Football players’ head injuries are increasing, as is the evidence that such head traumas can lead to long-term brain health issues. An expert tells Healthnews that the NFL’s decision to further mandate and allow protective Guardian Caps is a step in the right direction for player safety.
Amid ample evidence of the dangers of head injuries sustained by football players, the NFL recently announced that it would be mandating protective soft-shell helmet covers — known as Guardian Caps — at every preseason practice, every regular-season and postseason practice with contact, and allow them during regular games.
These Guardian Caps were worn during training camps last season, and the league announced that they’ll see increased use during the 2024 season based on evidence that they can significantly reduce the force endured by players’ heads.
The rule will apply for players in positions where head contact is seen most, with running backs and fullbacks joining the previously included linemen and linebackers, the NFL said in its announcement. The only positions not required to wear the caps during practice with contact are kickers, punters, quarterbacks, wide receivers, and defensive backs.
The announcement came after data revealed that the 2022 season saw an increase in the number of diagnosed concussions, which was largely attributed to concussions suffered by quarterbacks.
The league says its data demonstrates that if one player is wearing the Guardian Cap at the time of a helmet hit, the cap will absorb 11 to 12 percent of the force, while the force of the impact is reduced by around 20 percent if both players are wearing it.
“Allowing players to wear the Guardian Cap during games is a major step in the right direction for player safety,” says spine care physician with Baptist Health Miami Neuroscience Institute Richard Morgan, DO, who also played football at Wagner College. “By limiting the amount of exposure to high velocity and forceful head impacts, we may be able to prevent resultant long term cognitive symptoms.”
The harms of football-related head impact
According to Morgan, each head impact sustained by a player causes the brain to collide against certain parts of the surrounding bony skull, resulting in tiny injuries in regions of the brain that impact the skull but may not be immediately evident or cause symptoms at the time of the impact.
Similarly to a shoulder or knee injury, these tiny sequential injuries may cause a build-up of “scar tissue” and accelerate degeneration, he explains. And a collegiate or professional player can sustain more than 1,000 head impacts in a single season, including during practice and games. Depending on where specifically this scar tissue build-up occurs in the brain, it may amount to more profound cognitive, behavioral or mood changes long term.
These symptoms were first described in the 1920s and boxers as ‘punch drunk,’ and research has since come a long way to characterize the microscopic changes that occur in the brain resulting from repetitive head injuries.
Morgan
According to the National Institutes of Health, studies of American football players have shown that repeated traumatic brain injuries can lead to chronic traumatic encephalopathy, or CTE — a serious condition in which tangles of a protein called tau build up in the brain after repeated head impacts. The damage resulting from this deadly type of neurodegenerative disease resembles Alzheimer’s disease, potentially leading to dementia and eventually death.
Morgan explains that an improved understanding of the dangers of head trauma has fortunately led to important engineering innovations aimed at improving athlete safety in several sports.
For example, F1 racing has decreased head and neck injuries by driving the continued evolution of protective equipment such as the HANS device and helmet.
“The Guarding Cap may be the start of a similar evolution of equipment in football, aimed at preventing immediate and long-term brain injury,” he says. “The Guardian Cap may decrease the risk of concussion and burden of each head impact without significantly interfering with the game.”
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