Football practices are at higher risk of concussion than games, study suggests



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College football players have suffered far more concussions in practice than in games, medical researchers reported on Monday, a finding that is sure to add to the years-long debate over the regulation of training regimes in the world. sport.

It is much less clear whether the college sports industry will nationalize safety reforms like those passed by the NFL, which limits the number of full contact practices per season, or certain college conferences. But with the NCAA and its members facing urgent decisions on other fronts, including the coronavirus pandemic, far-reaching new rules are unlikely to be imminent.

The authors of the new study, published in JAMA Neurology, a peer-reviewed journal, found that 72 percent of the concussions they looked at in five seasons of college football occurred during practice. And although preseason training made up about a fifth of the time the researchers studied, they found that almost half of concussions occurred during that time.

The changes to the rules that govern the games, they wrote, “are an important part of protecting athletes during competition”, but they said that reviews of training activities before and during the season “could result in a substantial reduction ”in concussions.

“The biggest surprise was the breadth of the data, not just the trend of the data,” said Dr. Michael A. McCrea, lead author of the study and professor of neurosurgery at the Medical College of Wisconsin, where he is co-director. . of the Neurotraumatology Research Center.

“Most people, scientific or not, are aware that there is more contact activity during the preseason than during the regular season, so I’m not sure the trend of this finding is a surprise.” , he continued. “But maybe the magnitude of it.”

In an editorial also published in JAMA Neurology on Monday, two other brain injury experts called the study’s results “shocking,” especially given the statistics on concussions and exposure to head shocks, known as HIE, during contractually regulated practices in the NFL

Professional teams cannot run more than 14 padded workouts during the regular season. In the 2019 NFL regular season, less than 7% of concussions occurred during practice, according to league data.

“Concussions in games are inevitable, but concussions in practice are preventable,” wrote the experts, Dr. Robert C. Cantu and Christopher J. Nowinski, who were not the authors of the study conducted. by McCrea, in their editorial. “The practices are controlled situations where the coaches have almost complete authority over the HIE risks taken by the players.

Although they acknowledged that the NCAA made recommendations and insisted on broader changes, they acutely noted that “guidelines are not rules.”

The NCAA, which derives its authority from its member schools, did not immediately comment on Monday.

In a speech in January, Mark Emmert, the president of the NCAA, said the association had “made wonderful progress in the area of ​​concussion protocols,” perhaps a reference to a 2015 term that said each school participating in a Power 5 conference submitted their concussion guidelines to the national committee annually. (This procedure was abandoned during the coronavirus pandemic.)

During his speech at the NCAA convention, Emmert, without elaboration, urged to add “a few teeth to our health and safety protocols” and said there should be a system that “holds each other up. accountable for the commitments we make to promote, defend and lead these protocols. “

But the NCAA legislative process is grueling, and few sports businesses are as sprawling and rambling as Division I college football. Although the NCAA limits practice time and enforces rules regarding matters such as transfers and recruiting, conferences that play football in Division I have tremendous day-to-day power and set policies which may vary from league to league.

In 2016, for example, the Ivy League – which plays in the Championship Football subdivision, not the Football Bowl subdivision which attracts most of the money and attention – banned full-contact strikes for all regular season practices. The rule is the only one, the editorial noted, nearly five years later.

The NCAA itself has often stuck to what it describes as “recommendations” for dealing with concussion risk, including that three days of practice per week during the regular season should involve zero contact or minimal. The NCAA’s approach, say the study authors, “had a limited effect in reducing the incidence of pre-season concussions.”

The results published Monday were slow to develop. In the study, conducted at six Division I schools that are part of a research consortium partly funded by the NCAA and the Pentagon, 658 football players wore helmets equipped with accelerometers.

By the end of the 2019 season, when the study ended after recording more than 528,000 head shocks in five seasons, 68 of the monitored players had suffered concussions. The researchers followed players from the Air Force, Army, North Carolina, UCLA, Virginia Tech, and Wisconsin. Spring practices were not included, McCrea said.

Crucially, the researchers found variations in head impact exposures between individual players, even among teammates playing the same position, McCrea said.

“Some teams train differently from other teams, and some players play differently from others,” said McCrea.

Beyond any comprehensive strategy that may emerge, he said, athletes should engage in more localized efforts to try to reduce risk.

“There is a shared responsibility here: on the scientists who produce the evidence, on the policy makers, on the institutions and the coaches and the players,” he said. “I think we all have a responsibility.”

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