YOCEMENTO, Kan. - In 1965 Ralph Nader wrote his earthshaking Unsafe at Any Speed: The Designed-in Dangers of the American Automobile, addressing the automobile industry's resistance to the introduction to safety features such as seat belts in designing cars.
Is football the new GM?
In an earlier article, I attempted to explain the physiology of repetitive hits to the head in football and the consequent brain damage. I mentioned the case of an eighteen year old. He died of other causes, but his brain upon examination showed evidence of tau neurofibrillary tangles; the same kind of tangles found in Alzheimer victims. The young man played only two years of high school football.
This evidence should be the source of concern for parents and young players. Is playing football at any age a potential threat to the brain?
While looking for an answer, I found a popular article, "Is Football Safe For Kids" by Kent Hannon, Sports Illustrated For Kids, 04 February 2008. The article, posted on various youth football program websites, is being used to calm parents' concerns about the dangers of football. The article concludes that "yes" football is safe for kids. All it takes is good equipment, proper tackling techniques, and a physics equation: force = mass x acceleration to prove the point.
Better Equipment + Proper Tackling Techniques = Safety
The article centers around an interview with a gentleman named Ray McEwen, a grounds keeper for the University of Georgia Bulldog's Sanford Stadium who in the past coached youth football. Mr. McEwen emphasized the importance of the helmet. Compared with the leather helmet introduced in the Army-Navy game in 1893, helmet design has come a long way. In 2002, the leader in helmet design and sales Riddell introduced the new "Revolution" helmet designed to reduce the incidents of concussions. A three-year, Riddell-financed study of high-school players by the University of Pittsburgh Medical Center found that the annual rate of concussion was 5.3% for players wearing the Revolution helmet and 7.6% for players wearing standard helmets.
Yet, it would seem that Mr. McEwen has placed too much faith in the helmet. He witnessed his son's traumatic helmet-to-helmet entanglement with another player, which resulted in his son's helmet being split in two. He is thankful that the helmet took all the force. But did it?
If helmets are working as well as Mr. McEwen believes that they do, then why are there so many concussions? A recent report from the Brain Injury Association Of Arizona states that there are about 41,000 concussions annually in high school football alone. And these are the reported concussions. The institute estimates that at least another six percent of concussions occur without being reported or even recognized. And this does not include moderate, sub-concussive, repetitive hits to the head, which has been shown in research to have effects on the brain just as devastating as the concussive hits.
Another study done by the University of Pennsylvania Sports Medicine Center points out that since the advent of the better helmet, the way in which players tackle has changed. Feeling more secure with protective head gear, players now use their helmets and subsequently their heads as "battering rams." Despite football programs such as youth programs discouraging helmet-to-helmet tackles, head-to-head tackling continues to happen at an alarming rate. In fact, it is even glamorized: the article talks about "head-jarring tackles, the kind that sports shows love to include in their highlight films."
Force = Mass x Acceleration
Citing the equation "force = mass x acceleration", Mr. McEwen, states that we don't have to worry about kids getting hurt playing football, because kids are smaller and do not generate much force.
This equation most definitely applies to bones. A two hundred fifty-pound bag of potatoes dropped from twenty feet in the air on to my foot would have a greater chance of breaking my foot than an eighty-pound bag dropped from two inches above my foot. But does this same logic apply to the brain as well?
To answer this question I spoke with Dr. Gavin Buffington, chair of the Department of Physics at Fort Hays State University. His answer to my question is an unequivocal "no." "The mass in the equation is the brain, and the size of the brain remains constant. A child's brain is relatively close to the same size of an adult brain. So a sixty- pound player is no different than a three hundred-fifty-pound player when you are talking about trauma to the brain."
According to Dr. Buffington, the more important equation to look at when it comes to football and brain injuries is the momentum-impulse theorem: the change in momentum equals the summation of forces over time.
This is saying that the change in momentum is equal to the change in force times the change in time. When the skull with the brain inside is in motion and then comes to a stop, the brain, too, must come to a stop. To come to a stop, the momentum of the brain has to be dissipated. The force is roughly determined by the speed the skull and brain are going, so this equation focuses our attention on the length of time the brain has to dissipate a hit. The more time your brain has to accommodate the hit, the better. Let me give an over-simplified example: if there are 12 units of momentum, and the time is 3 units, the force could be 4 units for each of the units of time. But if the time is only 1 unit, then the force on the brain would be 12 units--three times as much.
What makes the brain different than a bone in the leg like the femur is that the brain is surrounded by the meninges. The meninges hold the cerebral spinal fluid that encapsulates the brain. Unlike the femur, the brain is not directly connected to the head by tendons and ligaments. You could say that the brain floats inside the cranium, with the fluid acting as a cushion for the brain.
During regular activities such as turning our head, the movement of the brain goes unnoticed. However, if the head is subjected to quick acceleration--such as taking an elbow to the head during a tackle--the fluid does not have adequate time to react to the motion. Instead, the brain floating in the cranium reacts something like a pinball, bouncing off the cranium walls, causing bruising of the brain and concussions.
But what does time have to do with force. Isn't a hit a hit? Ben Faber, a physics student at the California Institute of Technology [in the interests of full disclosure, let me point out that Ben is our son] explains by using the following example. "Think of catching a baseball with your bare hands. If you keep your hands out in front of you and still, you will feel more pain at the time of impact, than if you catch the ball by sweeping your hands back behind you in a fluid motion. The same happens in the cranial cavity. If there is a large change in momentum over a short period of time, such as a player's head hitting the ground during a tackle, the force on the head is greater than if the player is allowed to throw his head back when hit by a tackle--which is harder on the cervical spine, but better for the brain. The head's motion backwards gives the brain more time to absorb the force leading to less damage to the brain."
And our competitive drives make matters worse. Our local high school coach is starting a year-round conditioning program to compete with the likes of rival Hutchinson High School. Dr. Buffington thinks that this will make matters worse for the player's brain. "When a kid muscles up, this usually results in increased neck muscle strength (hence, the no-neck look you see in some players). Now when the player is hit, he will have more neck strength to resist the hit. This will increase the force applied to the brain. It is like a car driving into a solid wall versus a pond. When you hit the wall, the time over which the change in momentum takes place is very short, making the force greater compared with driving into a pool, where the water allows more time to change the momentum meaning less impact to the car. Think of strengthening the neck as reinforcing the wall."
With the inherent dangers to the brain, why are parents allowing and even encouraging their children to play football? The Federated Football Association in Hays admits players as young as the 4th grade. In West Point, New York, there is a youth football program called the Junior Black Knights which allows children as young as six years old to play tackle football. The program's motto is: "Kids Don't Care What You Know Until They Know That You Care."
Do parents know enough to care that football is a dangerous sport? If they do know, do they not care? Dr. Buffington believes that parents do care. But he also believes that parents must have some inkling about the pitfalls of football. So why do they allow their children to play football? Dr. Buffington shrugged his shoulders. "It's lost on me."