Football Helmet Hits and Brain Injury – What Should Be Done?

It is no surprise that anyone playing football risks physical injury. More and more data is pointing to brain injuries caused by high speed collisions to the player’s helmet. I once had the pleasure of dining with Michael Strahan who played for the New York Giants for fourteen seasons. Our conversation was engaging and covered a range of topics, but we didn’t talk much about football. Interestingly, he spoke about how proud he was of his sister, who has an interest in science – particularly biochemistry. He is fortunate to have sustained minimal injuries while playing on the national level, but I wonder whether he might be an exception.

A recent National Geographic report presents some recent data in a dramatic, interactive display. Below is a snapshot of data collected from a single player sustaining more than 500 helmet hits. As you see, many of them represent hits greater than 80 times the force of gravity (a severe car crash is estimated at 120 g’s) and two of the hits resulted in a concussion.

One 21-year-old defensive end took 537 hits to the head during a season of football games and practices at the University of North Carolina. Of those, 417 had magnitudes of 10 g or more (shown). Two resulted in concussion. Click and drag on the graphic below to rotate it and get a clearer sense of the location and magnitude of all the recorded impacts.

These data indicate that the currently used helmets may not offer sufficient protection, particularly in cases in which players experience hundreds of hits. Do we need more data to revise the safety requirements for helmets in professional and amateur football?

Comments

#1 D. C. Sessions
January 25, 2011

These data indicate that the currently used helmets may not offer sufficient protection, particularly in cases in which players experience hundreds of hits.

Barring helmets like Rick Moranis’ in Spaceballs, you’re not going to get that kind of protection, and if you did players would just hit harder because the the incremental immediate downside isn’t nearly as important as winning the game.

Please recall: assuming a perfectly even deceleration curve (constant force applied to the head, just enough to stop short of bottoming out [1]) deceleration varies as the inverse square root of stopping distance. So doubling the helmet thickness can, at best, reduce acceleration by 40%.

Except that we don’t know what the deceleration really will be to design the materials of the helmet. So we have materials which increase their resistance with compression, and as a result deceleration isn’t constant and for all but the skull-buster impacts is stiffer than the ideal curve.

Better protective gear causes more aggressive play. The question is whether the aggression increases faster or slower than the protection.

Personally, I’m seriously interested in a comparison between injuries in rugby vs. American football.

[1] Bottoming out is bad. Really bad. Don’t let it happen.
#2 Art
January 25, 2011

Perhaps you are looking at the wrong end of the issue.

As an example, how would eliminating cleats change things? Without cleats you limit the ability of players to accelerate and change direction quickly. If people aren’t accelerating so quickly, and are unable to make the moves that make blind-side hits possible you might go a considerable way toward reducing the force of impacts and the resulting damage.

The brain injuries are just one component in a complex system of equipment, players, behaviors, field, and rules. Limiting the consideration to heads and helmets may not be the best approach if the goal is to limit injury.
#3 darwinsdog
January 25, 2011

Why should anything be done? If someone wants to play football they should be aware of the risk of concussion & other injuries and if they decide to play in spite of these risks, why is it anyone else’s business? Personally, I think that football players are wimps for even wearing helmets & padding. They should show all the fans how tough they are by playing naked. Heck, linemen should be given baseball bats for whacking each other over the heads with & for breaking the legs of the guy with the ball. This would make the stupid game actually interesting to watch.
#4 D. C. Sessions
January 25, 2011

Why should anything be done? If someone wants to play football they should be aware of the risk of concussion & other injuries and if they decide to play in spite of these risks, why is it anyone else’s business?

For the same reason we don’t allow children to be shaken as “discipline.”

Now, if you’re prepared to ban contact sports (including basketball, which is only called a “non contact” sport for laughs) then we might be in a position to talk.

Me, I’m a volunteer emergency medic. I’ve seen too many kids who will be lucky to get to 18 going for yet-another-ambulance-ride following a “routine concussion” thanks to high school football. Too many of them actually lose consciousness and then the coach has them back in the same game.

Remember: winning isn’t the most important thing, it’s the only thing.
#5 Dub
January 25, 2011

“For the same reason we don’ t allow
children to be shaken as ” discipline.”"

The fact that not all football players are children seems to have escaped you…

I agree that people below the age of responsibility should be protected, and that the best possible protection should be available to everyone regardless of age. But any adult who chooses to play football should be deemed capable of being responsible for their own choices; it’s a bit patronising to think adults need protection by the same rules as children.
#6 D. C. Sessions
January 25, 2011

I agree that people below the age of responsibility should be protected

Which is what I meant to say and now see that I didn’t. It should have been “… ban contact sports in high school …”

Note that I spend quite a bit of time every winter taking care of idiots who do stupid things on snow. I’m all for their having a chance to improve the species by application of Darwinian selection to their own genes, although I prefer that they do so while adequately informed. And old enough that “informed” means something.

Organized, sponsored, brain damage with authority figures encouraging medically insane activities is slightly different.
#7 phil
January 25, 2011

Whether you can expand it to cover all contact sports, I have thought for a long time that high schools really should not have football teams. At the small school I went to, the insurance policy for football was equal to the entire athletics budget outside of football. Even if you leave aside the question of whether schools ought to be sponsoring and promoting such dangerous activities, that’s a lot of money that could be spent on something besides providing physical activity to a single small group of boys.
#8 Matt Evenhouse MD
January 26, 2011

I am an Er doc who has moved over to the technology and consulting side of the house. I know first hand the devastation of head and spine injuries. Recently I have been working alongside the folks who make the helmet pads for military helmets. I have spent a good deal of time trying to understand the helmet issue so I could make good recommendations to helmet users. The simple facts are stunning – current helmet standards are based on outdated research and overly simplistic models of injury. The standards are very slow to change. Most manufacturers build to the standard. This results in helmets designed to meet standards which are based on inadequate information. Out of date standards = out of date helmets.

On the plus side,, there are numerous computer modeling programs in development and a dedicated cadre of scientists and engineers working to validate the models. We are very close to realizing significant improvements in helmet design. I hope the current debate will fuel funding which will speed the development of new modeling, new standards and therefore better helmets.

I sympathize with the purists in the crowd who would love to redesign the entire helmet concept from scratch.

Helmet design and use has its own history, its own influences and its own culture. The look, feel, shape, color, and size of a helmet reflects not only the injury profile it was intended to affect, but also the culture and traditions of the wearers. It is purely academic to recommend redesigning the sport or eliminate cleats. Reality is messy and complicated.

The US military is a great place to see the evolution of helmet technology. They have a need to protect soldiers from ballistic, blast and blunt injury all with one helmet system. The helmet needs to protect while it serves the mission profile of a diverse array of helmet wearers. The advances in helmet technology occur on a daily basis in this area, spurred on by the large number of brain injuries occurring in the wars.

Recently the Lawrence Livermore Laboratory compared helmet padding technology from the U.S. Army – made by Team Wendy – the authorized provider of US military helmet pads to helmet padding in standard professional football helmets. The results showed that the military product outperformed the football helmet product in each testing category.
#9 Calli Arcale
January 26, 2011

Dub — I strongly suspect there are more children playing football than adults, and one can make an argument about role models. If we don’t protect the pro footballers, what incentive do the kids have to wear the protection?

Otherwise, I mostly agree that adults can make whatever damn fool choices they want as long as they aren’t hurting other people. OTOH, that logic can also be used to blame employees for more prosaic occupational injuries due to genuine negligence by the employer, so obviously there’s some sort of continuum of responsibility, and maybe the question of whether or not money is involved should be part of the equation. *shrugs* There’s a reason I’m a software engineer and not a coach.
#10 Jeff
January 26, 2011

Thank you very much for your thoughtful and informative comment.
#11 Chris
January 27, 2011

Has anyone considered removing or reducing the size and extent of the facemasks on helmets? Without a facemask, no player would launch himself headfirst at an opponent. I suspect this would eliminte most serious head injuries.
#12 MissouriMule
January 27, 2011

@ Chris #11 Facemasks also protect players from idiot players. I can not find the picture but there was an infamous injury back in the pre-mask days where a college player cocked his elbow and drove it into the face of an opponent. If I remember correctly the opponent was already down and the idiot very intentionally flew elbow first into his face. Many folks agreed after that that helmets needed masks.
#13 anne ozment
January 29, 2011

Most football players are adult, or nearly adult men, and should be responsible for choosing lifestyle behaviors that will protect their (one and only) brain. However, when testosterone rules, common sense can go out the window. We, as a society, have to consider the cost to society of caring for mTBI injuries, in terms of health care, long term care and reduced quality of life for those who choose to engage repeatedly in activities that can damage the brain. How many IQ points is it worth to a person to have a fantastic football career?
#14 Max
January 29, 2011

Several people here have opined that adult football players should be responsible for choosing their lifestyles that protect their brains. But how many players have been adequately informed of the risks that they are facing? How many are relying on a college scholarship to open up possibilities they would otherwise not have?
#15 antipodean
February 1, 2011

D.C.- just in case you are still watching… I have no data but it might be one of those cases when the difference is so striking you hardly need any.

IMHO- The helmets and the shoulder padding are the problem, not the solution.

Rugby’s not exactly short of injuries, including concusions. But we don’t take 500 blows to the head a year and 2 concussions. This is possibly because we don’t smash into other people with our heads on purpose. The helmets and the shoulder padding encourage head-on-head contact
#16 Marck
February 7, 2011

Most football players are adult,

Not really.

There are 32 professional teams in the USA. There are a few hundred college teams across all divisions. Those will be your 18-23 year olds more or less. Adults in the legal sense.

There are something in the order of 36,000 Highschools in the USA.
#17 Omega Centauri
February 7, 2011

“If someone wants to play football they should be aware of the risk of concussion & other injuries and if they decide to play in spite of these risks, why is it anyone else’s business?”
As others have pointed out, the players are largely adolescents. And the culture puts a lot of pressure on kids to play. I can remember as a 6foot 180pound high school student, that certain PE types could barely disquise their disgust at me for not having the highschool spirit and being part of the team. And more often then not, the pressure comes from the father. It is well known that in this age group risk taking behavior among males is endemic.
#18 randy
February 7, 2011

my solution, get rid of helmets. that will reduce head to head collisions.
#19 Jeff
February 8, 2011

Yes, eliminating helmets would make players exert more caution. On the other hand, helmets have proven to be highly effective in preventing or minimizing brain injuries from accidents {not intentional hits!} in a range of sports, from football to race car driving to horse back riding, to white water rafting, to name a few.
#20 Navy SEAL Medic
February 9, 2011

As a dude who’s seen more than his fair share of nasty head injuries, I can say with complete and utter confidence that the key to protecting a person’s melon lies not so much in the design of the helmet as it does in the padding contained within it.

Wearing a helmet system that is designed to simply meet the “current specs” is akin to a person installing a balloon clown creation for use as their vehicles airbag!

Let’s look at it all in a different way; Riddell makes the official NFL brain bucket, choosy mom’s choose Riddell. What mom’s don’t realize is that Riddell makes a helmet with a padding system designed to protect a 285lb person from one major catastrophic blow to the dome. Little Johnny weighs just 80lbs…..rendering his padding system completely worthless as it is totally incapable of achieving the Crush Efficiency needed to enable the whole acceleration/deceleration event to occur at a constant. Simply put, little Johnny gets no more protection from that NFL fabulous Riddell than he would from having someone from the local bricklayers union encase his head in cinder blocks!

Let’s not blame Testosterone, face masks, shoulder pads, cleats, school budgets, fathers, role models, or even helmets, let’s blame the people who continue to allow a horrifically sub-standard padding system to be put into any helmet used for any purpose.

From short buses to space shuttles, and gridiron’s to combat zones (I’m only comparing head trauma in football and combat, because everyone involved is wearing a helmet), one need only to read the Lawrence Livermore Laboratory Report to figure out what needs to be implemented with respect to EVERY HELMET BEING MADE TODAY….as well as retro-fitting those already intimately involved with peoples craniums!

Let’s SEAL the deal folks!
#21 Danny DeMichele Entrepreneur
February 9, 2011

The brain injuries are just one component in a complex system of equipment, players, behaviors, field, and rules. Several people here have opined that adult football players should be responsible for choosing their lifestyles that protect their brains.
#22 Jeff
February 9, 2011

Excellent comment. Thank you!
#23 Sam C
March 1, 2011

Jeff #18:

Yes, eliminating helmets would make players exert more caution. On the other hand, helmets have proven to be highly effective in preventing or minimizing brain injuries from accidents {not intentional hits!} in a range of sports, from football to race car driving to horse back riding, to white water rafting, to name a few.

You touch briefly on a crucial difference between football and those other sports: in rafting, horse-riding etc. the participant is not aiming to injure him/herself, nor aiming to inflict injury (or at least hit hard) on another person, in fact exactly the opposite. Few sports (apart from boxing) aim to actually inflict injury, although in several ball sports, big men (and spectators?) love to hurt their opponents.

In the UK we don’t have cycle helmet laws. There are standards for their construction, but wearing is completely voluntary. To me, and to all the casualty (ER) doctors I have heard, it is clear that helmets are A Good Thing in almost all cycling accidents. That is, there may be a small number of cases where helmets could make things worse (by exacerbating rotation of the head due to the bigger lever arm) but they will help in the vast majority of cases – or at least not make things worse.

The general pro-cycling organisation, the CTC (Cyclists Touring Club) is against compulsory helmet wearing, and I have no problem with that policy, nor with arguments about compulsion reducing the number of people cycling (as reportedly occurred in Australia), nor with arguments about personal liberty.

But what I do find worrying is that a number of anti-compulsion campaigners feel the need to come out with pseudo-scientific arguments trying to prove that helmets are bad and that’s why they shouldn’t be compulsory. Me, I wear a helmet in the city, but not when out on quiet roads. Is that rational? Don’t know, but I don’t feel the need to concoct a (pseudo-)scientific justification, I just say “it’s legal, it’s my choice”. The antis sometimes sound distressingly like anti-vaccine campaigners.
#24 Jeff
March 1, 2011

Thank you for your thoughtful comment.
#25 ajlounyinjurylaw
March 7, 2011

It is debatable whether a helmet can ever completely protect these players from dangerous rotational impacts. Helmets only provide minimal protection against concussions and brain damage.
#26 nyautoaccidentlaw
April 7, 2011

I think its great to look into good helmets but really football players are well awarer of the dangers, and if they aren’t aware then it should be taught. Willing to put up that risk makes a very good game to watch.
#27 K.M.
May 9, 2011

I believe, if a person wants to play football, they have the right to be properly protected. To me, this relates to the issue of using aluminum baseball bats. Yes, the public knows they may not be safe to use especially in little league, however, I’m sure a league somewhere continues to use them. Knowing the dangers associated with an activity, rarely stops somebody from participating.
#28 Houston Personal Injury Attorney
October 20, 2011

Whether you can expand it to cover all contact sports, I have thought for a long time that high schools really should not have football teams. At the small school I went to, the insurance policy for football was equal to the entire athletics budget outside of football. Even if you leave aside the question of whether schools ought to be sponsoring and promoting such dangerous activities, that’s a lot of money that could be spent on something besides providing physical activity to a single small group of boys.
#29 Douglas Kennedy
February 19, 2012

I know football will be around for a long time, but I think that as an “advancing” culture, we Americans should reconsider how much money and energy goes into the sport. So many more people could be engaged to be active if we put the football money into a pool that helped the obesity-epidemic-group to move more, be active and have fun doing so.
#30 GWinters
May 12, 2012

Design a helmet that will allow any 250 lb man to safely run head first into a concrete wall without injury and the number of neck injuries will increase proportionately.

Remove all possibility of injury from the game and fans will lose interest.

Some injury appears to be necessary to capture the public’s insatiable appetite for violence. Although the game itself doesn’t need fans to continue, sponsors do. It’s really about selling beer.
#31 Anonymous
September 18, 2012

I got a concussion in football when I played in Middle school It was very serious for a couple of hours I had forgotten my middle name. Nothing should be done as far as extra protection in helmets. I knew the risks of getting these kinds of injuries when I played and so should everybody who does