Brett Favre and Tua Tagovailoa bring new attention to NFL head trauma

Recently, trauma cases involving NFL stars have raised new concerns about the league’s ongoing problems with head injuries — and raised questions about whether the NFL could be doing more to protect its players.

In early September, Tua Tagovailoa, a quarterback for the Miami Dolphins, suffered a frightening third (diagnosed) concussion, prompting some fans and former players to push for his retirement. Following that injury, former Green Bay Packers star quarterback Brett Favre announced a Parkinson’s diagnosis during congressional testimony on Tuesday, suggesting that repetitive head trauma was likely a significant contributing factor. And on Thursday, Malik Nabers, a rookie wide receiver for the New York Giants, set a receiving record before leaving the game with a concussion.

It’s no news that professional football can be dangerous: The NFL first acknowledged the connection between football and CTE – chronic traumatic encephalopathy, a degenerative brain disease – in 2016. CTE is most common in athletes who suffer repeated blows to the head, military personnel exposed to explosive blasts, and has been linked to the deaths of famous football players, including Andre Waters and Mike Webster. More than 300 former football players have been diagnosed with CTE after their deaths. (A brain autopsy is required for an accurate diagnosis.)

Because of concerns about CTE and other illnesses related to brain trauma, the league has invested in improving the equipment worn by players, changing practice and game day rules and promoting techniques to reduce head contact. This season, these changes include allowing players to wear new headgear designed to better protect players’ brains. But this week was a reminder that America’s most popular sport still has major problems.

In recent years, the NFL has made major changes to helmets and protective equipment as well as changes to the rules of the game to reduce collisions, Allen Sills, the NFL’s chief medical officer, told Vox.

Perhaps one of the most eye-catching events this season is the introduction of a new type of headgear called “Guardian Caps” – layers of foam padding worn over a helmet during games. The caps, which most players have been required to wear during practice since 2022, are designed to potentially reduce the impact players suffer when hit in the head by about 10 percent, according to the NFL.

However, there are a few problems with the caps. First, players are not required to wear them during play, and relatively few players have chosen to do so so far, limiting their impact.

And independent studies have not confirmed their effectiveness. Despite the NFL’s findings, separate research teams from the University of North Carolina and the University of Nevada-Reno found limited strength reductions for players who wore the caps, while a third study from Stanford found strength reductions in the laboratory but did not see them as athletes wearing them on the carried field. Sills argues that this variability is due to differences in the researchers’ and the NFL’s methodology, noting that the NFL plans to release its research results in the next few months.

The NFL also claims that its researchers found that Guardian Caps when worn in practice reduced concussions by about 50 percent, a result that some doctors were skeptical of.

A major problem, doctors told The New York Times, is that better helmets and guardian caps protect the head but not the neck – which can be crucial to preventing concussions. They note that blows and twisting of the neck play a large role in causing concussions.

As Jamshid Ghajar, a neurosurgeon, told the Times, racing drivers’ helmets, like those used in Formula One races, are more effective at preventing concussions because they stabilize the neck even in an accident. The NFL has disputed the Times’ characterization of concussions, and Sills argued that concussions are not predominantly caused by what he called “neck forces.”

The NFL also announced the use of 12 new helmet models this season designed to protect players from position-specific hits, as well as a new rule designed to allow kickoffs – a part of the game in which players often run toward each other at high speeds – safer. The effectiveness of these changes is still unclear, and it is important to note that even with these changes, football’s fundamental problem with body collisions and head contact remains.

As Julie Stamm, a neuroscientist at the University of Wisconsin Madison, states, “The best way to prevent (head trauma) is to avoid impact.”