The study, published online in JAMA Neurology in February 2021, found that over five seasons, 72 percent of concussions and 67 percent of head impact exposure occurred in practice, not game play. Furthermore, nearly half of the concussions and two-thirds of the high-impact hits to the head that the researchers recorded took place during preseason training, which accounts for only one-fifth of the season. “It’s actually shocking that this is allowed to occur,” says Christopher Nowinski, PhD, CEO and cofounder of the Concussion Legacy Foundation in Boston, who was not involved in the study but coauthored a February 2020 editorial in JAMA Neurology that accompanied the study. “We’ve known for more than a decade that most hits to the head happened during practice, and that doesn’t need to happen ever. This study shows there’s a tremendous need to reduce hits to the head through education and new rules.” Dr. Nowinski noted in his editorial that professional football drastically reduced the number of concussions their players suffer by limiting contact in practice. Now that the National Football League (NFL) Players Association allows only 14 full-contact practices during its 17-week season, only 18 percent of NFL concussions have occurred in practice. As for high-school football, nearly 40 states have rules that ban or limit full-contact practices. “College football has gotten a pass because all the power resides with the coaches,” says Nowinski. “And the coaches won’t change the practices cause they think it will put them at a competitive disadvantage, even if that means sacrificing the brain of a young person.” Nowinski pointed out that some coaches are paving the path forward, noting that in 2016, the coaches in the Ivy League voted to eliminate full-contact practices. For the current study, a team of neurosurgery professors at the Medical College of Wisconsin, along with colleagues from the Concussion Assessment, Research, and Education (CARE) Consortium, tracked the data from sensors placed in the helmets of 658 players at six different schools from 2015 to 2019. The sensors detected more than 500,000 hits to the head, for a median number of 415 head hits for each player for every season, with preseason head hits happening twice as often as regular season ones. During the study, 68 players who wore sensors had diagnosed concussions. “This is likely a severe undercount,” says Nowinski, highlighting that the sensors only went to the starters so the head hits from a team’s reserves were not recorded at all. And, since the reserves usually play in practice but not in the games, they would likely add to the portion of practice-related head injuries if they were counted. “ RELATED: Facts About Post-Concussion Syndrome
Football Practice Reform Needs to Come From the Coaches
Nowinski complimented the researchers for delivering a sobering message to the NCAA, which funded the study along with the U.S. Department of Defense. The researchers wrote in their study that the NCAA’s interventions have had a minimal effect in reducing the incidence of preseason concussions. “It’s important to draw attention to the issue and to open up a discussion about what college football can do,” he says. “Unfortunately though, the power is in the hands of the coaches, who are not yet motivated to change their ways.” The researchers acknowledged Nowinki’s point in the study. “Football practice reform to reduce exposure and risk of concussion will undoubtedly require engagement from coaches, who ultimately design and implement drill-specific practice activities,” they wrote. “Our data supports the development of robust educational offerings that should be customized to specific audiences, including coaches, athletic administrators, and players.” Nowinski pointed out that the very act of observing practices for head hits should have reduced the number of injuries occurring, and yet the study recorded more than half a million head hits when the coaches knew that a team of researchers was watching and recording every moment of impact. “These are coaches who know they’re being monitored and recorded,” says Nowinski. “So, just imagine what’s happening at a program where kids are on scholarship to play football and there’s no oversight. “That’s largely why we’re focused on practice,” he adds. “It is entirely within the control of the coach. You’re literally hitting your own teammates, but you can learn how to play and learn the necessary skills without helmet-to-helmet contact or lowering your head to hit someone.”
