The fall sports season seems to get the rap as “concussion season.” I cannot count how many conversations I’ve had with people on the safety of football related concussions. 1.7-3 million sports and recreation-related concussions happen each year and 300,000 are football related. The media tends to LOVE to write articles and news segments on the danger of football related to concussions along with chronic traumatic encephalopathy (CTE) as it is a huge attention grabber. I often find myself giving people the actual facts behind concussion research from current evidence. A recent viewpoint paper in JOSPT related to CTE states, “The benefits of rapid, widespread reporting and increased public awareness are counterbalanced by misinformation and an oversimplification of an increasingly complex topic.”
I relate this media-dense topic to news reports when someone tragically passes away while running a marathon. The news seems to spin the topic and make viewers believe running is bad for you. However, they “forget” to mention that the risk of sudden death during a marathon is 0.8 per 100,000 people. Notable: the risk of dying from diabetes is 23 per 100,000 and risk of dying in a motor vehicle accident is 1 per 6,700 people.
Although concussions cannot be taken lightly, I believe we need more research before we start jumping to conclusions on the danger of football. For example, current high school statistics from UPMC show that women’s soccer sees the second-most concussions in high school sports and women’s basketball sees the third most. With this being said, football still sees the most concussions in high school sports, but that doesn’t mean it should be the only sport being talked about. Current surveys are showing that the number of participants in football has gone down by 25,901 participants in 2016-17 and many schools have changed from 11 man to 8 man football.
The decline in football participation is being correlated to the risk of concussion, chronic traumatic encephalopathy, and fear. It is important to note that football is the safest that it has ever been. I’m not a huge fan of rule changes (we will not talk about the newer treating quarterbacks like princesses rule), however rule changes on hitting defenseless players have made a huge impact in risk-reduction. Let me be clear: impact does have to happen for a concussion to occur, but the amount of impact seems to not matter as long as the player is not defenseless. Have you watched a game and seen how hard they headbutt each other after a touchdown, yet no concussion occurs?
Since the rule change in the NFL for targeting a defenseless player was instated, concussions in regular-season games dropped from 173 reported cases in 2012, 148 in 2013, and 112 in 2014. Additionally, concussions resulting from helmet-to-helmet hits were down 43% over two years (52 reported cases in 2014 after 91 in 2012). In youth football the Heads Up program resulted in a 76% reduction in injury and 34% reduction in concussions since 2013, with hits to defenseless players down 68%.
Last, we will briefly talk about chronic traumatic encephalopathy (CTE). The important thing to note from the 5th international conference on concussion in sport is, “A cause and effect relationship has not yet been demonstrated between CTE and sport-related concussions or exposure to contact sports.
As such, the notion that repeated concussion or subconcussive impacts cause CTE remains unknown.” Although the current evidence on CTE seems pretty strong and is continuously developing, we are not able to say subconcussive hits in football cause this condition until more research is done.
Questions, Thoughts, Comments, send them our way!
Dr. Dillon Caswell, PT, DPT
References
Asken BM, Bauer RM. Chronic Traumatic Encephalopathy: The Horse Is Still Chasing the Cart. J Orthop Sports Phys Ther. 2018;48(9):672-675.
Available at: http://www.upmcphysicianresources.com/files/dmfile/S725-UPMC_Restore_Concussion_SpecEd_11. 2.
Available at https://operations.nfl.com/media/1815/2015healthsafetyreport.pdf.
Available at: https://bleacherreport.com/articles/2726124-report-shows-continuing-drop-in-high-school-football-players
Mccrory P, Meeuwisse W, Dvorak J, et al. Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017.
Meaney DF, Smith DH. Biomechanics of concussion. Clin Sports Med. 2011;30(1):19-31, vii.
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