Surviving Traumatic Brain Injury

So, Whaddya Think?

 My Opinion: Rethinking the Design of Football Helmets

by

David Lloyd

presented

by

Donna O’Donnell Figurski

The reason for a hard helmet in American football is to prevent deaths from skull fractures. The attempts to make bigger and thicker helmets have been based on trying to absorb linear impact force, but that’s based on the faulty notion that linear impact force is related to brain injury (Condi, 2015).

It is the sudden rotation of the head that actually causes brain injury (Meaney, Morrison, & Bass, 2014). A bigger helmet “leverages” rotation, increasing the likelihood of brain injury (2016, January). We need to rethink helmet design entirely. I suggest using an artificial scalp (Aare, 2003), like the leather helmets from the 1930s (Stamp, 2012, October), with a springy, lightweight, carbon-fiber framework to absorb linear impact. The design should include guarding the mouth and chin.

David Lloyd – Brain Injury Survivor

Another possibility would be a variation of the so-called “invisible helmet” (Haupt & Alstin, 2016), which is like the airbag in a car. Players would wear invisible-helmet-collars, which instantly expand to cushion the head upon impact. (While I think this could be a great idea for bicyclists, I suspect it would not work for football, but since it occurred to me just now, I thought I would include the idea.)

I would also put a couple of strategically placed, clear, and inexpensive disposable gelatin capsules in the helmet. These gelatin capsules would contain a bright-colored liquid dye in the center. When an impact is sharp enough to cause the gelatin capsule to release the dye, the capsule turns bright red (assuming a red dye was used) to indicate a possible brain injury. The moment a player’s dye-capsule breaks, that player is out of the game (possibly along with the opponent who hit the player). A light-sensor could trigger an electronic ID number to be broadcast instantly to officials, so an appropriate response could happen immediately. Every incident in which a dye-capsule is broken is recorded as a possible sub-concussive injury. Players with too many sub-concussive injuries can no longer play, regardless of apparent brain health.

In addition, a smart phone-based application (Lathan, Spira, Bleiberg, Vice & Tsao, 2013) is used to test the player’s response times to a short series of tests, with scores compared with a baseline. Concussion is diagnosed on the field when the player’s test score is significantly different from his baseline. If a concussion is diagnosed, the player does not return to the field, and, at the discretion of the physician, the player may be treated with a neuroprotective drug, such as NeuroStat® (Campbell, Elmér, & Bronnegard, 2015), to prevent the death of neurons, which generally occurs before the symptoms of concussion are apparent.

I think the Kevlar insert sounds like a very good idea. Put that layer next to the head, below the artificial scalp I suggested. This in turn is to be below a light weight, springy framework, which I imagined would absorb linear impact by rapidly changing shape and then dissipating the energy by vibrating. The artificial scalp layer, in addition to sliding to absorb rotational impact, would also insulate the player from damage due to the vibration energy.

The three most important issues are (1) detecting potential sub-concussive injuries when they happen and before they cause symptoms (via the gel-capsules), (2) protecting against skull-fracture, and (3) protecting against sharp rotation, which requires a helmet with a much smaller surface area.

Many studies (Kis, Saunders, Hove, & Leslie, 2004) over the years have concluded that protecting against linear impact is equivalent to protecting against rotational impact. If one reads only abstracts and conclusions from these studies, one may be led to believe rotational factors don’t need consideration. However, only recently have there been any attempts to measure rotational damage, and even in those cases, the tests actually measure linear impact from various angles. They assume it is possible to infer information about rotational impact from this information (Kis, Saunders, Irrcher, Tator, Bishop, & Hove, 2013).

I don’t believe a linear impact test provides any significant data regarding rotational injury to the brain. I think a meaningful test of rotational impact is with my dye-in-gelatin suggestion. It is simply not possible to design a laboratory test that can reliably measure all possible angles of force (Hernandez, Shull, & Camarillo, 2015) created in a multi-vector, real-situation impact. I have yet to see a meaningful test of damage caused by compression waves (Laksari, Wu, Kurt, Kuo, & Camarillo, 2015), which, depending on frequency, can be augmented by hard objects, such as helmets or even the skull itself. Create a clear-gel facsimile of a brain, add a few grapes to the gelatin to simulate denser areas of the brain, put it in a structure like a skull, wrap the skull in something analogous to skin and hair, and put THAT in a helmet. Then spin it, and drop it onto a fast-moving conveyor belt. Now count the fractures in the gelatin per cubic millimeter (using a microscope), and you will have BEGUN to create a meaningful model of what happens in a brain injury. It is likely that one cannot realistically study impact on the brain unless the artificial brain is connected by a neck to a body (Hernandez, Shull, & Camarillo, 2015).

I think attempting to reform the game would meet such extreme resistance that all kinds of misinformation would get published – obscuring the facts and preventing change. A better approach is to detect and track sub-concussive injuries before they compound to a level that threatens lives or affects mental performance.

Some are suggesting the elimination of football, but this “solution” makes no sense unless we eliminate all contact sports. I know boxing is much worse than football, in terms of the risk of brain injury. I’m pretty sure I could find evidence to indicate that hockey and soccer are statistically more likely to cause brain injuries than football, but even basketball, track, wrestling, swimming, skating, ice skating, and even bicycling present similar dangers. [Actually, football is second only to cycling, followed by baseball and basketball for associated brain injuries (Sports-related Head Injury, 2014, August)]. In my mind, the greater danger to the collective health of the nation would be the elimination of these various sports (Devine, & Zafonte, 2009). Humans need to be active, and there is no way to eliminate the potential danger of living a healthy life.

So, Whaddya Think?

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