Education Is the Difference
There is no silver bullet. Reducing brain injury and improving safety in football requires a multi-faceted approach. I believe in the overarching goal of education. But the approach to education should be very specifically related to that which emphasizes effective knowledge transfer resulting in change in behavior.
Multiple well-designed research surveys (or a brief period of channel surfing on a Sunday during football season) reinforce the fact that players, coaches, and other stakeholders are aware of the risks associated with practice and competition, but very few have changed their behavior or approach to the game. Coaches tend to coach certain ways, and players tend to play with a gladiator mentality. More than 10 years of “education” has raised awareness of the safety issue, but has done very little to change behavior. If education is to result in effective knowledge transfer that makes football safer, both the message and the messenger are critical.
Changing the Stigma of Injury
For stakeholders, I advocate for a message that emphasizes the optimistic and beneficial outcomes associated with the changed behavior, rather than emphasizing simple facts and fear. Athletes are competitive by nature. They want, more than anything else, to compete and to be better athletes. The power of denial is too strong to be overcome by the power of statistics and lists of risks associated with under-reporting or minimizing concussion symptoms. The social capital associated with participation is more valuable to most athletes than the “better safe than sorry” and “when in doubt sit out” messages associated with traditional education efforts.
Many times, athletes are put through a concussion protocol only when they have obvious signs and symptoms that can’t be hidden, or after they’ve tried to play through an injury only to get worse and worse with subsequent participation, eventually leading to forced self-report. A different, more effective approach to meaningful knowledge transfer involves teaching athletes about the role the brain plays in athletic performance. A message combined with assessment, measurement, and tracking of vision, balance, speed of mental processing, reaction times, prediction, and other skills that are neurologic in nature re-frames the brain in the context of sport. A more efficient brain with higher levels of these skills should also contribute to impact/collision avoidance and reduction in risk. Training these skills and monitoring improvements through testing and on the field exposes the athletes to concepts related to a healthy brain prior to an injury.
Framing the understanding of the brain in sports in this way completely changes the attitude associated with brain injury and will be much more likely to result in the desired changes in behavior as compared to the traditional “facts and fear” approach. In this way, and with this spirit, emphasizing what is known about risk reduction through limiting contact practices, the importance of hydration, safe and effective tackling techniques, the benefits of neck strengthening, and other aspects of concussion safety and prevention will be embraced by athletes and stakeholders, rather than seen as necessary evils.