Concussions in American football

Abstract

The purpose of this study is to gain information and insight into the effects that brain injuries have on football athletes. As well as, the safety measures that have been placed to help lower those harmful injuries on the field and their effectiveness. For this study, the Mesquite Independent School District’s 5 high school football teams will be examined during a football season. Players will be between the ages of 14 to 18 years of age. Programs should do additional studies to determine if incorporating multiple safety measures will show a greater decrease in reported brain injuries for youth football.

Introduction

Today in America, there is many discussions on football safety.

Within the last 10 years, the football league has changed the aspect of the game with how it handles injuries, as well as prevention measures to keep athletes safe. In 2015, the movie “Concussion” which starred Will Smith as the lead character that shed light on Dr. Bennet Omalu discovery of Chronic Traumatic Encephalopathy (CTE).

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The National Football League has denied having any connection with football and brain injury. Between 2012 and 2014, the National Football League diagnosed 446 separate incidences of concussions among its players (Hanson, Jolly, & Peterson, 2017). A study was conducted that looked at 202 football players donated brains. Of that total, 87 percent was diagnosed with brain damage with 111 of those brains coming from the National Football League. President Obama also made a statement saying “I'm a big football fan, but I have to tell you if I had a son, I'd have to think long and hard before I let him play football” (Fedor & Gunstad, 2016).

Football is a popular sport for youth in America to play.

With girls also being able to join teams in this day and age, talk about youth safety has also been a trending topic. Many questions if CTE is seen with professional football players' brains, what could it do to players playing early? USA Football launched USA Football in August 2015. This program trains safety coaches, who will teach coaches in their league, and educate parents and players on proper techniques to ensure safety.

The purpose of this study is to gain information and insight on the effects that brain injuries have on football athletes. As well as, the safety measures that have been placed to help lower those harmful injuries on the field and their effectiveness. The authors in the articles have discussed topics over the effects ranging from young athletes to professionals. I will be using their theories that are discussed within those articles.

I hypothesize that these articles will reflect the opinions of most that the effects of brain injuries in football are harmful for youth football. It will also provide evidence that safety measures that have been placed are effective to reduce injury and is continuing to grow.

Brain Injury

Brain injury I football has been a hot topic in the last 15 years. A single concussion can cause headaches, memory disorders, reduced attention span, and sleeping disorders (Hanson, Jolly, & Peterson, 2017). Enduring this injury multiple times can create long term conditions such as dementia, depression, suicide, and others. In a recent case the NFL settled a legal case filed by former players for $870 million dollars. This settlement occurred, although they deny any link with chronic traumatic encephalopathy (CTE) and NFL. The discovery of CTE has caused a huge public awareness within the football community and other contact sports. Common symptoms of CTE are memory problems, depression, poor impulse control, anger, apathy, and impaired motor behaviors (Asplund & Best, 2015). Today, the only way to confirm the diagnosis of CTE is through an autopsy. 1000 head impacts per season can happen to a high school player. Most of these injuries are undetected or unreported by the athletes, medical staff, parents, and coaches (Asplund & Best, 2015). The NFL diagnosed 446 concussions between the years 2012-14. To improve safety, public awareness of brain injuries in sports increased. Risk reduction has been attempted by using qualified licensed health professionals to clear injured athletes before resuming to play. Other suggestions for reduction have included changing the rules to limit deliberate or avoidable head trauma in contact sports. The implementation of the “Crown of the Helmet Rule” (CHR) was created to reduce the incidence of concussions and head injuries (Hanson, Jolly, & Peterson, 2017).

Kids Safety

Children between the age of 11 and 12 are introduced to training in helmets and pads used for engaging in high-speed collisions with each other. Such forces can cause traumatic brain injury (TBI). In the 2015 football season, at least 11 students died. It is proposed that tackling needs to be removed from youth football to eliminate concussions and injuries. The Academy of Pediatrics (AAP) recommends that rules need to be enforced, younger players be taught proper technique, and other precautions be used to prevent intensive injuries. Bachynski, 2016, stated The Academy of Pediatrics (AAP) do not promote the mission they have which sates “to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults.” USA Football started promoting the “Heads Up” campaign that teaches coaches with knowledge on how to train players, coaches, and parents on how to reduce concussions in young athletes. In a 1953 conference, Dr. George argued that football and several other contact sports should not be participated by children 12 years of age or younger. As popularity grew, medical objections were overshadowed (Bachynski, 2016). With knowledge of knowing the serious consequences of short and long-term repetitive brain trauma and no change has been made, mission standards are not being held by the AAP. Fedor & Gunstad, 2016, state 912 concussions reported from 2008 to 2010 in American high school football. This accounted for 63.6 % of concussions reported by male athletes during this period. When in comparison to the professional league 170 concussions were reported during the 2012 season. In a study, participants answered a series of questionnaires regarding football safety. The study found 92.6% of those participants said they would allow their child to play in football (Fedor & Gunstad, 2016). Professional athletes that played in the NFL has mixed opinions on their child’s participation in football with some making statements saying they would let their son play at an early age (Fedor & Gunstad, 2016; Asplund & Best, 2015).

Safety Innovation

Safety in contact sports has been a major discussion in these past years. Most suggestions to reduce risk of brain injury includes changing the rules to limit deliberate or avoidable head trauma, find innovations to improve player’s helmets, and the use of technology to receive live data on player’s health during games. As stated previously, the “Crown of the Helmet Rule” (CHR) was created to reduce the incidence of concussions and head injuries. Players are penalized if intentional contact is made with another player using the top of his helmet (Hanson, Jolly, & Peterson, 2017). The Riddell 360 reduces force from frontal impacts and redirect energy by using hinge clips and flexing facemasks. The design uses an occipital lock to hold the head and create stability. There’s also comfort added for the player by adding a hexagonal liner system. Head-Impact Telemetry System and Sideline Response System are used together to allow easy and accurate monitoring of on field head impact using wireless communications. These technologies are patented and record frequency and severity of impacts. An MX Encoder measures the location, direction, duration, and magnitude of head impacts. This also use the same design as the other technologies with electronics in the helmet and transmits the information wireless to the sideline. Coaches and trainers/medical staff are provided with real time information about the player’s health (Venables, 2013).

Although most reports have found that helmets don’t reduce the incidence of concussion, recent studies suggest that some helmet designs may be effective. In Foster et al., 2018, study suggestion of using open cell polyurethane auxetic foams in sports helmets were examined to see if they reduced the severity of linear impacts. Also, the usage of player safety coaches (PSC) was concluded as an effective method to injury safety for high school football in Kerr et al., 2016 study. The different innovations examined in these articles are stepping stones to the future to promise safety to all athletes.

Method

Participants

For this study, the Mesquite ISD 5 high school football teams will be examined during a football season. Players will be between the ages of 14 to 18 years of age. On 2 teams, regular standards and procedures will be used to measure how many brain injuries are reported. The other 3 teams will incorporate the usage of cell polyurethane auxetic foams in sports each player’s helmet. This will be accompanied with the Head-Impact Telemetry System and Sideline Response System to measure impact during the game. Permission must be granted by each participant’s parent or legal guardian.

Measures

Previous seasons concussion reports will be reviewed to use as a reference for the studies effectiveness. This study will be evaluated by athletic trainers that will track injuries at each practice and game. A player safety coach will be in attendance at each practice and game to ensure the “Heads Up” safety measures are being properly enforced.

Discussion

It is more dangerous for youth to be sedentary than to risk injury playing a contact sport, making shutting down contact sports in youth programs not the answer to solving brain injury in football (MacDonald & Myer, 2017). The statement retired players showed greater levels of impairment in 40s-60s if they began playing football before the age of 12 is believed to be a false statement. Another article made an opposing statement claiming there is no direct link to suicide in NFL vets with athletes who played football at a younger age (Asplund & Best, 2015 & MacDonald & Myer, 2017). If safety measures were used as one unit the way it is organized in my experiment design, I believe the reduction of brain injury would be seen effective on a larger scale. Examining rule changes, there was an effective reduction of TBI by limiting the impact of body checking (Bachynski & Goldberg, 2014). The downfall of focusing on protecting had an injury is that lower extremities may result in higher reports of injury. In Hanson, Jolly, & Peterson, 2017 study, a 32% reduction in concussions from defensive players was observed, but a 34% increase in lower extremity injuries was also reported when the CHR was enforced.

It has also been stated that helmets do not help to prevent brain injuries, but with the usage of the foam padding, it will help cushion any severe impact. For the high impact energies, the auxetic foam inserts reduced the peak acceleration in Foster, et al., 2018 study. These results, it supported previous findings that auxetic foams can be used in sports safety. As cases continue to receive tremendous media attention, the fact remains that current evidence suggests the risk of CTE is very low when we consider the total number of athletes who have played American football. Over the past 60 years there have been only 63 autopsy-confirmed cases of CTE in American football players (Asplund & Best, 2015).