Youth Football Concussions


Concussions have become a major issue not just with the National Football League, but also with youth football programs including Pop Warner and in elementary, middle and high schools and with parents who must consent to their children participating in these programs.

Pop Warner, known as the most popular youth football program in the United States, reports that participation has dropped 9.5 percent between 2010 and 2012. The reduction is blamed on the increased publicity on concussions and concussion protocol now plaguing the National Football League and youth football programs and in high schools and middle schools.

According to information provided to ESPN’s Outside the Lines, Pop Warner lost 23,612 players over a two-year period. Although the organization blames a number of issues for the decline including the desire of youngsters to concentrate in one sport, the organization’s chief medical officer Dr. Julian Bailes claims that head injuries is the number one cause for the falloff.

Concussion Effects On Pre-Teen And Teens

It is said that as many as 70 percent of football players in the United States are elementary and middle school students. Many of them suffer head injuries. This has become a major concern because neurocognitive and brain changes can occur due to repeated hits to the head, even when there is no evidence that a concussion has occurred.

A number of studies of the affects of head blows on youngsters who play football have been performed by a number of organizations including the Department of Biomedical Engineering and Mechanics at Virginia Tech University and Wake Forest Baptist Medical Center.

The Virginia Tech University study concentrated on youngsters who were between the ages of 9 and 12 who played organized football games and practiced regularly. The goal was to determine under what conditions high-magnitude head impacts occurred during practice and how much these activities coincided with game activities. It is believed that the data from the study will assist coaches on how to structure practices and games to reduce risks to young players.

The study isolated 45 players who were exposed to hits on the head from two categories –- juniors consisted of fourth and fifth graders who were 9 to 11 years old and seniors included sixth and seventh graders who were 11 to 13 years old. Researchers collected data and videos during a 14-game season and 55 practice sessions. The kids involved in the study wore helmets that included accelerometers that measure head impact. Whenever an accelerometer recorded a hit greater than 14.4g that data was automatically transmitted to a computer on the sideline.

Each impact was portrayed based on four things –- 1) the position of the player who suffered the head impact, 2) the location on the field that the hit occurred, 3) the cause of the hit, and 4) whether the hit occurred during a game or practice.

The measuring devices recorded 7590 hits. Five hundred seventy one or 8 percent were categorized as high magnitude. Youngsters who played quarterback, running back, and linebacker suffered more impacts than youngsters who played other positions. The high impact hits occurred when the player was tackled. Youngsters who played on the offensive and defensive lines suffered head impacts when blocking.

Of course, the more time a youngster played, the greater chance he would suffer a high-magnitude head impact. Youngsters who played quarterback, running back, and linebacker received such impacts during a game in the open field more often than youngsters at the line of scrimmage.

The study found that more of the higher intensity hits occurred during games rather than during practices. Twice as many high magnitude hits occurred among the Seniors than Juniors. Researchers concluded that difference in size and weight between Juniors and Seniors alone did not account for the differences in the number of high magnitude hits. Video data showed that intensity of activity in practices or coaching style might account for some of the differences.

Eamon Campolettano, lead researcher of the study and a graduate research assistant, and Dr. David Dodick, a professor of neurology with the Mayo Clinic in Scottsdale, Arizona, who both participated in the study, concluded that although one player suffered a diagnosed concussion, multiple sub-concussive impacts can add up to long-term damage to the brain.

Dodick added that the younger a child is exposed to this type of impact, the more likely they will have psychiatric and neurological problems later in life.

Campolettano suggested that youth football could be made safer if practice activity did not include tackling or heads-up tackles and he believes that trained coaches should be involved in teaching proper technique to youth players.

Wake Forest performed two studies.

The first used in-helmet sensors to record the number and location of impacts to the head and the linear and rotational acceleration the hits caused to the heads of 97 players who were between 9 and 13 years old .The youngsters participated in an organized youth football program that included practices and games over four seasons. Three competition levels were part of the study. They included:

• Level A consisting of players who were 11 years old and weighed up to 124-lbs.
• Level B including players who were 12 years old and who weighed up to 139-lbs.
• Level C consisting of players who were 13 years old and who weighed up to 159-lbs.

The study found that youngsters in level C had greater linear head accelerations than kids in Levels B and A. Moreover, linear and rotational accelerations were considerably greater in games. Although about two-thirds of all head contacts within the three levels occurred during practice, a greater percentage of high-magnitude impacts were higher in games. In addition, the number of impacts in games increased with the level of play.

The second Wake Forest study involved differences in the number, location and magnitude of head impacts suffered by young athletes during youth football practices. The information coming out of the study could encourage recommendations for activities performed during practice and could include modifications of some high-intensity drills to reduce risks to players.

The research included the collection of biomechanical data as well as videos to evaluate the number, location, and intensity of head hits suffered by nine players during practices. The players were members of the same team and their average age was 11. The helmet of each player was equipped with a Head Impact Telemetry (HIT) System, which measures head acceleration resulting from the hits. Hits that was greater than 10g were automatically transmitted to sideline computers. Videos were paired with the biomechanical data.

The practices included 11 drills –- dummy/sled tackling, install, special teams, multiplayer tackle, Oklahoma, one-on-one, passing, position skill work, scrimmages, and tackling drill stations.

The nine players who participated in the study were involved in a total of 30 contact practices and sustained a total of 2,125 head hits. Frequency of impacts was determined by the number of impacts that occurred per minute per player for each drill. Intensity of each hit was determined by the amount of linear and rotational acceleration of the head.

The study found that the most number of head impacts occurred during contact drills involving multiple players. The higher intensity hits happened during tackling drills. It also concluded that the high magnitude head impacts that occurred during open field tackles were caused by the acceleration of the players as they moved toward each other across distances of more than three yards. However, on one-on-one tackling drills, the intensity of head impacts was less than during open field tackling because less ground is crossed before the encounter between the two players occurs. Although there was a high rate of head impacts during multiplayer tackle drills, they were of lesser intensity than impacts that occurred during other tackling drills. The study suggests that this may be because there was more emphasis on blocking instead of tackling during the drill.

The study provides information that will assist health professionals, coaches, and youth football leagues whether or not to modify or eliminate particular drills from practice sessions to reduce risks to players.

Could Helmet Innovations Remedy The Problem

Modifying or eliminating some practice drills and better technique in executing tackles during games can help to reduce high magnitude head impacts. However, the best way to limit the hard hits that may or may not lead to concussions is to innovate the helmet so that it absorbs most of the intensity of the blow.

There are companies that offer and/or are developing helmets that do reduce the intensity of impacts, thus reducing the chance of concussions. They include Guardian Cap Innovations, Vicis, Xenith, and Riddell.

The Guardian Cap is a soft shell cover that has the proper density, stiffness, and energy absorption to reduce the initial impact. It is made of custom urethane foam with an exterior made of a low coefficient fabric similar to spandex that has a decoupling effect. It is designed to fit over the top of the helmet and loops around the facemask with elastic straps and Velcro.

The cap has been through a series of impact tests which involved placing a football helmet on a head form similar to a crash test dummy. The form had an accelerometer in it. It was struck at various speeds and the G-force that was inflicted on the head was measured. Then the tests were performed with a Guardian Cap on the helmet. The result was up to 33 percent less impact intensity than without the cap.

Many former NFL players have spoken highly of the cap. They include Fred McCray, who played for a number of NFL teams including the San Diego Chargers and New England Patriots; Rodney Harrison, who played for the Chargers and Patriots; Mark Kelso, who played for the Buffalo Bills; and Steve Walsh, who played quarterback for a number of NFL teams including the Dallas Cowboys, New Orleans Saints, and Chicago Bears.

The cap was first introduced in 2012 and is now worn in practice sessions by more than 60,000 athletes who participate in youth football. Moreover, football programs of more than 50 colleges including Clemson University are using the cap during their practice sessions.

In addition, the Guardian Cap won the first NFL HeadHealthTECH Challenge. The program is a comprehensive plan by the National Football League and Football Research, Inc. to encourage sporting good companies, manufacturers, other small businesses, entrepreneurs, and universities to develop improved helmets and protective equipment in the next three to five years.

Vicis is developing the Zero1 helmet that includes, a layer of hundreds of flexible columns that perform like a shock absorber sandwiched between a flexible outer shell made of a bendable plastic, and an inner shell and liner that offers a better fit around the head of the player.

According to the company, it has received more than $10 million in funding as well as $500,000 from the National Football League to develop the helmet.

Xenith’s helmet features a lining of 18 thermoplastic airflow shock absorbers embedded in a flexible cap that dissipates energy to decrease acceleration of the head preventing the shaking that causes concussions.

Riddell is developing the SpeedFlex helmet with such features as:

• Flex of the helmet’s shell, facemask and attachment system to reduce impact-force to the head.
• A ratchet-style chinstrap attachment system for proper fit.
• An interior liner in the helmet that contours with the shape of the player’s head to improve comfort and fit.

An innovation that could lead to better helmets that could prevent concussions is “shear thickening fluid.” The fluid is similar to oobleck, a substance that is the result of mixing cornstarch and water. When you squeeze the substance in your fist, it becomes a hard ball. However, when you release the grip, the substance drips like liquid. Some scientists believe that “shear thickening fluid” will someday be incorporated into football helmets.

As of now, however, most helmets currently being used by football players of the National Football League, college, high school, and middle school as well as youth football leagues such as Pop Warner, do not adequately protect against high magnitude impacts. So hits that cause semi and full concussions will continue to occur.