarding the possible removal of the kickoff in the NFL to protect against injuries, concussions as the main reason.  Mara used the oft cited decline in concussions with the rule change from last year.

Granted the forces changed but also as I stated in my previous post about the decline, reducing the exposure will reduce the incidence.  It would be like taking driving privileges from 16 year old’s and allowing them to drive at 16 1/2.  The number of accidents and fatalities will drop.  It should be noted that in our data collection of concussions we found only two concussions due to kickoffs, the previous season we found six.  Hardly a monumental decrease, but none-the-less a decrease and if they wanted to reduce the chances they did do that.

I am pro-football; with the proper precautions put in place (see athletic trainers and education).  I am even more pro professional football as it is played by adults that should now have all the relevant information regarding player safety.  I am also against “wussifying” any sport, but I am for making it as safe as possible.  It will be impossible to erase concussions from football, heck they can happen in everyday life.  The high rotational, acceleration and deceleration forces implored on the body playing football are too dynamic to contain.  Certainly there is no protective equipment that can attenuate concussions either.  However players, teams and the league can try to use common sense when dealing with concussions.

Treat them as a brain injury and honor and respect those that are concussed, use the best practices in managing and recovering from a concussion.  This includes immediate removal and proper rest, period.

If the NFL thinks that taking a singular play that amounted to less than 1% of concussion in the NFL last year is better business (see less litigation) then I think that they are throwing the baby out with the bath water.  Not only would this eliminate one of the most exciting parts of the game they would essentially be removing the following;

• Onside kick (how do you get a chance to get the ball back late?)
• Special teams players (some play on punt and extra point but they would be removing some players livelihood)
• Kick returner specialists (speed kills, right, what about the 100+ yard returns)
• The double commercials (after score and after kickoff, isn’t that lost money for the NFL?)

The data compiled by The Concussion Blog reveals that the punt team has double the concussion problem than the kick off, does that mean the NFL will now move away from the punt?

There is a better way, it starts with the acceptance and respect of concussion and it is not only on the NFL it is on the players as well.  This cannot be solved by changing the game, it has to be changed by those that deal with the concussion on an intimate level.

And food for thought;

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.  (The “don’t try this at home, we are professionals” disclaimer)
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. 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.