According to the UPMC Sports Medicine concussion program, “Between 1.7 and 3 million sports related concussions happen each year. 5 out of 10 concussions go unreported or undetected.” (“Concussion Facts and Statistics”). This suggests that a huge amount of athletes are are going undiagnosed and aren’t receiving the proper treatment that the brain needs. The Brain Injury Research Institute says that, “Lack of proper diagnosis and management of concussion may result in serious long-term consequences, or risk of coma or death.” (“What is a Concussion?”) “Brain injuries cause more deaths than any other sports injury. In football, brain injuries account for 65% to 95% of all fatalities. Football accounts for more than 60% of sports related concussions” (“What is a Concussion?”) Because there is no definite concussion test and diagnosis is based solely on symptoms, many concussions go unnoticed. The athlete themself might not even notice immediate symptoms which will motivate them to return to the game, even if it isn’t in their best interest. Second Impact Syndrome is a condition in which a second concussion occurs before the first concussion has completely healed. This disorder is becoming increasingly common as the number of undiagnosed concussions begin to rise. The second blow to the head causes cerebral swelling, brain herniation, and death is very likely to occur. (“Second Impact Syndrome”) In order to prevent Second Impact Syndrome, athletes shouldn’t return to play until they are completely asymptomatic. The hypothesis is that if a football helmet is constructed to set off an alarm when an athlete suffers a blow to the head, then medical attention cannot be ignored and the athlete can be properly evaluated for a concussion. This would prevent athletes from playing through brain related injuries and allow them to get proper treatment. Football coaches at every level of play could utilize this tool to help ensure the health of their athletes and prevent the outcome of Second Impact Syndrome.
A 2004 study by McCrea was created to investigate the frequency of unreported concussions. A total of 1,532 varsity football players from 20 high schools in the Milwaukee, Wisconsin, area were surveyed. The questions on the survey consisted of 1) number of concussions before the current season, (2) number of concussions sustained during the current season, (3) whether concussion during the current season was reported, (4) to whom he concussion was reported, and (5) reasons for not reporting concussion. Of those who said they had sustained a brain related injury, only 47.3% reported their injury. The most common reasons for concussion not being reported included a player thinking the injury wasn’t serious enough, not wanting to be removed from a match, and lack of awareness. The study concluded that the main concern associated with unreported concussions is an athlete's increased risk of brain damage if a second concussion is sustained. (“Unreported Concussion in High School Football Players: Implications for Prevention.”) Similarly, a study by the University of Hawaii Sports Medicine Research Group was conducted to see if a concussion symptom survey was consistent with their previous concussion/head injury on the university's PPE history form. Both male and female athletes were surveyed. Seventy-one percent of athletes reporting symptoms that would suggest a concussion were not identified as having a history of head injury on the PPE medical history form. The concussion symptom survey revealed greater numbers of athletes experiencing symptomatic head injuries than the screening questions on the PPE history form. This suggests the athlete's failure to report previous head injuries. (“A Comparison of a Preparticipation Evaluation History Form and a Symptom-Based Concussion Survey in the Identification of Previous Head Injury in Collegiate Athletes.”)
A study conducted by multiple universities examined concussion symptoms and return to play time in youth, high school, and collegiate football athletes. They collected data by collecting each injured players mean number of symptoms, the prevalence of each symptom, and their return to play time. Overall there were 1429 reported concussions with a mean of 5.48 symptoms. Throughout all levels 15.3% resulted return to play at least 30 days after the concussion and 3.1% resulted in return to play less than 24 hours after the concussion. The odds of return to play less than 24 hours after injury were larger in youth athletes than high school athletes. (“Concussion Symptoms and Return to Play Time in Youth, High School, and College American Football Athletes.”) Many athletes return to play before giving the brain injury proper time to heal due to lack of knowledge and eagerness to get back out on the field. There are many risks involved with returning to play before a concussion has properly healed such as a greater risk for a second concussion due to a lower concussion threshold, second impact syndrome, and worsening of symptoms. Because of this, many high schools and colleges have adopted a return to play protocol. This protocol is a step by step progression to get the athlete back on the field. However, many argue that this return to play protocol isn’t always helpful because every concussion is unique and “Return To Play needs to be individualized, and many physiologic factors and diagnostic modalities need to be taken into consideration.” (“A Review of Return to Play Issues and Sports- Related Concussion.”)
The NCAA requires schools to have a concussion management plan, education for student athletes on the signs and symptoms of concussion, a process to ensure that student athletes with signs and symptoms be removed from play, and that the student athletes receive medical clearance before returning to play. (“A Review of Return to Play Issues and Sports- Related Concussion.”) The NCAA also doesn’t allow student athletes to start the Return to Play protocol until they are completely asymptomatic. Similarly, The NFL (National Football League) has adopted their own strategies to ensure the health of their athletes. Their policy says that once a player is removed from a game or from practice the athlete should not return until fully asymptomatic, has a normal neurological exam, normal neuropsychological testing, and has been cleared both by the team physician and the independent neurological consultant. (“A Review of Return to Play Issues and Sports- Related Concussion.”)
In order to develop a helmet that can accurately detect a “concussion-like” blow to the head, trials must be run. Watermelons strapped with helmets will be dropped from different heights. The force that causes trauma (bruising, dents, soft spots) will be recorded. After the trials have been run and the average force has been recorded, the helmet will be developed to sound at the specified force. This new feature to old school football helmets could be very beneficial to the sports medicine field by eliminating the amount of sports-related, specifically football, concussions that go undetected or undiagnosed. By utilizing this tool, athletes are more likely to get an accurate diagnosis and a proper treatment plan.