RUNNING HEAD: CONCUSSIONS: REDUCING THE IMPACT THROUGH

TECHNOLOGY

Concussions: Reducing the Impact through Technology

Jesus Crespin

University of California: Berkeley

Abstract
CONCUSSIONS: REDUCING THE IMPACT THROUGH TECHNOLOGY

A traumatic brain injury is one of the most detrimental injuries that a player can receive

in the sport of football. This type of injury can affect a player’s cognitive abilities as well as stop

the player from playing for a few weeks. To understand the severity of a traumatic brain injury

one must understand what the lifelong effects will be. The first part of this paper will introduce

chronic traumatic encephalopathy by explaining what the illness is, how the illness was

discovered, signs and symptoms, and the physiology behind the illness. The next part of the

paper will introduce sub-concussive hits and the effects that these hits have on a player’s body by

using case studies. The last part of the paper discusses the different types of technology that are

being develop to provide players of all ages with very protective equipment that will hopefully

reduce the number of concussions in the future.

Keywords: Biomimicry, Helmets, Football,Concussion, CTE

CONCUSSIONS: REDUCING THE IMPACT THROUGH TECHNOLOGY

Concussions: Reducing the Impact through Technology

Football has long been a popular sport in America for many reasons. For some football is

a pass time and form of entertainment that they can watch and interact with by following a team

or player. For others football is a hobby, they play the sport because it is what they played when

they were growing up, or they just play for the exercise and fun of the sport. Most people do not

think about the risk that each player is taking during each play, but in reality each time the ball is

snapped the athletes are running the risk of receiving a traumatic brain injury that will put them

out for a few weeks, but will have a greater effect on them in the long term.

Chronic Traumatic Encephalopathy

As defined by the Mayo Clinic, Traumatic Brain Injury or TBI is an injury that occurs

after a violent impact to the body and head. According to this definition any type of impact that

will affect a player’s cognitive ability as well as their ability to move can be classified as a

traumatic brain injury. Some of the most common forms of the traumatic brain injuries are

concussions, skull fractures, brain contusions, and penetrating injuries (Mayo Clinic). All forms

of traumatic brain injury will lead to some type of impairment on the brain. The effects of the

injury may be temporary but the results will last a players entire life.

It was recently discovered that most types of TBI lead to Chronic Traumatic

Encephalopathy, otherwise known as CTE. CTE is a degenerative brain diseases that affects a

player’s body after a player having a lifetime of impacts to the head. Chronic Traumatic

Encephalopathy is an illnesses that was first discovered by Dr. Bennet Omalu in his research on

a retired professional football player. Omalu performed an autopsy on a retired player and took

five tissues samples from different areas from the player's brain. The tissue samples showed that
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the player had suffered from brain bleeds and had dead neurons in his brain. Dr. Omalu also

stated that the player had no family history of depression and that the player had not suffered any

known head injury outside of football (Omalu).The effects of CTE can vary depending on which

of the four stages of CTE a brain is in. Stage one CTE is the first stage of the disease, it is

accompanied by headaches and loss of concentration and attentiveness. The second stage of the

disease has symptoms that include suicidal thoughts, emotional irregularities, short term memory

loss, and difficulty with language. The third stage of the disease is where most players are

considered cognitively impaired. This stage is where we see players have aggressive outburst,

mood swings, and memory loss issue. Stage four is the last stage of CTE, by now a player can

expect to experience memory loss that will lead to dementia, they may have difficulty speaking

and may also have trouble with their fine motor skills(Ortiz). One of the most common reasons

why people develop CTE is through football. Football is a highly physical sport that involves

colliding with other player to stop the opposing team from scoring. Over time these impacts

result in trauma to the brain that can lead a onset of stage one of CTE.

Chronic Traumatic Encephalopathy effects many structures in the brain and causes

damage to the brain that would not ever be seen in a healthy person. Concussions lead to cuts

and contusions on the surface of the brain, but there is much more damage done because of the

rotational force being applied to the brain tissue. This causes the brain to stretch which damages

deeper structures in the brain. This stretching also causes the brain to receive damage in the

tissue which adds up over time and reduces the number of neurons and tissue in the brain

(Camarillo). This is a problem because many structures in the brain control different functions in

the body. The cerebellum and the frontal cortex of the brain are example of these interior and

surface structures of the brain. The cerebellum assists us in our fine motor skills such as writing,
CONCUSSIONS: REDUCING THE IMPACT THROUGH TECHNOLOGY

typing, and eating. Damage to this structure would impair these functions. Similarly, the frontal

lobe controls memory and it controls our impulses, damage to this structure makes it harder to

remember events as well as makes controlling impulses harder leading to emotional outburst.

Damage to these structures are problematic because it affects the livelihood of a person, the brain

damage they experience effects almost every aspect of their life. Most people who suffer from

CTE experience difficulty with their temper and emotional issues. In Omalu’s study the player’s

family stated that they felt he was bipolar. Additionally, the research stated that he had issues

with relationships, the retired football player had many relationships but he was never married

(Omalu). This is often one of the reasons why players develop depression and other mental

health issues that unfortunately either, last a player’s lifetime or cause the player to take their

own life. Chronic Traumatic Encephalopathy is often linked to numerous concussions that lead

to structures in the brain being injured but recent studies suggest that any continuous impact to

the head maybe a cause of CTE.

Sub-Concussive Hits

Aaron Hernandez was a professional football player that developed chronic traumatic

encephalopathy without having a continuous series of concussions. In April of 2017,he took his

own life; It was later discovered by researchers at Boston University that Hernandez had one of

the worst cases of CTE that was ever recorded. Hernandez like many professional football

players, started playing the game at a young age. Hernandez then continued his football career

into highschool and then throughout college at the University of Florida only to be drafted into

the National Football League. During his three seasons in the NFL Hernandez was a star tight

end for the New England Patriots. Hernandez only suffer one concussion during his whole

professional career, yet he developed CTE (Natale). This is unusual because CTE is supposed to
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develop after a lifetime to concussions, yet Hernandez had a limited amount of them. However,

the position that Hernandez played may be responsible for his development of CTE. The tight

end position is one of the most physical positions in the game. Tight ends are often running

routes to catch passes or protecting the running back and quarterback by blocking players from

the opposing team. This impacts a player because they often tackled or have helmet to helmet

contact with other players which make them more prone to concussions than other players in

different positions.

Earlier this year a prominent college football player, Tyler Hilinski, took his own life on

January 16, 2018, this event caused questions about the young man's mental health. However,

Hilinski brain was sent to be researched on, and it was discovered that the young quarterback

suffered from the early stages of chronic traumatic encephalopathy (Kercheval). Hilinski was 21

years-old and played the position of quarterback,which is thought to be one of the most protected

positions in the game of football.

Mental health is a big issue because many retired football players taking their own lives,

in fact many former player have stated in a recent study that they have experienced some form of

mental illness. Out of the 220 recently deceased football player 99 percent of the players had

signs and symptoms of chronic traumatic encephalopathy (Kercheval). The death and discovery

of CTE in Hilinski, Hernandez and other professional players has put pressure on the National

Football League and other governing bodies of the sport to find a solution to the concussion

crisis that football is experiencing. A study of 111 brains was conducted and 110 out of all 111

professional football player’s brains that were tested had CTE. The issue of mental health is a

current epidemic in society. However, it would be fair to conclude that the mental health issues

that players face is correlated to the damage caused by the head injuries that the players receive
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from constantly tackling or getting tackled repeatedly by other players with great force. We see

that both players had a limited number of concussions, yet they both developed CTE. Recent

research suggest that these men could have suffered from sub-concussive hits, impacts that are

below the threshold of a concussion but still are impactful on the brain. Research form the

University of Boston states that playing football as an adolescent may put you at higher risk for a

neurodegenerative disease because the force from the tackles will affect the structures in your

brain and impair healthy development. The findings of the study stated that if a player starts

playing football before the age of 12, he is more likely to experience mental illnesses like

depression and have an impaired memory(BostonUNews). The research continues on by stating

that changes in the structure of the brain may be the result of repeated impacts to the head and

not the number of concussions a player receives. The Concussion Legacy Foundation also

suggest that concussions may not be the main cause of CTE, but rather subconcussive hits that

lead to the development of CTE(Concussion Legacy Foundation).These study show just how

dangerous football can be when children are playing the game. Both of these Hernandez and

Hilinski had played football from a young age and both had a very low number of concussion,

yet they still developed chronic traumatic encephalopathy. These studies suggest that maybe

football does not have a mental health issue maybe the issue is something greater. In order to fix

this problem we must not look at the effects of mental health, we must look at how helmets are

being produced and adjust industry standards for helmets to include concussion reduction.

Chronic traumatic encephalopathy can occur with a lifetime of tackles and impacts to the brain,

yet how much do helmets protect a players brain.

Advancements in Helmet Technology

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Helmets are not designed to protect the athlete from concussion, but helmet companies

are developing technology that could help reduce the number of concussions and protect players

of all ages. There are many ways that helmet technology is advancing to meet the needs of

players. One of these ways is by using biomimicry in the design of the helmets to dissipate the

force that is applied to the brain. Biomimicry is the manufacturing of items to closely resemble

structures that are seen in nature. Researchers have observed animals such as hedgehogs, rams,

and produce such as fruit in search for answer to aid in the concussion epidemic. These

organisms are important to study because they often take forcefull and repeated impacts not only

to their head but their body as well. From the organisms that have been researched, the

researchers have concluded that most of these animals and plants dissipate linear and rotational

force to lessen the impact on themselves.

One start up company called Hedgemon has fashioned a liner for football helmets that

mimic the same structure of a hedgehog’s quills. The liner is made from tightly grouping

together synthetic quills made from polymers to reduce the rotational and linear force of the

impact to reduce the likelihood of a concussion.The quills further protect the player because

unlike the foam in traditional helmet liners the polymer in the quill allows them to keep their

shape and to continue to serve absorb shock (Swift). In a different approach researchers at

Mississippi State are using rams to advance helmet technology. The ram is being used because

the researchers noticed that the ram is naturally protected when it collides with another object

whether it be another ram or a predator. The researchers have also modeled their technology after

the woodpecker due to the bird’s ability to strike trees at high speeds. In both of these case the

animal have special feature that protect their brain. The ram’s horns and the woodpecker’s beak

are both lengthy, these features help dissipate the energy from the impact that these animals
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would experience. The researchers have added structures to the helmet that would simulate

similar structures in a ram’s horn to help dissipate the energy. In their test they have determined

that their helmet has reduced the likelihood of a concussion by almost three times when

compared to a normal helmet (Mississippi State.com) Advancements in biomimicry help lead the

change in helmet technology, but is the industry responding.

Current helmet regulation for football helmets is set by and industry standard, which is

different when compared to regulations for bicycle and motorcycle helmets which are regulated

by the Department of Transportation with constantly changing standards. This leads to an

industry standard that is set by football helmet manufacturers that unfortunately evolves very

slowly, but with the increased pressure by football players helmets and helmet testing are

evolving. Virginia Tech Helmet Rating is a biomedical engineering research group that has

tested helmets since 2003. They are one of the main sources for helmet safety in athletics. They

use a variety of data gathered from actual football games and test football helmet against similar

impacts. They then give the helmets a rating out of five stars. The two current major helmet

manufacturers in the sport of football are Schutt and Riddell. These two companies account for

90 percent of the helmets that are seen in the league and both have a five star rating by Virginia

Tech’s Helmet Ratings (Virginia Tech Helmet Rating).

Riddell and Schutt are not bad companies, both are trying to improve their helmets but

are their develops accessible to every level of the sport. Riddell for example has created inserts

that track real time data on the impacts that the player is receiving. On the other hand, Schutt is

adding liners and impact absorbing materials like plates that move to dissipate the rotational

force that is commonly associated with concussions and TPU cushions that will spread the force

out evenly among the head to reduce the impact of the forces on the brain. Riddell’s best helmet
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uses 3D scanning to make the helmet fit the players head as well as provide protective padding

that it better suited to the player’s head. However, the cost of the F7 by Schutt and the Precision-

Fit by Riddell almost 1,000 dollars for one helmet, which is too expensive for most high schools

and pop warner clubs to purchase for their players(Riddell.com,Schutt.com, Virginia Tech

Helmet Rating). Additionally, the Riddell helmet is inconvenient and wasteful because each

helmet would only benefit the player it is designed for. The research and development of helmets

is looking positive for the game of football however we must be cautious because no helmet can

prevent a concussion. Helmets can only decrease the force that is applied to your head and body

in the hopes that a concussion will not occur. The challenge that these companies and researchers

face is trying to produce a reusable inexpensive helmet that will reduce concussions while being

a profitable product.

The future of football could be bright due to the advancement of helmet technology.

Football can continue to hold its place in American society as a game that teaches character and

teamwork to young children but the game need to recognizes the need for better equipment and

better management. The NFL,the sports biggest league, funds many concussion and helmet

research projects, in fact the NFL alone gave 100 million dollars to concussion research in 2016

and promised 40 million dollar to research for five years after 2016 (Belson). However, this

research is not alway accurate. For example, Dr. David Camarillo from Stanford University has

stated that the current CDC video depicting a concussion, which was funded by the NFL, is does

not accurately portray what is happening during a concussion. But not all NFL policies are

inadequate, in 2018 the NFL has banned players from using ten underperforming helmets that

over 200 players may have been using. The league is also testing new helmets like Vicis Zero1

helmet, which is one of the top rated Virginia Tech Helmets, and posting helmet information in
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the facilities of each team about helmet safety to inform athletes about the helmet that they are

using during practices and the games. These small changes can make a great impacts on the lives

of professionals and the lives of the youth that look up to the professional players as role

models.

The advancement of helmet technology can only lead for a safer and more dynamic

experience for future generations of children that decided to play football. With the advancement

of helmet technology through biomimicry and other means it seems that football maybe here to

stay. But, we must realize the unfortunate truth that no helmet will ever prevent a concussion.

With no way of diagnosing CTE in vivo science has a challenging dilemma, should they declare

football unhealthy for children. IN reality helmet technology is rapidly developing, but is it

developing fast enough to safe the next generation of professional football players. Parents or

legislators must decide if allowing children to play tackle football is ethical, when there are other

alternatives that can teach them the fundamentals such as flag football.

Annotated Bibliography

Belson, K. (2017, December 21). N.F.L. to Spend $100 Million to Address Head Trauma.

Retrieved from https://www.nytimes.com/2016/09/15/sports/football/nfl-concussions-

100-million-roger-goodell.html

This article discussed how the NFL was funding research for concussions and helmets. The
author Gave a rough estimate of how much funds the NFL commissioner delegated to the
research for the next five year from 2016 to 2021.I plan on using this piece to should how much
money is being spent by the NFL on the safety of their players. I also plan on showing how the
NFL has gained a great profit from their season but they do not use a lot of the money for
research. Then, the article will be used to show how the research they are funding is not always
accurate.
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BostonUNews. “Study Suggests Link between Youth Football & Later-Life Emotional,

Behavioral Impairment.” EurekAlert!, 2017, www.eurekalert.org/pub_releases/2017-

09/buso-ssl091417.php

This study discusses the live long emotional effect on the brain when children play youth
football
before they reach adolescence. This was done by examining different NFL athletes and
recognizing that the players who started playing football at a young age had more a worse
memory than players who started at later ages. They study also suggest that
subconcussive hits at
a young age is more detrimental to the younger players.
I plan on using this research done by Boston University researcher to come at an angle of
why
young children should not be allowed to play football at a young age. I would also like to
demonstrate that the adolescent brain is much more fragile than the post adolescent brain.
I
would also like to bring up the idea of a subconcussive hit and the effect that these hits
have on
thebrain.

Camarillo, David, director. Why Helmets Don't Prevent Concussions — and What Might.

TED: Ideas Worth Spreading, 2016,

www.ted.com/talks/david_camarillo_why_helmets_don_t_prevent_concussions_and_wh

at_might?language=en.

This is a video by David Camarillo a researcher at Stanford University who focuses on

concussions and the mechanism of injury that allows for concussions to occur. Camarillo
discusses ways to further advance helmet technology in order to lower the number of concussion
in sports. He also suggests that helmet technology may be experiencing a progression within the
coming years.
This source will help me explain current forms of mapping brain movement in the skull. I can
also use this video to show the flaws in helmet regulation in sports and nationwide. This video
provides a great mechanism to show how head injuries occur and also will provide me with great
examples of current helmet technology that reduces risk of concussion.
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Kercheval, B. (2018, June 26). Washington State QB Tyler Hilinski found to have CTE,

'brain of a 65-year-old' after suicide. Retrieved from https://www.cbssports.com/college-

football/news/washington-state-qb-tyler-hilinski-found-to-have-cte-brain-of-a-65-year-

old-after-suicide/

This article explains mental health statistics in football and the death of Tyler Hilinski. I plan on
use the former player’s story as a case study for subconcussive impacts. This includes the
position he played and his age to should how young he was and how the position he played is
often seen a being protected. The statistics in the article I plan on using to go over mental
health’s impact on football. I will then state that mental health is not the issue in the game but
rather the idea of subconcussive impacts.

Mayo Clinic. (2018, January 17). Traumatic brain injury. Retrieved from

https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-

causes/syc-20378557

This source describe what CTE is and the signs and symptoms. This source describes the causes
and treatment of CTE. It also goes over the diagnosing process for the illness. I plan on using the
article in conjunction with my previous knowledge to illustrate how the brain is impacted by
CTE and concussions. The article will help me refresh my knowledge as well. I plan on using
this to also help the audience understand the severity of the disease.

Msstate. (n.d.). We Ring True. Retrieved from

https://www.weringtrue.msstate.edu/helmetresearch/index.html#about

This article is about the research happening at Mississippi State that is dealing with biomimicry
in helmet technology. The article states that the researchers have looked at structures from
animals like woodpeckers and rams that have shock absorbing features. I plan on using the
article to describe the type of work that is being developed by researcher to help protect players.
I will describe the structures that they are developing in helmets to make the helmet three times
more effective when compared to current helmets.

Natale, Nicol. “5 NFL Athletes Who Had CTE.” EverydayHealth.com, Everyday Health,

22 May 2018, www.everydayhealth.com/concussion/symptoms/nfl-athletes-who-cte/.

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This is an article of five athletes who had CTE. This article documents the thoughts of relatives
and what the relatives believe to show that their loved one had CTE before it was diagnosed. It is
written by a journalist so the article may not be the most reliable source.
I plan on using this source for my case study of Aaron Hernandez and his case of CTE. The man
had on recorded concussion yet he had one of the worst cases of CTE on record according to
researchers. I plan on using him as an example for helmet regulation and for subconcussive hits.

Omalu, Bennet I., et al. “Chronic Traumatic Encephalopathy (CTE) in a National Football

League Player.” Journal of Forensic Nursing, vol. 6, no. 1, 2010, pp. 40–46.,

doi:10.1111/j.1939-3938.2009.01064.x.

This is a research article that details the findings from Dr. Omalu about the results of a lifetime
of concussions. This was a study done by autopsing a retired professional football player and
showed neuro impairment in the player. Omalu then researched another brain to find similar
impairment, he concluded that concussion and hits to the head were causing such impairments.
Additionally, he concluded that the only way to diagnose this ailment was to perform an autopsy
on an individual's brain.
Bennet Omalu is the doctor that discovered CTE or Chronic Traumatic Encephalopathy. This
paper will give me the ability to explain CTE to my audience by interpreting his research to
provide a less complex summary of the significance of CTE. It will also allow my to start my
vertical dive into why helmets are not enough and are not protective enough.

Ortiz, A. (2017, September 21). Learn the symptoms in the four stages of CTE - The Boston

Globe. Retrieved from https://www.bostonglobe.com/metro/2017/09/21/symptoms-

watch-for-four-stages-cte/Q1wniQOnQXH1bU8OibU3WJ/story.html

This source gives a summary of the four stages of chronic traumatic enchelpahty and what
symptoms are associated with each stage. The article is useful to me as I can use it to describe
the stages of CTE. This will help me later develop my essay and will help me make a stronger
argument. The article will also help me further explain the severity of CTE. I believe this to be
relevant especially in the case of the case studies because it will help give the audience a better
understand of what stage of CTE the players are in.

Schutt. (n.d.). Schutt Sports. Retrieved from https://www.schuttsports.com/football

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They are one of the most notable helmet manufacturers in the sport of football. I use information
from their website pertaining to the top of the line helmets that they sell. I use the price and the
materials use to explain how the helmet is effective but is too expensive for the helmet to be
purchased in the masses.

“Subconcussive Impacts.” Concussion Legacy Foundation, 31 May 2018,

concussionfoundation.org/CTE-resources/subconcussive-impacts.

This article details how the effect of a subconcussive hit affects the body and gives an
overview
about the details behind a subconcussive impact. The article discusses ways to prevent
hits such
as starting football at a later age, it also discusses modifying the way players tackle. The
article is
a overview of the issues and concerns surrounding subconcussive hits.
The article is written by the Concussion Legacy Foundation they are a reputable source that
informs the public about the dangers of concussions and how to prevent and aid in rehabilitation
of concussions. I plan on using some of the information to take a vertical dive in the subject of a
subconcussive hit and also use it to connect on the idea of how we can better helmets in order to
eliminate the possibility or lessen the chance of injury.
Swift, N. (n.d.). Hedgemon: A Hedgehog-Inspired Helmet Liner.

This is a paper on the biomimicry of a hedgehog's quills. The start up has created a synthetic
quill made from a polymer that is able to distribute the force of the impact. I used this paper to
show that the force from a concussion originates from a linear and rotational force that is applied
to the brain. I then explain the science an application of the quills and how effective the liner is
compared to the current liner in a football helmet.

Riddell | Protect and Perform. (n.d.). Retrieved from

http://www.riddell.com/?gclid=EAIaIQobChMInvSe6rSY3wIVw7jACh2QiAYOEAAYASA

AEgLgNPD_BwE

They are one of the most notable helmet manufacturers in the sport of football. I use information
from their website pertaining to the top of the line helmets that they sell. I use the price and how
the helmet is produced to explain how the helmet is effective but is too expensive for the helmet
to be purchased in the masses.
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Varsity Football Helmet Ratings. (n.d.). Retrieved from

https://www.helmet.beam.vt.edu/varsity-football-helmet-ratings.html

This is a website that rates helmets from helmet manufacturers. It shows that some of the helmet
manufacturers are looking for change in the industry. I use this article to price and to find the
rating of some of the safest helmets on the market. I also use this to show that the NFL is trying
to better themselves. However, I also make the argument that the helmets that are on this site are
more expensive and are thus not purchased by pop warner and high schools for their players.