Agreed. It will likely come down to rule/policy changes for practices and games to reduce the number of head contacts. And we still need better reporting and RTP management (i.e., a 7-day return to play is a dangerous joke).
I play corner, i wear it for practice, but not in games because the ifaf hasnt approved guardian caps for game yet. Its cool for practice but the point is not play like naruto (running with head forward)
Awesome video and I love that when I independently tried to look up the literature found the same studies. (Made me feel as though I understood the data as well.) Curious of your thoughts on the NFL's reporting of that nebulous 50% decrease. While we don't see data on the decreased concussions I presume it theoretically could still be possible as clinical significance is not always directly related with statistical significance in a study (extremely common in sport science research because 1% performance enhancement can be the difference in a win or loss). My confusion comes knowing that the players wearing the caps didn't see an increase in concussion rates upon removal of the caps. Simply a gap in the research, or something fishy from the NFL? if the numbers are as big as they report it seems they would have some formal publishing or release. Thanks!
Thanks for the kind words! And I think you have your question flipped. You're wondering why players who removed the cap didn't see more concussions. However, removing the cap is actually the baseline/control condition (i.e., regular helmet). And, from the data, adding the cap didn't LOWER concussion numbers as proposed. So, again, re-removing the cap wouldn't increase numbers (because it's simply returning to the way it always has been/control). I do think it's a PR push to show efforts at improving player safety - and I don't think it's malicious. There has been a very unfair and biased attack on "concussion-football" data, so naturally, they want to flaunt safety. However, the data that DOES exist is reducing contact practice time, wearing mouth guards, and performing dynamic neuromuscular warm-ups (see my most recent live recording).
Thank you for this informative video. I’m curious your thoughts on the guardians caps for youth football players (7th and 8th grade level) Our school district was gifted guardian caps. Do you think they are possibly more beneficial for this age group who are using poorer quality helmets, that are older. My son’s helmet is from 2015. I think it is optional for them to use and I’m wondering if I should push my son to wear it or not worry about it. Thanks!
Generally, the lab and player data isn't convincing for anyone (in my opinion). We also have to worry about the "perception of safety" that players may feel from wearing this, which may result in engagement in more risky plays/situations. Based on the data, investment in a newer helmet would go further than the investment in the Guardian Cap.
Head impacts are *associated* with TES/CTE, not causal. We can’t define subconcucussion because we can’t even really define concussion objectively. Accuracy of public knowledge of CTE is ~48% (despite this, confidence in knowledge is high). My point? This conversation is a lot more nuanced. 🙏❤️🧠
@@drmarkheisig the high school kids are bigger than ever. The future of football, physiologically, is BiggerFasterStronger. And ultimately there will be a season or even one weekend of unprecedented travesties. BiggerFasterStronger
@@drmarkheisig i was watching a PBS documentary on HS football in regards to head injuries and the Trinity team in Texas looked like a death squad. They went up against one of the higher rated teams but it didnt matter. Trinity(#1) punished them all game long, moreso physically than on the scoreboard. And the scoreboard wasnt pretty.
What are your thoughts on their use for youth hockey? I"ve seen many a kid have their legs swept out from under them and go down hitting the back of their head on the ice, hard. I'm also guessing youth helmets aren't near the quality of the professional helmets that showed the least effect from the caps. Was looking into getting one for my 9yo because usually it's those back of the head on the ice contacts that seem to ring his bell the most but would love your perspective.
Most modern ice hockey helmets are high quality (I say this as a former ice hockey forward-13 years). Remember, even though we saw a ~10% decrease in the lab, we didn't see any changes in player contact data. Regarding concussion prevention in ice hockey, it's best to properly wear a fitted mouthguard and your helmet (see my recent "live" recording on prevention). But added soft-shell covering? It's probably not worth the money.
I'm here because I was considering purchasing one for my 11 y/o son. Alas it would appear the NFL is continuing to grasp at straws to create the appearance that football can be safe for brain health. Thank you for the info. I am also interested in the distinction of concussions (as defined medically) vs. repetitive hits to the head that do not qualify medically as a concussion, but which as I understand it are though to be a major contributor to CTE. Could you comment on this, and if their is any harm reduction that can be done to prevent CTE specifically, not just concussions? Also is there a similar situation where the MIPS system for cycling helmets is mostly marketing with little benefit?
First, I think it's important to note this about concussion news in the media: - 82% of concussion publications have "spin" that makes the information false or misleading - Data that FINDS a link between head impacts/football & CTE (compared to data that finds no link) is cited 4X more, has 7X more attention on media/social media, is mentioned in 99% more news stories, 98% more media outlets, and reaches 2X as many people on Twitter. Fear gets attention. However, lots of data shows that NFL players are better off than the general population. But I digress. *Concussion vs. RHI: ruclips.net/video/slW336fr4_Y/видео.htmlsi=cdSfv-Ojzcm_Q5iD *Concussion (CTE) prevention: ruclips.net/user/liveKHiB7wdS0OQ?si=WU-MY8S2vrIt75gu I don't have enough info on the MIPS to comment - that will have to be a future video! :)
@drmarkheisig Thank you for taking the time to reply! I will check out those links 👍🏻 MIPS is basically a thin plastic inner layer of the helmet that claims to allow the helmet to rotate around the head during glancing blows, dissipating the force more.
In dirt bikes, the Kalik brand did extensive research. The shape and texture of the helmet is better if it doesn't increase rotation through traction. Round rather than angular, slick vs grippy. The Guardian cap appears to be a device that increases the traction/rotation. The larger the diameter, the greater the rotational force or torque. The Mips slip system shows much promise, but isn't applied in football.
Good information I think we can all agree though new technology & head protection is needed. A bike helmet or motorcycle helmet won't give full protection in all accidents or injuries either also but without it the damage & injuries would & could be a lot worse or life changing. I think it's good that technology on this is moving forward & getting better. Good to think about perhaps this Dr & other's/science could get together & invent one. Head injury/concussion person here & I got mine by a fall landed head first on my frontal lobe. All good now thankfully but man I wish Drs/people would have believed me & my symptoms. I had to do it on my own
Yep. This is why you'll hear me echo this exact message at the end of the video --> Wear your helmets & we should be glad to learn from our research mistakes to move the protective equipment in better directions.
So the nfl pushing these on their players is just them trying to save face and make it seem like they are advancing in making the game safer which takes heat off their backs once these players retire and arent well?
That's a possibility. Though, I think the research is well-intentioned. We do want to push forward with research for protective tech that can minimize brain trauma - this just doesn't seem to be meeting that mark in the lab or on the field. The NFL is also making moves by changing the kickoff and hip-drop tackle, which will theoretically lower dangerous impacts. The BIG problem I see with the NFL is the lack of following proper concussion identification and rehab protocols. "When in doubt, sit out" is seldom honored, and the standard 21-30 recovery time is regularly ignored. That's where we run into my most recent catchphrase: "concussion is not the problem. Poor management is."
@@drmarkheisigthey are the equivalent of the tobacco industry's use of marketing filters. Filters are ineffective at reducing any toxins including nicotine and tar, the laws of physics don't allow, filters to work. You're a doctor you know physics and you know that the laws of physics will not allow guardian caps to work effectively nor will helmets or any other form of marketing device. The NFL needs to say there's no safe way to play football and playing football puts at high risk of CTE no matter the age or level it's played at, until that happens, the NFL is a corrupt industry engaging in a fraud. NFL= big tobacco
I don’t see any negative side to using them. Our HS program acquired them this year and our players feel better protected in practices and parents are happy.
That's actually the proposed downside-player perception of safety. The concern is that players will feel safer engaging in compromising or dangerous plays while the cap provides no extra safety benefit. Additionally, NFL player interviews report that it can be warm to wear, and increased brain temperature relates to increased energy demand and greater acute phase excitotoxicity (i.e., glutamate release) in concussion. (Though this risk is probably minimally additive to the core temp increase from exercise and the helmet itself.) While your players may want to wear them, "informed consent" tells us it would be prudent to inform them that the published data on these caps do not show a decreased risk of concussion.
@@drmarkheisig Yeah we don’t use them to reduce concussions. We use them to help minimize the effects of a hit to the head whether it’s helmet to helmet or helmet to ground. No piece of equipment will stop concussions. We take a three tier approach. 1. Proper weight training with neck strengthening exercises. 2. Proper hitting and tackling techniques. 3. Technology such as the best helmets we can afford including Guardian Caps in addition to mount guards. Football s a dangerous sport along with everything thing else in daily life. Parents need to be informed and do what they feel is best. I also know that medical studies and how the data gets interpreted can change over time as more information becomes available. As far as added heat to the head, we address that with several water breaks and required heat monitoring with weather devices on the field. We had head related injuries over the past two seasons. This year with even more players in our program, since using the caps we’ve had none. Thanks for the info and I’m happy that research is continuing. Our experience has been positive and we’d be hard pressed to remove them from our program while convincing parents their kid is safer without unless our CIF football governing body makes an official statement.
So most concussions are not from football? LOL. Most people don't play football. How much does your risk of concussions increase when you play football?
I mean this compassionately; I'm not sure that you know what you're asking. Let's break this down: - Most concussions are from accidental falls and motor vehicle accidents. Of course, that car accident risk is not there if you're not in a car. - Football is a contact sport with a risk of concussion. Of course, if you do not play, that risk is not there. - Football players sustain concussions at rates ranging from 0.5 to 2.5 per 1,000 athlete exposures (AEs). For every 1,000 athlete exposures-whether that’s 1,000 players in one game or one player participating in 1,000 games-the average athlete might sustain 1 to 2 concussions within this range. And that would be the risk of engaging in football. Does that make sense?
This is such an excellent breakdown. Thanks for making this information brief and easily digestible!
Glad you enjoyed it!
Nice to see an actual concussion expert discussing this. Very informative
Glad you liked it!
Great video. Hopefully we can find better technology or rule-changes that will maximize player safety.
Agreed. It will likely come down to rule/policy changes for practices and games to reduce the number of head contacts. And we still need better reporting and RTP management (i.e., a 7-day return to play is a dangerous joke).
I play corner, i wear it for practice, but not in games because the ifaf hasnt approved guardian caps for game yet. Its cool for practice but the point is not play like naruto (running with head forward)
Wow I almost bought a Cap. Glad I looked up this video.
Glad you didn’t waste your money 🤙
Awesome video and I love that when I independently tried to look up the literature found the same studies. (Made me feel as though I understood the data as well.) Curious of your thoughts on the NFL's reporting of that nebulous 50% decrease. While we don't see data on the decreased concussions I presume it theoretically could still be possible as clinical significance is not always directly related with statistical significance in a study (extremely common in sport science research because 1% performance enhancement can be the difference in a win or loss). My confusion comes knowing that the players wearing the caps didn't see an increase in concussion rates upon removal of the caps. Simply a gap in the research, or something fishy from the NFL? if the numbers are as big as they report it seems they would have some formal publishing or release. Thanks!
Thanks for the kind words! And I think you have your question flipped. You're wondering why players who removed the cap didn't see more concussions. However, removing the cap is actually the baseline/control condition (i.e., regular helmet). And, from the data, adding the cap didn't LOWER concussion numbers as proposed. So, again, re-removing the cap wouldn't increase numbers (because it's simply returning to the way it always has been/control).
I do think it's a PR push to show efforts at improving player safety - and I don't think it's malicious. There has been a very unfair and biased attack on "concussion-football" data, so naturally, they want to flaunt safety. However, the data that DOES exist is reducing contact practice time, wearing mouth guards, and performing dynamic neuromuscular warm-ups (see my most recent live recording).
How does a player feel about the extra mass & weight of it?
(In general)
From what I’ve heard they don’t mind a ton, though it can tend to get hot. That presents its own unique problem/risk factor in concussion. 🤷♂️
Thank you for this informative video. I’m curious your thoughts on the guardians caps for youth football players (7th and 8th grade level) Our school district was gifted guardian caps. Do you think they are possibly more beneficial for this age group who are using poorer quality helmets, that are older. My son’s helmet is from 2015. I think it is optional for them to use and I’m wondering if I should push my son to wear it or not worry about it. Thanks!
Generally, the lab and player data isn't convincing for anyone (in my opinion). We also have to worry about the "perception of safety" that players may feel from wearing this, which may result in engagement in more risky plays/situations.
Based on the data, investment in a newer helmet would go further than the investment in the Guardian Cap.
Hmmmmm
How about subconconcussive hits that accumulate during practises & games
(In regards to your closing statement)
Still results in CTE
Head impacts are *associated* with TES/CTE, not causal. We can’t define subconcucussion because we can’t even really define concussion objectively. Accuracy of public knowledge of CTE is ~48% (despite this, confidence in knowledge is high). My point? This conversation is a lot more nuanced. 🙏❤️🧠
@@drmarkheisig the high school kids are bigger than ever.
The future of football, physiologically, is BiggerFasterStronger.
And ultimately there will be a season or even one weekend of unprecedented travesties.
BiggerFasterStronger
@@drmarkheisig i was watching a PBS documentary on HS football in regards to head injuries and the Trinity team in Texas looked like a death squad. They went up against one of the higher rated teams but it didnt matter. Trinity(#1) punished them all game long, moreso physically than on the scoreboard. And the scoreboard wasnt pretty.
What are your thoughts on their use for youth hockey? I"ve seen many a kid have their legs swept out from under them and go down hitting the back of their head on the ice, hard. I'm also guessing youth helmets aren't near the quality of the professional helmets that showed the least effect from the caps. Was looking into getting one for my 9yo because usually it's those back of the head on the ice contacts that seem to ring his bell the most but would love your perspective.
Most modern ice hockey helmets are high quality (I say this as a former ice hockey forward-13 years). Remember, even though we saw a ~10% decrease in the lab, we didn't see any changes in player contact data. Regarding concussion prevention in ice hockey, it's best to properly wear a fitted mouthguard and your helmet (see my recent "live" recording on prevention). But added soft-shell covering? It's probably not worth the money.
@@drmarkheisig thank you! Helmet is one thing we don't skimp on.
What can decrease the intensity of the brain banging around the skull on sudden deceleration after impact?
Appropriately-timed neck stiffness (we think).
I'm here because I was considering purchasing one for my 11 y/o son. Alas it would appear the NFL is continuing to grasp at straws to create the appearance that football can be safe for brain health. Thank you for the info. I am also interested in the distinction of concussions (as defined medically) vs. repetitive hits to the head that do not qualify medically as a concussion, but which as I understand it are though to be a major contributor to CTE. Could you comment on this, and if their is any harm reduction that can be done to prevent CTE specifically, not just concussions? Also is there a similar situation where the MIPS system for cycling helmets is mostly marketing with little benefit?
First, I think it's important to note this about concussion news in the media:
- 82% of concussion publications have "spin" that makes the information false or misleading
- Data that FINDS a link between head impacts/football & CTE (compared to data that finds no link) is cited 4X more, has 7X more attention on media/social media, is mentioned in 99% more news stories, 98% more media outlets, and reaches 2X as many people on Twitter.
Fear gets attention. However, lots of data shows that NFL players are better off than the general population. But I digress.
*Concussion vs. RHI: ruclips.net/video/slW336fr4_Y/видео.htmlsi=cdSfv-Ojzcm_Q5iD
*Concussion (CTE) prevention: ruclips.net/user/liveKHiB7wdS0OQ?si=WU-MY8S2vrIt75gu
I don't have enough info on the MIPS to comment - that will have to be a future video! :)
@drmarkheisig Thank you for taking the time to reply! I will check out those links 👍🏻 MIPS is basically a thin plastic inner layer of the helmet that claims to allow the helmet to rotate around the head during glancing blows, dissipating the force more.
🔥❤️
In dirt bikes, the Kalik brand did extensive research. The shape and texture of the helmet is better if it doesn't increase rotation through traction. Round rather than angular, slick vs grippy. The Guardian cap appears to be a device that increases the traction/rotation. The larger the diameter, the greater the rotational force or torque. The Mips slip system shows much promise, but isn't applied in football.
Good information I think we can all agree though new technology & head protection is needed. A bike helmet or motorcycle helmet won't give full protection in all accidents or injuries either also but without it the damage & injuries would & could be a lot worse or life changing. I think it's good that technology on this is moving forward & getting better. Good to think about perhaps this Dr & other's/science could get together & invent one. Head injury/concussion person here & I got mine by a fall landed head first on my frontal lobe. All good now thankfully but man I wish Drs/people would have believed me & my symptoms. I had to do it on my own
Yep. This is why you'll hear me echo this exact message at the end of the video --> Wear your helmets & we should be glad to learn from our research mistakes to move the protective equipment in better directions.
So the nfl pushing these on their players is just them trying to save face and make it seem like they are advancing in making the game safer which takes heat off their backs once these players retire and arent well?
That's a possibility. Though, I think the research is well-intentioned. We do want to push forward with research for protective tech that can minimize brain trauma - this just doesn't seem to be meeting that mark in the lab or on the field. The NFL is also making moves by changing the kickoff and hip-drop tackle, which will theoretically lower dangerous impacts. The BIG problem I see with the NFL is the lack of following proper concussion identification and rehab protocols. "When in doubt, sit out" is seldom honored, and the standard 21-30 recovery time is regularly ignored. That's where we run into my most recent catchphrase: "concussion is not the problem. Poor management is."
@@drmarkheisigthey are the equivalent of the tobacco industry's use of marketing filters. Filters are ineffective at reducing any toxins including nicotine and tar, the laws of physics don't allow, filters to work. You're a doctor you know physics and you know that the laws of physics will not allow guardian caps to work effectively nor will helmets or any other form of marketing device. The NFL needs to say there's no safe way to play football and playing football puts at high risk of CTE no matter the age or level it's played at, until that happens, the NFL is a corrupt industry engaging in a fraud. NFL= big tobacco
I don’t see any negative side to using them. Our HS program acquired them this year and our players feel better protected in practices and parents are happy.
That's actually the proposed downside-player perception of safety. The concern is that players will feel safer engaging in compromising or dangerous plays while the cap provides no extra safety benefit. Additionally, NFL player interviews report that it can be warm to wear, and increased brain temperature relates to increased energy demand and greater acute phase excitotoxicity (i.e., glutamate release) in concussion. (Though this risk is probably minimally additive to the core temp increase from exercise and the helmet itself.)
While your players may want to wear them, "informed consent" tells us it would be prudent to inform them that the published data on these caps do not show a decreased risk of concussion.
@@drmarkheisig Yeah we don’t use them to reduce concussions. We use them to help minimize the effects of a hit to the head whether it’s helmet to helmet or helmet to ground. No piece of equipment will stop concussions. We take a three tier approach. 1. Proper weight training with neck strengthening exercises. 2. Proper hitting and tackling techniques. 3. Technology such as the best helmets we can afford including Guardian Caps in addition to mount guards. Football s a dangerous sport along with everything thing else in daily life. Parents need to be informed and do what they feel is best. I also know that medical studies and how the data gets interpreted can change over time as more information becomes available. As far as added heat to the head, we address that with several water breaks and required heat monitoring with weather devices on the field. We had head related injuries over the past two seasons. This year with even more players in our program, since using the caps we’ve had none. Thanks for the info and I’m happy that research is continuing. Our experience has been positive and we’d be hard pressed to remove them from our program while convincing parents their kid is safer without unless our CIF football governing body makes an official statement.
Not good enough
There will NEVER be a helmet hood enough to protect the himan brain. It just protects the skull!
Human
Yup 🤙
@@drmarkheisig a form of warfare disguised as a sport, or even worse, a human demolition derby marathon.
So most concussions are not from football? LOL. Most people don't play football. How much does your risk of concussions increase when you play football?
I mean this compassionately; I'm not sure that you know what you're asking. Let's break this down:
- Most concussions are from accidental falls and motor vehicle accidents. Of course, that car accident risk is not there if you're not in a car.
- Football is a contact sport with a risk of concussion. Of course, if you do not play, that risk is not there.
- Football players sustain concussions at rates ranging from 0.5 to 2.5 per 1,000 athlete exposures (AEs). For every 1,000 athlete exposures-whether that’s 1,000 players in one game or one player participating in 1,000 games-the average athlete might sustain 1 to 2 concussions within this range. And that would be the risk of engaging in football.
Does that make sense?