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Your Take: Time To Get Enlightenedby: Vin Ferrara
Founder and CEO, Xenith, LLC
© January 2011
Note: The following is an excerpt from Building the Enlightened Warrior,
Mounting evidence indicates that playing football in an extreme fashion might destroy your brain. Concussions have clearly been an uncontrolled epidemic in football for decades. Epidemics are not instantly cured by simple solutions. They require complete strategies for risk reduction.
We must end the gladiator mentality that permeates football. Because of this mentality, big hits are rewarded, at least culturally, with cheering, highlight films, and awards with names like “Headhunter” and “Hammer.” Young players proudly show off the marks on their helmets. However, there is absolutely nothing in the National Federation of High Schools Football Rule Book that rewards hitting; nothing about being a gladiator. The “rewards” are entirely cultural, and the dangers entirely real.
It is critical to realize that football has always been popular, and will continue to be popular. The game can remain physical, fast, and entertaining, and will likely attract even more young athletes if it can become a safer activity. This is no longer about being a gladiator. It is about being an Enlightened Warrior.
Football rules and techniques must be thoroughly examined, with the goal of eliminating neurological injuries. The most effective rules and techniques will be geared towards eliminating the use of the head for contact. Coaches, leagues and officials should take a zero tolerance policy towards this practice. Eliminating head first contact will not only minimize concussive episodes, it will minimize other more severe injuries, including spinal cord injuries.
It is entirely possible, and preferable, to tackle without using one’s head. Xenith sponsors a very effective tackle training technique, coached by Bobby Hosea, called “Dip n’ Rip”. This technique has players deliver an upward thrust, with contact made across the chest and shoulders. This technique drives the runner upright, while the head remains out of the impact. Players make sound tackles with the focus on stopping forward progress.
Protective equipment receives a tremendous amount of attention, both positive and negative, with regard to injury prevention. Some may blindly look for technology solutions, perhaps only after the problem has reached significant magnitude, at which point it is likely too late. Others believe that protective equipment cannot help, or they perceive that protective equipment leads players to take more risks, thereby making the problem worse.
In reality, protective equipment can play an important role when applied in the proper context. Protective equipment that minimizes the sudden movement of the head will reduce the risk of brain injury. However, no responsible equipment manufacturer believes that equipment alone can completely solve the problem of concussive episodes. No responsible equipment manufacturer wants their equipment to create a false sense of security. No responsible equipment manufacturer wants their equipment used as a weapon. However, better equipment is clearly a piece of the risk reduction strategy.
Arguably the biggest problem in football is “playing through” a concussive episode; this is an extreme thing to do, and dramatically increases the risk of further injury and increased disability. This is a result of the gladiator mentality, which mandates playing through pain. Players may come forward to reveal symptoms of a concussive episode, but it remains likely that players will work to stay on the field. It will be up to those around the players to recognize and report injuries.
Certified athletic trainers are often closest to players regarding physical injuries, and are therefore in a logical position to spot concussive episodes, or elicit honest information from players. Efforts to increase or mandate the presence of athletic trainers are certainly likely to result in better injury recognition.
In the absence of certified athletic trainers, coaches, officials, parents, and players still have a role. One concept, promoted by Dr. Gerry Gioia of Children’s National Medical Center, is called “Carry the Clipboard.” The Center for Disease Control (CDC) offers free materials, designed to attach to a clipboard, providing a helpful checklist for awareness and management of concussive episodes. Carry the Clipboard suggests that one adult at each sporting event be assigned to carry the CDC information on a clipboard, designating that adult as responsible for recognizing players who appear to be debilitated, and for contacting a local expert. Preparation for more serious or critical injuries is also strongly advised.
Once an injury is experienced, proper management under the care of an expert (or someone closely aligned with an expert) is imperative. Improper management, or no management, dramatically increases the chances for repeated injury, prolonged dysfunction, progressive disease, or fatality.
Return to play decisions are rarely clear cut, but the science is evolving rapidly, and conservative management is always warranted. A great rule of thumb is “when in doubt, sit them out.”
The epidemic of concussive episodes is a major public health issue. A role for legislation or mandates clearly exists. Several states have passed or are considering measures that require players to receive medical clearance before returning after a diagnosed concussion. This is a step in the right direction, but is relevant after the fact, and assumes a diagnosis was actually made; it is aimed at secondary prevention, and is not going to affect the vast majority of the injuries that go undiagnosed.
Primary prevention, the goal of preventing an injury from ever occurring, must be paramount. Legislation by the government, or mandates by institutions, aimed at educating anyone involved in overseeing athletic activities and minimizing exposures, would prevent countless injuries. If a youth football coach knew the dangers of concussive episodes, and was compelled to think about the practices he ran, the techniques he taught, and the behavior he rewarded, primary prevention would be a reality, and the gladiator mentality would die out. The Enlightened Warrior would be born.
Concussive episodes in football have reached epidemic proportion, and a complete risk reduction strategy must be built. Football has evolved over decades into something it was not intended to be, and the sport is often played in an extreme way. The extreme form of football must be eliminated, so the benefits of the game, including teamwork, selflessness, overcoming adversity, and achieving goals, can be maximized.
It is time for some enlightenment.
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