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."

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!

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