21 Hour Football Program – Case 2: The Movement to Make the Game Safer

Jan 10, 2018 | Program Development

By Mike Kuchar
Senior Research Manager
X&O Labs
Twitter: @MikekKuchar



Chapter 1: The “Reality” Behind the Perceived Concussion Problem in High School Football



Coaches know that the game of football has never been safer. But we also know that it’s never been harder to coach. It’s no longer the on-field endeavors that consume us. That’s become the easy part. These days our time is torn between taking CPR/first aid certification, heat acclimation courses and becoming versed on concussion protocols. But do the parents know how well versed we’ve become in these issues? We can’t assume they do. So it becomes necessary for us to tell them. While some coaches use a single spring parents meeting to do so, other chose to develop a consistent, streamlined method as a form of constant communication. As Bedford High School (VA) head coach Chris Watts told us, “Coaches are doing a great job of protecting their players, but a poor job of protecting their sports’ reputation.  Parents need to hear about the measures that coaches are taking to keep players safe, and it’s just not happening.”

So what do you say? How do you communicate the vision of your program? Before we detail how successful coaches educate parents on how their program is promoting safety, we wanted to provide the hard facts behind why football is safer than ever.  We wanted to profile two recent studies related to this topic as well as provide tangible evidence from world-renowned neurosurgeons on this topic.

“No Association Between Playing High School Football and Brain Injuries”

Source: JAMA Neurology, July 3rd, 2017

According to a report published in JAMA Neurology on July 3rd, there is no statistically or clinically significant harmful association between playing football in high school and increased cognitive impairment or depression later in life. The study was designed to estimate the association of playing high school football with cognitive impairment and depression at the age of 65. A representative sample of male high school students who graduated from high school in Wisconsin in 1957 was studied. In this cohort study using data from the Wisconsin Longitudinal Study, football players were matched between March 1 and July 1, 2017, with controls along several baseline covariates such as adolescent IQ, family background, and educational level. For robustness, three versions of the control condition were considered: all controls, those who played a non-collision sport, and those who did not play any sport.

Among the 3,904 men in the study, after matching and model-based covariate adjustment, compared with each control condition, there was no statistically significant harmful association of playing football with a reduced composite cognition score. After adjustment for multiple testing, playing football did not have a significant adverse association with any of the secondary outcomes, such as the likelihood of heavy alcohol use at 65 years of age.

According to the report, “For men who attended high school in the late 1950s, playing high school football did not appear to be a major risk factor for later-life cognitive impairment or depression. For current athletes, this study provides information on the risk of playing sports today that have a similar head trauma exposure risk as high school football played in the 1950’s. Cognitive and depression outcomes later in life were found to be similar for high school football players and their nonplaying counterparts from mid-1950s in Wisconsin. The risks of playing football today might be different than in the 1950’s, but for current athletes, this study provides information on the risk of playing sports today that have a similar risk of head trauma as high school football played in the 1950’s.”

The full-length report on this can be read by clicking here.

“Female Soccer Players Suffer the Most Concussions in High School Sports”

Source: American Academy of Orthopedic Surgeons, March 14, 2017

It is also a known fact that girls suffer more concussions than boys when competing in high school sports per participation rates. Girls soccer in particular is the most dangerous sport for head trauma, according to a newly released study by the American Academy of Orthopedic Surgeons. Three researchers studied data from 100 American high schools spread across 11 years to track the number of concussions reported against all other injury types. Overall, the researchers counted 6,399 concussions against 40,843 total injuries, with girls suffering a “significantly higher” rate of concussions than boys and girls’ soccer standing out as the single most common sport for head trauma. “The study authors hypothesize that girls may face a greater risk of concussions and other injuries in soccer due to a lack of protective gear, an emphasis on in-game contact and the practice of ‘headers’—hitting the ball with your head,” the study reads.

“While American football has been both scientifically and colloquially associated with the highest concussion rates, our study found that girls, and especially those who play soccer, may face a higher risk,” said lead author and Northwestern University Feinberg School of Medicine orthopedics professor Dr. Wellington Hsu. “The new knowledge presented in this study can lead to policy and prevention measures to potentially halt these trends.”