Concussions and Protecting Our Players

[The Honey Badger]

Read the articles in post #347. They answer many of your queries.

From the first article, second paragraph ;

Head injuries and concussions pose a serious threat to the welfare of young players. And research has shown that at youth level, on average between one and two players from each team will suffer a concussion every season. This is significantly higher than other contact sports such as ice hockey and American football.




Last sentence would lead you to think that protective sporting wear may have a role to play.

I am not advocating hard helmets, but perhaps more can be done to make the soft ones more effective.




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[The Honey Badger]

Strewthcobber,

Great visual.

So the no 1 cause of concussion by a Huge Margin is a head clash.

My point is that if everyone on the field wore head gear, then when you have a head clash you have double the padding.

We will never know if head gear reduces the incidence of concussion until trials are conducted with all players wearing head gear.

Apparently the incidence is lower in American football, for some reason.

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[The Honey Badger]

Said players may well feel some positive reinforcement for themselves after having so many knocks, regardless of the actual research, a placebo effect if you will for the risk of further concussions.

Said players are skewing the statistics and buggering up the research.

Perhaps only players prone to concussion wear headgear.




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[Gnostic]

I don't think you can make that assertion from the quoted research. The fact that there is no statistically significant reduction (in other words no definitive yes or no) with headgear makes the argument hard to support one way or the other in terms of concussion. That said other research I saw regarding the NFL argued quite vigorously that the excessive padding and armour of NFL players made them reckless and contributed to very significant injuries while not mitigating the risks of concussion. This study referenced some of the civil cases now before the US courts by ex-players suffering from suspected RTE.

 

[Quick Hands]

So, does anyone think Headgear may have assisted in this situation? View attachment 10189

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Yes. All the studies show that headgear would in most cases prevent this type of injury (but would have no impact on whether the player suffered concussion as well)

 

[Quick Hands]

From the first article, second paragraph ;

Head injuries and concussions pose a serious threat to the welfare of young players. And research has shown that at youth level, on average between one and two players from each team will suffer a concussion every season. This is significantly higher than other contact sports such as ice hockey and American football.




Last sentence would lead you to think that protective sporting wear may have a role to play.

I am not advocating hard helmets, but perhaps more can be done to make the soft ones more effective.




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Don't cherry pick a couple of sentences to prove a point. These are statements of the obvious, but every single study that I have read (and I've read quite a lot because I was awake to this 15 years ago and was a voice in the wilderness), no matter what the time span, what the age group or in which country has come to the same conclusion:


Wearing protective headgear will prevent (in most cases) the following:

1. scalp wounds and ear injury
2. skull fractures

But has been found to have no impact on concussion. I know that you're motivated by trying to stop players being injured, but the evidence is both clear and overwhelming.

This is reposted from earlier (my bold)

Outside the United States, there has been much study regarding the possible role of headgear in preventing concussions. In 2004, Rugby World Cup video footage was reviewed to show a statistically significant decrease in superficial head injury by those wearing rugby headgear.14 This was most prominent among forwards, who tend to be more physical. However, no reduction in concussion was noted. Marshall et al. reviewed protective equipment through 304 club-level players in New Zealand.20 Headgear again led to a statistically significant reduction in both ear and superficial scalp lacerations without concussion protection. Both scrum caps and mouth guards illustrated no statistically significant reduction in concussions.20 McIntosh performed a randomized controlled trial of rugby players in Australia with modified headgear in the 13- to 20-year-old age groups over a 2-year period. Comparison was made with the popular habit of not wearing headgear, standard available International Rugby Board headgear, and a new experimental headgear with added foam density. The intention-to-treat analysis showed no difference in the rates of head injury or concussion between controls and headgear arms. The final conclusion is that the board could not recommend modified headgear for reduction of concussions.

 

[cyclopath]

Strewthcobber,

Great visual.

So the no 1 cause of concussion by a Huge Margin is a head clash.

My point is that if everyone on the field wore head gear, then when you have a head clash you have double the padding.

We will never know if head gear reduces the incidence of concussion until trials are conducted with all players wearing head gear.

Apparently the incidence is lower in American football, for some reason.

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You're missing the point. The actual contact of 2 skulls isn't the issue, it's the deceleration force leading to the brain being injured within the skull. A padded skull hitting another will suffer the same deceleration within a negligible margin of error. They probably help reduce scalp injuries which result because the scalp is under tension so direct force leads to it splitting. The contact area is spread by the padding so less focussed.

 

[Strewthcobber]

Worth mentioning that World Rugby regulations limit the effectiveness of existing headgear by mandating densities thicknesses and materials.

There is research out there that shows you can reduce risks with different designs but there doesn't seem to be much desire to head in that direction at the moment


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[Quick Hands]

Worth mentioning that World Rugby regulations limit the effectiveness of existing headgear by mandating densities thicknesses and materials.

There is research out there that shows you can reduce risks with different designs but there doesn't seem to be much desire to head in that direction at the moment


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But the design won't have any effect on the cause of concussion which is the force of deceleration, as indicated by Cyclo above.

 

[Quick Hands]

Strewthcobber,



We will never know if head gear reduces the incidence of concussion until trials are conducted with all players wearing head gear.



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No, because in any clinical trial you need a control group with which to compare. There have been numerous trials which compare the incidence of concussions between a group wearing headgear and a group not wearing head gear. The group wearing headgear had a significantly lower incidence of scalp and ear wounds, but the same incidence of concussions.

 

[Quick Hands]

From the first article, second paragraph ;

Head injuries and concussions pose a serious threat to the welfare of young players. And research has shown that at youth level, on average between one and two players from each team will suffer a concussion every season. This is significantly higher than other contact sports such as ice hockey and American football.




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And two paragrahs later it says:

But as our recent research shows, wearing protective headgear may actually result in an increased risk of injury. This means that at the youth level, parents may insist on their child wearing headgear in the belief they are helping to reduce the injury risk, when in fact the opposite could be true.

 

[Derpus]

You're missing the point. The actual contact of 2 skulls isn't the issue, it's the deceleration force leading to the brain being injured within the skull. A padded skull hitting another will suffer the same deceleration within a negligible margin of error. They probably help reduce scalp injuries which result because the scalp is under tension so direct force leads to it splitting. The contact area is spread by the padding so less focussed.

This is what i always thought, but presumably a brain inside a hard helmet would still experience the exact same deceleration as a brain inside headgear, so why are NFL concussions less common? i would believe dodgy reporting or otherwise the impact must have some effect.

I wonder what the stats are like for higher force impacts, like motorcycle accidents where helmets are worn.

 

[cyclopath]

This is what i always thought, but presumably a brain inside a hard helmet would still experience the exact same deceleration as a brain inside headgear, so why are NFL concussions less common? i would believe dodgy reporting or otherwise the impact must have some effect.

I wonder what the stats are like for higher force impacts, like motorcycle accidents where helmets are worn.

In NFL it may be under-reported - there have been some fairly damning programmes on it, but that's just a guess.
Motorcycle accidents would be broken into different sorts of impacts - falls / slides; catastrophic deceleration etc.......... so would be hard to compare with rugby. A high speed motorcycle impact into an immovable object could kill you in many ways. Severe deceleration aint kind to many other organs - major vessels / liver / spleen / lungs / bowel.

 

[Quick Hands]

 

[Quick Hands]

 

[Quick Hands]

I suspect that until the last few years that concussion incidents have been grossly underreported for various reasons.

This US study notes some of them

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC155428/

 

[lou75]

Actually, I thought the kid wearing the helmet was easier for the scout to spot, I didn't for a moment think those flimsy things could protect a head from concussion

 

[Strewthcobber]

But the design won't have any effect on the cause of concussion which is the force of deceleration, as indicated by Cyclo above.

Absolutely you can reduce the magnitude of deceleration forces. High school physics will show you that if you increase the distance that the impact occupies, then the force goes down. Think airbags, crumplezones, tirewalls etc

One issue is that existing headgear are too thin to effectively make a difference, and hard shell helmets don't deflect/crumple.

They can't attenuate enough energy during impact to reduce the forces sufficiently to reduce the concussion force below the threshold

I agree with your later posts showing that there maybe other impacts from introduction of these sort of new headgear which may result in worse outcomes

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[Quick Hands]

Absolutely you can reduce the magnitude of deceleration forces. High school physics will show you that if you increase the distance that the impact occupies, then the force goes down. Think airbags, crumplezones, tirewalls etc

One issue is that existing headgear are too thin to effectively make a difference, and hard shell helmets don't deflect/crumple.

They can't attenuate enough energy during impact to reduce the forces sufficiently to reduce the concussion force below the threshold

I agree with your later posts showing that there maybe other impacts from introduction of these sort of new headgear which may result in worse outcomes

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But there has already been a 2 year trial using headgear with increased foam padding and the evidence was that it had no impact on concussion.

McIntosh performed a randomized controlled trial of rugby players in Australia with modified headgear in the 13- to 20-year-old age groups over a 2-year period. Comparison was made with the popular habit of not wearing headgear, standard available International Rugby Board headgear, and a new experimental headgear with added foam density. The intention-to-treat analysis showed no difference in the rates of head injury or concussion between controls and headgear arms. The final conclusion is that the board could not recommend modified headgear for reduction of concussions.

 

[Derpus]

Absolutely you can reduce the magnitude of deceleration forces. High school physics will show you that if you increase the distance that the impact occupies, then the force goes down. Think airbags, crumplezones, tirewalls etc

One issue is that existing headgear are too thin to effectively make a difference, and hard shell helmets don't deflect/crumple.

They can't attenuate enough energy during impact to reduce the forces sufficiently to reduce the concussion force below the threshold

I agree with your later posts showing that there maybe other impacts from introduction of these sort of new headgear which may result in worse outcomes

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So, uh, just make the headgear thicker?