11/16/2010 08:14 pm ET | Updated May 25, 2011

Football Players as Battering Rams

There has been a flurry of media coverage recently on concussions and/or paralyzed football players. There have also been a lot of discussions on television, radio, over dinner as well as in newspaper articles about how hard and violent football should be. To paraphrase the general sentiment, "the harder the better, that's what the fans want."

Concurrently, there has also been a heightened awareness to safety -- safety in cars, in health care, in food, in sports, etc. Guess when the last time football helmet safety measures were updated? According to The New York Times "standards haven't been meaningfully overhauled since 1973 and therefore helmets may not be properly designed to prevent concussions." What is even more of interest is that the agency that provides safety guidelines, NOCSAE, is financed by a fee on helmet sales.

I have co-authored numerous published research studies on the effect and consequences of using the top or crown of the helmet as a battering ram. I am constantly disappointed that for all the orthopaedic, biomedical and neurological research identifying the dangers to the athlete when they forcefully charge head first at one another, there has not been a coordinated effort response to remedy. Where is the public outcry?

The potential for immediate and permanent paralysis from the neck down, death or more subtle acute changes in personality or possible chronic permanent neurologic sequelae secondary to multiple concussions are being treated as isolated human interest stories on the evening news -- freak accidents versus expected consequences of poorly executed accepted techniques. The catastrophic injuries that are occurring on the professional, college, high school and even Pop Warner football fields are being addressed with a show of sadness. They are being treated as isolated unfortunate occurrences. There is little if any significant effort to identify the root causes of the injuries and to make changes to prevent these so called "freak accidents." There is little outrage regarding the need for increased safety procedures. Actually, the outcry is more along the lines of "please, go away, don't tell me the facts."

Those responsible for the plays on the field and even the players themselves seem to be ignoring years of expert insight. What players, their coaches, the owners of the teams and the fans do not want to acknowledge is that although a player may accept pain as part of their "job," and of the sport, avoidable permanent and chronic consequences to themselves and their opponents should not be accepted or tolerated.

The brain is vulnerable. The skull protects the brain and the helmet protects the skull. A hard hit to the head jolts the brain and the brain may be impacted against the skull damaging the tissue. Initial and subsequent damage can lead to serious sequelae. Helmets can probably be made safer to better protect the player's brain, but if that means the player feels less vulnerable and more inclined to use their helmeted head to hit harder, brain as well as neck injuries will still occur and possibly even escalate in number and severity.

Spear tackling, using the head as a battering ram, places the player at risk for paralysis and places the brain in jeopardy for both acute and chronic pathology. Spear tackling is axial load and using the top of your head to ram into an extremely muscular football player is similar to diving head first into an empty pool.

The rules of the game and expectations of the fans have to change. Fans no longer gather in coliseums to watch lions eat slaves or gladiators fight Christians so they can cheer those who are able to limp away for another chance to fight another day. So, players... and parents of young Pop Warner players, be forewarned. When the coach or team manager tells you to 'go out there and hit em' hard' think twice before using your helmeted head as a battering ram. Use your head to think! Think about the damage, the permanent damage that can result. Where will the cheering fans, managers, coaches and team owners be if you end up permanently damaged? The rules of the game and expectations of the fans have to change.

Play to win but play smart, play safe! Protect yourself, protect your head.