Matthew Ducsik

PAH 575

High School Football Standards and Concussions

More than one million young men play high school football every year. This participation results in 350,000 injuries in absolute numbers, or 16-20 injuries per 100 players. Research suggests that between 17-48% of players suffer some type of injury each season (Turberville, 2003, Langburt, 2001).

A concussion is a type of traumatic brain injury caused by impact or rotational forces. Although the brain is protected by the skull and cerebrospinal fluid, trauma occurs where the forces are such to offset this protection. Concussions are graded on three levels of progressive severity. There are multiple grading systems; however, each system assigns grades based on amnesia, confusion, loss of consciousness, and symptom duration. The rate for concussion in the general population is .6% (6 per 1000).

Scientific literature states that between 6-48% of high school football players reported at least one concussion, characterized by loss of consciousness or loss of awareness (Langburt, 2001). 15% of players report having symptoms lasting longer than seven days; 1.5% report symptoms longer than 30 days. All high school athletes face a higher degree of risk for concussion; however, football players account for 52-63.4% of all cases.

Efforts to reduce or mitigate the effects of concussions have centered around two areas: helmet replacement and coach education. In 2009, Oregon passed SB 348, also called “Max’s Law that trains coaches how to recognize signs of concussion. Legislatures removed a provision from a previous version that would have forced school districts to replace used helmets frequently. Interestingly, one study showed that for every year increase in coaching experience, the risk of concussion increased by 13% (p < .05).

Helmet replacement mandates have been politically controversial, with financial concerns representing the largest barrier. St. Louis passed a policy that mandates replacing any helmet that is over 10 years old. Critics have cited the high costs of such initiatives and the relative lack of scientific evidence that proves that newer helmets protect players better against concussions.

Football helmets themselves represent a safety innovation from past years. However, helmets have never been formally tested against the types of forces that cause concussions. In addition, there is no government or independent oversight on the industry. Helmets are tested for their ability to withstand extreme forces that cause skull fractures, but they are not evaluated on their ability to protect against the hundreds of potentially concussive blows that a player may encounter in one season. There is additional concern that helmet standards have not kept up with modern football and the increased size and speed of players.

Questions:

  1. Some critics of current helmet standards believe that the FDA should assume oversight of the helmet industry in order to ensure that proper safety standards are met. Do you agree with this position?
  2. Given the uncertainty around a football helmet’s ability to protect against concussion, which do you think is the better policy: force school districts to use newer helmets, or force manufacturers to adhere to higher standards?
  3. Choosing either option, what are some ways to leverage the current public awareness of football-related concussions to bring a policy to a formal agenda?

Readings:

Please skim the research on incidence of concussion and risk of injury in high school football.

Wikipedia provides an overview on the physiology of concussions:

Excellent New York Times article on helmet standards and safety:

New articles on “Max’s Law,” the bill itself, and the voting:

Article on the St. Louis helmet policy: