Book Review by Dorothy Bedford: “Fourth Down and Inches”

Dorothy Bedford is an avid follower and contributor to The Concussion Blog.  She has offered up a book review – out of the blue and appreciated – for me to post here.  I have not read the book and if I get the chance may offer up my two-cents but until then I think that perhaps some of you may want to know about the book.  With out further ado here it is (Thanks Dorothy);


The history, the stories, and the latest science of football concussions

“Fourth Down and Inches: Concussions and Football’s Make or Break Moment”   by Carla Killough McClafferty (2013)

Every week during the season, a few famous players’ concussions attract attention. They are attended by expert medical teams. Every week during the season, many youth and high school players suffer head injuries in silence because they don’t believe that a “ding” is a real injury, or they don’t want to “let the team down,” or the coach shrugs it off, or the parents don’t realize the medical or academic consequences. This book could change all that.

Carla McClafferty has written an excellent survey in a format accessible to a broad age spectrum of football players, their families, fans and youth football volunteers. With an extensive selection of heavily captioned illustrations and photos, and featuring short, punchy chapters the author presents a balanced view of the epic story of American football’s 1905 head injury crisis and the hidden, functional brain injuries underestimated and misunderstood until modern scientific methods began to reveal the truth in the 21st century. The colorful historical tale fills about one-third of the book, while the unfolding of a new perspective on brain injury and clear explanations of the latest research mix throughout the balance of the 87 page text, (plus wonderful supplemental material in the form of notes, bibliography, and further reading suggestions).

As a concussion safety advocate and fan, I have one or two minor quibbles with the author’s presentation of science. For instance, she overlooks the fact that the physics of the game have changed dramatically since my father was an All-American in 1938 – players are now expected to be bigger at every age, and better conditioned, meaning the forces in a hit are much greater: up to 100g’s in youth football, and increasing by age bracket. Similarly, while she explains the medical importance of return to play protocols, the fact of the matter is that youth athletes must be able to tolerate the cognitive exertion of return to learning in the classroom before returning to sport.

On the other hand, McClafferty effectively quotes some of the most insightful results of the most current research in a most accessible manner, leaving no doubt about its interpretation. This information is useful to parents and athletes playing any contact sport (soccer, hockey, lacrosse, even basketball). Her stories of players, both then and now, are recounted in a most engaging manner. The reader will also become familiar with the biggest names in the world of medical and scientific research focusing on concussions, and be prepared to recognize their results and quotes in news reports.

Some people think that the work being done in concussions as a war on football, meant to kill America’s favorite sport. On the contrary, think of the research and resulting rules changes as a way to save it.

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