The potential solution to serious head injuries in football is counter-intuitive

To any serious observer of pro (or college) football, it’s readily apparent that the association between the sport and serious, long-term brain damage is potentially an existential threat. Hollywood has made movies about the connection, many former NFL players are having their brains autopsied and turning up with signs of chronic traumatic encephalopathy (CTE), and parents increasingly appear to guiding their children away from tackle football at the youth level:

In September (2019), the NFSHSA witnessed its first decline in high school sports participation in 30 years. The number fell from about 7.98 million to about 7.94 million – a 43,395 difference – with football the biggest contributor to the decline.

The sport clearly has a problem.

Over the past 5 or 6 years, the NFL has taken several steps to try to demonstrate that they’re aware of the issue and that they care about it. They’ve changed the rules to try to minimize helmet-to-helmet contact and penalized it heavily when it occurs. They’ve put protocols in place that require medical evaluation for any serious head contact. No longer are those collisions simply written off as a player “getting his bell rung.”

They’ve worked to add an array of helmet designs that ostensibly reduce the likelihood of brain trauma when those hits do occur. And, this offseason, they’ve added a requirement that players at certain positions wear “guardian caps” – essentially padded coverings on their helmets – to try to minimize the likelihood of head-jarring collisions resulting from incidental collisions in the pre-season.

All of this seems to be moving in the right direction to reduce concussions, but what if some of it isn’t?

Raising the Red Flag

In so many respects, our default response to trying to reduce or prevent injury is often to progressively improve our defenses against it. In football, that can be seen dramatically with the evolution from a thin leather cap and minimal body padding 100 years ago to the space-age material clad gladiators that we’ve seen occupying the gridiron for the past half-century.

And I suspect most fans would view that as progress in the mission to keep players safer. But what if it’s not? Informed by discussions going on in the boxing world, I’ve been thinking about this issue since the controversy around head injuries started picking up steam – perhaps the last decade or so – and have been an advocate of the perspective that a way to reduce serious head injuries in football is actually to start stripping some of the armor away.

Take away the indestructible plastic helmet and metal facemask, and you’ll see a lot few players involving their heads in intentional contact – for obvious reasons. This perspective is not uniquely mine, of course.

I said a long time ago if you want to change the game take the mask off the helmet,” Mike Ditka said on NBC Sports. “It will change the game a lot. If you want to change the game and get it back to where people aren’t striking with the head and using the head as a weapon, take the mask off the helmet.”

And, increasingly, there’s a body of research that appears to be pointing in this direction.

So, I was fascinated to wake up this morning and see that at least one NFL head coach is thinking along similar lines.

Robert Saleh, head coach of the New York Jets isn’t calling for the abolition of helmets, but he is raising parallel concerns to the ones that I’ve outlined above about the new guardian caps:

He’s concerned that players will get in the habit of using their heads more than they otherwise would, given that the Guardian Cap eases the impact.

“I do think because of the soft blow, it’s kind of lending the players to use their heads a little bit more,” Saleh said. “I do think the first time when they take it off — anybody who has played football knows the first time you take your helmet off or you hit with the helmet or you have a collision, there’s a shock. I do think that if you’re waiting until the first game for that shock to happen. . . . I don’t know, time will tell. It’s just interesting with those Guardian Caps and what exactly are we trying to accomplish.”

In the same way that modern helmets imbue players with a sense that their heads are safe within those highly-engineered confines, Saleh is suggesting that extra padding provided by the guardian caps potentially lulls players into the false sense that head contact isn’t so bad, and that there could end up actually being more head injuries as a result when the players go back to playing without the caps.

I think that’s a very astute insight, and that he’s likely right.

Well then, why not simply mandate guardian caps permanently, so that rebound effect never occurs? I think this is a pretty likely outcome over the course of the next couple of years. So what’s the problem?

Let’s say that the guardian caps reduce the effect of impact by 10% (the number cited above), but that they increase the comfort level that players feel being a little more reckless about their head by 15%. It’s still quite possible to easily imagine a scenario where the severity of hits drops a bit but the frequency of those hits increases sufficiently to negate, or even reverse, those gains.

It’s not sufficient to test the impact performance of helmets in laboratories. As Saleh so critically points out, the thing that matters most is how those tools are deployed in the real world, by actual players, not doctors, like the NFL’s Allen Sills, who didn’t take kindly to Saleh’s disturbing lack of faith:

“The brain does not acclimate to head impacts,” Sills said. “The Guardian Cap helps mitigate those forces at a time of the season when we see the greatest concentration of them.”

I applaud Saleh for raising the issue, and I hope that, rather than pursuing a solitary path of increasing defensive equipment escalation, that the league will give serious attention to a far less obvious potential solution, in order to save its players, save itself, and save the game that we all love dearly.