New Medical Study Spotlights Football Concussion Rates
During Practice Sessions
By Doug Abrams
In early May, National Public Radio aired a story about a new study on the prevalence of concussions in football. The study, published in JAMA Pediatrics, found that at the high school and collegiate levels, players are more susceptible to concussions in practice sessions than in games.
The JAMA Pediatrics study found that in high schools and colleges, 58% of football concussions occurred in practices and 42% occurred during games. Fifty-eight percent is quite a bulk. A political candidate who wins election by 58%-42% celebrates a landslide, and the study’s 58% finding demonstrates a “concussions landslide.”
The study also found that in youth leagues, 54% of football concussions occurred during games. That number means that a hefty 46% occurred during practices. When a political candidate receives 46% of the vote, the campaign’s message resonated with voters, even without gaining a majority. The study’s hefty 46% “concussions minority” should resonate with parents and coaches who are concerned about youth leaguers’ safety.
Two Strategies for Safer Practices
The JAMA Pediatrics study concerned only one sport and only one type of injury, but the findings should stimulate closer attention to what happens generally in practice sessions – and not just in football. Football holds no monopoly on injury or risk, and the way that coaches plan and conduct practices vitally affects the health and well-being of the athletes and their families. Well-attended games sometimes attract the lion’s share of attention while practice sessions, without onlookers in the stands, escape under the radar. But an injury is an injury, and the resulting short-term or long-term disability does not depend on whether the damage occurred with the scoreboard running.
Safety in practice sessions is the subject of this column. I am neither a medical researcher nor a physician, but the new JAMA Pediatrics findings do not surprise me. As a high school and collegiate hockey player in the mid-1960s and early 1970s, and as a youth hockey coach since then, I understand why practice sessions can carry higher injury rates than games. But I also understand that coaches can lower these rates significantly with prudent, commonsense measures that enhance safety without changing the essential character of the game.
The potential for higher injury rates in practice sessions almost stands to reason. A winning hockey goalie who makes 30 saves, for example, is usually the game’s star; but in a practice, the goalie may face 30 shots in one repetitive drill that lasts only a few minutes, and may face a hundred or more shots in an hour-long session. And many teams schedule more practice sessions than games throughout the season. It would not surprise me to learn that goalies get hit in the face with shots more often in practices than in games. More repetitive shots on net in more sessions = more chances of hits to the head.
Two commonsense measures can help coaches reduce the likelihood of practice session injuries: (1) reasonably reducing repetitive risks, and (2) eliminating unreasonably dangerous drills in favor of effective drills that teach skills more safely. Both measures deserve discussion here.
Reducing Repetitive Risks
First, reasonably reducing repetitive risks in practice sessions. . . . Last month, the executive committee of the Georgia High School Association, the state’s governing body for interscholastic sports, voted unanimously to limit full-contact drills in football practices. The new limits, which take effect August 1, apply during both the preseason and the regular season. Georgia becomes the latest state to adopt limits designed to prevent concussions and other traumatic brain injuries in interscholastic football without changing the essential character of the game.
The GHSA says that its new rules resemble existing National Collegiate Athletic Association and National Football League rules, which many Georgia high schools were already following. The Macon Telegraph reports that during the preseason, full-contact drills will now be limited to 135 minutes each week, but not on more than two consecutive days. When a team holds two-a-day practices, contact may take place during only one session.
The newspaper reports that in practice sessions during the season, full contact is now limited to “90 minutes per week, or 30 minutes per practice spread across three practices. Full contact on back-to-back days will be permitted, but three straight full-contact practices will be prohibited.”
Eliminating Unreasonably Dangerous Drills
Now, eliminating unreasonably dangerous drills . . . . Some years ago, I was watching a hockey practice for young teens in another community. The two coaches had the players do a “Suicide Drill” (their name for it), which featured manufactured mayhem with two pucks. “Team one” of five players skated out of one end of the rink with its puck, while “Team two” of five players skated simultaneously out of the other end, also with a puck. Each team skating full speed passed its puck several times as it avoided the other team through center ice on its way to the opposing net to take a shot.
The Suicide Drill’s purpose was to train players to keep their heads up as they skated through center ice. Heads-up hockey is an important skill at all age levels, but that particular drill should never have found its way into the practice agenda. Within two minutes, a full-speed collision at center ice landed a player in the hospital with a broken jaw.
In any sport, the best drills combine realism with safety. The hockey team’s Suicide Drill failed on both counts because, without simulating real game conditions, the drill carried an unacceptably high risk of injury that should have been apparent as the coaches planned the practice agenda. The team would have been much better off if the coaches had asked themselves a simple question before practice: “If the players do this drill, what might happen?”
When coaches foresee that a drill carries an unacceptable risk of injury, they can usually choose a safer drill that teaches and develops the same skill. Few, if any, skills have only one drill known to the coaching world. Safety is the coach’s primary responsibility to the players, and anticipating unacceptable risk is key to fulfilling the responsibility. Hindsight may indeed be 20/20, but coaches protect their players best when they also rely on 20/20 foresight to anticipate avoidable danger in practice sessions.
Sources: Thomas P. Dompier et al., Incidence of Concussion During Practice and Games in Youth, High School, and Collegiate American Football Players, JAMA Pediatrics, http://archpedi.jamanetwork.com/article.aspx?articleid=2281575 (May 4, 2015); NPR, Concussions Can Be More Likely In Practices Than In Games, May 11, 2015; Ron Seibel, GHSA Votes To Limit Contact In Football Practice, The Telegraph of Macon, Apr. 13, 2015; Assoc. Press, GA Sports Officials Vote To Limit Football Drills, Apr. 14, 2015; Doug Abrams, 20/20 Foresight, USA Hockey Magazine, Sept. 2014.