Concussions and football: New helmets, new tools

Football season is almost here again — professional players, high school and college students are all gearing up for the season. You don’t have to be a physician to understand that lowering your head and charging full speed into another person is not good for your health. When my teenage son decided to join his middle school football team and become a lineman, I weighed my concern versus the positive benefits he would gain: teamwork goal oriented behavior and camaraderie.

Luckily, he wasn’t hurt and he didn’t sustain a concussion. I was also glad that these days coaches are quicker to remove injured players from the game and to administer the King-Devick test of rapid number naming for concussions, which is a quite sensitive test well studied by Dr. Steven Galetta chairman of neurology at NYU Langone Health and Dr. Laura Balcer, co-director of the NYU Langone concussion center. 

At the same time, more sensitive imaging studies for concussion are becoming available and blood test markers are, too. Coaches and doctors have a growing arsenal of tools.

Early detection of concussion means getting players off the field before repeated blows and traumatic brain injury can occur. It also means sidelining players when needed and giving their brains a chance to heal over several weeks or month. 

I interviewed Hall of Famer and Giants linebacker Harry Carson a few years ago and I was struck by his recognition of how football had hurt him along with his resolute courage to overcome his disability as a successful television broadcaster. He was concerned about the risk to a teenager’s developing brain.

“It’s up to the parent as to what they’ll allow their kids to do. Part of the reason I’m so vocal is that I want parents to understand what they’re signing their kids up for.” 

Yes, as both a parent and as a physician, I am aware. But besides warning our teenagers and young adults about the short-term and long-term impact of head injuries in sports, what else can we parents do? One idea that has received a lot of attention is improving the helmets the players wear. For the first time, a helmet has been developed, which may finally make a difference. However, even the most sophisticated helmet still leaves the brain at risk.

The promising helmet is known as the Vicis Zero 1 Helmet, and it was first developed in 2017, when neurosurgeon Dr. Sam Browd teamed up with mechanical engineer Per Reinhall.

This helmet is much more expensive than traditional helmets, but it appears to be worth the money since it has four layers of protection. Its outer layer is designed to absorb shock, the next layer moves in multiple directions to reduce force, an inner shell prevents direct impact injury, and an inner foam layer is there to provide comfort.

For the last three years this helmet has been rated as the safest in the NFL, where it is receiving increasing attention and use. It has expanded into college football and now into high schools. 

I spoke with Dr. Frederic P. Rivara, vice chair and professor in the department of pediatrics at the University of Washington. He is a pioneer in helmet safety and he recently led a study by the Harborview Injury Prevention and Research Center, which evaluated the Vicis Zero 1 by surveying coaches in 21 high schools where the helmet was used by almost 100 percent of the players last season but not at all in the prior two seasons.  “We found that reported prevalence of concussions was lower using the Vicis helmet. This difference was both clinically and statistically significant.” 

Dr. Rivara also said that the coaches believed players had fewer headaches after games and generally felt better this last season compared to prior seasons with other helmets.  However, he cautioned that this was a small retrospective study and therefore not yet definitive, and larger prospective studies (where you test the helmet in play against other players wearing a different helmet) are still needed.

Still, he felt the study “suggests that in actual use it lessons the risk of concussions and overall impact to the head and brain.”

Repeated concussions are risky for the developing brain and I must confess that I was happy when my son decided not to sign up for the high school football team this year.

But for those who do sign up, I would urge caution, restraint and willingness to sit on the sidelines if you hit your head and don’t feel well.

Rapid number naming tests, blood and special imaging tests can all help detect concussions and a new helmet may help you to avoid them, but the best avoidance of all remains choosing a less risky sport.

Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent. Follow him on Twitter: @drmarcsiegel.