Counting Concussions: Will a 'Pitch Count for Head Injuries' Save the NFL?

Will Carroll@injuryexpertSports Injuries Lead WriterJanuary 27, 2014

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The Sports Legacy Institute, one of the leading researchers in the fight against the damage done by concussions at all levels of football and other sports, announced Monday that it had developed what it called a "hit count." In combination with several leading sensor makers, Chris Nowinski, the former WWE wrestler who leads the SLI, said the hit count is expected to become the new standard in preventing concussions.

This hit count is very similar to how the pitch count works in baseball. Sensors inside the helmet will record the number and severity of hits the player takes, and once it reaches a certain amount, depending on the level and severity, the player will be removed from the game.

David J. Phillip/Associated Press

The Hit Count program was developed in partnership between the SLI and Dr. Robert Cantu, one of the world's leading experts on concussion. The Cantu scale is the industry standard for measuring concussion severity. The program is focused on raising awareness of how hits actually affect the brain, measuring hits in practice and games that are sub-concussive rather than just the big hits that leave a player on the field, as is current practice.

The SLI says that the average high school football player receives 76 hits per practice, totalling up to 2,235 hits over the course of a season. That's a huge number and one that has to be troubling for any parent. Measuring these hits is going to create an awareness and may result in a practice redesign to focus on technique rather than contact, much in the same way that John Gagliardi did for years at his winning college program at St. John's of Minnesota. 

The SLI presentation involved several makers of sensors, implying that this system is agnostic to the brand or type of sensor. Since no sensor manufacturer seems to have significant market traction at this point, this shouldn't be a stumbling block or a leg up for any of them, though the wide adoption of this program could create a quicker growth for many of them. 

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These sensors are small accelerometers, similar to the type in smartphones that allow for motion controls. In addition to several sensors in the helmet, there is a small radio to transmit data and a central hub that is on the sidelines to allow for monitoring. 

Of course, this brings us to the first stumbling block for a system of this type: It is not going to be cheap. While the NFL could quickly outfit all 32 teams and not miss the cash, high schools in many areas are already strapped for cash. While some areas are building huge stadiums and growing, this could put pressure on smaller programs and create a major division between the haves and have-nots.

Larger, richer schools don't deserve better protections for their players than smaller programs. In fact, it could create downward pressure on some of these schools to drop football. One possible solution is to have multiple schools pool their talent and have one team, but this would reduce participation as well. 

Some of the cost could be offset by reduced insurance premiums, but that is not enough to make the startup cost a zero sum for schools. Worse, it would be very difficult for youth-level programs to put this together. There's simply not the infrastructure in place in most leagues to have this in place. Every Pop Warner team couldn't use this system as it exists currently. 

Another equipment issue is the wide use of older helmet models. In many cases, these helmets are used for years, being passed down from player to player and "reconditioned" as necessary. While helmet manufacturers say that this creates no additional risk while holding costs down, most of them would not be able to be retrofitted to include the necessary sensors. This would create a "grandfathering" system that could take years to filter out of the current system.

A third issue is that counting hits doesn't remove the issue of a concussion-inducing impact. As Dr. Aaron Gray of the University of Missouri put it, "it only takes one hit and it could be the first of the game." Obviously, the Hit Count program is not designed to be a replacement for common sense, but in many cases, it could be pitched as a replacement for care. 

Remember that the vast amount of practices at the high school level do not have a medical professional on hand. Even at games, estimates have just over half of the high schools with a doctor or athletic trainer on hand to treat players. The number is vastly lower at the youth level. 

With the cost of a sensor-based system approaching that of an athletic trainer in year one, some athletic administrators could make a compelling case to use monitoring rather than providing professional care. While the Hit Count program is not attempting to be an either/or situation, I can see this becoming an issue at low-budget programs. 

For coaches, the adoption of this system is going to be a challenge as well. Years of practice and game technique will need to be adjusted. The descended wisdom of football is resistant to even small change, so we may see some older or stubborn coaches pushing back against the system. They could also be pushed out more quickly, creating a new generation of coaching. That could be a positive or negative.

Coaches will also have to deal with a new variable. Much in the same way that big data is changing how coaches get feedback on players, coaches may now have to apportion playing and practice time based on a hit count.

Imagine a player who has 10 hits left in a game before he must be removed, but there's five minutes left in the game and the length of the field to drive for the win. How would the coach use his star quarterback or running back or linebacker given those parameters? How would he even know? It introduces an interesting new variable to the system that, currently, the system is not ready to handle.

This is exacerbated at lower levels. While most NFL teams could lose any player and have an adequate backup, this is not the case at the high school level. The star system is highlighted in high schools where there are vast differences in talent.

A player like Kyler Murray, the top QB recruit out of Allen, Texas, is just on a different level. A coach seldom gets more than one of this type in a career, if ever, and his use has to be maximized in every way. Telling the coach that his star player is on pace to be pushed out of the game midway through the fourth quarter is not going to get a positive result.

While these concerns are all valid and must be addressed, I believe that there are two issues that will lead to the success or failure of the program. There are two entities that will drive the adoption and, indeed, should be leading it both in terms of use and in financial terms as well.

The NFL's adoption of sensors could introduce the vast population of football fans and parents to the technology, making them more comfortable with how the data will be used. While I don't expect the NFL to adopt the hit count itself, the use of sensors for monitoring would be a huge step. While there has been discussion of pilot programs or even the full-scale use of sensors in the past, the NFL could adopt this wholesale without issue of cost or implementation.

As well, the program is going to need the buy-in of broadcasters. ESPN has been innovative in many ways after it became a broadcast partner of both the NFL and NCAA, and here's a way it could be not only innovative, but a public good. ESPN and other broadcasters could show the technology, use the data in a responsible way and even enforce the usage.

Imagine Brent Musberger noting that Jameis Winston had taken 66 hits as Florida State entered the fourth quarter of the BCS Championship against Auburn. With each hit, the dramatic tension would rise. They could broadcast the force of each hit. "That looked bad, but it was only 45G's, Kirk," Musberger might say. He could question why a player who took a 100G hit was not on the sidelines being checked. In no way would he be changing what he does, but he would be doing a public service by increasing awareness with the data.

The Hit Count program has many challenges, but it is a nice step forward. The existence of technologies like these sensors is not a Star Trek fantasy. They are here now and accessible to a great number of programs. Parents and fans should in fact wonder why they are not more in use already. If Hit Count pushes this forward and leads to new innovations and reduces the unnecessary amount of hits that players currently take, it will be a huge success.

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