The worrying incidence of concussions and other
head injuries in sports such as American football,
hockey, and rugby is a health and welfare concern
that may affect the long-term popularity and econom-
ic prospects of these sports. Should the public come
to perceive playing a particular sport as too risky,
or parents in rising numbers refuse to allow their
children to participate, the sport will face a crisis of
social acceptability that, if uncorrected, will erode its
commercial viability.
Some sports governing authorities appear to under-
stand what’s at stake. For example, preventing head
injuries in American football has become a preoc-
cupation at all levels of the sport – for good reason: it
gives rise more serious brain injuries than any other
sport. High school players alone suffer as many as
43,000-67,000 concussions a year, though the true
incidence is likely much higher.
More than half of
concussed athletes are thought to ignore their symp-
toms partly because they fail to recognise them:
one study found over 60 per cent of high-school
American football and soccer athletes reported hav-
ing symptoms of brain injury but only 20 per cent
realised they had suffered a concussion.
sions can result in severe brain damage, particularly
in younger age groups, causing a condition called
chronic traumatic encephalopathy, the symptoms
of which include sudden memory loss, paranoia,
and depression during middle age. The disease is
also known as
dementia pugilistica
, or punch-drunk
syndrome, because historically the vast majority of
its victims were boxers.
At higher levels of competition, a conflict of interest
surrounds the identification and treatment of head
injuries. Top college and professional teams have
strong financial incentives to keep players on the
field; historically weak regulations governing injured
players and the difficulties of assessing neurological
injury compound the problem. The NFL in particular
has been singled out for its poor record;154 concus-
sions from either practice sessions or games were
reported from the start of the preseason to the eighth
week of the 2010 regular season.
The issue has also been the subject of a inquiry
before the Judiciary Committee of the U.S. House of
Representatives, in which the NFL was compared to
the tobacco industry and resulted in the resignation
of the doctors leading the league’s Head, Neck and
Spine Medical Committee.
In December 2009, the NFL announced stringent
new rules for managing concussions, requiring
players who exhibit any significant symptom to be
removed from a game or practice and barred from
returning the same day. In August 2010, new rules
banned delivering contact above the shoulder to
“defenceless” players and mandate fines for violent
helmet-to-helmet hits. But the effects of these rules
have been limited, and high-profile severe head
injuries have continued almost unabated since the
new rules were imposed.
The NCAA has established a committee on concus-
sions to set new guidelines to recognise and manage
this injury. It has highlighted the University of North
Carolina’s policy of testing student athletes for injury
as a model for other universities.
i Sean Gregory, “The Problem with Football: How to Make
it Safer”,
, 28 January 2010.
ii “Head Injuries in Football”,
New York Times
, 21 Octo-
(accessed 28 February 2011).
iii Associated Press, “Concussions reported in NFL up 21
percent from last season”,
, 13 December 2010,
last-season, (accessed 28 February 2011).
Legal issues relating to football head injuries (Part I & II), hearings
before the Committee on the Judiciary House of Representatives
28 October 2009 and 4 January 2010,
(accessed 28 February 2011).
v “New NFL Rules Designed to Limit Head Inju-
, 6 August 2010,
designed-to-limit-head-injuries (accessed 28 February
Head Injuries in Sport: A Growing Concern
GUARDING THE GAME Preserving the Integrity of Sport
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