Brooke de Lench Brooke de Lench   IN: Top Stories, Prevention & Risk Reduction, Identification & Diagnosis, Treatment & Management, Effects of Concussion and Repetitive Head Impacts, Blogs   Tagged: , ,  
  • Brooke de Lench

    Author: Executive Director of MomsTEAM Institute, Founder and Publisher, MomsTEAM.com, Producer of The Smartest Team: Making High School Football Safer. Follow Brooke on Twitter @brookedelench. Email her at delench@MomsTEAM.com.

  • Brooke de Lench

The Smartest Team: Staking Out The Sensible Middle In The Polarized Debate About Football

It has been an exciting week for those of us who worked so hard over the past two years to produce The Smartest Team: Making High School Football Safer.   

After kicking off with our premiere on Oklahoma Educational Television (OETA – PBS) in August, and with stations in North Carolina and Colorado having aired the documentary in September, the beginning of October marks the first full week of broadcasts on PBS stations in more than ten states. 

While we are having a hard time keeping up with all the stations that are airing the documentary, there are stations in twelve additional states that are set to air the documentary during the week of October 7th, including our “home” station, WGBH2 in Boston, where it will run from 3 to 4 p.m. on Sunday, October 13th right before New England football fans click over to CBS’s broadcast of the Patriots-Saints game, and right before a rebroadcast of the already controversial Frontline documentary on the National Football League, “League of Denial.” (appropriately, many PBS stations are coupling our documentary with “League of Denial,” as they make a good pair: one focusing on the past and one looking forward with solutions).  By the time the fall football season is over, most of the nation’s PBS stations will have broadcast our documentary. 

It has also been extremely gratifying to hear so many positive comments about The Smartest Team from football fans, parents, athletic trainers,  coaches, and players around the country, now that they have had a chance to watch it, and to receive invitations to come speak to their schools or football programs about implementing our Six Pillar approach to comprehensive concussion risk management.

Concussion, Inc.

On the other hand, we know that there are those who are not at all happy that we are taking a pro-active, glass-half-full approach to trying to meeting the challenge concussions and head injuries pose in football.  In an effort to discredit the The Smartest Team, it appears that powerful interests in the multi-million business that is Concussion, Inc. are working overtime, both in the Twittersphere, through a whisper campaign, and via other even more insidious back-channel means, to cripple our ability to spread the word about our documentary, including trying to convey to the viewing public the impression that MomsTEAM and I are somehow peddling junk science because, to take one example, (spoiler alert!) they claim that the dramatic year-over-year drop in the concussion rate we documented in the Newcastle High football program was not the product of a controlled, qualitative case study or peer-reviewed research, and that our objectivity has somehow been clouded by alleged conflicts of interest, including asserting that we are merely a cipher or football apologist on the payroll of the National Football League.

Backed by science

We have never claimed that The Smartest Team is anything but what it is: a documentary showing how a single high school football team, based on the recommendations of a world-class team of concussion experts, implemented a concussion risk management program that we believe represents the current “gold standard,” from teaching players how to tackle without using their heads to strengthening their necks so as they are better able to withstand the forces that cause concussion, from encouraging players to honestly report concussion symptoms to utilizing cutting edge technology in the form of impact sensors to give sideline personnel another tool in their toolbox to employ in identifying athletes who may – emphasis on the word “may” – have sustained impacts of sufficient magnitude that may have resulted in some cases in concussions, so that they may be monitored for signs of concussion or may be asked to undergo a balance, vision, and/or neurocognitive test on the sidelines, the results of which may suggest a removal from play for the remainder of the game and referral to a concussion specialist for formal evaluation away from the sports sideline, which may result in a clinical diagnosis of concussion.

We don’t claim that we conducted a controlled study.  I am not an epidemiologist, medical doctor, athletic trainer, neuropsychologist or an expert in biomechanics. I am a journalist and youth sports safety advocate and expert. I made The Smartest Team to get people to look at football in a new and more pro-active way.

Does The Smartest Team advance a particular point of view? Absolutely. Does it marshal facts in support of that point of view? You bet. But in expressing the view that, as two-time Super Bowl winning running back Howard Griffith says in the narration introducing the last section of the documentary, there are steps that can be taken now to make the sport of football at the high school and youth level safer, we are doing no more than documenting recommendations that, in every single instance, have already been made by leading experts in the field, including medical doctors, physical therapists, strength trainers, athletic trainers, neuropsychologists, equipment manufacturers, biomechanical experts, and scientists whose work has been rigorously peer reviewed before being published in prestigious medical journals such as the British Journal of Sports Medicine and the The American Journal of Sports Medicine.

To some extent, one concussion journalist was right when he noted in a recent Tweet that The Smartest Team isn’t “bombshell” material, because there is really nothing we say in the documentary that hasn’t been said before.  What is refreshingly different about our documentary is that, instead of focusing exclusively on, and sensationalizing, the concussion problem, we emphasize solutions.

 

The challenge we face – that all those who, like us, want to strengthen and preserve the great game of football – is having our message heard.  For the most part, the national media doesn’t seem interested (surprise) in reporting good news – that there are ways to make football safer – because it is bad news, scary news, sensational news, that sells, and that some in Concussion, Inc. depend for their very existence on promoting.

Admittedly, in an age in which more and more people tend to gravitate towards opposite ends of the spectrum in their opinions on just about anything, in the case of the great debate about football, either urging parents to find another sport for their child to play or extolling its many benefits (extremely well documented, by the way, in Daniel J. Flynn’s powerful book, The War on Football: Saving America’s Game) while minimizing its risks, it is hard to be heard above the maddening crowd when one occupies the reasonable, pragmatic, pro-active, middle.

From my vantage point, having spent a lot of time with the wonderful football community in Newcastle, Oklahoma, from talking to football parents across the country, and from becoming educated about the actual facts about the safety of football, I believe that, not only is football a sport worth saving, but that those who call for radical changes in the way it is played, and by whom, or for it to simply be abolished, represent a small, but extremely vocal and influential minority. It is therefore essential that what Flynn calls the “tired media narrative that accentuates the negative and ignores the positive” be balanced by the facts about football, which are “overwhelmingly positive, if well hidden.”  That is precisely what The Smartest Team seeks to accomplish. 

Meticulously researched

Each element of our Six Pillar™ approach is supported by the very latest peer-reviewed research that the naysayers claim is lacking.  For proof of just how meticulous we have been in making factual assertions in the documentary, one simply has to  look at the documentary’s bibliography and annotated guide

Each of those bibliographies sets forth a verbatim recitation from the transcript of key statements made over the course of the documentary (with time signature references), after which is a list of the peer-reviewed journal articles or other sources and related MomsTEAM content which support those statements.  In an age when the truth has become, all too often, a malleable concept, we take our reputation as the trusted source of health and safety information for youth sports parents very seriously, and for anyone to imply otherwise suggests as, Jack Nicholson tells Tom Cruise in the classic movie A Few Good Men that they can’t handle the truth.

So, you might be asking well what about the slide at the end of the documentary reporting (another spoiler alert) that the 2012 Newcastle High football team had only two diagnosed concussions, as compared to the 16 diagnosed concussions sustained by players during the 2011 season? 

It is important to begin at the beginning: to remember that Newcastle came to me and MomsTEAM for help. The program knew that in order to keep the boys active, healthy and playing the game they love, it needed to reduce the high rate of concussion. The school board, superintendent, principal, coaches, athletic director, AT, team doctors, parents and players, all enthusiastically supported the project.  They understood the importance of everything we were suggesting and documenting.

We worked very closely with all of the stakeholders involved in Newcastle football, not just at the high school level but youth and middle school as well, and trusted that they would provide us with the names of the boys who were concussed. Because some of the players wore impact sensors which provided us with some data, the process was as transparent as it could be.  It was in the best interest of the team to be honest with us, and if more players had sustained concussions, they knew that we would have explored on camera how and why they occurred (as we did with the two players who were concussed).  We also taught the players the importance of using a “buddy system” to watch out for concussion signs in their teammates, and were gratified that they acted responsibly in watching each other’s backs.

Since we weren’t conducting a controlled study, we don’t know why the number of concussions dropped from 16 to 2. But here again, we aren’t overselling or claiming credit for the drop, although we would like to think it was due to something other than pure chance.  But it is a  fact that the number dropped, and I don’t believe that there is anything unseemly or boastful about reporting that fact, which we did without any embellishment. 

Indeed, we have gone out of our way on to make clear that “to what extent the sharp reduction in the number of diagnosed concussions at Newcastle High was the result of greater concussion awareness by players, coaches, parents, and medical staff, improved tackling technique, chest, shoulder, and neck strengthening, and improved conditioning, and/or properly fitted helmets, is unknown,” that “MomsTEAM and the producers of ‘The Smartest Team’ make no representation that other football programs will experience a similar reduction by implementing a comprehensive concussion risk management program like the one featured in the film, nor do they believe this result is typical,” and that “[I]t is important to remember that taking steps to try to reduce the number of concussions is just one of six ways to make a football program safer.” 

Ongoing process

We also  have been careful to explain in the introduction to the bibliography  that the documentary is no more than an “audio-visual blueprint,” and “an introduction to a set of principles (the Six Pillars™) to guide development of a sound concussion risk management program – one based on the latest research and opinions of experts – to provide a solid foundation on which to build such a program; that we see it only as as a jumping off point for what we hope will be the beginning of a multi-year and continuing process involving parents, coaches, players, athletic directors, school boards, booster clubs, and health care professionals, motivated by a desire to preserve all that is good about youth and high school football, to work as a team to implement best practices in concussion risk management.

That the concussion landscape is constantly changing and shifting in response to new technologies, studies, and the thinking of experts is also an important point worth emphasizing. As former i1 Biometrics’ CEO Lawrence Calcano observes near the end of the documentary, “The process of understanding what is happening to athletes when they compete is not a process that we’re gonna end in the next three months or six months, or next football season. This is a multi-year activity that’s gonna require the collection of a very significant amount of data. Over time, when you have millions of data points, then the medical community and the research community can begin to make sense of it and decide at what point, you know, is there injury?”

Because we recognize that our understanding of concussions, how they can be prevented, treated and managed, and the effect that repetitive sub-concussive impacts may have on an athlete’s brain and cognitive function, is rapidly evolving, we are making every effort to stay abreast of those changes by continuing to follow and work with the Newcastle football program on ways to improve player safety. Because new impact sensors have come on the market since we filmed the team in 2012, we have worked with the team and leading sensor manufacturers to outfit players with several new brands of sensors. As before, we are not conducting a controlled study, but taking these steps with one simple objective: to keep the players safe.  It’s hard to argue with that. 

Our hope is that youth and high school football programs around the country, after learning about the Six Pillar™ approach outlined in the documentary, will themselves implement similar concussion risk management programs, experience a drop in the number of concussions, and protect the long-term health of players by hiring an athletic trainer if they don’t already have one, doing a better job of identifying concussed athletes, removing them as quickly as possible from games or practices, affording them the physical and cognitive rest they need to allow their brains to heal, and allowing them to return to game action only after they have returned to baseline on all their pre-concussion tests and have completed the graduated, symptom-limited exercise program most experts recommend.. 

Not paid by NFL

Now, on to the second question that some folks are asking, and a loaded one at that: What role did the NFL play in the production of The Smartest Team, and isn’t our objectivity clouded by financial support from the league? The simple fact is that the NFL had nothing to do with the documentary, nor has it provided ever provided financial support to MomsTEAM. EVER.  We joined forces with NFL in October 2012 strictly as a “content partner” to its NFL Evolution website (now called NFL Health Playbook).  Each week, the NFL ran a selection of five MomsTEAM articles and/or videos, for which there was no charge.  I am now nor I have ever been a paid consultant to the NFL, either for supplying content, or for participating in their annual Health and Safety roundtables, or for offering suggestions on how best to reach sports parents, especially moms.

Everything I did for the NFL was pro bono and was  intended to strengthen and preserve the sport. MomsTEAM’s editors and I always retained complete control over the editorial content of MomsTEAM and the The Smartest Team was in no way influenced by any corporation or sports organization.

Have I, on occasion, applauded steps taken by the NFL to improve player safety? Absolutely. But I have also taken the NFL to task on many other occasions. (Exhibit A: I was highly critical of the NFL in an episode of ESPN’s Outside the Lines). [Update: Indeed, on the very first business day in February 2014 after I was introduced to Roger Goodell at a reception at the home of Atlanta Falcons owner Arthur Blank, where he learned of my criticism of the NFL in that OTL segment, I received an email from the editor of the NFL website, NFLEvolution, that the NFL had decided to no longer run our content.]

Simply put, for anyone to suggest that I or MomsTEAM is in the pocket of the NFL is flat out wrong.  As I have since the very beginning of MomsTEAM in 2000, I answer only to one group and one group only: sports parents. 

Originally published on MomsTEAM.com on October 2, 2013

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