I am honored and privileged to post an article from Will Carroll regarding concussions. I thank Will very much for his time and contribution!
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Changing The Culture
Will Carroll for The Concussion Blog
It’s a quiet, warm Saturday morning in July. Coming up to the Colts Complex on the west side of Indianapolis, it’s normal to see players walking in. It’s not normal for them to be nine years old.
USA Football is rolling out what amounts to a pilot program they are calling the “Protection Tour.” It’s a multi-part seminar for kids, coaches and parents that focus on the concussion issue. Sponsored in part by the NFL, it’s easy to see why they chose this program. USA Football isn’t the typical governing body. They don’t have any form of control over the largest programs, the NFL and NCAA. They don’t even hold any sway over scholastic programs. They’re more a lobbying organization, taking hold of “should bes” like coaching standards and player safety.
The Protection Tour is made of up of three “stations”. In the first and perhaps most important, coaches and players are shown tackling drills that emphasize old fashioned concepts like shoulder contact, athletic position, and wrapping up. These kinds of hits won’t make SportsCenter, but they are safer for everyone. There’s an emphasis here on getting to the younger players. USA Football President Scott Hallenbeck doesn’t have unreasonable expectations. “We’re not going to change Troy Polamalu,” he explained, “but we can get to kids from 8 to 10 and make a difference. We can start changing the culture.”
The kids are also checked for helmet fit, an important point that is often overlooked in many youth leagues. While the focus has been on helmet design and the controversial practice of reconditioning, simply getting the fit right can help reduce risk. Helmet manufacturer Riddell sent representatives to help teach coaches and parents how to help get and keep the proper fit. They made important points about regularly checking the fit, since simple things like haircuts, sweat, and maintenance can change the fit. Riddell did a nice job of keeping things general; it never turned into a sales pitch.
The final station was for the parents. USA Football’s medical director Patrick Kersey gave a nice presentation regarding concussions. While he avoided the technical, Kersey was very positive about the progress being made. One of the points he drove home was that while concussions are very serious, when treated properly there is a high return rate. Kersey focused on recognizing any symptoms, making sure that medical personnel were involved quickly, and that caution is required. For a developing brain, concussions require even more rest. “The culture is against waiting,” Kersey explained to me after his presentation, “but a week or two weeks of rest is nothing considering the consequences if we don’t allow the brain to heal.”
After the presentation, Kersey took some questions from parents and I was very interested in hearing what these involved parents would ask. It’s clear that they’re looking for a technological solution. Two parents asked about accelerometers and whether new chin straps that include them could help. Kersey was non-committal on these, as the research is sparse, but he too is hoping new technologies will help. Another parent asked whether the pediatrician was the appropriate place to take their child. Kersey pointed her to a list of trained physicians — this is an Indiana-specific list, but I’m sure there is similar in each state — which is an important resource for most parents. There were questions about ImPACT testing – which is provided without cost in Indianapolis by St. Vincent Sports Performance – and about which helmet Kersey preferred.
That latter discussion brought up some interesting points. I’m a clear advocate of new technology, but aside from the Simpson helmet that was tested last season, there’s limited changes in helmet technology and no new entrants to the market. I pointed to a series of banners showing a number of great Colts players and asked Kersey if he saw a major change between the helmets of Raymond Berry, Eric Dickerson, and Peyton Manning. Clearly, that’s an oversimplification, but there’s very little change to the basic design, internally and externally, to the football helmet. Worse, there’s little incentive for companies to enter the market, especially with lawsuits flying in every direction.
The Protection Tour stop was a great first step and a nice first step in tackling – no pun intended – this issue. I can see this expanding quickly, with the NFL leading the way. Part of the draw to this event was, no doubt, the chance for kids to play in the Colts training facility. There are 31 other places just like this around the country. There are more if you include high level colleges or even high schools. Education is the first step in changing the culture of football and saving it from what some think is possible extinction from fear of injury and lawsuits. It will be interesting to see if the NFL leads the way in expanding this worthwhile program.
The Concussion Blog 
I found the USA Football website based on a recommendation from my son’s sports specialist about 6 or so weeks after my then 8-year-old was concussed. My son was still getting some afternoon headaches, and based on our experience with bantam football, I was looking for ways to create a safer experience for other boys. I was impressed by the amount of health and safety information on their site. Yet, I was also upset that although all the information I needed to keep my son safe was so readily available, his program hadn’t even bothered to let parents know that the information was out there (in fact, they really didn’t provide us with any health and safety information even though such information was provided to high school players at our school).
I wrote to my legislators and the sponsors of our state’s youth concussion law to try to get them to extend it down to the youngest levels of play. I can’t say that I’ve gotten much of a response. In a recent article on the concussion law, one of its sponsors stated that it didn’t apply to the lower levels because there was no governing body to oversee its implementation below high school. So, as of today, there are no concussion requirements that apply to middle school or lower level sport programs.
Parents really should be provided with concussion information before signing their child up for any sport with a significant concussion rate (including soccer, especially for girls). It’s more than a shame that many aren’t getting the information they need to make informed decisions. Common sense would seem to indicate that smaller bodies would result in smaller impacts, but in actuality that does not seem to always be the case based on the limited impact study at the youth level (I believe Duma said some impacts were equivalent to a car accident). Your average parent isn’t aware of the biomechanical and other issues that make children more likely to sustain concussions. Additionally, many may not be aware that younger children can take much longer to recover from concussions (30 to 45 days for an 8-year-old).
Now, I think the safety programs USA Football are sponsoring are great – but, if they’re really serious about reducing concussions at the lowest levels of play, I would like to see them lobby to get state concussion laws extended to youth players. If they make a public call for this, then as far as I’m concerned they aren’t taking a basic step which could ensure all parents are provided with concussion information when signing up for youth football.
Will, as an employee of a helmet manufacturer, I’m obviously biased. But I’m curious as to why you believe there has been no technological advancement in helmets. It’s ironic that you point out Bill Simpson’s helmet from last summer – which was nothing more than a publicity stunt to promote his helmet technologies to his racing customers – as advancement. Unfortunately, the Colts allowed his relationship with the Irsays to manipulate Austin Collie and others to wear it.
That’s innovation? Making a $700 helmet (because it was made out of carbon kevlar) that will have to be replaced when it receives a significant impact, like a racing helmet? How is that innovation or progress? Innovation in an industry such as football, which is inherently dangerous, should be as accessible to as many players as possible – from the pros to the Pop Warners.
There has been much technological progress in helmets the past five years and the speed at which we’re improving the performance/protection of helmets is increasing. We’re making helmets lighter, because of new materials and manufacturing processes. Our TPU Cushioning is now in its fourth generation and is now specifically tuned to absorb the impact of both high-velocity impacts, as well as low-velocity impacts. We’ve developed new materials that allow us to increase the air flow inside helmets, which helps players control their core body temperatures.
We’re not the only ones making technological advances. Riddell has increased the protective capabilities of their helmets from the Revolution model that Peyton Manning wears. They’re not as good as ours, of course. LOL.
Technology is not the answer to the concussion problem. There are too many factors that cause concussions that helmets do very little to affect. In fact, it’s our position that any helmet company, sales person or academic study that claims one helmet is better than another at reducing the risk of concussion is lying. Helmets will only be a part of the overall solution. But that doesn’t mean they’re not improving.
Glenn — I didn’t say they weren’t improving. I said there were limited changes. It’s still a plastic shell with padding inside and a mask up front. Form follow function, to be sure, but there’s been very little in the way of real changes. Every incremental improvement is important, yes, but we’re stuck in an area where we’re only dealing with very small incremental improvements.
Your attack on Simpson is noted and as you’ll also note, I didn’t put much stock in his results. That said, I vehemently disagree with your point that technology is not the answer. If that’s the case, why is your company spending money to improve your helmets?
I’ll agree that it is not the whole of the answer, but helmets are at what I call the “seatbelt” level. Cars added seatbelts in the 50s. Then we added crumple zones, airbags, collision detection systems, radar … it goes on and on. There’s still car accidents, but more people walk away from them.
Which is what we’re hoping for with football, right?
Kelvar helmets may stop of a bullet or catch some frags but there is no evidence it will prevent or attenuate a concussion.
Good for Shutt. It is good to see a manufacturer speak plainly.