Chris Borland Retirement Decision: 3 Lessons for Sports Parents (Full Blog)

The decision by San Francisco 49er Chris Borland to retire from the NFL after just one season out of concern for the long-term effect of head trauma has predictably generated a media firestorm. But lost amid the hoopla is what it means for sports parents.

Here are two lessons I think parents with kids playing -- or considering playing -- football or other contact and collision sports can take away from the Borland retirement, and one lesson they shouldn't take away:

1. Retirement from contact/collision sports should always be an option.

Borland is to be applauded for making his decision to walk away from a pro career only after carefully weighing the risks and rewards with family, friends, doctors, and concussion experts, and after doing his own research. Parents need to let themselves and their children know that there is no shame in doing the same.

As we teach in The Smartest Team documentary, retirement is the last pillar of our Six Pillar concussion risk management program, one which parents and athletes should keep open as an option at all times. 2015-03-18-1426711630-9440336-Newcastleplayerwithhelmetinlockerroomcompressed.jpg
© MomsTEAM Institute, Inc. 2013-2015

In making a retirement decision parents should know that medicine has not yet figured out how many concussions, or, for that matter, how many hits are too many.(1) There is no magic number, no over-under. The number that leads to permanent loss of memory, concentration, or reasoning skills, and/or that increases the risk of dementia and other problems later in life, is unknown and is likely influenced by various lifestyle and environmental factors, such as smoking, alcohol consumption, physical exercise, and personal and family history.

2. The "culture of resistance" to self-reporting of concussion symptoms is a huge problem in sports which requires urgent attention.

Borland admitted that he failed to report a possible concussion during his rookie training camp because he feared that, if he did, he might not make the team. Unfortunately, the failure to honestly self-report symptoms is the rule, not the exception; all too often, parents, coaches, teammates, and the very culture of the contact and collision sports (what the Institute of Medicine (1) dubbed the "culture of resistance") encourage athletes to remain silent.

How can we change that culture? For starters, parents need to consistently reinforce with young athletes the message that continuing to play with concussion symptoms puts them at increased risk of more serious brain injury (2,3), a longer recovery time (2,3), and, in very rare circumstances, catastrophic injury or even death from second impact syndrome.

Parents and coaches also need to work to create a safe reporting environment in which athletes perceive the positive consequences to reporting (being able to return to play sooner, not later; avoiding long-term brain injury), believe that coaches, parents, and teammates expect them to report concussion symptoms, and have increased confidence in their ability to report concussion symptoms.

The problem we face is that overcoming the culture of resistance by creating a safe concussion reporting environment is going to be extremely difficult, and take a long time (indeed, some doubt whether it can ever be accomplished), so what do we do in the meantime? What's our Plan B?

Many, myself included, believe that the answer to the problem of chronic concussion under-reporting lies in impact sensors which can be used for real-time monitoring of head impact exposure (e.g. number, severity, location, and cumulative impact) at all levels of football, and other helmeted and non-helmeted contact and collision sports where practical, to identify high risk impacts and alert qualified sideline personnel to consider performing an early concussion assessment. (I will leave my thoughts on the use of impact sensors for tracking the number of hits to another day)

Some, including my hometown paper, The Boston Globe, are now urging college, high school, and recreational leagues in contact and collision sports to consider mandating use of impact sensors, or, at the very least, experimenting with the technology, and for professional leagues, like the NFL, to follow the lead of the Arena Football League in mandating their use, believing that star players, by using the devices, could help break down barriers to more widespread adoption.

Unfortunately, the National Football League has gone in exactly the opposite direction, deciding last month to suspend a pilot program using sensors in players' helmets for the 2015 season because data collected during the 2013 season was not considered reliable enough (for what, the league didn't say), and because the Players Association questioned whether the data would be kept private and not used against a player. (Do you hear money talking?)

While the technology isn't perfect, I think that, as long as appropriate safeguards are put in place to ensure that the privacy of the players is protected, and that access to the data the sensors generate is restricted to those who can use that data intelligently (such as a certified athletic trainer or coach), the best way to refine and improve impact sensor technology, and educate players, coaches, parents, and ATs about the advantages to it use, is, well, to use it.

3. It's the straw that broke the camel's back (not)

Finally, the one thing I urge sports parents not to do in response to the Borland retirement is panic. Some are predicting that the news itself will prompt many parents to pull their kids out of football. They may be right. But I don't view the decision by one professional athlete to retire as meaning all that much in the larger scheme of things.

It is clear from media reports that Borland made a careful, reasoned decision based on a thorough investigation of the risks and benefits of continuing to play professional football. In deciding whether to allow their child to start playing or continue playing collision sports, I believe parents should do the same: weighing the risks of participating in a particular sport - based on the most up-to-date information about those risks - against the benefits to the child of participating, before making a decision that makes sense for them and their child, given their particular situation.

In making that decision, it is worth noting that, despite widespread media coverage and speculation regarding the late-life or post-retirement risks of cognitive impairment in athletes who engaged in sports involving repetitive head trauma, and that chronic traumatic encephalopathy (CTE) causes them to be a high risk of suicide, there has been little to no peer-reviewed scientific literature that establishes, much less quantifies, such risks.(4) In other words, the media is ahead of the science.

The fact is that this line of research is still in its infancy. What scientists are realizing is that it's probably not how many concussions or hits an athlete sustains that makes a difference, but their total exposure to concussive and sub-concussive blows - in other words, a dose response.

Chris Borland decided that he didn't want to increase that exposure by continuing to play professional football. No more, no less.

For more youth sports concussion safety information, visit the MomsTEAM Youth Sports Concussion Safety Center.

Brooke de Lench is Executive Director of MomsTEAM Insitute, a 501(c)(3) tax-exempt organization, Founder of, and Producer of the PBS documentary, The Smartest Team: Making High School Football Safer.  You can follow Brooke on Twitter @brookedelench.



1. Institute of Medicine (IOM) and National Research Council (NRC). 2013. Sports-related concussions in youth: Improving the science, changing the culture. Washington, DC: The National Academies Press.
2. McCrory P, et al. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Br J Sports Med 2013;47:250-258 & n. 59-65.
3. Harmon K, Drezner J, Gammons M, et. al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med 2013;47:15-26 (a concussion decreases the cognitive ability and reaction time of an athlete, which theoretically diminishes the ability of the athlete to respond to the demands of the sport, increasing the risk of a second brain impact or injury or injury to other body parts. In addition, early activity after concussion can prolong symptoms and neurcognitive recovery).
4. Gardner A, Iverson G, McCrory P. Chronic traumatic encephalopathy in sport: a systematic review. Br J Sports Med. Published Online First: June 26, 2013. doi: 10.1136/bjsports-2013-092646.


Youth Sports Liability Waivers: Protecting Towns At The Expense of Our Children’s Safety?

Before every sports season, parents all across the countries are asked to sign forms holding the sports program in which their child will be participating harmless and releasing the program from liability should he be injured. No ifs ands or buts.  The parent or guardian of a child using a program or town’s facilities must sign a waiver.  Such forms are typical for all camp programs; sports clinics and sporting events organized by independent groups, such as the baseball, soccer and football organizations using town fields.

When I was asked to sign such forms back when my sons were playing sports, I remember asking their father, a practicing attorney; “Is this truly a binding legal document? What would happen if one of our boys suffered a catastrophic accident as a direct result of the town or school’s negligence and needed medical care for the rest of his life?”

In essence, the forms say that even if the town allows your child to play on unsafe fields or use poorly maintained or unsafe equipment – say, for instance, a soccer goal that isn't properly anchored – and he is injured or killed when the goal falls on top of him, you agree not to sue the town. While the waivers thus insulate program organizers and municipalities from lawsuits if a child gets injured except where in instances of gross negligence, one wonders whether they do so at the expense of protecting children against preventable injuries.

Even though my sons are no longer playing organized sports in the town where they grew up, I remain committed to making youth sports safer, both at the national level in my daytime job for MomsTeam and, in the evening, in my own community, where I recently raised the question of whether liability waivers are binding and enforceable.

The situation that has sparked my concern was a new athletic complex built in my town less than 100 feet from a high-traffic highway (i.e. one with over 50,000 vehicle trips per day). I was concerned because I knew that there was mounting epidemiological evidence establishing a link between vehicular air pollution and adverse effects on the respiratory and cardiovascular health of children. I was concerned because doctors say that the toxins inhaled by children while playing sports – specifically the fine and ultra-fine particulate pollution in car and truck exhaust fumes – are especially dangerous. I was worried that children playing on those fields were being unnecessarily put at risk of severe asthmatic attacks and, in rare cases, sudden cardiac death. I wondered whether liability waiver forms would insulate the town from a lawsuit if, god forbid, a child playing on one of the new fields were to suffer an asthma attack and die.

To get an answer to my question, I called the Massachusetts Interlocal Insurance Association (MIIA), a non-profit organization incorporated by the Massachusetts Municipal Association in 1982 to provide insurance services to cities, towns and other governmental entities in Massachusetts. I was told that municipalities are protected from lawsuits if a guardian has signed a liability waiver under a legal doctrine called sovereign immunity, which limits or eliminates the liability of government entities, even in cases of negligence.

I asked one of the account representatives for the town of Concord if she was aware of the potential liability associated with the new athletic complex. She told me that pollution is everywhere and explained that the town was immune from injury claims. I asked her if the town would be immune if a severely asthmatic child from another town who had not signed a waiver suffered a fatal asthmatic attack while playing on one of the new fields. Suddenly, the account representative was no longer interested in speaking with me.

The account representative’s response – or in this case, lack of response - begs my next question: was the town paying higher insurance premiums to cover the risk associated with building fields so close to a highway? And, if the answer was no, I wondered if the town was protected and ready for any potential liability stemming from such increased risk.

Last week I read an article in the Fort Myers News-Press  about a case before the Florida Supreme Court which has put into question the legality of youth sports liability waivers and has some worried that youth sports in the state could be in jeopardy because insurance costs would go up without such waivers. Others say such a ruling would make sports safer because it would increase the program’s incentive to maintain safe fields.

I will continue to follow the case and hope that readers from around the country will weigh in on the issue. I am particularly interested in how your community handles the safety of children of children playing sports on town fields. Does it force people to sign a waiver stating that they will not sue if something goes wrong? Is your community proactive when it comes to sports safety by implementing a risk management program which can help keep insurance premiums under control?

Average: 5 (1 vote)

Artificial Turf: On The Fence About Risk

Over the past few months questions have been raised about the safety of artificial turf. I have followed the issue with interest, of course, and get e-mail requests every week asking for my views.

Frankly, I have mixed feelings about artificial turf.  I graduated from college with a full leg cast after suffering a torn ACL one March playing college lacrosse on a still partially frozen grass field in New Hampshire.  I wonder to this day whether the injury would have happened had I been playing on artificial turf.

I have also seen first-hand what can happen when an athlete, whether playing lacrosse, soccer, or football, hits their head on the unyielding surface of a rock hard artificial turf field. (Yes, I know, the modern turf fields are a lot less hard, and grass fields can be hard as well). 

Yet, I also understand why some believe that the crumb rubber infill used in modern turf fields poses an unreasonable risk of harm to young athletes.  After pouring through three inches of support materials compiled in the 2014 SBR Studies manual, and, recognizing that I am not a scientist, I'm not in a position to say one way or the other, although there is some evidence to suggest that soccer players, especially goalkeepers, may be at increased risk of cancer from regular play on artificial turf.  All I can say at this point is that we need to watch the issue very carefully, and to recognize that some of the safety concerns which have been raised against artificial turf could prove troubling if borne out by research.  

I do want to make one thing very clear, however. We have no skin in this game.  While advertising from one artificial turf manufacturer, Field Turf, ran on eight articles,  we notified the company earlier this month that its insertion order would not be renewed, and that we will no longer accept advertising from artificial turf manufacturers going forward.  The reason is we don't want even the appearance of being less than completely objective in our information on the subject. 

At no time has Field Turf's status as a MomsTEAM sponsor influenced in any way the editorial content of our articles on artificial turf.  Our policy has always been and continues to be to provide the most objective and accurate information on youth sports safety as possible.  As is the case with some safety issues in sports, there is not yet clear science in the form of peer-reviewed research to allow a consensus to form on the safety of artificial turf. As a 501(c)(3) tax exempt organization dedicated to protecting young athletes with trusted sports safety education, MomsTEAM relies on the support of viewers like you to give you unbiased information so you and the community where you live can decide, based on the most complete information possible, on which side of the fence you fall. 

Brooke de Lench is Executive Director  of MomsTEAM institute of Youth Sports Safety, producer of  The Smartest Team: Making High School Football Safer (PBS) and author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins).  You can follow Brooke on Twitter @brookedelench.


Research Papers and Peer-Reviewed Studies: A World of Difference

Note to reader: I wrote this blog on February 25, 2014 and updated it to include new information and updates one year later February 25, 2015 about a new "helmet add-on paper.

Last week, we posted to the site a group of four articles about a peer-reviewed study in the Journal of Neurosurgery showing that football helmet design affected concussion risk among a large group (or what scientists call a "cohort") of college football players.

Because the study's findings matched almost exactly the estimated difference in concussion risk in the STAR helmet ratings, a test developed by the co-lead authors of the study, Virginia Tech-Wake Forest's Stefan Duma and Steven Rowson, which is designed to measure the effectiveness of football helmets in reducing the forces that cause concussion, we also updated an existing article about those ratings to include a reference to the new study. Young football player drinking from squeeze bottle

Just before those articles were published, we received a press release from the American Academy of Neurology about an abstract of a research paper on football helmets slated for presentation to the AAN Annual Meeting in Philadelphia in late April 2014.  The press release said that, using crash test dummies, researchers in Florida had found that football helmets do "very little" to protect kids against the rotational forces that cause concussion, and quoted the co-lead author, Dr. Frank Conidi, director of the Florida Center for Headache and Sports Neurology and Assistant Clinical Professor of Neurology at Florida State University College of Medicine, as saying that the study dispelled the assumption of "generations of football and other sports participants" that their brains are protected by their investment" in football helmets.

While numerous newspapers and reporters - with at least one notable exception (see below) - elected to take the research paper largely at face value in publishing stories (links to which then popped up repeatedly in our Twitter feed and were dutifully retweeted), MomsTEAM took a pass, which led many to wonder, on Twitter and via email, why?

For a number of reasons.

First, as many of you know, MomsTEAM has been covering the concussion beat for 14 years, longer than anyone in the mainstream media.  Since I and my staff, especially Senior Health and Safety Editor Lindsey Barton Straus, began writing about concusssions in general, and fooball helmets in particular, back in 2000, we have tried to live up to our reputation as the "trusted source" for youth sports safety information by making sure that anything we publish has been properly vetted and is based on methodologically sound scientific research.

As a result, we have become skeptics, critics and curators of credible information on the subject.  In a now very crowded space of concussion activists, bloggers, and a largely uneducated media, we continue to see our mission of keeping all sports active kids safe by separating fact and fiction, and making sure what we publish, while it may not be the first to discuss a particular development, is the most comprehensive and objective.

Second, all we had to report on was an abstract of a research paper.  With so many researchers vying for limited funding dollars and attention, the trend these days seems to be a game of jumping the gun, sending out press releases about abstracts of papers before they have appeared, if they ever do, in peer-reviewed journal papers.  While MomsTEAM occasionally reports on research papers, we are careful to point out that they have not been subject to scrutiny by the scientific community. 

In this particular instance, when Lindsey and I dug deeper, our investigation raised in our minds serious concerns that reporting on this particular research paper at this preliminary stage might give it more credence than perhaps - emphasis on the word, "perhaps" - it deserved. Without even talking to anyone with expertise in the subject, we were concerned about reporting on the paper knowing absolutely nothing about the methodology the researchers employed, especially when it involved an unspecified modification to the NOCSAE drop tests, purportedly to capture data about rotational forces.

Capturing data on rotational forces, much less setting helmet standards or designing helmets that reduce such forces, has been a monumental challenge for biomechanical engineers and helmet manufacturers for decades. We have been critical of NOCSAE in the past for its failure to test football helmets for their ability to reduce rotational acceleration (although, as we also recently reported, the organization says it will be announcing a new helmet standard at its next meeting in June which will for the first time include a standard on rotational acceleration).* Our original and updated article about the Virginia Tech STAR ratings also includes criticism by NOCSAE that it did not capture data on rotational acceleration (talk about the pot calling the kettle black!). As a result, we needed to be extra cautious in publicizing a paper employing a new methodology.

Third, that the research paper being publicized by AAN was commissioned by BRAINS, Inc., a Florida research and development company employing a co-author, Dr. John Lloyd, also raised a red flag. As we noted in our article about the new Virginia Tech-Wake Forest helmet study - which compared concussion data on an older model of Riddell helmet (the VSR4) versus a newer Riddell model (the Revolution) -  a similar conflict of interest led many in the concussion research community to discount a 2006 study reporting a difference in concussion risk between the Riddell Revolution and other helmets, peer-review notwithstanding, because it was funded by, you guessed it, Riddell.

Fourth, when we did ask respected researchers in the field to comment on the Condini-Lloyd paper, while they declined to comment on the record for MomsTEAM, we can say that they were not at all impressed by what little could be gleaned from the press release, one characterizing it, off the record, as "a train wreck."

And lastly, fifth, we weren't at all clear what the take-home message of the paper is. 

If the point of the paper is to say that current helmets don't protect very well against concussion, and, because they don't, the emphasis needs to be on coaches teaching proper tackling technique, players strengthening their neck and shoulder muscles, and officials more strictly enforcing the rules against helmet-to-helmet contact, then there was nothing new to report to MomsTEAM readers, as the fact that helmets are not designed to protect against concussions in the first place, and that proper tackling, neck strengthening, and rules enforcement are seen as more effective ways to reduce concussion risk, are positions we have been taking for years, and are part of Pillar Two of the Six Pillar approach to concussion risk management we outlined in our PBS documentary, "The Smartest Team."

On the other hand, if the point of the paper was to emphasize the point that football helmets should be tested on how well they attenuate rotational forces, which are the principal cause of concussions, and that new testing standards are needed, there was, once again, nothing new on which to report. There is already a well-formed consensus about the need for new standards, a subject on which MomsTEAM and I have reported for years. 

The bottom line is that, after considering all these factors, MomsTEAM decided not to run a stand-alone article, but to direct our readers instead to our existing, continually updated, content on football helmets and concussion risk reduction, including the following:

Study Showing Helmet Design Can Reduce Concussion Risk Leaves Many Questions Unanswered

Virginia Tech Football Helmet Ratings: Helpful But Come With Limitations

Proper Tackling Reduces Risk of Catastrophic Injury Says Ex-Pro

Neck Strengthening: Reducing Concussion Risk In Football

Seven Ways To Reduce Risk of Traumatic Brain Injury In Sports

The Six Pillars of Concussion Risk Management: The MomsTEAM Approach

Making Sure Football Helmet Fits: A Simple, But Effective Way To Minimize Concussion Risk?

Still looking for an article about the Condini-Lloyd study that got it about right? Check out this article by Melissa Healy, one of our favorite sports health and safety reporters, which does a terrific job of at least presenting the major issues the research paper raises, albeit not in the depth that MomsTEAM does. 

FEBRUARY 25, 2015 UPDATE: A year later, we are waiting for the results of the Condini-Lloyd to be published in a peer-reviewed medical or biomechanical journal.  In the meantime, Dr. Loyd has come out with a new research paper, this one slated for presentation to the American Academy of Neurology annual meeting in April 2015, in which he concludes, apparently using the same drop test methodology as in his previous paper, that a number of helmet add-ons, including Guardian Cap, do not, according to his research, reduce the risk of concussion. Once again, a slew of news outlets have uncritically published the press release, and it is has been dutifully publicized in the Twittersphere.

But for pretty much the same reasons MomsTEAM elected not to publish an article about the new study, we have again chosen to take a pass on posting an article about Dr. Lloyd's research paper based on the AAN press release because, without knowing the details, we would essentially be "buying a pig in a poke."  

Nevertheless, in the interest of getting both sides of the story, here's what Guardian Cap had to say about Dr. Lloyd's new research paper:

Dr. Lloyd's study is concerning to Guardian Caps, a company who has devoted the past four years to providing athletes with a superior energy management solution. Guardian has been tested extensively at Oregon Ballistic Labs, Wayne State University, Veritas and at several Universities. Our test data is available for review upon request. Guardian is currently being used by over 35,000 players from youth through D1 College levels. Guardian has several concerns with the findings that Dr. Lloyd reports:

  • Dr. Lloyd reported that three different add-on products "reduced linear accelerations by about 11 percent, but only reduced angular accelerations by 2 percent." This conclusion does not detail individual findings, but just averages all three products. Because he did not report individual findings, Guardian Caps may have, in fact, tested much higher than other products. Unlike the other products tested, Guardian Caps are decoupled from the helmet, further reducing rotational and angular accelerations.
  • The article does not disclose that Dr. Lloyd is an inventor and is working on his own football helmet that uses non-Newtonian Fluids (starch and water mixture). In a previously published article, Dr. Lloyd states that his helmet reduces concussions up to 50%.
  • A drop test is not a statistically significant way to measure rotational/angular accelerations. This test should be conducted on a linear impactor testing setup. Furthermore, researchers have yet to conclude on two other main factors that affect the end data: 1) which multi-axial accelerometer data acquisition system collects the most statistically significant data and 2) the proper mounting placement and method so as not to affect the significance of the data. Dr. Lloyd's failure to account for these key nuances in testing essentially invalidates any and all yielded data. 

The bottom line: caveat emptor.  

*Update: True to its word, NOCSAE did announce a proposed football helmet standard at its July 2014 meeting. For my blog about that meeting and the new helmet standard, click here.  

Brooke de Lench is Executive Director of the non-profit MomsTEAM Institute, Founder and Publisher of, and Producer/Director/Creator of the PBS documentary, "The Smartest Team: Making High School Football Safer."  You can reach her via email ( and follow her on Twitter @brookedelench.



How a Group of Outcast Teen Boys Taught Me the Value of Youth Sports

Two weeks ago I was invited by the editors at Huffington Post to participate in a special blog event.  

Brooke de Lench and Concord U-14 boys soccer team

The invitation read: 

With March Madness igniting yet another wave of sports mania around the country, we'd like to take a moment to examine why sports mean so much to us as a society. We're hosting a mini blog series and social campaign leading up to the start of the tournament around the following prompt: Why are sports so valuable for our children to play?


For the post I submitted, click here.  


Improving Concussion Safety In Youth Sports: Why I Opt For Grass Roots Activism Over Class Action Lawsuits

Last week was chock full of news on the youth sports safety front. Nocsae decertified two men's lacrosse helmets, and I fielded some troubling emails about child sports safety advocates who allegedly spend their time monitoring social media, especially Twitter, for reports of youth sports injuries to take to plaintiffs' personal injury lawyers.

But, speaking of lawsuits, the big sports safety news of the week - at least in the media's eyes - was the filing of a class action in Illinois state court claiming that the Illinois High School Association (IHSA) was negligent in failing to institute what the 52-page Complaint contends are best practices in educating parents and athletes about the dangers of sport-related concussions and repetitive head trauma, and in the identification and management of head injuries by high schools in the state.

I had a chance to read the complaint today and while I agree with many of the goals of the lawsuit (MomsTeam has been a consistent and vocal advocate for having a certified athletic trainer at every high school, for instance), I will leave the job of deconstructing the plaintiff's Complaint to Donald Collins, one of our longtime experts (for Don's thought provoking article on the lawsuit, click here) I do want, however, to comment more generally on whether litigation is the best means to the end of keeping kids safe playing contact and collision sports.

If the IHSA class action lawsuit makes one thing clear for those of us, including many of the incredibly dedicated health care professionals and educators on MomsTEAM Institute's Board of Advisors, BODs, staff and expert panel, who spend our days working to protect children in sports through education, advocacy and research (something I have been doing for the past 15 years at MomsTEAM, and for a quarter century, if I count my time working to improve sports safety as an activist ), it is that we need to redouble our efforts to accomplish change pro-actively through adoption of best health and safety practices in every community, at every level of sport, in this country.

Finger pointing 

Instead of pointing fingers and laying blame at the doorstep of any particular group or organization by filing lawsuits - which, by their very nature, are adversarial and based on conflict resolution (although they certainly have their place as a vehicle for change, as Don Collins also recognizes in his piece on the Illinois class action) - I believe the better approach is to involve all those with a stake in making sports safer, from parents and athletes to coaches and administrators, from equipment manufacturers to school boards, municipal and town recreation departments, in a collaborative, cooperative effort to make sports safer for our children. 

This is the approach we are taking in our SmartTeamsTM program. Instead of emphasizing what hasn't been done to make sports safer (as the for-profit mass media, plaintiffs personal injury lawyers and their hired experts make their living doing), we choose to celebrate and highlight programs which are pro-active, applauding them for what they have done and are doing to make sports safer.

Instead of seeing the sports safety glass as half empty, we choose to see it is as half full.  

Instead of attacking football for what hasn't been done to make it safe (in some cases, because it is such attacks which boost their notoriety and thus generate donations for their non-profits), we have tried, not just with the release of our PBS documentary, "The Smartest Team: Making High School Football Safer," but in all the years before and since, to highlight all the ways in which the safety of athletes has been improved.  (In doing so, of course, we are in no way excusing those who have acted in a grossly negligent manner so as to cause actual injury to individual athletes. The remedy for those athletes and their families still lies in individual - or, in the case of former NFL players, class - tort actions for damages).  Indeed, it is building a grass roots movement based on this model that is at the very heart of our SmartTeamsTM program.

Good news

As the acknowledged pioneer in youth sports concussion education, and as the trusted source for objective, well-researched youths sports safety information, literally for the entire span of the 21st century, we at MomsTEAM have been privileged to witness and report on remarkable and positive changes in sports concussion safety, from increased awareness on the part of parents, athletes, and coaches about the dangers of concussions and repetitive head impacts (RHI), from an exponential increase in our understanding of the effect of concussions and RHI on the developing brain which have resulted in a growing movement to set limits on the number of full-contact football practices, from Pop Warner to the NFL, to research showing the important role neck strengthening may play in reducing concussion risk, from the use of baseline and post-concussion neurocognitive, balance, and visual testing to gauge an athlete's readiness to return to play to the use of sensors to improve the chronically low rate at which concussions are identified on the sports sideline.

With few exceptions, long gone, thankfully, are the days when athletes were routinely allowed to return to competition the same day if their concussion symptoms cleared in a few minutes after injury (thereby exposing them to increased risk of delayed recovery, permanent brain damage, and even catastrophic injury or death).  

No longer is the seriousness of the injury measured using a cookie-cutter approach which arbitrarily assigned a "grade" to the concussion depending on whether an athlete lost consciousness (which research has long since showed is not a marker for a more serious concussion and, in any event, is only present 5 to 10% of the time).  

The same kind of rigid approach to return to play, which depended on the number and grade of previous concussions, has been replaced by an individualized return to play protocol requiring an athlete to not only be asymptomatic, to be off all academic accommodations, and to return to baseline on neurocognitive, balance, and vision tests, but to successfully complete an exercise program of gradually increased intensity without concussion symptoms.

Separated by the letter V 

Do we have a lot of work yet to do? Absolutely. Is there a role for litigation in making sports safer? Certainly, just as there is a role for legislation, as was accomplished in the space of four years with the enactment of concussion safety laws in nearly every state. 

But I continue to believe the best way to make sports safer is not by filing class action lawsuits, spending my time scouring the Internet for media reports of catastrophic injuries so I can shine a spotlight on all that is supposedly wrong about youth sports safety in this country,or to feed to the personal injury lawyer bar to generate expert witness or consulting fees, but through education and grass-roots activism in which all stakeholders work together and are on the same team, not as plaintiffs and defendants, and not as litigation adversaries separated on a case caption by the letter "v." 


Six Years After: Concussion Risk Management Still A Work In Progress


It is hard believe that it has now been six years since I gave the keynote address at the National Sports Concussion Summit in Marina del Rey, California. Harder, yet to think we have been leading this charge since 2000.

In that speech (a full copy of which you can view by clicking here), I offered some suggestions on how each of us — whether we be parent, coach, official, athletic trainer, clinician, current or former professional athlete, sports safety equipment manufacturer, whether we were there representing a local youth sports program, the national governing body of a sport, or a professional sports league, could work together as a team to protect our country's most precious human resource — our children — against catastrophic injury or death from sudden impact syndrome or the serious, life-altering consequences of multiple concussions. 

Note that my focus was on second impact syndrome and the effect of multiple concussions. I wasn't talking then about total head trauma - a concept popularized by MomsTEAM's concussion expert emeritus, Dr. Robert Cantu - or discussing the effect of repetitive subconcussive hits, or what is now commonly being referred to repetitive head impacts, or RHI.  It wasn't until two years later that researchers at Purdue stumbled upon, literally, evidence that high school football players who had not been diagnosed with concussion neverless suffered similar short-term neurocognitive impairment from the cumulative effects of RHI.  As anyone who has been following the subject of sports-related head injuries knows, the concern about RHI has continue to grow exponentially over the past four years, as researchers have used ever more sensitive and sophisticated imaging techniques such as diffusion tensor imaging (DTI) and fMRI to identify short-, medium, and long-term effects on the brain of RHI.

In assessing progress on such important health and safety matters as head injuries, childhood obesity, and physical activity, issuing report cards seems to be all the rage, so in assessing which of my suggestions have been adopted, to what extent, and how much more work we need to do, I'm going to assign grades as well, recognizing that they are just my personal opinion as to the degree of progress.

Safety-conscious parents

As I told the audience that day in April 2008, one which included such luminaries as super sports agent Leigh Steinberg and representatives of the National Football League, the story of how I became a sports safety activist, with a particular interest in concussions is one that is likely familiar to those of longtime readers of MomsTEAM.  

As the mother of triplet sons, I had always taken a keen interest in their safety. I suspected then, and I suspect now, that all parents would say, if asked, that they put their kids' safety first — whether it is playing organized sports, at home, or riding their bike in the neighborhood. Some parents — particularly mothers, who have been the guardians of children at play since the dawn of day — not only talk that talk, but walk the walk, and are very protective.

I admit that, when it came to my sons' safety — and the safety of their teammates, I fell — and still fall — at that end of the spectrum, because I feel that, while life always involves some degree of risk, childhood should be a time when it is our responsibility as parents to minimize those risks and make it one of our highest priorities.

Not a whole lot has changed in six years.

While there were then, and are now, lots of very protective parents, at the other end of the spectrum, there are still some parents who are, sad to say, willing to sacrifice their child's safety and — in the case of concussions, their long term health — at the altar of a winning performance, a touchdown scored, a scholarship won, a pro contract inked, not just fathers, but mothers, too (for proof, one only has to watch the recent reality television show, "Friday Night Tykes.").

Many parents admit that they allow their children to play in such circumstances even though they know about the potential for adverse long-term health consequences, like major depression and permanent cognitive impairment.

Where I think we have started to make progress is with the large group of parents in the middle, who want to protect their children from long term injury but simply didn't know their role and what to expect of their "teammates" — the coach, the ATC, the team doctor, the athletic director.  Fewer parents still think that concussions only occur with a loss of consciousness and/or that it isn't dangerous to play with a concussion. More parents are becoming educated about the risks head injuries - whether of the diagnosed concussion variety or the result of repetitive impacts - and the steps that can and are being taken to minimize those risks. 

In part, of course, the increased public awareness of the issue is the result of relentless, saturation media coverage of the issue (I have a whole bookshelf of concussion books and DVDs).  Studies are also showing that the enactment of Lystedt laws in 48 states and the District of Columbia (all since May 2009, a year after my speech), which require that parents receive at least some minimal head injury information as a prerequisite for their child's sports participation, is increasing awareness.

I would also like to think that MomsTEAM's continued efforts to educate parents about concussion risk management and our PBS documentary, "The Smartest Team: Making High School Football Safer," which aired on over 300 stations last fall and which will be broadcast on almost all 387 stations in the fall of 2014, has played a role in increasing awareness. 

Yet we still have work to do.

Grade: B-

Culture of resistance

In 2008, I commented that "Too many young athletes — from 9-year old cheerleaders to star middies on high school Lacrosse teams — are still failing to self-report their symptoms to the coach, sideline medical staff, their friends or even their parents, forcing clinicians to try to manage concussions somewhat in the dark."

I noted that "Kids fail to self-report because, too often, they are told by their parents, but far more often by their coaches, and, more subtly, by the very culture of sports itself, that they should remain silent:

  • to avoid jeopardizing their spot in the starting lineup
  • being labeled a "sissy" by their coach and/ or their parents
  • to demonstrate to the coach and their teammates that they can "take a hit like a man"
  • to show that they can be as tough as their professional heroes
  • believing that the glory of individual and team success, the promise of a college scholarship, or the lure of a lucrative professional career is somehow worth the risk of lifetime impairment."

I noted that such silence can, as we all know, be deadly.


AYSO Convention Puts Spotlight On Player Development, Playing Time

For three days over Memorial Day weekend, it was my honor and sincere pleasure to be the keynote speaker and a guest observer and consultant at the 2009 National Annual General Meeting of the American Youth Soccer Organization (AYSO) in Dallas, Texas. The majority of the more than 700 folks in attendance were regional commissioners-the true backbone of the AYSO. The AYSO has long been at the top of my list of best national youth sports organizations. They have the right values, mission statement and an amazing number of dedicated volunteers and staff.

One of the highlights of the NAGM was the Friday night cowboy cookout. I am in the photo (above) with two regional commisioners. During dinner we were introduced to AYSO's newest Hall Of Fame inductees, Burton Haimes and Cherie Tucker, and a number of this year's award winners. Burton has devoted 33 years (more than half his life) as an AYSO volunteer; Cherie has volunteered for over 35 years. The slide show about Burton and Cherie left me speechless. They truly represent what makes AYSO so special: an overwhelming feeling that all of the people connected with AYSO are connected with each other and, as many folks stated; are part of one big family.

During my time as an observer of the NAGM I had the chance to attend meetings, to learn about various protocols and procedures, and hear about proposed amendments to bylaws, rules and regulations. Yet, most interesting for me was the opportunity to spend time with so many wonderful regional commissioners (RCs) from every state in the nation to learn about issues unique to their state and region (Imagine being the commissioner for New York City. Not like trying to find fields in rural Iowa?)

I made a point of meeting and talking with as many RCs before my keynote to get a "pulse" of what the big issues were that their communities are facing. It was also a chance to see if I needed to tweak or adjust my speech to address those issues. Overall, the general concerns were about the economy (not surprising) and the future direction of the AYSO to keep pace with what families are seeking for their children's sports experience. These concerns were reflected in the proposed bylaw amendments.

Promoting player development

One proposed bylaw amendment was to add Player Development to the five philosophies the AYSO has had since its inception in 1964: Everyone PlaysTM, Balanced Teams, Open Registration, Positive Coaching and Good Sportsmanship.

The amendment (which ultimately passed) stated as follows: "We believe all players should be able to develop their soccer skills and knowledge to the best of their abilities, both individually and as members of a team, in order to maximize their enjoyment of the game." The new philosophy goes into effect August 1, 2009 and the change will roll through materials as they are reprinted to ensure there is minimal budget impact at any level of the organization. The new philosophy will be incorporated into AYSO's by-laws and its mission statement. As I have written in the past, too often in today's youth sports player development takes a back seat to winning. It was great to see the AYSO include player development as an express goal of the organization.

"Three quarters play" rule

Another rule change was dubbed the ‘three quarters play" rule. Proposed by Lorrie Maher of New York, it would have required, in addition to the existing AYSO rule requiring that every player play at least half of the game, that all team members play at least three quarters of the game before any team member would be allowed to play the entire game.

From my years as a soccer coach, youth sports parent and administrator, and from the emails I get from kids and parents every day, I know at the top of their list of complaints is lack of equal playing time. The number one reason kids drop out of team sports, as a recent study by the Women's Sports Foundation again confirmed, continues to be because they aren't having fun (cited by 39% of both boys and girls). I believe most of those kids, and probably some of the 15% of boys and girls in the WSF survey who say they dropped out because they "weren't good enough players," did so because they weren't getting enough playing time and didn't see the point of sitting on a bench most of the game while other kids played the entire game. Kids know that to get better in the sport they need to play, especially in games.

I have long advocated - both in my book, Home Team Advantage, and on this website - in favor of an equal playing time rule for kids before 6th grade and a significant playing time rule during middle school and at levels below high school varsity. I thought this was a golden opportunity to set the AYSO apart from all the other youth sports clubs who have become complacent about the 50% playing time rule.

Worth implementing

Unfortunately, Lorrie's amendment did not pass. But that doesn't mean it isn't worthy of implementation. If you are a soccer coach (or a baseball coach, basketball coach, football coach; whatever team sport you are coaching), why not make it your rule: that everyone plays 75% before anyone plays 100%? Or you could propose it be implemented at the club or league level.

I always made it my policy that everyone on my team played three-quarters of the games and I alternated the players that played the entire game. I encouraged kids to take "byes" as a family day, so that when I had a fuller roster we could pull off the ¾ policy. I hope that Lorrie continues to educate people on the importance of her amendment change.

Imagine how a parent would feel knowing that her child (1) had a chance to play three quarters of every game if he/she wanted to; (2) rest during the game; (3) take a game off occasionally to spend time with his or her family? That's a recipe for a great youth sports experience with tremendous value! The first club that promotes such policies will surely see its numbers double.

I left the weekend with many new friends and a strengthened partnership with the folks at AYSO and plan on many years of writing about all they are doing right.

QUESTION: How do you feel about a 3/4 play rule? Has your child's coach, club or league been one of the first to adopt this rule? Does it work? Please register so you can leave your comment below.

Average: 5 (3 votes)

Buyer Beware: Part III (Unequal Technologies Up To Its Old Tricks Again)

I was scanning my Inbox this morning when an email from Medco Sports Medicine caught my eye promoting the Unequal® Gyro Helmet Liner and Unequal® SOLO Helmet Liner with the claim, in big capital letters, that "HELMETS WITH UNEQUAL® PREDICT A SIGNIFICANTLY LOWER RISK OF CONCUSSIONS."

The email went on to state that, "With over 85 patents and patents pending, our UNEQUAL® military grade composite handles blunt force trauma and impact shock better than any padding on the market of equal weight and thinness. UNEQUAL® is ultra-thin, flexible and comfortable. Athletes in any sport in which collisions or wipe-outs occur can go all out and achieve a higher level of performance with less fear of injury."

Medco Sports Medicine ad for Unequal Technologies

Hold on, one second. What is the ad saying?

The first sentence seems to be saying that the UNEQUAL products (a) "handle" (b) (i) blunt force trauma and (ii) impact shock (c) "better" than (d) any padding on the market of equal (i) weight and (ii) thinness.

The third sentence contains an equally bold claim: that, simply by wearing one of UNEQUAL's products under their helmets athletes in (1) any sport in which collisions or wipe-outs occur (2) can go (i) "all out" and (ii) achieve a "higher level of performance" (3) with "less fear" of injury. 

To say that the ad leaves me with more questions than answers is perhaps the understatement of the year.

Here are just some of the questions I have:

  1. What does "handle" mean? 
  2. What does the ad mean by "blunt force trauma"? Is it referring to straight-ahead hits (hits measured in g's) and not the rotational forces (measured in rads/second2) that experts say cause most concussions? Does it mean when the padding is hit with a hammer? Does another player's helmet hit with "blunt force"? Where is the biomechanical proof that the UNEQUAL padding "handles" this trauma "better"?
  3. Are there actually padding products on the market of comparable weight and thinness to the UNEQUAL products, or has the ad simply set up a straw man? (A classic technique used by advertisers for years: set up a straw man that can be knocked down because it doesn't exist) After all, it says UNEQUAL padding is "ultra thin." That suggests to me that there may not be other products on the market that are as ultra-thin.
  4. What does "all out" mean?  Does mean playing with reckless abandon? Doesn't that kind of overly agressive play, while it might look good on film and impress college scouts, actually increase risk of injury as a result of the phenomenon called "risk compensation"?
  5. What does "higher level of performance" mean? How can a claim like that be supported?
  6. What does "fear of injury" mean? How is measured?
  7. Is the ad actually telling athletes that their risk of head trauma is signficantly reduced by wearing the UNEQUAL helmet padding, even if they play with reckless abandon? Where is the scientific evidence to support that claim???
  8. Where is the evidence to support any of these claims? 

Deja vue all over again

Reading the ad, I had an overpowering sense that I had been here before. As it turns out, I had.  In August 2012, I wrote a blog that pointed out that Unequal was making totally unsupported claims that its products reduced concussion risk.

Apparently, Medco didn't read the blog. Either that or it has scientific evidence to support the claims in its email.  Given the number of studies that appear in peer-reviewed medical and biomechanical journals on an almost daily basis, I could have missed the study showing that UNEQUAL's helmet padding was, well, actually unequaled. But I doubt it (and, if I'm wrong, I would love to be able to report that a study has shown that athletes wearing the company's product have a signficantly lower concussion risk than those that don't)

It could be, however, that the most important word in the entire ad is "predict".   Perhaps what UNEQUAL is saying is that some unspecified biomechanical test it performed in a laboratory predicts a signficantly lower concussion rate? But, as many organizations (such as NOCSAE), experts, and peer-reviewed studies have reminded us over the years, tests done in a laboratory environment do not mean that a product's use can lead to an actual reduction in concussion rates in the real world, on the field, on athletes playing, practicing and, all too often, banging helmets. 

As I said more than two years ago, and what I continue to find most distressing today, having covered the subject of concussions in youth sports in depth for the past 14 years, is that Unequal has clearly not learned anything and is more than content to continue to make completely unsupported claims.

Worse, as it did in 2012, in trying to calm the fears of parents and athletes about the risk of concussion, Unequal appears, once again, to be intentionally lulling them into a false sense of security about the ability of protective equipment to make a contact or collision sport significantly safer. In other words, what they are claiming is that if only an athlete were to wear Unequal's padding they could go into battle on the gridiron "with less fear of injury."  As I said then, and repeat now, without the answers to the questions I posed above, such a claim, in my opinion, crosses the line from sales puffery into false advertising.

Crossing the line 

The proof, as they say, is in the pudding. The fact is that NO mouth guard, football helmet, helmet padding or soccer headband has yet been shown in a methodologically sound, peer-reviewed study to significantly reduce the risk of concussion in real players playing on real fields, pitches, and rinks, under real practice and/or game conditions. Until there is convincing evidence that they do, MomsTEAM, MomsTEAM Institute and I will continue to serve as a consumer watchdog (someone has to do it), calling out equipment manufacturers who suggest, like Unequal, that their product do just that, and to provide all youth sports stakeholders with the best and most objective concussion and head injury information on the Internet.

When the line between sales puffery and false advertising is crossed, as I think it was here, I hope that the FTC, as it has in the past, will step in to protect consumers.

In the meantime, my advice to parents, and to my friends on social media, continues to be BUYER BEWARE!

Brooke de Lench is Executive Director of the non-profit MomsTEAM Institute, Founder and Publisher of, and producer of the PBS documentary, "The Smartest Team: Making High School Football Safer."  You can follow her on Twitter @brookedelench or via email (


Average: 5 (1 vote)

Proposed ASTM Standard For Women's Lacrosse Headgear: Why I Voted To Approve

Today, I did something I had never done before. As a member of ASTM International's subcommittee on standards for headgear and helmets, I had the privilege of voting on a proposed helmet standard, in this case a new standard developed for headgear in women's lacrosse.

Girl's lacrosse player cradling ball in her stick

I voted in favor of the proposed standard (balloting closes today, so the results aren't yet known; if there are objections, they must be addressed before the standard moves to the second and final balloting phase among a larger portion of ASTM membership).  But I didn't vote in favor because I necessarily think that introducing helmets into the women's game is a good idea (as anyone who follows the sport of women's lacrosse knows, the issue has been the subject of furious and often heated debate in recent years, well-chronicled in a recent article on the US Lacrosse's website, which also contains a very helpful discussion of how the ASTM standard now being voted on was developed).

Instead, I voted to approve the draft standard because, without an established standard in place to regulate the headgear that has come on to the market in recent years (none of which, according to US Lacrosse, has been developed based on scientific testing, and none of which the organization - the governing body for both the men's and women's game - has endorsed), consumers are essentially "buying a pig in a poke": in other words, without a clue as to whether the product they are buying has any safety value at all.

Whether headgear in the women's game will make the game safer, of course, is open to debate. The data, says Dawn Comstock, PhD, a professor of Epidemiology for the Pediatric Injury Prevention, Education, and Research (PIPER) program at the Colorado School of Public Health, MomsTeam Institute Board of Advisor and a co-author of a 2014 study on injuries in high school lacrosse [1], "is quite clear - boys most commonly sustain concussions (nearly 75%) from athlete-athlete contact, the kind of mechanism we all know helmets don't always do a great job preventing - while girls most commonly sustain concussions (nearly 64%) from being struck by the ball or the stick, the kind of mechanism that helmets are actually quite good at preventing. Thus, this data clearly supports the call to put girls lacrosse players in helmets." 

But, as a former college lacrosse and high school field hockey player, I have reservations about whether requiring female lacrosse and field hockey players to wear helmets will make the sports safer, or, as a result of the phenomenon called risk compensation, actually result in more, rather than fewer, head injuries.

But the only way we will know the answer to that question is to make sure that whatever helmets female lacrosse players wear meet standards that are based on science, and have been developed after a deliberative and collaborative process by an independent organization, like ASTM, which is not funded by helmet manufacturers (unlike NOCSAE), and which does not just invite, but requires input from equipment manufacturers, product testing laboratories, researchers and governing bodies, in this case US Lacrosse.


From the numerous conversations (both on the telephone and via email) that both MomsTEAM's Senior Health and Safety Editor, Lindsey Barton Straus, and I have had over the years with our friends at US Lacrosse, especially CEO, Steve Stenersen (who I started talking to way back in 1999-2000), director of health and sport safety, Bruce Griffin (who was one of the principal authors of the draft standard), and Ann Carpenetti, vice president of lacrosse operations and co-chair of the women's lacrosse headgear task group, I am confident that the draft standard is based on sound science.

My hat is off to US Lacrosse (which, by the way, is an organization that I highlighted in my book, Home Team Advantage, for having a Board of Directors, unlike almost all other sports governing bodies, comprised equally of men and women), for providing the funding needed to design testing protocols and conduct the testing which yielded the data and measurements used in shaping the new headgear standard. 

US Lacrosse is acutely aware that developing a headgear performance standard that spurs the introduction of protective equipment designed to limit peak head acceleration resulting from an impact to less than 80g of linear force without introducing additional safety hazards (such as by encouraging more stick contact to the head) is a significant challenge.  

"It's our hope that developing a women's lacrosse-specific headgear standard that reflects the significant rule and culture differences between boys' and girls' lacrosse will mitigate the focal impact forces that occur from stick-to-head contact in the girl's game while maintaining the integrity of girls' lacrosse. Whether or not that results in a reduction of concussive events in girls' lacrosse is unknown, although we will certainly be studying it," said Stenersen.

At the same time, US Lacrosse has been correct to point out that protective equipment should be viewed as just one essential element in producing a safe playing experience.  Months before the Florida High School Athletic Association voted in late September to mandate soft headgear for girls lacrosse for the 2015 season, Stenersen told MomsTEAM that he believed it would be "highly irresponsible" for high school associations and youth leagues to focus solely on requiring increased protective equipment if it meant ignoring what Stenersen viewed as "the most critical component to a safer, more enjoyable lacrosse experience: requiring nationally-standardized, sport-specific training for coaches and officials as a fundamental qualification to assure that the boys' and girls' lacrosse is being taught (and the rules are being enforced) correctly."  

Well said, Steve. Well said. 

1. Xiang J, Collins C, McKenzie L, R Comstock. Lacrosse Injuries Among High School Boys and Girls in the United States: Academic Years 2008-2009. Am J Sport Med; 2014. DOI: 10.1177/036354651453991 (published online July 22, 2014)