by: Dr. Gregory Hughes
Links to research documents and web pages are located at the end of this article.
Within the past decade, professional football has seen the media cause a dramatic rise in attention to the head safety of its athletes. Yet, for the past 20+ years, researchers have invested countless hours conducting neurologic (head-related) studies… And, the published results of these studies have resulted in the public becoming more aware of the long-term consequences associated with head trauma. Further down the athletic food chain, non-professional athletes have begun to be affected by the emphasis on head safety. While some leagues may be slow to adopt changes to their rulebooks, the few that I officiate for have been proactive with this matter.
Recently, I was asked “do you think removing the helmet from football will prevent players from initiating head-on-head contact?” Prior to having started as an official, I may have given a simple yes or no answer, but many years of medical training, practicing dentistry, and officiating have taught me that there is seldom a clear cut answer. I will present the research I have come across before offering my opinion to this question. The intention of this article is to present the history of the football helmet and the facts associated with the helmet’s intended purpose.
While many contact sports require the use of a helmet, my research has mainly produced information with football-based roots and funding. Most of the information given will be tied to football, but can be extrapolated to fit other contact sports.
“Why was the helmet introduced into contact sports?”
If I had the ability to travel back in time, I would stop first at the 1893 Army-Navy football game. Why?…well this is the first written record of leather football helmets being used. While different design variations existed (ex – Beehive, Dog ear, & the Flat top), these original helmets all lacked facemasks, but did have protective flaps to cover players’ ears, and were secured on the head via a tie string [2,5]. Serious and fatal injuries from playing football were not uncommon in this time period, so the introduction of the leather helmet was a major step in improving head safety.
Despite the public’s lack of awareness regarding the sequelae (aftermath) of concussions at that time in history, it became apparent that there was a need to better protect players’ heads. By 1905, data collected from the 1869-1905 seasons would show 18 deaths and 159 serious injuries were linked to American football . As technology improved throughout the 20th century, developments and improvements with metal alloys and polymers led to the introduction of stronger helmets with facemasks. The single bar facemask made its debut in 1951, and by 1958 the double bar and cage-style facemasks could be seen on the football field.
While these new protective features proved to reduce spinal cord injuries between the 1955-1964 seasons, head injuries and fatalities from the sport were on the rise. By 1967, it became apparent to start collecting injury data. Come 1968 (a year before either NASA would launch Apollo 11 to land on the moon or the Woodstock Music & Art Fair [aka “Woodstock”] would make its place in America history), the saddest statistic of all would hit the headlines. This year would produce a peak in deaths sustained from football related head and neck injuries (32 to be exact) . This rise in injuries and deaths sparked the need for better protective equipment. Thus in 1969, the National Operating Committee on Standards for Athletic Equipment (NOCSAE) was formed to commission research with the aim of reducing injury in athletic competition [2-5].
Like the advent of the leather helmet in the 1890s, the introduction of NOCSAE proved to be a pivotal change in the world of protective sports equipment. The organization sought to develop standards that would ensure a football helmet would prevent serious head injury after repeated impacts to the head in a variety of weather conditions. In 1973, NOCSAE released its initial standards to which helmet manufacturers were required to test their helmets. To gain NOCSAE approval, it was the manufacturers responsibility to install the testing equipment in their facilities and test the equipment; at least two helmets per model and size are required .
NOTE – NOCSAE itself does NOT test any sporting equipment, it is only the regulatory body that sets the testing standards equipment that must meet to receive the NOCSAE stamp of approval. To be NOCSAE approved, equipment manufacturers sign licensing agreements with the regulatory body and certify that the equipment has been tested and meets the industry standard . Check your helmets, shin guards, lacrosse balls, etc… and you will see the NOCSAE approved logo!
The next obstacle for head injury prevention in football to overcome was to recertify that a USED helmet would be capable of meeting the NOCSAE standard for the next season of play. In 1975, the data showed that 84% of used helmets failed the NOCSAE test. This statistic sparked the formation of the National Athletic Equipment Reconditioner’s Association (NAERA), whose main purpose was to ensure that used equipment could be properly refurbished. NAERA would become a member of NOCSAE in 1976 .
By 1978, the NCAA would mandate the use of a NOCSAE approved helmet to reduce the risk of head injury; high school football would follow suit in 1980 [3,4]. By 1990, the number of deaths from head and neck injuries in high school football would drop to ZERO! With the release of the 2006 data, we have learned that the reduction in serious head injuries due to mandating helmet use in football is around 88% !
Thus, the purpose of the helmet (in any contact sport) was, and still is, to reduce serious head injuries (mainly skull fractures & bleeding on the brain) [1,3-6]!
To answer the question that has been posed to me many times, “do you think removing the helmet from the game will prevent players from initiating helmet-to-helmet contact?” My personal opinion is that the helmet has proven essential in reducing serious head injuries and fatalities. Its removal will not stop the violent collisions associated with contact sports. Today, more emphasis is being placed on concussion prevention, but that was NOT the original intention of the helmet.
Remember, the advent of the helmet regardless of the sport (football, lacrosse, softball, baseball, dirt biking, cycling, skateboarding, snowboarding, skiing, water sports, etc…) was to prevent serious head injury. Newer helmet designs have aimed at improving concussion prevention, but presently, no helmet is capable of preventing all head injuries . This is evident if you visit one of the largest football helmet manufacturer’s website (schuttsports.com); the company will make you acknowledge that you have seen their disclaimer (that pops onto your screen) before you can enter the website .
Presently, the best precaution for concussion prevention in football is to emphasize a heads-up tackling approach [8,9]. For other contact sports, this can be correlated to teaching players not to use their head to initiate contact with their opponents. While leading with the head may allow a player to produce a powerful blow, the risk of doing so could not only end an athlete’s career but also result in serious injury, paralysis, or death.
2. Daneshvar DH, Baugh CM, Nowinski CJ, McKee AC, Stern RA, Cantu RC. “Helmets and Mouth Guards: The Role of Personal Equipment in Preventing Sport-Related Concussions.” Clin Sports Med. 2011 Jan;30(1):145–163.