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The NCAA’s Committee on Competitive Safeguards and Medical Aspects of Sports has called on the committees that set the playing rules for the various NCAA sports to evaluate the health and safety implications of every rule change before an action is taken.
The committee noted that while rule changes are typically made to ensure fairness on the playing field, or to adapt to changes in playing styles or equipment in a given sport, they can also have a health and safety impact by, for example, enhancing the risk of concussion.
It cited “a prime example” involving “a recent proposal from the Men’s and Women’s Ice Hockey Committee that would require schools to add 10-inch pegs to their rinks that goals would rest upon in order to keep them more firmly anchored in place. The committee wanted to add the pegs so that goalies can’t intentionally bump the goal off of its spot in order to stop play and negate an offensive threat. The committee’s discussion took place amid the context of competitive fairness, but there are potential health and safety implications of the goal being more difficult to move – players careening into a goal sitting on those pegs could, potentially, be at greater risk.
“So the competitive safeguards committee emerged from its meeting with a statement calling for all discussions of playing rule changes to include an evaluation of health and safety implications, even if the rule change, such as the hockey recommendation, wasn’t proposed for reasons related to health and safety. The committee asked that the NCAA Sport Science Institute and playing rules staffs develop a collaborative formal review process and report their progress at the committee’s December meeting.”
The non-profit Sports Legacy Institute (www.sportslegacy.org) announced earlier this week “a major advance in the effort to prevent concussions and brain damage in contact sports” with the launch of the Hit Count® certification program after two years of development.
Hit Count® builds on the progress that head sensor device companies have made in developing devices that can measure acceleration of the head. Current products used on the field are focused on alerting coaches, medical professionals, and parents when a potential concussive impact occurs.
Inspired by Pitch Counts baseball, which set limits to the number of times a player throws from the mound to prevent arm injury, Hit Count® Certified Devices will have a second function that measures and “Counts” impacts that exceed the Hit Count® Threshold, set by a committee of leading scientists, with the goal of minimizing brain injury.
“Research using sensor devices has revealed that each year in the United States, there are over 1.5 billion impacts to the heads of youth and high school football players,” said Chris Nowinski, Founding Executive Director of SLI who launched the Hit Count® initiative in 2012 with SLI Medical Director Dr. Robert Cantu. “Most hits are unnecessary and occur in practice. By utilizing Hit Count® certified products as a teaching tool for coaches and a behavior modification tool for athletes, we can eliminate over 500 million head impacts next season.”
Committee member Gerry Gioia, PhD, of Children’s National Medical Center and George Washington University School of Medicine, unveiled that the Hit Count® Threshold will be set at the subconcussive level of 20 g’s of linear acceleration. “This is the beginning of a major research and public health effort to limit brain trauma in sports. While current science does not provide a “safe” or “unsafe” Hit Count®, our goal is to eventually provide clear guidance for coaches and parents. We will need the youth sports, sensor manufacturer, and medical science communities to work together to provide reliable answers.”
Hit Count® Certified products will go through “a rigorous test protocol” developed by the University of Ottawa Neurotrauma Impact Laboratory in conjunction with engineers from the six Hit Count® Initiative sponsors, including Battle Sports Science, G-Force Tracker, i1Biometrics, Impakt Protective, MC10, and Triax.
“Head sensor devices involve complex technology, and many sensors on the market today are not accurate,” said Dr. Blaine Hoshizaki, Director of the Neurotrauma Lab that developed the test, which is open to any company in the space. “Hit Count® Certification, the first and only sensor certification in the marketplace, will give consumer and research scientists the confidence that the sensors are accurately measuring impacts, providing simple and actionable data.”
G-Force Tracker, which is implanted inside football, ice hockey, and lacrosse helmets, is the first company to be Hit Count® Certified, with more products expected to be tested and certified later this year.
The “blue ribbon” consensus committee that set the threshold included Drs. Robert Cantu and Ann McKee of Boston University, Kevin Guskiewicz of the University of North Carolina, David Hovda of UCLA, Gerry Gioia of Children’s National Medical Center, Blain Hoshizaki of the University of Ottawa, William Meehan of Harvard Medical School, and Kelly Sarmiento of the U.S. Centers for Disease Control and Prevention (CDC).
NFL players have been warned of long-term consequences of brain trauma as part of concussion education since 2010
Now it is time for the NCAA to adopt a similar approach, according to an organization called the Sports Legacy Institute (SLI), which is led by sports brain trauma experts Dr. Robert Cantu and Chris Nowinski.
In 2010, the NCAA began requiring concussion education for athletes and requiring members to develop and implement concussion management programs. However, concussion education materials provided by the NCAA to student athletes made no mention of the risk of Chronic Traumatic Encephalopathy (CTE), according to the SLI.
CTE is defined as symptoms associated with any degenerative brain disease for which brain trauma is an established risk factor, as a long-term consequence of concussions and sub-concussive brain trauma.
By contrast, NFL players began receiving concussion education materials developed by the NFL, NFL Players Association, and Centers for Disease Control and Prevention (CDC) with the following warning:
“According to CDC, ‘traumatic brain injury can cause a wide range of short- or long-term changes affecting thinking, sensation, language, or emotions.’ These changes may lead to problems with memory and communication, personality changes, as well as depression and the early onset of dementia. Concussions and conditions resulting from repeated brain injury can change your life and your family’s life forever.”
Cantu noted that CTE “can be a devastating neurological disease, and anyone voluntarily exposing themselves to repeated brain trauma should be warned of the consequences, even though we cannot yet perfectly quantify the risk.”
SLI claimed that it made its first request of the NCAA in January 2012.
Nowinski, a former All-Ivy defensive lineman for Harvard University, added that “NCAA athletes are not financially compensated for the health risks to which they are exposed. We need to appreciate the irony of asking scholarship athletes to trade a free education for the risk of a degenerative brain disease that may minimize the benefit of that education. Athletes deserve to have informed consent and the opportunity to modify their behavior based on established science.”
CTE, originally referred to as “dementia pugilistica” because it was believed to only affect boxers, is a progressive brain disease believed to be caused by repetitive trauma to the brain, including concussions or sub-concussive blows. CTE can only be definitively diagnosed after death through examination of the brain, and in recent years CTE has been diagnosed in dozens of former athletes at multiple research centers, including active and former NCAA athletes.
SLI noted that University of Pennsylvania football co-captain Owen Thomas committed suicide in April 2010, and was diagnosed with CTE despite never having a diagnosed concussion. Owen’s mother, Reverend Katherine E. Brearley, stated, “As responsible parents we had warned Owen of many life dangers such as drinking and driving, HIV, illegal drug use. If we had read some simple materials about the effects of CTE it would have allowed us to start a conversation with Owen. This would not have changed the fact that he had CTE, but we would have tackled that possibility as a family. We need materials for parents and young athletes to help them engage in a meaningful dialogue about the possible dangers.”
Former Eastern Illinois wide receiver Mike Borich, who was named NCAA Division One Offensive Coordinator of the Year as a Brigham Young University football coach in 2001, died in 2009 at the age of 42 while suffering from CTE, according to SLI. Borich struggled with problems with cognition, behavior, and addiction that may have been related to the disease.
Cantu and Nowinski serve on the Ivy League Concussion Committee and the NFL Players Association Mackey/White Traumatic Brain Injury Committee. In addition, Cantu serves as a senior advisor to the NFL Head, Neck and Spine Committee, and Nowinski is on the board of directors of the Brain Injury Association of America.