H. Hunt Batjer, MD, FAANS, FACS (left)
Co-Chair, National Football League Head, Neck and Spine Committee
Dallas, TX
Richard G. Ellenbogen, MD, FAANS, FACS (right)
Co-Chair, National Football League Head, Neck and Spine Committee
Seattle, WA
The National Football League (NFL) has a tremendous opportunity, if not responsibility, to continue to advance progress on the prevention and treatment of head injuries. As volunteer members of the League’s Head, Neck and Spine Committee, our mandate is to provide counsel on neurological issues relevant to the health and safety of football. We have dedicated our careers to caring for patients and studying a wide range of scientific issues related to the diagnosis, management and long-term effects of head injuries, including concussions. It is through this lens that we aim to enact change that will not only impact professional football players but generate a watershed effect on athletes of all ages, across all sports and the general public.
We work closely with the League to encourage investment in research that will advance the diagnosis, prevention and treatment of head injuries. Already the NFL, along with its partners, is spending $100 million to support scientific research and investments in new technologies. And as NFL Commissioner Roger Goodell announced in September, the League has pledged an additional $100 million through its Play Smart. Play Safe. initiative to champion new developments in medical research, engineering, biomechanics, advanced sensors and material science that mitigate forces and better prevent injuries.
The Head, Neck and Spine Committee uses the latest available injury data, compiled by Quintiles, an independent third party, to shape our recommendations on practice guidelines, rules changes, protocols and policies. We work with the clubs, the NFL Players Association and the Competition Committee to understand how head injuries occur during the course of the game, what they mean and what needs to change. In the last 14 years alone, there have been 42 rules changes to eliminate dangerous tactics and reduce the risk of injuries, especially to the head and neck. This includes a number of changes made to the kickoff — including moving the kickoff forward five yards — which led to a significant decrease in injuries — including concussions — on that play. And one of the most significant developments has been the enactment of the NFL Game Day Concussion protocol, which addresses the diagnosis and management of concussions and mandates a strict step-by-step process to assess whether or not a player can return to the game.
While there was a 58 percent increase in reported concussions from the previous season — an 18 percent increase over the four-year average — this is not entirely surprising as we have been working with the League and the Players Association to create new programs designed to identify and diagnose injuries better. Unaffiliated neurotrauma consultants (UNCs) and independent certified athletic trainers (ATs) at each game are increasing awareness and enhancing identification of the injuries, and an overall culture change stemming from increased awareness is improving identification and self-reporting.
This progress and culture change must be shared through all levels of play — especially to young athletes, coaches and parents. Programs such as USA Football’s “Heads Up Football,” have taken important cues from the professional level and implemented safety protocols, tackling techniques, practice guidelines and educational efforts to recognize and respond to head injuries. Moreover, significant legislative efforts such as the enactment of strict return-to-play laws in all 50 states — known as the Zackery Lystedt Laws — which the League supported, protect young athletes from returning to play too soon after a concussion. These efforts help to promote active participation, which benefits young people physically and builds positive leadership and teamwork skills, while minimizing safety risks.
As neurosurgeons who have worked in this area for decades, we are encouraged by the changes made by the NFL. More importantly, we know that the changes being made to the sport of football will impact all sports. We can make sports safer while still preserving the essential benefits kids receive from participating in them. This is a critical time as more is understood about the brain for professionals in our field to take a leadership role, encourage change and support efforts to advance the science around concussions.
Editor’s Note: We encourage everyone to join the conversation online by using the hashtag #ConcussionFacts.
