John Doherty: Newer helmet models a long-term investment

The Pantagraph

April 17, 2023

Two of the most famous hits to quarterbacks, at least in recent memory, occurred last season to the same signal caller.

The Dolphins’ Tua Tagovailoa suffered a non-concussion concussion against the Bills on Sept. 25 and was allowed to remain in the game despite being clearly staggered. Four nights later, against the Bengals, there was no doubt when he was knocked unconscious while both hands postured spastically.

In both cases, hits from opponents launched Tagovailoa backwards off his feet and he landed on the back of his head.

Last month, a study from the University of Cincinnati on how well helmets reduce the force of impacts was published online ahead of print in the Journal of Biomechanical Engineering (JBE). Scheduled to appear in the publication’s June issue, the investigation looked at Riddell, Schutt, Vicis, and Xenith helmets and found that the front of all brands and models offered far more protection to the head than the back of those helmets did.

That is fine for the vast majority of football players. A study published in 2010, in the Journal of Athletic Training, found that the plurality of hits was to the front of the helmet — as opposed to the top, either side, or back of the helmet — for every position.

Except quarterback.

For that position alone, the back of the helmet received the most blows.

Interviewed last month by WVXU radio, the NPR affiliate in Cincinnati, Eric Nauman — co-author of the JBE study — specifically mentioned Tagovailoa’s injuries to illustrate his findings.

(Nauman’s previous work may be familiar to regular readers of this space. Until two years ago, he was one of the principals of the Purdue Neurotrauma Group, whose work had been cited here frequently. However, at that time, he left West Lafayette to follow colleague Thomas Talavage, who had departed a year earlier. Consequently, the Purdue Neurotrauma Group is no more.)

In a separate interview published online by Physical Therapy Products, Nauman advocated minor padding changes that could offer major benefits at all levels of the game. “I don’t care as much about the NFL. Our audience is mostly high school or under — the 98% of players who don’t play after high school,” Nauman said. “If we can keep them safer through high school, that would be great.”

Improved technology that is affordable would be great, too.

Just last week, the NFL released its latest list of approved and prohibited helmets. The third-highest rated of the bunch is a new VICIS model specifically designed for quarterbacks, presumably with better padding in the back. The two that are ranked higher are also VICIS models, designed for linemen, and were introduced in 2021.

In an email sent last week announcing the new helmet, NFL Chief Medical Officer Dr. Allen Sills wrote, “The quarterback-specific helmet — the VICIS ZERO2 MATRIX QB — performed 7% better in quarterback-specific testing than the most popular helmet worn by quarterbacks last season.”

Unfortunately, since it is custom-fitted, expect it to sell for over $1,000. Even similar off-the-shelf VICIS models are just under $800. By comparison, off-the-shelf Riddell models that also made the approved list sell in the $500 range. Is that “7% better” worth 100% more money?

Furthermore, the NFL ratings are based on laboratory tests, which when it comes to preventing concussions, have rarely translated to similar on-field results. Smaller studies have shown NFL players and some collegians have had fewer concussions wearing the more modern and higher-rated helmets. However, larger scale studies of high schoolers have found concussion rates the same across helmet brands and models, regardless of design, age, or laboratory rating.

A 2020 literature review in the journal Evidence Based Practice reported, “In high school football players, appropriate helmet fit seems important in decreasing concussion rates.”

In his email, Sills concluded, “These developments and more innovation to come — including extending position-specific testing to additional positions — reflect exciting developments that are making the game safer for players on the field.”

Safer in terms of preventing concussions?

The data suggest otherwise.

Still, Sills and the helmet manufacturers may be on to something.

A study Nauman’s University of Cincinnati group completed along with researchers from Emory University in Atlanta looked at high schooler’s brains pre- and post-season. Fifty-four high school football players wore newer highly rated helmets and 62 wore older lower rated models. The results were published in Annals of Biomedical Engineering in October of 2021.

A similar study, performed by the same two centers and published in the same journal 13 months later, compared 52 high schoolers in highly ranked helmets to 53 in lower rated models.

“We found little difference in the rates of sports-related concussion across both helmet groups,” said Gregory Myer of Emory’s Sports Performance and Research Center, a co-author of both studies, in an Emory newsletter.

However, post-season MRI examinations found far less cortical thinning (in the 2022 study) and damage to the white matter (in the 2021 study) in the brains of those wearing the newer models. Myer attributed the difference to the newer helmets being able to better absorb and disperse the force of the thousands of sub-concussive hits that occur each season.

And it is those thousands upon thousands of sub-concussive hits over the course of years — not individual concussions — that cause chronic traumatic encephalopathy, according to multiple studies out of Boston University’s CTE Center.

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