Head Injuries In Football Research Articles

“I’m Worried They Will Come Back to Haunt Me”: Examining How Retired National Football League Players Make Sense of Concussion Risks

This qualitative study examines how former National Football League (NFL) players retrospectively make sense of concussion risks post-retirement. Semi-structured interviews were conducted with retired NFL players ( N = 10) who sustained at least one official concussion during their professional career. Guided by sensemaking theory and reflexive thematic analysis, themes were generated to characterize player attitudes toward concussion risks. Themes identified include concussions represent an invisible threat, concussions create more concern than other injuries, and head injuries change player outlooks on career longevity. Player strategies to mitigate concussion risks included avoid thinking about the risks by focusing on the moment or on the financial rewards, rely on teammates to look out for each other’s health, and recognize the fine line between valor and discretion. The findings inform risk communication efforts geared toward reducing head injuries in football, as players must balance competing goals of elite performance and sustaining their football career versus prioritizing their long-term health.

Football Shoulder Pad Design and Its Effect on Head Kinematics in Shoulder-to-Helmet Impacts.

Shoulder-to-helmet (STH) impacts have been shown to cause approximately twenty percent of concussions in football yet little research has investigated shoulder pad design and STH impacts. This study aimed to characterize STH impacts and identify the effect of shoulder pad design on the struck head kinematics. Additional padding was added to a shoulder pad, and was then compared to an unmodified control shoulder pad. Participants performed a series of tests where they struck a helmeted Hybrid III dummy with both shoulder pad variations to compare struck head linear and rotational kinematics. The study found the modified shoulder pad reduced peak linear acceleration by 31% (Δµ = -9.13g's (-∞, -7.25), (p = 4.10e-08)), rotational acceleration by 28% (Δµ = -565rads-2(-∞, -435), (p = 2.10e-07)), peak rotational velocity by 10% (Δµ = -2.42rads-1 (-∞, -1.54), (p = 6.9e-05)), and increased impact duration by 40% (Δµ = 9.96ms (8.06, ∞), (p = 1.142e-08)). Impact response corridors were developed for both shoulder pad conditions and can be used to establish a controlled lab test setup that replicates STH impacts. Our findings suggest that shoulder pads have the potential to reduce head injury in football and warrant further research.

The neurological risks of playing association football.

SummaryAims:The present study aims to provide a narrative review of the literature surrounding concussion and head injury in football and its clarity in evaluating the risk of long-term neurological disease.Findings:Epidemiological studies have shown correlations between participation in professional football and increased incidence of neurodegenerative disease and there have been reports of chronic traumatic encephalopathy (CTE) in the brains of former players in autopsy. These findings have been assumed by some to be the result of repetitive brain injury from head injuries and/or from heading the ball over a player's career. Data linking increased heading exposure with dementia is conflicting, and studies are limited by the reliance on retrospection and undocumented reports of concussion. It remains unclear whether CTE is unique to sportsmen or a variant of dementia pathology endemic in the population.Conclusions:Although logically appealing, there is no current evidence that heading is the cause of neurodegeneration amongst footballers and risks should be balanced by the protective mental and physical benefits of the sport. Physicians have an important role in providing balanced views in this emotive and controversial area.

Decision-making to stop or continue playing after football injuries - a systematic video analysis of 711 injury situations in amateur football

ABSTRACT Scientific injury registration via video analysis is lacking in amateur football. The purpose of this study was to analyse match injury situations with a focus on the decisions made by players and referees after sustaining a football trauma. In a retrospective cohort study, traumatic injuries sustained in any of the 305 matches of the highest amateur level (4th league) in Germany in the 2015–16 season were assessed by means of video analysis and a standardised video protocol. In total, 711 traumatic incidents at 919 different body regions had been recorded. The three most frequently injured body regions were the ankles (34.1%), the head (17.5%) and the knees (17.0%). 90% (n = 156) of head injuries were direct contact injuries, this percentage was significantly higher than that of contact injuries on ankle (68.4%; p < 0.001) or knee (52.6%; p = 0.001). Referees decided on foul play significantly more often in case of knee injuries (57.1%; p = 0.002) or ankle injuries (64.5%; p < 0.001) than in head injuries (39.8%). Only 26.1% of players with a head injury opted for substitution, which was lower than after ankle (27.8%; p = 0.78) and knee injuries (34.0%; p = 0.13). In conclusion, amateur football is associated with a considerable number of injury situations that are followed by match interruptions and the substitution of players. Players and referees decided to continue playing more often after a head injury than after an injury to other body regions. An advanced education programme on the risks and management of head injuries in football is required to prevent long-term health consequences.

A Qualitative Study of Youth Football Coaches' Perception of Concussion Safety in American Youth Football and Their Experiences With Implementing Tackling Interventions.

Due in part to concern about the potential long-term effects of concussion and repetitive head injuries in football, some programs have implemented tackling interventions. This paper explores youth football coaches' perception of football safety and their experiences implementing these interventions aimed at athlete safety. Using a qualitative approach, coaches were interviewed by means of a semi-structured protocol that covered: (a) demographics; (b) background and experiences; (c) personal relevance risks, safety, and benefits of youth football; (d) experiences with tackling technique; (e) experiences with mouth guard sensors; and (f) opinions on disseminating information on football safety. Most coaches felt that learning tackling at a young age helped prepare them for their playing later in life and believed that youth should begin playing tackle football at a young age. Coaches were mixed regarding their concerns about the risk for concussion and subconcussive head impacts. Still, most were receptive to changes in rules and policies aimed at making football safer. Findings from this study demonstrate that youth football coaches are important stakeholders to consider when implementing changes to youth football. Understanding coach perceptions and experiences may inform future efforts aimed to educate coaches on rules and policies to make the game safer for youth athletes.

A Review of the Incidence of Head Injuries in Football, Baseball, Ice Hockey, and Cycling

Head injuries in sports have merited greater attention from professionals, the media, and the general public in recent years. The purpose of this research was to conduct a review of articles that focus on the incidence of head injuries in football, baseball, ice hockey, and cycling. Twenty three studies were identified for inclusion because they contained quantitative data on the number or percentage of head injuries in those four sports. A table was created comparing the data by: sport, research design, level of play, and number of head injuries. Analysis of the data showed that the most studied sport was ice hockey, the most studied level of play was the professional level, and the most used study designs were case studies and emergency department surveillance. Some studies included implementation of prevention strategies to decrease the incidence of head injuries. The most common prevention strategies were rule changes and better equipment. Future studies will help determine the most successful prevention strategies that can be implemented in each sport to further reduce the incidence of head injury in sports.

Head injuries in professional male football (soccer) over 13 years: 29% lower incidence rates after a rule change (red card).

Absolute numbers of head injuries in football (soccer) are considerable because of its high popularity and the large number of players. In 2006 a rule was changed to reduce head injuries. Players were given a red card (sent off) for intentional elbow-head contact. To describe the head injury mechanism and examine the effect of the rule change. Based on continuously recorded data from the German football magazine "kicker", a database of all head injuries in the 1st German Male Bundesliga was generated comprising seasons 2000/01-2012/13. Injury mechanisms were analysed from video recordings. Injury incidence rates (IR) and 95% confidence intervals (95% CI) as well as incidence rate ratios (IRR) to assess differences before and after the rule change were calculated. 356 head injuries were recorded (IR 2.22, 95% CI 2.00 to 2.46 per 1000 match hours). Contact with another player caused most head injuries, more specifically because of head-head (34%) or elbow-head (17%) contacts. After the rule change, head injuries were reduced by 29% (IRR 0.71, 95% CI 0.57 to 0.86, p=0.002). Lacerations/abrasions declined by 42% (95% CI 0.39 to 0.85), concussions by 29% (95% CI 0.46 to 1.09), contusions by 18% (95% CI 0.43 to 1.55) and facial fractures by 16% (95% CI 0.55 to 1.28). This rule change appeared to reduce the risk of head injuries in men's professional football.

Cerebral concussion: a historical perspective.

No topic in sports has gathered more attention and publicity than the diagnosis, management, and long-term effects of cerebral concussion. The relevant history of concussion starts in 1905 when President Theodore Roosevelt drew attention to the football 'death harvest'. Soon after, rules started to change to reduce the amount and severity of head injuries in football. Up until 1980, the primary focus regarding concussions was to diagnose a potentially fatal intracranial hemorrhage. While aware of long-term consequences of concussions, the perception at the time was that virtually all concussions would 'clear' with time and rest. Concussion management guidelines gave way to objective neuropsychological testing in the early 1990s with the development of the ImPACT™ (Immediate Post-Concussion Assessment and Cognitive Testing) neurocognitive test. Led by organized football, in 1994 the National Football League (NFL) formed the Mild Traumatic Brain Injury Committee which began to investigate the cause of concussions, evaluate equipment (particularly helmets), and recommend methods for prevention. In 2005, the first case of chronic traumatic encephalopathy was described in a deceased football player, raising concerns about the long-term consequences of head injuries and concussions. Major advancements in contact sports and the military are underway to reduce the incidence of concussions and subconcussive blows to the head.

Use of headgear in football A computer simulation of the human head and neck

Although head injuries in football having approximately the same incidence as in American football and ice hockey, head protectors are barely used for prophylaxis. A detailed human head-neck model including force elements describing the material behaviour of human soft tissue structures such as ligaments, tendons, cartilage layers, intervertebral discs and muscles has been developed using multi-body system (MBS) modelling techniques to investigate the effectiveness of commercial headgear. For ball-head impacts at ball velocity of about v=20m/s the simulations calculate a Head Impact Power (HIP) index of 4.1 kW resulting in a five percent injury risk for concussion. When using headgear the resulting HIP-value comes to 3.91 kW meaning that the reduction of the injury risk is very small.

Do UK university football club players suffer neuropsychological impairment as a consequence of their football (soccer) play?

Male players from football and rugby clubs and sportsmen from a variety of noncontact sports clubs at a UK university were compared on biographical and neuropsychological test measures. A data analysis paradigm was developed and employed to control the inflation of Type 1 error rate due to multiple hypotheses testing. Rugby players sustained most head injuries in their chosen sport, but neuropsychological tests of attention, memory, and executive function provided no evidence of performance impairment attributable to the number of head injuries sustained or the football, rugby, or noncontact sport groups. Footballers' heading frequency was related to the number of football head injuries sustained, but no relationship was detected between footballers' heading frequency and their neuropsychological test performance. Following discussion of pertinent methodological limitations it is concluded that there was no evidence in this dataset of neuropsychological impairment consistent with either mild head injury incidence or football heading frequency. However, a need for further research examining the long-term neuropsychological consequences of such head injuries was identified.

Catastrophic Head Injuries in High School and College Football Players

Background Catastrophic head injuries in football are rare but tragic events. Purpose To update the profile of catastrophic head injuries in high school and college football players and to describe relevant risk factors. Study Design Case series; Level of evidence, 4. Methods We reviewed 94 incidents of severe football head injuries reported to the National Center for Catastrophic Sports Injury Research during 13 academic years (September 1989 through June 2002). Results In the study period there were an average of 7.23 (standard deviation = 2.05) direct high school and college catastrophic head injuries in scholastic football participants per year. There were 0.67 injuries per 100 000 (95% confidence interval: 0.54, 0.81 per 100 000) high school and 0.21 injuries per 100 000 (95% confidence interval: 0.0, 0.49 per 100 000) college participants for a risk ratio of 3.28 (95% confidence interval: 0.81, 13.3). The injuries resulted in subdural hematoma in 75 athletes, subdural hematoma with diffuse brain edema in 10 athletes, diffuse brain edema in 5 athletes, and arteriovenous malformation or aneurysm in 4 athletes. Fifty-nine percent of the contacts reported that the athlete had a history of a previous head injury, of which 71% occurred within the same season as the catastrophic event. Thirty-nine percent of the athletes (21 of 54) were playing with residual neurologic symptoms from the prior head injury. There were 8 (9%) deaths as a result of the injury, 46 (51%) permanent neurologic injuries, and 36 (40%) serious injuries with full recovery. Most players sustained a major impact to the head either from tackling or being tackled. Conclusion The incidence of catastrophic head injuries in football has remained low since the advent of the modern day football helmet in the early 1970s. The incidence of catastrophic head injuries in football is dramatically higher at the high school level than at the college level. Although the reason for this discrepancy is unclear, an unacceptably high percentage of high school players were playing with residual symptoms from a prior head injury. Coaches, athletes, athletic trainers, and medical personnel need to adhere to the guideline that an athlete with any neurologic symptoms from a head injury should be strongly discouraged from returning to play.

Mechanisms of head injuries in elite football

Objectives: The aim of this study was to describe, using video analysis, the mechanisms of head injuries and of incidents with a high risk of head injury in elite football....

Analysis and evolution of head injury in football.

To review head injury in football through historical, anatomic, and physiological analysis. We obtained data from a thorough review of the literature. The reported incidence of concussion among high school football players dropped from 19% in 1983 to 4% in 1999. During the 1997 Canadian Football League season, players with a previous loss of consciousness in football were 6.15 times more likely to experience a concussion than players without a previous loss of consciousness (P < 0.05). Players with a previous concussion in football were 5.10 times more likely to experience a concussion than players without a previous concussion (P = 0.0001). With the implementation of National Operating Committee on Standards for Athletic Equipment standards, fatalities decreased by 74% and serious head injuries decreased from 4.25 per 100,000 to 0.68 per 100,000. Significant declines in both the incidence and severity of head injury have been observed. The enhanced safety records in football can be attributed to the application of more stringent tackling regulations as well as the evolving football helmet. The role of a neurosurgeon is critical in further head injury prevention and guidelines in sport.

Head injury in football

There are a number of differences between the treatment of head injury in football and the treatment of head injuries arising in the general population from motor vehicle accidents and other causes. Firstly, there is the potential for prevention by appropriate measures such as training, appropriate rules and laws and the wearing of protection. Secondly, there is a degree of deliberateness of bodily contact in the so-called contact sports and in particular the collision sports. Thirdly, there are issues of management and decisions about return to play for those with mild head injury and rehabilitation for those with more catastrophic injuries. The risk of repeat injury and the aftermath of repeated injury is important.

Protocol for triage of football head injuries

Protocol for triage of football head injuries