…it is undeniable the NFL has leveraged its funding, independent expertise, and extraordinary access to advanced technologies to improve the game’s level of safety for players and has actively prevented concussions.

The NFL Earns a First Down in Concussion Prevention

Nearly a decade of research and over $100 million investment has led to concrete, measurable results in concussion prevention 

By Christina Eichelkraut

With Super Bowl LIX just a few weeks away, many people are eagerly looking forward to an opportunity to cheer on their favorite teams and players (or maybe just see Kendrick Lamar perform and enjoy some great commercials).

For the Brain Injury Association of Arizona, this year’s Super Bowl presents a perfect opportunity to check in and assess efforts by the NFL to address the extraordinarily high rate of Chronic Traumatic Encephalopathy (CTE) in its players.

And we’re delighted to share that if the NFL’s concussion prevention initiatives were a field goal the announcers would yell, “It’s GOOD!”

We’ll admit that like many other entities in the brain injury space, we had some concerns about the NFL tackling this issue internally. So when the NFL invested $100 million in 2016 to research CTE and prevent of concussions, we sat up and paid very close attention.

Tackling a Particularly Difficult Area of Brain Injury

Before diving into what the NFL has done to prevent concussions – and it has made some truly extraordinary strides in concussion research and prevention –  it’s important to acknowledge that within the brain injury research sphere, CTEs themselves are a particularly difficult brain injury to get a handle on. We know a lot less about CTEs than other types of brain injury. After all, there is still no way to diagnose CTE in living patients, making clinical studies extremely difficult to create and conduct.

Further, though early CTE does get worse over time – it is a degenerative disease, after all – it generally does not have overt or obvious symptoms. It’s not unlikely there have been misdiagnosed cases of CTE outcomes that are actually due to totally different neurological and psychiatric disorders, including anxiety and depression.

All of which makes CTEs specifically more challenging to diagnose, study and develop effective treatment for than other brain injuries.

Regardless, what we do know is that many contact sports players do end up with CTE, that CTE is a terrible and debilitating head injury, and that efforts should be made to prevent it wherever and whenever necessary, regardless of the cost.

Though not the focus of this article, it is also worth noting that CTE remains an issue for combat veterans, other extreme sports athletes, and some members or particularly dangerous occupations. So any research or advancements in CTE prevention and treatments benefits far more people than just football players. If oil rig and construction workers, cheerleaders and – dare we ask? – soccer players end up with better helmets as a result of NFL’s testing and research, it’s all to the good and we’re here for it.

Putting the “Prove” in Improvement

Over the past decade, to its credit, the NFL has invested an extraordinary amount of money and technology to prevent or decrease the number of concussions its players sustain. It has spent $60 million dollars on “safety technology” which includes, but is not limited, to better helmets for players.

That investment into research and technology seems to have paid off, or at least put a dent in the issue. Last year, the NFL was able to proudly proclaim the lowest number of concussions ever since it began tracking the issue in 2015.

Let’s look at what contributed to these outcomes.

Better helmets. No one loves a good helmet more than BIAAZ, and the NFL deserves credit here for going far beyond simply “improving” its helmets. Through years of dedicated research that leveraged some of the most advanced sports technologies available, the NFL is now introducing helmets customized for each player’s position.

And, in 2024 Guardian caps – foam coverings that go over a helmet – were mandated for all players to wear during all contact practices in 2024 (despite complaints from some players). Additionally, players are now allowed to wear Guardian caps at regular season games at their discretion.

For all the player and fan grumblings, however, the numbers don’t lie: there was nearly a 50 percent reduction in concussions for players that wore the caps during mandated sessions

A Vast Amount of Credible Research. When it pledged the $100 million in 2016, the NFL used $40 million to create its Scientific Advisory Board, part of its Play Smart. Play Safe initiative.

It’s easy to look askance at an organization conducting its own in-house research into its own biggest PR headache (pun intended). But data collected from NFL research initiatives has proven to be reliable and useful to the brain injury research community.

Much of the NFL research has led to some real breakthroughs in our understanding of concussions and CTE, and concussion protocols in sports medicine overall. In fact, other research organizations have sought the NFL’s guidance, funding or resources to assist them with ongoing CTE research, such as the use of blood biomarkers to potentially diagnose CTE.

Finally, the NFL now has a vast amount of data relating to football players and concussions, including information gleaned from biosensors placed in mouthguards. While it’s true that data can be manipulated and “mathwashing” does happen, it seems unlikely the NFL is doing this to any significant degree. After all, healthy players are in the NFL’s best interest on every level.

And, the NFL could not have developed its new rules, protocols and equipment if it were being intellectually dishonest about what the data told them. For example, the way position-specific helmets are designed in terms of where additional 3D-printed padding is placed. There’s simply no benefit to anyone to ignore useful data that leads to functional design in that case.

We’re excited about the idea of the NFL sharing its methods for developing the helmets with other contact sports organizations (OK, that may be wishful thinking on our part, but we can dream, right?).

New rules and concussion-specific protocols. The NFL has also adopted new rules that prohibit head strikes and new protocols – some based on advanced research from the Department of Defense – on when and how a player can return to play after sustaining a concussion.

This also includes new methods for on-field diagnosis of concussions, such as including ataxia as a “no-go” indicator (meaning a player displaying these symptoms may not return to the field).

Conclusion: Maybe Not a Touchdown (Yet), But Definitely a Clean Field Goal

There is no doubt football remains an incredibly violent contact sport. BIAAZ would love it if the NFL took its concussion research and prevention to the next level, for example by researching related issues such as neck stability that impact how much a brain is jostled in its skull upon impact.

Still, it is undeniable the NFL has leveraged its funding, independent expertise, and extraordinary access to advanced technologies to improve the game’s level of safety for players and has actively prevented concussions. We’re glad the NFL has chosen to meet this challenge head on – and with a darn good helmet, too.

That’s something we can all cheer for, regardless of the player, team or conference.

ABOUT BRAIN INJURY ASSOCIATION OF ARIZONA

The Brain Injury Association of Arizona (BIAAZ) is the only statewide nonprofit organization dedicated to improving the lives of adults and children with all types of brain injuries through prevention, advocacy, awareness and education. BIAAZ also houses the Arizona Brain Health Resource Center, a collection of educational information and neuro-specific resources for brain injury survivors, caregivers, family members and professionals.

What began in 1983 as a grassroots effort has grown into a strong statewide presence, providing valuable life-long resources and community support for individuals with all types of brain trauma at no charge.