Human Limits

Exploring performance and health with Michael J. Joyner, M.D.

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Making Football Safer?

There has been a lot of talk recently about the long term health risks associated with U.S. football.  There are two main concerns, the first relates to the long term effects of concussions and cognitive impairment later in life.  The second relates to the long term health risks associated with being “very big”.

It turns out that the neurological consequences of football are more typically seen in so-called speed positions that are associated with high velocity open field “big hits” in comparison to collision positions like the line.   The non-neurological long term health risks of professional football go something like this:


“National Football League players from the 1959 through 1988 seasons had decreased overall mortality but those with a playing-time BMI ≥ 30 had 2 times the risk of CVD mortality compared to other players and African-American players and defensive linemen had higher CVD mortality compared to other players even after adjusting for playing-time BMI.”


Some of these concerns were highlighted in a piece by the columnist George Will who summarized it this way:


“Decades ago, this column lightheartedly called football a mistake because it combines two of the worst features of American life — violence, punctuated by committee meetings, which football calls huddles. Now, however, accumulating evidence about new understandings of the human body — the brain, especially, but not exclusively — compel the conclusion that football is a mistake because the body is not built to absorb, and cannot be adequately modified by training or protected by equipment to absorb, the game’s kinetic energies.”



The first thing to remember is that the modern game of football emerged after deaths in college football in the early 1900s led President Theodore Roosevelt to demand that the game be reformed or banned.  So, the safety of football is not a new issue and in that spirit I make the following suggestions:

  1. Limit substitutions.   If players had to play both ways my bet is that the premium on very large players (300 pounders) would be replaced by a premium on big but not huge players who had the athletic skills to do more than one thing and also the stamina to play for longer.   When teams go to no huddle offenses frequently their defenses complain about the lack of rest caused by an offense that gets off the field too fast.  So, there would be a new emphasis on conditioning.
  2. Shorten the time between plays.  If there were a 20 second clock between plays the game would be more continuous and that would make conditioning even more important and limit the utility of really big players.  It might also limit the likelihood of pre-planned, high speed big hits.
  3. Get rid of some of the protective equipment.    It is unclear if the protective equipment is in fact that protective.  Perhaps it gives the players a false sense of security and encourages them engage in high risk, high impact hits.

Some of the ideas above would make U.S. football more like rugby so I bounced them off four outstanding physiologists from rugby loving countries:  Danny Green and Bob Callister from Australia, Tim Noakes from South Africa, and Peter Raven originally from the UK.    All of my colleagues agreed the ideas above had merit.    Dr. Green sent me a fascinating paper about body size in rugby and how it has changed over the last 100 year, and it is unusual for a top class rugby player to be much bigger than 110kg (about 245 lbs).

In closing, I doubt the ideas above will ever be adopted wholesale, but various forms of football have existed for centuries and perhaps the game will evolve in the ways I have outlined above.  If so, I bet we will end up with a safer game to play and watch that is equally exiting.  Watch a clip of the 7 on 7 version of rugby that will be coming to the Olympics in 2016 and see wide open game.   Add the forward pass and imagine what would be possible.



One Response to “Making Football Safer?”

  1. October 12th, 2012 at 4:20 pm

    JP says:

    Our most popular sport, because of the violence and strategy, could see an epidemic with the void of players in the next generation. Parent’s fear and precautions are already having an effect on football enrollment with the “bad press” over the last several months. One community (I don’t have a reference) saw their youth football enrollment drop so dramatically this fall that they were reduced to 4 teams. Fall for 2011 there were 8 teams in the league.

    A smaller pool of players will ultimately affect the game. The lack of inner-city baseball programs in the US during the 70’s and 80’s ultimately led to a drastic demographic shift to Latin players in MLB. Football doesn’t have an international feeder system.

    I like these ideas and I do believe that reducing the protective gear will help – especially preventing players from leading with their head and risking brain and spinal injuries. The question then becomes, who is willing to try it and will it damage the reputation of the game – i.e. shrinking revenue? It would be interesting to know if the “leather” helmet generation had fewer head traumas per hit and if it is relevant data.

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