The Last Rep

Consussions - Part II
by: Aaron S. Lee
© More from this issue

          
With each snap of the ball, football players are at constant risk for career-ending concussions. American Football Monthly has gathered seven of the industry’s top experts to discuss this epidemic in a Last Rep two-part series. AFM encourages coaches to use this platform as a first step in their continuing education on player safety. Please contact medical experts and gear manufacturers to learn the latest safety measures in dealing with concussions.

---

What role do helmets, chin straps and mouthpieces have in preventing concussions?
“Another way to ask this question is “What role does an improperly/loosely fit helmet, an improperly fit or unsnapped chin strap and no mouthpiece or a bitten down one play in causing concussions?” I think you get the idea. Football coaches today must run a program, they cannot just simply coach a team. The selection of protective equipment and the proper fitting of the players in this equipment is a responsibility and an obligation that coaches must perform.” - Billy Rice, Schutt Sports, former athletic trainer

“Helmets were designed to offer some protection to the player’s head, not the neck and spine. Football helmets were originally designed to reduce the incidents of skull fractures and to minimize the occurrence of head and scalp lacerations. These primary objections have been met with today’s helmets. Football helmets, chin straps and mouth pieces do not eliminate the risk of sustaining a concussion.” – Garry McNabb, Adams USA

“The helmet and face mask protect the face and head. The helmet cushions a blow to the head and disperses the energy throughout the helmet. The chin strap helps keep the helmet in place. Padded chin straps give some protection to the chin. The mouthpieces keep the upper and lower teeth from coming together. If the upper and lower teeth collide with enough force, it could cause a concussion.” – Dale Strauf, Head Equipment Manager, Cornell University, President Athletic Equipment Managers Association (AEMA)

“We believe that a properly designed and fitted helmet can reduce the risk of concussion. New data and new technology are just now becoming available. Clever product designers will come up with new ways to use this information, and I think you’ll see a continued evolution in protective equipment.” – Thad Ide, Riddell

What kind of testing is currently being done by doctors or gear manufacturers to help reduce the odds of players suffering a concussion?
“Speaking for Schutt Sports, our testing approach is three-fold: 1) We continue to meet all established industry helmet standards which have been in place for a number of years, e.g., the NOCSAE Standard and the ASTM Standard for helmet performance. 2) We perform ongoing Research and Development, always testing new materials and concepts to see if they can be incorporated into the helmet to improve its performance. 3) We are also testing to suggested protocols put out by independent research which has recently become available.” – Billy Rice

“All interested parties, NFL, NOCSAE, labs like ours at UT and others are all trying to identify the mechanisms (some are well understood, some not so well, some may yet to be discovered), predispositions, other risk factors and threshold limit values, to name a few. This work includes mathematical modeling, on-field data acquisition using several approaches, neuropsychological testing to determine if and when an MTBI has occurred and it’s severity, as well as novel lab test methods for headgear that measure several factors all at once in hopes of establishing an MTBI standard test method that protective devices can be evaluated against.” – Dave Halstead, Director, Sports Biomechanics Impact Research Laboratory & Technical Advisor, National Operating Committee on Standards in Athletic Equipment (NOCSAE)

“The Pennsylvania State University is involved with four areas of research: 1) Impact testing of head gear using ASTM standards; 2. Neuropsychological testing by computer and clinician; 3. Three-Dimensional Balance Testing; 4. Real-life Linear and Rotational Head Accelerating Testing” – George Salvaterra, Head Athletic Trainer, Penn State

“Both Riddell and Schutt are using a new swinging pendulum method of testing helmet performance. This test method grew out of a long-term study funded by the NFL into the types of impacts that cause concussions.” – Thad Ide

What role (if any) does a player’s technique play in sustaining concussions?
“In my opinion, technique is the major contributor to concussions. If a student athlete continually blocks and tackles using the head, the chance of receiving a concussion is greatly increased.” – Dale Strauf

“That is unclear, the best data shows the unsuspecting player getting the injury. Clearly leading with your head or head hunting can increase you and your opponent’s chance of injury.” – Dave Halstead

"If the player uses the helmet in an improper manner or technique, i.e., by ‘butting, ramming or spearing’ it can contribute significantly to sustaining a concussion. The helmet has not been designed to be used as a weapon. Both the NCAA and NFSHSA have had a rule in effect since 1976 – 27 years! – which prohibits the use of the head as the primary point of contact when blocking or tackling.” – Billy Rice

What tips do you have to coaches to help their players avoid concussions?
“The most important point to make is the best way to prevent concussions and the cumulative effects of concussions is to manage it properly when you have one. If you have a single concussion and you allow those metabolic changes to recover sufficiently in the brain, then you should have a good outcome and the athlete should not be of further risk of cumulative problems ... however, if the athlete’s brain is 90 percent recovered, then the brain is not ready to be hit again ... that is when the athlete becomes more vulnerable to concussions ... the symptoms seem to last longer, it is easier to have a concussion, less biomechanical force results in a concussion and basically that is when you are in a dangerous situation with the athlete.” – Micky Collins, PhD, Assistant Director, UPMC Sports Concussion Program

“A concussion is a serious injury. The best thing a coach can do is take the injury seriously, make sure the player gets proper medical attention, and doesn’t return to play until cleared by his doctor.” – Thad Ide
“Warn the players of the possible dangers involved with spearing with the head. Teach blocking and tackling techniques that avoid direct contact with head. If these techniques are violated, bring it to the attention of the athlete.” – Dale Strauf

"First, ‘see what you hit.’ Keep your head up, don’t use the helmet as a weapon. Second, know what your helmet can and cannot do. Make sure your protective equipment is properly fitted. Understand what the ‘Helmet Tri-fecta’ encompasses. If the fit of your equipment changed for any reason, notify your football coach, ATC or equipment manager immediately. Third, if during the course of play you become disoriented, notify your football coach, ATC or equipment manager immediately.” – Billy Rice “In an effort to avoid concussions and head injuries, players should be instructed never to use the helmet or face mask as a point of contact. Players always should attempt to keep their head out of the play. Coaching the proper techniques to players is critical in minimizing and preventing serious injuries. Coaches should always be alert to the condition of the players during a game. They should look for signs that a player has been injured and remove that player from play if injury has occurred.” – Garry McNabb, Adams USA

What is one example of managing a concussion?
“We are seeing that increase cerebral blood flow after injury will make the injury worse and actually protract the recovery time. Understanding where the athlete is and knowing when to exert them and increase their blood flow to the brain ... when they are recovered. Exertion is a good thing, but the best thing is to have a good tool available to help manage the injury and that is what we have developed at University of Pittsburgh – a tool to do just that.

“The University of Pittsburgh currently oversees the concussion programs of the NFL, NHL, CART, IRL, MLB, New Zealand Rugby Union (www.ImpactTest.com) ... every Big Ten team uses the Impact software. More and more high schools are learning about this tool and it is important that more continue to implement its benefits.
“This is an injury that is not going away and as the speed of the game increases, along with the size of the athletes, it will only become more prevalent.” - Micky Collins

NEW BOOK!

Digital Download - 304 Pages of Football Forms for the Winning Coach