The Failures of The NFL Concussion Reduction and Prevention Strategy

A Strategy Targeted at the Inappropriate Level

Dr. Allen Sills, professor of neurological surgery at Vanderbilt Medical Center and NFL chief medical officer, recently explained that concussions are inevitable in football but can be reduced (Jani, 2022). It is is great news to hear that concussions can be reduced, as repeated episodes of concussions lead to the progressive brain condition: chronic traumatic encephalopathy (CTE), which arises in the football athlete. In fact, Mez and colleagues found that the longer an athlete plays the sport of football the more likely they will suffer from CTE (as a consequence of concussion). The authors calculated that the odds of attaining CTE increase every 2.6 years of playing the sport of football. This is a very eye opening statistic and is made worse by the fact that the concussion reduction and prevention protocol put in place is destined for failure.

Why is the NFL concussion reduction and prevention protocol essentially dead on arrival? Simply because the strategies function at the external level only and do not even consider the internal (i.e., athlete) level. This goes against how we should understand the function of systems within systems.

At Absolute, we are stating that changes at the external level only, even though well-intentioned, will undoubtedly lead to failure.

External Environment Changes Only - Really??

Complexity science enables us to know that to make true change in a system, the intervention must occur at the appropriate levels. In this case making a true change in the system would be a reduction in the occurrence of concussions in the football athlete. To make this a reality, we must view football as an ecosystem and, in doing so, there are two distinct environments of intervention to be considered: internal and external.

Changes in the external environment only are what Dr. Sills has suggested. For example, Sills and his colleagues have established risk reduction strategies such as changes to equipment, style of play, training and supervision by mapping various aspects of gameplay and trying to intervene at the patterns of the sport and the interactions of the athletes. (Jani, 2022)

Keep in mind that at Absolute we consider the external environment the Level of Competition. It is at this level that we want the athlete to succeed by by using training inputs to stimulate an increase in their internal capacities.

Do you see the blind spot?

No changes are suggested at the level of the athlete. As strength practitioners, we should call this protocol what it is, a band-aid solution that does not protect the athlete but rather sets them up for failure. The suggestion of making only external changes will only change specific external (motor) behaviours of the athlete as they attempt to adjust to the changes made at this level. These changes will not serve to change the physical preparation of the athlete!

Sadly, in this proposal there is no mention of utilizing strength training as a mechanism to change the football athlete in ways that enable him to better absorb, dissipate, and counteract collision forces which would be imperative to succeed at the Level of Competition while minimizing the risk of concussion and the statistical consequences of it.

Internal Environment Changes

These doctors need to come down from their ivory towers on campus and get in touch with the reality of the sport and the athlete in which they are trying to effect change in. In doing so, the doctors will understand to make the large ecosystem change they want, they must bring into the mix the physical preparation coaches. We have a seat at this table, regardless if they are inviting us at this point in time - which clearly they are not. This essay’s intent is to make us the uninvited guest at the table, which makes real change in the football ecosystem by directly affecting the athlete, the biological organisms that are actually suffering from the concussions and their consequences.

Understand: the conglomerate that will make real change in reducing concussions in football will be multidisciplinary and not singular (i.e., doctors only) - to believe otherwise is the definition of illogical thinking and to act in that manner will lead to failure in making any ecosystem change in football.

works cited:

1. Jani, K. (2022, April 18). NFL Chief Medical Officer and VUMC surgeon Dr. Allen Sills speaks on sports medicine and concussions. The Vanderbilt Hustler.