When the Baltimore Ravens and San Francisco 49ers face off at Super Bowl XLVII this weekend, they'll also be facing a common foe: the threat of concussion.
It's why Sunday's game will include cameras in the media box devoted to helping team trainers and physicians spot unusual behavior in players that suggests they may have suffered a head injury. (See a graphic of recorded head impacts suffered by one player over a season.)
"Imagine how controversial this would have been before," said Richard Ellenbogen, co-chairman of the NFL's Head, Neck, and Spine Committee, referring to the camera scheme. "The opposing team would have thought the other team was looking at their plays—but now the film is purely for safety."
Players' willingness to suffer those cameras is a sign of just how concerned they've become about head injuries in recent years.
Just last week, the NFL and helmet manufacturer Riddell were named in a lawsuit filed by the family of retired linebacker Junior Seau, who killed himself last year. Posthumous tests revealed that Seau had chronic traumatic encephalopathy (CTE), a brain disease linked to repetitive head blows.
Seau's family alleged that his suicide resulted from CTE, which can cause neurobehavioral problems like depression.
Several thousand former NFL players and family members have already sued the NFL over head injuries. As the litigation mounts, the sports world's focus on concussions, from the youth to professional levels, has quickened the pace of related research and education on the issue.
The effort has produced scientific studies, rule changes in football and other sports, and research investments, like the $100 million grant awarded this week by the NFL Players Association to Harvard Medical School for a ten-year study of players' health.
And on Sunday, an NFL announcement is expected on a big partnership on one of the concussion war's key fronts: helmet technology.
Testing on the Gridiron
At labs in Ottawa, Canada, and outside Knoxville, Tennessee, the push to monitor hits that can cause concussions is on dramatic display: Football helmets sit on dummy heads while a piece of machinery slams into them at a set speed.
Sensors in three places—the helmet, mouthpiece, and center of the head form—measure acceleration and G forces from the impact. The goal: to ensure the sensors in the helmet and mouthpiece come up with accurate measurements.
The NFL commissioned the nearly yearlong study as a possible step toward fitting players with sensors that would flag dangerous hits in real time.
Kevin Guskiewicz, chair of the NFL subcommittee on safety equipment and playing rules, says the tests cover 12 helmet locations at five different velocities to simulate the conditions of player impacts during football games. He expects results on those tests soon.
The need is clear: More than 200 concussions have been reported in each of the last three NFL seasons, according to Ellenbogen. Last year's count—excluding postseason and including preseason—was 217.
Guskiewicz, director of the University of North Carolina Sports Concussion Research Program, has already collected data on on some 350,000 impacts sustained by football players on the college team.
For nine seasons, he has analyzed the data in hopes of cracking what he calls the concussion puzzle. The biggest hits aren't always the most damaging, he discovered; location and repetition matter too.
"Helmets are supposed to prevent catastrophic brain injury, like hemorrhages," said Guskiewicz. "They do a good job of that, but we want a helmet that does that as well as prevent concussion."
Building Better Helmets
In seeking that kind of hlmet, the NFL has sought help from the U.S. military, which has long studied head safety, since soldiers can suffer from brain injuries caused by head-rattling blasts.
A couple of years ago, the NFL and other sports leagues gathered in New York with members of the Defense Advanced Research Projects Agency (DARPA) to discuss protective technology. The exchange of information between the NFL and the military continues to this day.
Accurate sensors that measure impacts in real time would be a big advancement in head-trauma protection, said Lt. Col. Frank Lozano, the U.S. Army's product manager for soldier protective equipment.
Already the Army has tens of thousands of sensors placed in the crown of certain soldiers' helmets to measure the forces exerted on their heads. "It comes down to understanding the transfer of energy through a helmet and into the head," Lozano said.
Concussion occurs when the brain is injured from shaking or slamming against the skull. The more a helmet can absorb the force of an impact, the less the brain absorbs.
Pads lining the inside of the helmet are vital to absorbing the shock. They can vary in material, stiffness, and thickness. Lozano noted that the Army looks every year at pad suspension systems in search of ways to improve their helmets.
The Army is also studying potentially new materials for making helmet shells. One special type of thermoplastic being studied, Lozano said, is many times stronger than steel but a fraction of the weight.
Driving Toward Progress
Combatting concussion isn't limited to football—or to the United States.
The NFL committee's Ellenbogen noted that he recently met with representatives from Australian rugby, British equestrians, and European soccer, who are actively trying to make their sports more concussion-proof.
At a concussion conference in Zurich last year, he said, officials from soccer's international ruling body, FIFA, were fascinated with the idea of using cameras in the media box to focus on players from different angles and help athletic trainers spot anything unusual.
The video can also be fed to team physicians on the field, who will be carrying iPads for the first time at a Super Bowl. The device allows them to record and time players' responses to a sideline concussion test covering areas like memory, concentration, and balance.
Symptoms such as disorientation, amnesia, and double vision require disqualification; others are subtler, like the time it takes to recall words and facts such as who scored last.
"There's no perfect test," said Ellenbogen. But he cited good doctors, better communication, technology, awareness, and more penalties for unnecessary roughness as positive advances in the field.