Is It Time to Retire the Football Helmet?

From the Wall Street Journal: An interesting article that compares the head injuries of the AFL and the NFL. Our game is not as rough as some may think.

NOVEMBER 11, 2009 Is It Time to Retire the Football Helmet?

New Research Says Small Hits Do Major Damage—and There's Not Much Headgear Can Do About It

By REED ALBERGOTTI and SHIRLEY S. WANG

This football season, the debate about head injuries has reached a critical mass. Startling research has been unveiled. Maudlin headlines have been written. Congress called a hearing on the subject last month.

As obvious as the problem may seem (wait, you mean football is dangerous?), continuing revelations about the troubling mental declines of some retired players—and the ongoing parade of concussions during games—have created a sense of inevitability. Pretty soon, something will have to be done.

Counterintuitive, or just plain dangerous? WSJ's Reed Albergotti discusses with colleague Chaz Repak why some experts think an NFL without helmets would vastly reduce on-field injuries in American football.

But before the debate goes any further, there's a fundamental question that needs to be investigated. Why do football players wear helmets in the first place? And more important, could the helmets be part of the problem?

"Some people have advocated for years to take the helmet off, take the face mask off. That'll change the game dramatically," says Fred Mueller, a University of North Carolina professor who studies head injuries. "Maybe that's better than brain damage."

The first hard-shell helmets, which became popular in the 1940s, weren't designed to prevent concussions but to prevent players in that rough-and-tumble era from suffering catastrophic injuries like fractured skulls.

But while these helmets reduced the chances of death on the field, they also created a sense of invulnerability that encouraged players to collide more forcefully and more often. "Almost every single play, you're going to get hit in the head," says Miami Dolphins offensive tackle Jake Long.

What nobody knew at the time is that these small collisions may be just as damaging. The growing body of research on former football players suggests that brain damage isn't necessarily the result of any one trauma, but the accumulation of thousands of seemingly innocuous blows to the head.

The problem is that there's nothing any helmet could do to stop the brain from taking lots of small hits. To become certified for sale, a football helmet has to earn a "severity index" score of 1200, according to testing done by the National Operating Committee on Standards for Athletic Equipment, or Nocsae. Dr. Robert Cantu, a Nocsae board member and chief of neurosurgery at Emerson Hospital in Concord, Mass., says that to prevent concussions, helmets would have to have a severity index of 300—about four times better than the standard. "The only way to make that happen, Dr. Cantu says, "is to make the helmet much bigger and the padding much bigger."

The problem with that approach, he says—other than making players look like Marvin the Martian—is that heavier helmets would be more likely to cause neck injuries.

One of the strongest arguments for banning helmets comes from the Australian Football League. While it's a similarly rough game, the AFL never added any of the body armor Americans wear. When comparing AFL research studies and official NFL injury reports, AFL players appear to get hurt more often on the whole with things like shoulder injuries and tweaked knees. But when it comes to head injuries, the helmeted NFL players are about 25% more likely to sustain one.

Andrew McIntosh, a researcher at Australia's University of New South Wales who analyzed videotape, says there may be a greater prevalence of head injuries in the American game because the players hit each other with forces up to 100% greater. "If they didn't have helmets on, they wouldn't do that," he says. "They know they'd injure themselves."

Dhani Jones, a linebacker for the Cincinnati Bengals who has played rugby, too, says head injuries in that sport do happen, but they're mostly freak accidents. "In football, you're taught to hit with your face," he says. "You're always contacting with your 'hat,' which is your head."

Taking away helmets might have other benefits for the sport. It would bring down the cost of equipment, which can be crippling for some schools. A slower game might also be more palatable to some parents. And with their heads uncovered, football players might be more attractive to endorsers.

By all accounts, banning helmets isn't on anyone's agenda. Greg Aiello, a spokesman for the NFL, says the league isn't contemplating the idea. Its focus is on improving helmet technology and on rules "that help take the head out of the game." Not wearing helmets, he says, "is not going to eliminate the risk of concussion in a sport that involves contact." Dr. Thom Mayer, a medical adviser to the NFL players' union, says there isn't enough research showing that playing without helmets would reduce brain injury. "It's an interesting theoretical question, but I don't think anybody would consider playing NFL football without a helmet," he says.

Larry Maddux, the head of research and development for helmet-maker Schutt, says even without helmets, players would inadvertently get hit in the head—and regular knocks and bumps could turn into concussions. Thad Ide, the vice president of research and development at Riddell, the NFL's official helmet sponsor, says getting rid of helmets would be a bad move. "There would always be incidental contact," he says.

So what should be done?

Julian Bailes, a neurosurgeon who has conducted brain research for the players' union, says the NFL should change the rules so linemen aren't allowed to go into three-point stances before plays—a rule that would prevent them from springing head-first into other players. He says he would also stop all head contact in football practices. Dr. Cantu says brain injuries could be reduced by enforcing rules already on the books in the NFL—especially helmet-to-helmet hits, which are not always called by officials. "There have to eventually be some hard sanctions for referees," he says.

To many, the solution is to come up with a better helmet. The NFL is currently conducting independent testing of helmets with a focus on "more accurate and comparative information about concussive forces," says neurologist Ira Casson, a co-chair of the NFL's Mild Traumatic Brain Injury Committee.

In the past, attempts to create a better helmet haven't met with much success. Robert Cade, who is better known as an inventor of Gatorade, created a shock-absorbing helmet that was used by a number of NFL players in the 1970s. In the late 1980s, Bert Straus, an industrial designer, came up with the ProCap, a soft outer shell that fits over helmets to help absorb blows. It was also used by some NFL players but also never caught on.

Nonetheless, the strongest argument for the helmet may turn out to be an economic one. The NFL is shaped around the notion that players can run into each other at high speeds without consequence. It's the same sort of idea that has made Nascar the nation's most popular form of motorsport. And beyond all this, there's the very real question of whether the prospect of serious mental impairment later in life will ever discourage people from playing the game—let alone watching.

"Without the helmet, they wouldn't hit their head in stupid plays," says P. David Halstead, technical director for the Nocsae, the group that sets helmet-safety standards. But without helmets, the game "wouldn't be football," he says.

http://online.wsj.com/article/SB1000142405274870440240457452788198429945...

- REED ALBERGOTTI and SHIRLEY S.